The Impact of Obstructive Sleep Apnea on Balance, Gait, and Falls Risk: A Narrative Review of the Literature

2020 ◽  
Vol 75 (12) ◽  
pp. 2450-2460 ◽  
Author(s):  
David Stevens ◽  
Brianna Jackson ◽  
Jayne Carberry ◽  
James McLoughlin ◽  
Chris Barr ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Disturbances ◽  
Large Scale ◽  
Falls Risk ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
Risk Of Falls ◽  
Osa Treatment ◽  
The Impact

Abstract Falls-related hospitalization and injury rates are steadily increasing globally due to a growth in the aging population, and the associated health problems that increase risk of falls. One such associated health problem is sleep disturbances and disorders. Recent cohort studies have shown that subjectively reported poor quality sleep is associated with an increased risk of falls. Obstructive sleep apnea (OSA) is a common sleep disorder characterized by the repetitive reductions, or cessation, of airflow. Some studies have shown that OSA impairs posture/balance and gait with nocturnal hypoxemia the likely main cause. Emerging evidence suggests that treating OSA by continuous positive airway pressure (CPAP) can improve gait, but no studies to date have examined the effect of CPAP on posture/balance. The overall control of balance relies on a complex interaction between several physiological functions including vestibular, muscle, visual, and cognitive functions. We postulate that OSA impacts balance by affecting these different systems to various degrees, with the nocturnal hypoxic burden likely playing an important role. Importantly, these impairments in balance/posture and possible falls risk may be alleviated by OSA treatment. Larger mechanistic studies are needed to properly elucidate how OSA affects falls risk and future large-scale randomized control trials are needed to determine the effectiveness of OSA treatment in reducing the risk of falls.

scholarly journals Impact of the type of mask on the effectiveness of and adherence to continuous positive airway pressure treatment for obstructive sleep apnea

2014 ◽  
Vol 40 (6) ◽  
pp. 658-668 ◽  
Author(s):  
Rafaela Garcia Santos de Andrade ◽  
Vivien Schmeling Piccin ◽  
Juliana Araújo Nascimento ◽  
Fernanda Madeiro Leite Viana ◽  
Pedro Rodrigues Genta ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Treatment Effectiveness ◽  
Obstructive Sleep ◽  
Pubmed Database ◽  
Osa Treatment ◽  
The Impact

Continuous positive airway pressure (CPAP) is the gold standard for the treatment of obstructive sleep apnea (OSA). Although CPAP was originally applied with a nasal mask, various interfaces are currently available. This study reviews theoretical concepts and questions the premise that all types of interfaces produce similar results. We revised the evidence in the literature about the impact that the type of CPAP interface has on the effectiveness of and adherence to OSA treatment. We searched the PubMed database using the search terms "CPAP", "mask", and "obstructive sleep apnea". Although we identified 91 studies, only 12 described the impact of the type of CPAP interface on treatment effectiveness (n = 6) or adherence (n = 6). Despite conflicting results, we found no consistent evidence that nasal pillows and oral masks alter OSA treatment effectiveness or adherence. In contrast, most studies showed that oronasal masks are less effective and are more often associated with lower adherence and higher CPAP abandonment than are nasal masks. We concluded that oronasal masks can compromise CPAP OSA treatment adherence and effectiveness. Further studies are needed in order to understand the exact mechanisms involved in this effect.

Hypoglossal nerve stimulation [HGNS] for Obstructive Sleep Apnea [OSA] treatment – a review

2017 ◽  
Vol 6 (3) ◽  
pp. 66-71
Author(s):  
Małgorzata Bilińska ◽  
Kazimierz Niemczyk
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Hypoglossal Nerve ◽  
Muscle Tone ◽  
Upper Airway ◽  
Western Society ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
Osa Treatment ◽  
Oncologic Diseases

Obstructive sleep apnea (OSA) is characterized by recurrent periods of upper airway obstruction (hypopneas and apneas) during sleep. It leads to repeated oxyhemoglobin desaturations, nocturnal hypercapnia, and arousals. Common symptoms include loud snoring with breathing interruptions. Excessive daytime sleepiness and cognitive impairment occur. Obstructive sleep apnea is a major cause of morbidity and mortality in Western society. Its association with an increased risk of development and progression of neurocognitive, metabolic, cardiovascular and oncologic diseases and complications is well described. The significant factor in OSA pathogenesis is reduced muscle tone in the tongue and upper airway. In the recent years, devices providing neurostimulation of the hypoglossal nerve (HGNS) were developed as an alternative for noncompliant CPAP (continuous positive airway pressure) patients. Clinical trials suggest that electrical stimulation of the hypoglossal nerve is effective. This is considered to be one of the targets of neurostimulation in the treatment of obstructive sleep apnea (OSA).

Tonsils and Adenoids: An Update

1995 ◽  
Vol 16 (1) ◽  
pp. 17-21
Author(s):  
Ellen S. Deutsch ◽  
Glenn C. Isaacson
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Disturbances ◽  
Recurrent Infection ◽  
The United States ◽  
Cor Pulmonale ◽  
Clinical Aspects ◽  
Adenotonsillar Hypertrophy ◽  
Obstructive Sleep ◽  
Increased Risk

Pediatricians frequently face the decision of whether to recommend that a child undergo a tonsillectomy, an adenoidectomy, or both. The reputation and the indications for these procedures have evolved over the years and continue to evoke controversy. The total number of tonsillectomies and adenoidectomies performed in the United States has decreased substantially over the past 30 to 40 years, although the proportion of procedures performed for obstructive sleep apnea (OSA) has increased. We will address the indications (Table), techniques, and complications of tonsillectomies and adenoidectomies, as well as current ideas concerning OSA. The palatine tonsils, adenoids, and lingual tonsils comprise a circle of lymphoid tissue in the nasopharynx and oropharynx, sometimes referred to as Waldeyer ring (Fig. 1). Although this tissue is immunologically active, no postoperative immune deficits generally have been acknowledged other than an increased risk of complications from polio1 prior to the availability of polio vaccines. Clinical Aspects The most common problems attributed to the tonsils and adenoids are recurrent infection and OSA, or its milder manifestation, adenotonsillar hypertrophy with obstruction. Chronic middle ear disease can be related to adenoid pathology. OBSTRUCTIVE SLEEP APNEA OSA either is becoming more common in children or is being recognized more frequently. Sleep disturbances, cor pulmonale, pulmonary hypertension, and congestive heart failure are potential complications of OSA.

scholarly journals Association Between Obstructive Sleep Apnea, Its Treatment, and Alzheimer's Disease: Systematic Mini-Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Chih-Yun Kuo ◽  
Hung-Ta Hsiao ◽  
Ing-Hsien Lo ◽  
Tomas Nikolai
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
The Elderly ◽  
Protein Levels ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
Osa Treatment ◽  
Underlying Mechanisms

Obstructive sleep apnea (OSA) and Alzheimer's disease (AD) are common in the elderly population. Obstructive sleep apnea that may cause significant changes in the cerebrospinal fluid β-amyloid and T-tau and/or P-tau protein levels is often identified as a risk factor for development of AD. Although the underlying mechanisms of AD are still not fully understood, a hypothesis associating OSA with AD has been already proposed. In this systematic mini-review, we first discuss the recent findings supporting the association of OSA with an increased risk of AD and then provide evidence suggesting the positive effect of OSA treatment on a reduced risk of AD.

scholarly journals Personalized treatment of obesity complicated with obstructive sleep apnea syndrome

2014 ◽  
Vol 11 (1) ◽  
pp. 48-52
Author(s):  
N V Strueva ◽  
L V Saveleva ◽  
G A Melnichenko ◽  
M G Poluektov ◽  
N V Gegel
Keyword(s):  
Obstructive Sleep Apnea ◽  
Body Weight ◽  
Sleep Apnea ◽  
Patient Adherence ◽  
Sleep Apnea Syndrome ◽  
Obstructive Sleep ◽  
Osa Treatment ◽  
Treatment Of Obesity ◽  
Clinical Conditions ◽  
The Impact

Obstructive sleep apnea (OSA) and obesity are mutually burdening clinical conditions. Weight loss is quite effective for the control of breathing disorders during sleep, but the impact of OSA treatment on the dynamics of body weight in obese patients remains poorly studied. Presented clinical case features a significant reduction in body weight in a patient with morbid obesity complicated by severe OSA with contemporary approach and without CPAP therapy due to high patient adherence to therapy and absence of comorbidities.

Protective Effects of Obstructive Sleep Apnea on Outcomes After Subarachnoid Hemorrhage: A Nationwide Analysis

Neurosurgery ◽  
2020 ◽  
Vol 87 (5) ◽  
pp. 1008-1015
Author(s):  
Christian Kaculini ◽  
David J Wallace ◽  
Audrey E Haywood ◽  
Joel Michalek ◽  
Justin Mascitelli ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Subarachnoid Hemorrhage ◽  
Sleep Apnea ◽  
Tobacco Use ◽  
Univariate Analysis ◽  
Protective Effects ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
Poor Outcomes ◽  
The Impact

Abstract BACKGROUND Obstructive sleep apnea (OSA) is typically associated with an increased risk of cardiovascular and cerebrovascular disease. Recent studies, however, have suggested that hypercapnia and chronic intermittent hypoxia may potentially provide protection against ischemic events like stroke. OBJECTIVE To evaluate the impact of OSA with presentation, hospital course, and treatment outcomes of patients with subarachnoid hemorrhage (SAH). METHODS Data for patients with SAH between the years 2011 and 2015 were extracted from the Nationwide Inpatient Sample (NIS) and stratified based on diagnosis codes for OSA. Univariate analysis was used to assess the prevalence of comorbidities in OSA patients diagnosed with SAH and several covariates, including patient demographics, aneurysmal treatment, in-hospital morality rate, length of stay, and costs. Multivariate logistic regression models analyzed the relationship between several comorbidities, including OSA, tobacco use, and hypertension, and poor outcomes after SAH. RESULTS Data from 49 265 SAH patients were used in this study, of which 2408 (4.9%) also had a concomitant OSA diagnosis. Patients with OSA compared to all other SAH patients had a significantly lower in-hospital mortality rate, as well as statistically significant lower odds of vasospasm, stroke, and poor outcomes. Additionally, hypercholesterolemia, obesity, and tobacco use disorder were also associated with more favorable outcomes. CONCLUSION SAH patients with OSA are significantly less likely to have a poor outcome when compared to non-OSA patients, despite having an increased risk of several comorbidities.

scholarly journals 1131 Obstructive Sleep Apnea Treatment and Dementia Risk in Older Adults

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A430-A431
Author(s):  
G L Dunietz ◽  
R D Chervin ◽  
J F Burke ◽  
A S Conceicao ◽  
T J Braley
Keyword(s):  
Older Adults ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Statistical Significance ◽  
Older Individuals ◽  
Survey Period ◽  
Lower Odds ◽  
Obstructive Sleep ◽  
Osa Treatment ◽  
The Impact

Abstract Introduction Obstructive Sleep Apnea (OSA) has been linked to dementia and Alzheimer’s Disease (AD), as well as pre-dementia. The potential benefits of OSA treatment on cognitive performance are inconclusive. Further, the impact of OSA treatment on the development of neurodegenerative disorders has not been sufficiently studied. This study examined associations between Positive Airway Pressure (PAP) therapy and incident diagnosis of pre-dementia (MCI), dementia (DNOS), or AD in a population-level sample of older adults. Methods Using a random 5% sample from Medicare claims data (persons age 65 and older), individuals with an ICD-9 diagnosis code for OSA prior to 2011 (n=53,321) were selected for analyses. Over the survey period (2011-2013), we further identified persons newly diagnosed with MCI (n=443), DNOS (n=378), or AD (n=1,057). We also identified individual HCPCS claims for PAP equipment as evidence of prescription, and repeated HCPCS claims for supplies as evidence of adherence to PAP treatment. Logistic regression models were used to adjust for potential confounders including age, gender, hypertension, and Parkinson’s Disease that might increase risk for dementia. Results Seventy-eight percent of beneficiaries with OSA were prescribed PAP, and 74% showed evidence of adherent use. After adjustment for potential confounders, prescription of PAP was associated with significantly lower odds of incident AD and DNOS (OR=0.78, 95% CI: 0.69, 0.89; and OR=0.69, 95% CI: 0.55, 0.85). Lower odds of MCI, approaching statistical significance, were also observed among beneficiaries who were prescribed PAP (OR=0.82, (95% CI: 0.66, 1.02). Evidence of adherence to PAP was significantly associated with lower odds of incident AD (OR=0.65, 95% CI: 0.56, 0.76). Conclusion Among older individuals with OSA, PAP prescription and adherence are each associated with a significantly lower risk of incident AD or DNOS, though not MCI. Although a prospective cohort design cannot prove causality, results suggest that treatment of OSA could reduce risk of subsequent dementia. Support This study was supported by The American Academy of Sleep Medicine Foundation Strategic Research Award 115-SR-15 (PI Braley).

scholarly journals Impact of obstructive sleep apnea on cerebral blood flow

2019 ◽  
Vol 73 ◽  
pp. 65-75
Author(s):  
Katarzyna Postrzech-Adamczyk ◽  
Artur Nahorecki ◽  
Paweł Łyszczak ◽  
Robert Skomro ◽  
Andrzej Szuba
Keyword(s):  
Risk Factors ◽  
Blood Flow ◽  
Obstructive Sleep Apnea ◽  
Cerebral Blood Flow ◽  
Sleep Apnea ◽  
The Body ◽  
Early Screening ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
The Impact

Aim: Obstructive sleep apnea (OSA) is a common disorder with growing incidence. Major risk factors for OSA are obesity, aging, gender and menopause. As life expectancy lengthens and the obesity epidemic is ongoing, we can assume that OSA will affect an increasing part of the population. Pathological consequences of this disease include an increased risk of arterial hypertension, coronary artery disease, arrhythmia, heart failure as well as cerebrovascular diseases, such as stroke, transient ischemic attack and cognitive dysfunction. The cerebrovascular system differs significantly from other vessels in the body. Brain oxygen demands constitute about 20% of the total oxygen consumed by the body. Conclusions: OSA significantly affects the cerebral blood flow both during sleep and daily activities. This can have serious health consequences and makes the brain more vulnerable to ischemia. In this review we describe the impact of OSA on cerebral circulation during both sleep and wakefulness and we also outline the pathophysiology of these changes. Results: In patients with other risk factors for cerebral ischemia, early screening and treatment for OSA should be introduced.

Childhood Obstructive Sleep Apnea, What a Surgeon Should Know. Part 1: Interpreting the Polysomnography Study; Part 2: Diagnosis and Management

FACE ◽  
2021 ◽  
pp. 273250162110580
Author(s):  
Erica Lauren Smearman ◽  
Joseph Williams
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Study ◽  
Diagnosis And Management ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
Study Evaluation ◽  
Level 1 ◽  
The Impact ◽  
Pierre Robin

Obstructive sleep apnea (OSA) and disordered breathing can be common in early development with certain conditions placing children at increased risk for OSA, such as micrognathia and the Pierre Robin sequence, craniosynostosis, and tonsillar hypertrophy. A Level 1 Sleep Study evaluation is recommended in all children with suspected sleep apnea. Part 1 of this review provides a discussion of the polysomnography study and interpretation. Part 2 focuses on diagnosis and management, emphasizing conditions that are amendable to surgical intervention and the impact of intervention on post-operative sleep study outcomes.

Sign in / Sign up

Export Citation Format

Share Document