Multimodal Telemonitoring for Weight Reduction in Patients With Sleep Apnea: A Randomized Controlled Trial.

Background: Telemonitoring the use of CPAP devices and remote feedback on device data effectively optimizes CPAP adherence in patients with OSA.

Research Question: Can expanding the scope of telemonitoring and remote feedback to body weight (BW), BP, and physical activity enhance efforts for BW reduction in Patients with OSA receiving CPAP?

Study Design And Methods: Participants were recruited from patients at 16 sleep centers in Japan with OSA and obesity who were receiving CPAP therapy. Obesity was defined as a BMI of ≥ 25 kg/m, based on Japanese obesity guidelines.

Sleep Apnea Syndrome (SAS) Clinical Practice Guidelines 2020.

The prevalence of sleep disordered breathing (SDB) is reportedly very high. Among SDBs, the incidence of obstructive sleep apnea (OSA) is higher than previously believed, with patients having moderate-to-severe OSA accounting for approximately 20% of adult males and 10% of postmenopausal women not only in Western countries but also in Eastern countries, including Japan. Since 1998, when health insurance coverage became available, the number of patients using continuous positive airway pressure (CPAP) therapy for sleep apnea has increased sharply, with the number of patients about to exceed 500,000 in Japan.

Three cases of parasomnias similar to sleep terrors occurring during sleep-wake transitions from REM sleep.

Unlabelled: Sleep terrors are a non-rapid eye movement (NREM) sleep-related parasomnia characterized by abrupt terror with a frightening scream. However, it remains unknown whether sleep terrors occur only from NREM sleep. We evaluated 3 cases of a sleep terrors-like parasomnia that occurred exclusively during arousals from rapid eye movement (REM) sleep.

Very early-onset of RBD with ADHD: a case report study.

We experienced a case of very early-onset REM sleep behavior disorder (RBD) with ADHD. This case showed typical RBD symptoms with REM sleep without atonia on polysomnography. Methylphenidate, which enhances the dopamine system, attenuated his ADHD symptoms but not RBD symptoms.

Decrease of Plasma Soluble (Pro)renin Receptor by Bariatric Surgery in Patients with Obstructive Sleep Apnea and Morbid Obesity.

Background: Plasma concentrations of soluble (pro)renin receptor [s(P)RR], which are elevated in patients with obstructive sleep apnea (OSA), have not been studied in morbid obesity. The aim of this study is to clarify effects of bariatric surgery on plasma s(P)RR concentrations and identify associated factors for their changes in OSA patients with morbid obesity.

Methods: Twenty-three patients with OSA complicated by morbid obesity (10 men and 13 women; body mass index, 40.

Prevalence of sleep-disordered breathing in Japanese medical students based on type-3 out-of-center sleep test.

Background: Sleep-disordered breathing (SDB), especially obstructive sleep apnea disorder (OSA), is thought to mainly affect men over the age of 40. Following findings that Asian people are more likely to experience severe OSA, regardless of obesity, we investigated the prevalence of SDB and OSA in a larger sample and in more younger age groups than those described in previous reports.

Methods: Between 2011 and 2016, 487 medical students (358 males, mean age 24.

Elevated Plasma Levels of Soluble (Pro)Renin Receptor in Patients with Obstructive Sleep Apnea Syndrome in Parallel with the Disease Severity.

(Pro)renin receptor ((P)RR), a receptor for renin and prorenin, is implicated in the pathophysiology of diabetes mellitus, hypertension and their complications. Soluble (P)RR (s(P)RR) is composed of extracellular domain of (P)RR and thus exists in blood. We have reported that plasma concentrations of s(P)RR were elevated in male patients with obstructive sleep apnea syndrome (OSAS).

Efficacy and safety of adjunctive modafinil treatment on residual excessive daytime sleepiness among nasal continuous positive airway pressure-treated japanese patients with obstructive sleep apnea syndrome: a double-blind placebo-controlled study.

Study Objectives: This double-blind study evaluated the efficacy and safety of modafinil for treating excessive daytime sleepiness in Japanese patients with obstructive sleep apnea syndrome (OSAS).

Methods: Patients with residual excessive sleepiness (Epworth Sleepiness Scale [ESS] ≥ 11) on optimal nasal continuous positive airway pressure (nCPAP) therapy (apnea-hypopnea index ≤ 10) were randomized to either 200 mg modafinil (n = 52) or placebo (n = 62) once daily for 4 weeks. Outcomes included baseline-week 4 changes in ESS total score, sleep latency on maintenance of wakefulness test (SL-MWT), nocturnal polysomnography, Pittsburgh Sleep Quality Index (PSQI), and safety.

Cephalometric assessment of craniofacial morphology in Japanese male patients with obstructive sleep apnea-hypopnea syndrome.

CRANIOFACIAL MORPHOLOGICAL ANOMALIES CAN BE DIVIDED INTO TWO PRINCIPAL CATEGORIES: skeletal anomalies and soft tissue anomalies. This study examined the hypothesis that the assessment of indices representing both skeletal and soft tissue can be used to appropriately identify the risk factor of obstructive sleep apnea-hypopnea syndrome (OSAHS). 232 suspected OSAHS male patients were examined with polysomnography and divided into two groups (202 males with OSAHS and 30 male controls without OSAHS).

Is laryngeal descent associated with increased risk for obstructive sleep apnea?

Background: A lower (more caudal) position of the larynx may result in a longer collapsible segment of the upper airway. One could thus hypothesize that the lower the larynx the greater the risk for obstructive sleep apnea (OSA). To test this hypothesis, we measured the upper airway length to the level of the vocal cord and the horizontal and vertical segments of the supralaryngeal vocal cord tract (SVT) using multislice CT scan in Japanese patients with OSA.

Evaluation of sympathetic activity by 123I-metaiodobenzylguanidine myocardial scintigraphy in dilated cardiomyopathy patients with sleep breathing disorder.

Background: Because increased sympathetic nervous activity (SNA) in patients with dilated cardiomyopathy (DCM) associated with sleep breathing disorder (SBD) is known to deteriorate the prognosis of cardiac failure, (123)I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy was used as the investigative tool in the present study.

Methods And Results: The study group comprised 53 patients (47 men, 6 women; mean age 56+/-3 years) with chronic stable DCM. Patients were divided into SBD(+) or SBD(-) group according to 24-h pulse oximetry results.

Anatomical balance of the upper airway and obstructive sleep apnea.

Background: Obesity and craniofacial abnormalities such as small maxilla and mandible are common features of patients with obstructive sleep apnea (OSA). The authors hypothesized that anatomical imbalance between the upper airway soft-tissue volume and the craniofacial size (rather than each alone) may result in pharyngeal airway obstruction during sleep, and therefore development of OSA.

Methods: Blind measurements of tongue cross-sectional area and craniofacial dimensions were performed through lateral cephalograms in 50 adult male patients with OSA and 55 adult male non-OSA subjects with various craniofacial dimensions.

Sepsis caused by food-borne infection with Escherichia coli.

We report a case of sepsis caused by Escherichia coli (E. coli) of serotype O-143. A 78-year-old man developed symptoms of gastroenteritis after ingesting raw meat on noodles.

[Adverse effects and adherence to nasal continuous positive airway pressure in patients with obstructive sleep apnea hypopnea syndrome].

The adverse effects of and adherence of a treatment with nasal continuous positive airway pressure (nCPAP) for obstructive sleep apnea and hypopnea syndrome (OSAHS) were examined. The subjects comprised 321 patients with OSAHS. An all-night polysomnography was performed for all subjects.