Bidirectional association of sleep disorders with chronic kidney disease: a systematic review and meta-analysis.

Background: Published studies have suggested a link between chronic kidney disease (CKD) and sleep disorders, although the exact nature of this association has not been uniformly described. Clarifying this relationship may facilitate evidence-based interventions that address the interplay between these disease entities. Such interventions could prevent obstructive sleep apnea (OSA) from worsening CKD and improve the quality of life for CKD patients by reducing the risk of developing OSA.

Plasma Metanephrines Yield Fewer False-Positive Results Than Urine Metanephrines in Patients With Obstructive Sleep Apnea.

Context: Obstructive sleep apnea (OSA) is associated with increased nocturnal sympathetic activity. In OSA patients, elevations in metanephrines may lead to false-positive tests when evaluating for pheochromocytoma or paraganglioma (PPGL).

Objective: To evaluate whether morning plasma metanephrines would lead to fewer false-positive results than 24-hour urinary metanephrines in OSA patients.

Efficacy of high flow nasal cannula as an alternative to continuous positive airway pressure therapy in surgical patients with suspected moderate to severe obstructive sleep apnea.

Purpose: To compare the efficacy of High flow nasal cannula (HFNC) as an alternative to Continuous Positive Airway Pressure (CPAP) therapy on the first postoperative night in patients with suspected moderate to severe obstructive sleep apnea (OSA).

Methods: This is randomised controlled trial conducted in a tertiary hospital which included elective surgical patients with STOP-BANG score of 5 and above. Forty patients were randomised into one of the four postoperative treatment groups: CPAP, or HFNC at three different flow rates (20 L/min, 30 L/min and 40 L/min).

Postoperative cardiorespiratory complications and continuous positive airway pressure efficacy in obese patients undergoing noncardiac surgery.

Background And Aims: One in six Singaporeans has obstructive sleep apnoea (OSA) due to obesity compounded by inherent craniofacial features. We assessed the incidence of cardiopulmonary complications and the effectiveness of continuous positive airway pressure (CPAP) therapy in minimising such complications within an obese population.

Methods: A retrospective study of elective noncardiac surgical patients with a body mass index ≥32 kg/m was conducted.

Comparing treatment effects of a convenient vibratory positional device to CPAP in positional OSA: a crossover randomised controlled trial.

Objectives: Up to 77% of patients with obstructive sleep apnoea (OSA) have positional OSA (POSA) but traditional positional therapy (PT) methods have failed as they were poorly tolerated. New convenient vibratory PT devices have been invented but while recent studies suggest high treatment efficacy and adherence, there are no published data comparing these devices directly with continuous positive airway pressure (CPAP). Our objective is to evaluate if a convenient vibratory PT device is non-inferior to CPAP in POSA treatment.

PEAK PlasmaBlade versus monopolar electrocautery tonsillectomy in adults: A prospective double-blinded randomized controlled trial.

Objective: To evaluate the efficacy and compare postoperative pain and recovery following PEAK PlasmaBlade and monopolar electrocautery tonsillectomy in adults.

Study Design: Prospective double-blinded randomized controlled trial.

Methods: Fifty-eight patients were recruited and randomized into 2 groups: PEAK PlasmaBlade (n = 29) or monopolar electrocautery (n = 29) tonsillectomy.

Adherence to Continuous Positive Airway Pressure therapy in Singaporean patients with Obstructive Sleep Apnea.

Purpose: To investigate the rates of Continuous Positive Airway Pressure (CPAP) uptake and adherence amongst Singaporean patients diagnosed with Obstructive Sleep Apnea (OSA), and to evaluate factors correlated with CPAP uptake and adherence.

Study Design: Retrospective review of medical records.

Methods: Medical records were reviewed for baseline demographics, daytime sleepiness, presence of nasal symptoms and OSA severity, initial treatment choice, the rate of CPAP treatment uptake and CPAP adherence at 1 and 12 months.

Robotic Obstructive Sleep Apnea Surgery.

Since the first report of the use of the da Vinci robotic system (Intuitive Surgical, Sunnyvale, CA, USA) in transoral robotic tongue base reduction for obstructive sleep apnea (OSA) was published in 2010, this surgical tool and technique has been used worldwide for the resection of tongue base tissue in the multilevel surgical treatment of OSA. The combined knowledge of the published literature on its use has enlightened sleep surgeons worldwide on this new yet evolving surgical tool. Here we will discuss the use of the da Vinci robotic system in the treatment of OSA, the pertinent surgical anatomy for a safe surgical procedure, the primary and secondary outcomes to expect in the multilevel and primary use of this technology in treating the tongue base, the predictors for success or failure, and the complications associated with this technique.

Obstructive sleep apnoea and Type 2 diabetes mellitus: are they connected?

Obstructive sleep apnoea (OSA), a sleep-related breathing condition, is diagnosed based on a patient's apnoea-hypopnea index from a sleep study, and the presence or absence of symptoms. Diabetes mellitus (DM) and OSA share a significant common risk factor, obesity, with all three conditions contributing to the risk of developing cardiovascular diseases. The pathophysiological links between OSA and DM are still unclear, but intermittent hypoxia may be an important mechanism.

Hyoid expansion with titanium plate and screw: a human cadaveric study using computer-assisted airway measurement.

Importance: Hyoid expansion with suspension can potentially increase the upper airway at the hypopharyngeal level, benefitting patients with sleep-related breathing disorder.

Objectives: To document the effect of hyoid expansion using titanium plate and screw on retrolingual hypopharyngeal airway dimension and to compare the airway dimension after isolated hyoid expansion with hyoid expansion + hyomandibular suspension.

Design: Anatomical cadaveric dissection study.

Effects of tonsillectomy on sleep study parameters in adult patients with obstructive sleep apnea--a prospective study.

Objective: The objective of this study is to evaluate the efficacy of tonsillectomy in reduction of respiratory disturbance index (RDI) and other sleep study parameters in patients with obstructive sleep apnea (OSA).

Methods: This study involves 34 adults with OSA and Friedman grade 3 or 4 tonsils. All 34 patients were treated with tonsillectomy, as the only surgical treatment for OSA from 2007 to 2011.

Is impedance pH monitoring superior to the conventional 24-h pH meter in the evaluation of patients with laryngorespiratory symptoms suspected to be due to gastroesophageal reflux disease?

Objective: Cough and laryngo-pharyngeal symptoms (LPS) are associated with gastroesophageal reflux disease (GERD). The role of acid reflux (AR) and non-acid reflux (NAR) in atypical GERD pathogenesis is controversial. The aims of the study were to determine the prevalence of high esophageal acid exposure time (AET) in patients presenting with cough or LPS and determine the incremental yield of multichannel intraluminal impedance-pH (MII-pH) monitoring.

Uvulopalatopharyngoplasty outcome assessment with quantitative computer-assisted videoendoscopic airway analysis.

Conclusion: Quantitative digital imaging upper airway analysis enables surgeons to assess the pre- and postoperative upper airway morphology quantitatively, objectively and accurately, and to correlate these changes in surgical parameters with improvement of obstructive sleep apnea.

Objective: This was a prospective study using a new method of quantitative computer-assisted digital-imaging videoendoscopic upper airway analysis to quantify objectively and correlate the changes in surgical parameters with improvement of obstructive sleep apnea following uvulopalatopharyngoplasty.

Patients And Methods: Nineteen male patients underwent uvulopalatopharyngoplasty for obstructive sleep apnea after continuous positive airway pressure trial.

Coblation vs electrocautery tonsillectomy: postoperative recovery in adults.

Objective: Comparison of coblation and monopolar electrocautery tonsillectomy in terms of postoperative pain and recovery.

Study Design: Prospective double-blind randomized controlled trial.

Methods: Patients with recurrent tonsillitis requiring tonsillectomy were randomized to 2 groups: coblation or monopolar electrocautery tonsillectomy.

Clinical predictors in obstructive sleep apnea patients with computer-assisted quantitative videoendoscopic upper airway analysis.

Aim: To identify the clinical predictors and assist surgeons in their clinical management of obstructive sleep apnea (OSA). A prospective study with a new approach to analyze the static and dynamic upper airway morphology between patients with OSA and normal subjects.

Method: Quantitative computer-assisted videoendoscopy (validated with upper airway magnetic resonance imaging) was performed in 49 (43 males, 6 females) patients with OSA and compared with 39 (22 males, 17 females) controls (apnea-hypopnea index [AHI] < 5).

Self-extrusion of a foreign body from the upper digestive tract to the skin.

Migrated ingested foreign bodies from the upper digestive tract have the potential to cause life-threatening complications. Cases of spontaneous expulsion to the skin of the neck are very rare. We present an unusual case of an ingested foreign body that migrated out of the upper digestive tract and self-extruded via the skin of the neck.