Showing 27 ideas for tag "apnea"

Goal 2: Reduce Human Disease

Clinical Trials in Pediatric Sleep Disorders

Long-term risk of recurrence of obstructive sleep apnea in children successfully treated with surgery during childhood.

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Very small, incomplete, retrospective studies, and some new emerging data from Hong Kong, suggest that a significant number of children with obstructive sleep apnea syndrome will develop progressive symptoms later in life, or will develop recurrence of OSAS after adenotonsillectomy. Further studies are needed to determine the long-term risk of recurrence. Results of this trial will influence clinical management in regards to ongoing surveillance and secondary prevention techniques.

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Goal 2: Reduce Human Disease

Sleep Apnea

The general area is that of preoperative risk management of sleep apnea patients undergoing major surgery. This field is burgeoning with clinical activity. A large amount of healthcare dollars are expended annually in order to detect sleep apnea and offer therapy that is of unproven value. Most all of the data is retrospective case series or a mixture of retrospective and prospective cohort studies. Yet, across the country,... more »

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Critical Challenge (CC)

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The existing data shows that sleep apnea may be moderate risk factor for poor outcomes and complications from surgery but the magnitude of the risk and the degree to which sleep apnea therapy modifies this risk is not known and won’t be determined without larger scale trials. This field desperately needs some randomized trials to answer some of these questions. Trials which randomize patients undergoing some major surgery to a sleep apnea treatment with CPAP if OSA is diagnosed before surgery  vs. treating with CPAP after surgery in the post operative period is one such study that could be performed.

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Goal 2: Reduce Human Disease

Sleep Apnea - Trial of Treatment vs No Treatment of Snoring

Randomized trial of the treatment of snoring vs. no treatment.

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Compelling Question (CQ)

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Snoring is increasingly implicated as potential disruptor of carotid artery intima and function. Repetitive vibratory trauma has been hypothesized as cause of this. Intermediate markers of cardiovascular risk such as intimal thickening have been linked to snoring as independent from sleep apnea. This field is ready for a larger scale trial in which snoring is intervened upon and IMT is measured as one of several endpoints. Other endpoints could be QOL measures, sleepiness, etc. Another reason this field is ready to be addressed is we now have inexpensive nasal resistors, which treat snoring without the need for surgery, oral appliances, or CPAP. These would allow the sleep medicine field to do a trial of such therapy vs. a sham therapy.

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Maternal sleep apnea treatment effects

Does assessment and treatment of sleep apnea in pregnancy reduce the risk of maternal heart, lung and blood disease and complications associated with delivery and risk factors in offspring (e.g., obesity)?

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Compelling Question (CQ)

Name of idea submitter and other team members who worked on this idea NHLBI Staff

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Goal 2: Reduce Human Disease

Clinical Trials in Pediatric Sleep Disorders - Effect of adenotonsillectomy

Effect of adenotonsillectomy on behavioral and cardiovascular outcomes in children with primary snoring

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The recent NHLBI Childhood Adenotonsillectomy (CHAT) study showed highly significant behavioral improvements in children with obstructive sleep apnea syndrome . This study included children with an apnea hypopnea index as low as 2/hr. Many small or suboptimally controlled studies suggest that even primary snoring can affect behavior. If large randomized controlled trials confirm this finding, it will radically affect the treatment of the estimated 10% of children who snore.

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Goal 2: Reduce Human Disease

Clinical Trials in Pediatric Sleep Disorders - Effect of adenotonsillectomy

Effect of adenotonsillectomy on neurocognitive and behavioral outcomes in infants and and toddlers with obstructive sleep apnea syndrome.

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Compelling Question (CQ)

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The CHAT study showed few significant changes in cognitive outcomes in school-aged children with OSAS. However, these children (aged 5-9 years) may have suffered from OSAS too long to allow for reversibility of central nervous system damage. The peak prevalence of OSAS occurs in much younger children. Theoretically, these children are much more likely to show cognitive improvement after treatment, due to a shorter duration of OSAS (with its resultant hypoxemic damage) and increased plasticity of their nervous system. These young children are often not treated, due to either underdiagnosis or concern about the increased risks of adenotonsillectomy in very young children. Thus, if it is found that early treatment reverses cognitive damage, the clinical management of these children would be profoundly affected.

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Goal 1: Promote Human Health

Missing upper teeth & sleep apnea treatment: Problems?

I am a 73 year old female with Hypersensitivity Pneumonitis, Complex Sleep Neap, using oxygen @ 4-5 L/min 24/7 who just had my upper teeth extracted. I notice this has a negative effect, or appears to, on the effectiveness of apnea treatment. I wake several times during the night with lips flapping! This did not happen before the extraction. Because there are still some lower teeth, I am unable to close my mouth... more »

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If this question has an answer, it would help an unknown number of persons by once again providing effective treatment for sleep apnea. I find fatigue is building again, as it did before I was diagnosed and treated.

It may be simply a matter of a different style of mask, but it appears ideas on what kind are a bit sparse on the ground.

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One would need a sampling of persons with lower teeth (some, or all) who also have sleep apnea. One would have to determine whether indeed, there is a deterioration in quality of treatment, and if the number of lower teeth are a factor. Does the form of apnea make a difference? Does age or body weight play a part?

This is not exactly couched in academic, medical terms, but it is still a valid question. Its solution, or if a solution already exists, it's distribution among sleep physicians, would help those who experience this combination of circumstances.

Name of idea submitter and other team members who worked on this idea Leslie H. Smyth

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