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Clinical Diagnosis and Treatment of Obstructive Sleep Apnea
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Clinical Diagnosis and Treatment of Obstructive Sleep Apnea

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Pulmonology".

Deadline for manuscript submissions: closed (25 November 2022) | Viewed by 4805

Special Issue Editor

Dr. Ludovico Messineo

E-Mail Website
Guest Editor
Division of Sleep Medicine, Brigham and Women’s Hosptial, Harvard Medical School, Boston, MA, USA
Interests: sleep apnea; pharmacotherapy; respiratory physiology; ventilation; COPD

Special Issue Information

Dear Colleagues,

Obstructive sleep apnea (OSA) is a highly prevalent, chronic respiratory sleep disorder that is estimated to affect 1 billion adults globally. The pathogenesis of OSA depends on an increased anatomical load and on altered physiological traits or endotypes (e.g., elevated loop gain, decreased arousal threshold, reduced pharyngeal muscle responsiveness). Currently, the only available treatment for sleep apnea is continuous positive airway pressure (CPAP). However, CPAP is burdened by numerous side effects and, consequently, poor compliance. Several other alternative treatments have been studied, yet none has provided OSA abolition in the same way that CPAP does. However, this gap in knowledge has progressively been filled with the help of personalized medicine. Pharmacotherapy, hypoglossal nerve stimulation, and mandibular advancement devices have all led to encouraging outcomes when tailored on specific altered OSA endotypes, although these data mainly came from pilot or small sample-sized studies. Nonetheless, the “magic” alternative treatment capable of abolishing sleep apnea regardless of its pathogenic trait (i.e., splinting the upper airway open in a similar fashion to CPAP) is still to be determined.

Dr. Ludovico Messineo
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • sleep apnea
  • pharmacotherapy
  • respiratory physiology
  • ventilation
  • COPD

Published Papers (2 papers)

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Research

13 pages, 1392 KiB  
Article
Associations of Chronic Diabetes Complications and Cardiovascular Risk with the Risk of Obstructive Sleep Apnea in Patients with Type 2 Diabetes
by Diana Cristina Protasiewicz Timofticiuc, Ionela Mihaela Vladu, Adela-Gabriela Ștefan, Diana Clenciu, Adina Mitrea, Vlad Pădureanu, Ion Cristian Efrem, Ileana-Diana Diaconu, Adina Turcu, Tiberiu Ștefăniță Țenea-Cojan, Anca Mihaela Hâncu, Maria Forțofoiu, Oana Mirea Munteanu and Maria Moța
J. Clin. Med. 2022, 11(15), 4403; https://doi.org/10.3390/jcm11154403 - 28 Jul 2022
Cited by 2 | Viewed by 2097
Abstract
Background: Type 2 diabetes mellitus (T2DM) is associated with increased mortality and morbidity, including cardiovascular diseases and obstructive sleep apnea (OSA). The aim of this study was to assess the associations between cardiovascular risk, chronic diabetes complications and the risk of OSA in [...] Read more.
Background: Type 2 diabetes mellitus (T2DM) is associated with increased mortality and morbidity, including cardiovascular diseases and obstructive sleep apnea (OSA). The aim of this study was to assess the associations between cardiovascular risk, chronic diabetes complications and the risk of OSA in adult patients with T2DM. Methods: The study included 529 patients with T2DM in whom moderate-to-severe OSA risk was assessed using the STOP-Bang questionnaire, dividing the subjects into two groups: group 1: STOP-Bang score <5, and group 2: STOP-Bang score ≥5, respectively. In all the subjects, cardiovascular risk was assessed using the UKPDS risk engine. Statistical analysis was performed using SPSS 26.0, the results being statistically significant if p value was <0.05. Results: 59% of the subjects scored ≥5 on the STOP-Bang questionnaire. We recorded statistically significant differences between the two groups regarding diabetes duration, HbA1c, HOMA-IR, albuminuria, as well as cardiovascular risk at 10 years for both coronary heart disease (CHD) and stroke (p < 0.05). Furthermore, through logistic regression, adjusting for confounding factors, we demonstrated that the STOP-Bang score ≥ 5 is a risk factor for 10-year fatal and nonfatal CHD risk. Conclusions: It is extremely important to screen and diagnose OSA in patients with T2DM, in order to improve the primary and secondary prevention of cardiovascular events in these patients. Full article
(This article belongs to the Special Issue Clinical Diagnosis and Treatment of Obstructive Sleep Apnea)
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8 pages, 1047 KiB  
Article
Switch of Nocturnal Non-Invasive Positive Pressure Ventilation (NPPV) in Obstructive Sleep Apnea (OSA)
by Pasquale Tondo, Caterina Pronzato, Irene Risi, Nadia D’Artavilla Lupo, Rossella Trentin, Simona Arcovio and Francesco Fanfulla
J. Clin. Med. 2022, 11(11), 3157; https://doi.org/10.3390/jcm11113157 - 1 Jun 2022
Cited by 5 | Viewed by 2054
Abstract
Background. Continuous positive airway pressure (CPAP) is considered the first-line treatment for patients with OSA, but Bilevel-PAP (BiPAP) therapy is a recognized option for noncompliant/unresponsive patients to CPAP. The present study was designed to evaluate the role of ResMed VAuto in the management [...] Read more.
Background. Continuous positive airway pressure (CPAP) is considered the first-line treatment for patients with OSA, but Bilevel-PAP (BiPAP) therapy is a recognized option for noncompliant/unresponsive patients to CPAP. The present study was designed to evaluate the role of ResMed VAuto in the management of two different issues raised because of the Philips recall: the treatment of naïve noncompliant/unresponsive patients to CPAP (Group A) and the switch to VAuto for patients already on treatment with Philips Auto-BiPAP (Group B). Methods. Sixty-four patients who required auto-BiPAP treatment from August to December 2021 were included in the study. The efficacy of each mode of PAP therapy was compared between the two groups of patients. Results. Group A showed a statistically significant improvement in the apnea–hypopnea index (AHI) (7.4 ± 8.5 events·h−1 vs. 15.2 ± 12.1 events·h−1, p < 0.001), and oxygen desaturation index (ODI) (9.4 ± 8.9 events·h−1 vs. 15.2 ± 8.8 events·h−1, p = 0.029) during VAuto in comparison to CPAP, respectively. Conversely, a similar trend was found for patients in Group B for global AHI, but a statistically significant reduction was just found in supine AHI and ODI. In group B, an AHI <5 events·h−1 was found in 89.3% during VAuto in comparison to 82.1% with Philips Auto-BiPAP (p = ns). The levels of IPAPmax and EPAPmin were not statistically different between the two devices (p = 0.69 and p = 0.36, respectively). Conclusion. Bilevel ventilation in VAuto mode is effective in the clinical management of two different issues derived from the Philips recall. The switching between two different auto-BiPAP devices can be performed easily and successfully. Full article
(This article belongs to the Special Issue Clinical Diagnosis and Treatment of Obstructive Sleep Apnea)
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