scholarly journals The Treatment of Central Sleep Apnea Syndromes in Adults: Practice Parameters with an Evidence-Based Literature Review and Meta-Analyses

SLEEP ◽  
2012 ◽  
Vol 35 (1) ◽  
pp. 17-40 ◽  
Author(s):  
R. Nisha Aurora ◽  
Susmita Chowdhuri ◽  
Kannan Ramar ◽  
Sabin R. Bista ◽  
Kenneth R. Casey ◽  
...  
Keyword(s):  
Sleep Apnea ◽  
Literature Review ◽  
Central Sleep Apnea ◽  
Sleep Apnea Syndromes ◽  
Evidence Based ◽  
Practice Parameters ◽  
Meta Analyses

The Association between Obstructive Sleep Apnea and Allergic Rhinitis: Current Literature Review

2021 ◽  
Vol 17 ◽  
Author(s):  
Shi Nee Tan ◽  
Baharudin Abdullah
Keyword(s):  
Obstructive Sleep Apnea ◽  
Allergic Rhinitis ◽  
Sleep Apnea ◽  
Central Sleep Apnea ◽  
Sleep Apnea Syndromes ◽  
T Helper 2 ◽  
Obstructive Sleep ◽  
Common Clinical Practice ◽  
High Level ◽  
Chemical Mediators

: Sleep-disordered breathing (SDB) is now a significant health problem in today's culture. It ranges from a spectrum of abnormal conditions during sleep from the primary snorer to mild, moderate, or severe obstructive sleep apnea (OSA). SDB also comprises other conditions, such as sleep-related hypoventilation, sleep-related hypoxemia, and central sleep apnea syndromes. One of the components of the pathophysiology of OSA that remain unclear is the association of allergic rhinitis (AR) in the evolution of OSA. Several studies relate OSA and AR's co-existence in the common clinical practice, but its correlation was not clear. This review article aimed to review the relationship between OSA and AR in terms of the role of chemical mediators and pathophysiological and the effect of AR treatment in support of OSA. The symptoms of AR further accelerate the clinical progression to OSA development. Inflammatory mediators such as histamine, cysteinyl leukotrienes, and interleukins are found at a high level in AR, which can aggravate AR symptoms such as nasal obstruction, rhinorrhea, and itchiness, which can then lead to sleep disruption in OSA patients. In addition, OSA patients also have increased chemical mediators such as tumor necrosis factor, interleukin 6, and 1, which would activate the T helper 2 phenotypes that can aggravate AR symptoms. This vicious cycle can potentiate each other and worsen the condition. Few studies have shown that treatment of AR can improve OSA, especially the use of intranasal steroid and leukotriene receptor antagonists. A detailed evaluation of rhinitis symptoms should be made for those OSA patients so that they can benefit not only from the improvement of AR but also the good sleep quality.

Efficacy of Adaptive Servoventilation in Treatment of Complex and Central Sleep Apnea Syndromes

CHEST Journal ◽  
2007 ◽  
Vol 132 (6) ◽  
pp. 1839-1846 ◽  
Author(s):  
Joanne Shirine Allam ◽  
Eric J. Olson ◽  
Peter C. Gay ◽  
Timothy I. Morgenthaler
Keyword(s):  
Sleep Apnea ◽  
Central Sleep Apnea ◽  
Sleep Apnea Syndromes ◽  
Adaptive Servoventilation

Abstract WP440: Stay at Home With Home Care: The Evidence for Readmission Reduction With Home Visits After Ischemic Stroke

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Ann M Leonhardt-Caprio ◽  
Craig R Sellers ◽  
Thomas V Caprio
Keyword(s):  
Ischemic Stroke ◽  
Literature Review ◽  
Best Practices ◽  
Home Care ◽  
Hospital Readmissions ◽  
Study Groups ◽  
Care Utilization ◽  
Evidence Based ◽  
Comprehensive Stroke Center ◽  
Meta Analyses

Background: Following hospitalization due to ischemic stroke (IS), 14.4% of Medicare recipients are readmitted within 30 days. Readmission after IS is associated with increased mortality, disability, and elevated costs. Purpose: To identify evidence-based practices to guide reduction of all-cause, 30-day hospital readmissions following IS in a comprehensive stroke center (CSC). Methods: A literature review focusing on readmissions in IS patients was performed using the PubMed, CINAHL, Embase, and Web of Science databases. Search terms: hospital readmission, IS, transition of care, and care transition. Limitations included English publications in the last 5 years. The 39 articles and abstracts reviewed included 2 meta-analyses, 4 literature reviews, 2 randomized controlled trials, 2 qualitative studies, 2 program evaluations, 2 design descriptions without results, and the remainder observational and cohort studies. Most studies were single site or limited geographic areas. Differing patient populations, definitions, and study methods limited the ability to combine results. Literature review results were then compared with baseline practices at our CSC. Results: While multiple best-practices were in place at our CSC, only 44% of IS patients were being referred to home care. Six of the publications reviewed identified home care as a successful component in reducing readmissions within 30 days, reporting statistically significant reduction in readmission rates ranging from 30% to 93% with 3 of 6 reporting p< .05, treatment effect of 1.7 reported by 1, and 2 study groups did not report significance of findings. Conclusions: Reducing readmissions for IS improves outcomes and is a focus of quality efforts across the nation. Using literature, we identified a gap in current best practices (the under-utilization of home care referrals) in our CSC. Despite limitations in the literature, there is clear evidence that the use of home care has reduced readmissions in multiple settings. This has been a successful first step in guiding development of an evidence-based readmission reduction program. An initiative to increase home care utilization at our CSC is currently under evaluation. More study is needed on home care use in the stroke-specific population.

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