Yoğun Bakımda Obstrüktif Uyku Apne Sendromu
Özet
Obstrüktif uyku apne sendromu (OSAS) toplumda sık görülmektedir.OSAS endotel disfonksiyonu ve sempatik deşarj gibi yollarla koroner arter hastalığı, hipertansiyon, kalp yetmezliği, pulmoner hipertansiyon, kardiyak ritim bozuklukları gibi kardiyovasküler hastalıkların görülme sıklığını ve şiddetini etkilemektedir.OSAS aynı zamanda KOAH, obzite hipventilasyon sendromu ve pulmoner enfeksiyonlar gibi solunumsal hastalıklara da sıklıkla eşlik eden ve bu hastalıkların klinik seyrine etki ederek morbidite ve mortalite artışlarına yol açmaktadır. OSAS kronik hastalıkların gidişatını etkilemekle birlikte yoğun bakımda entübasyon ve ekstübasyonda çeşitli zorluklara yol açmaktadır. OSAS’lı hastalarda uygun tedavi yöntemleri ile hastalardaki solunumsal ve kardiyovasküler mortalite ve morbiditelerin önüne geçilmesi mümkün olabilmektedir. Bu hastalarda entübasyon sırasında zor hava yolu önlemleri alınması hayati önem arz etmekte ve entübasyonda olduğu gibi ekstübasyon sırasında da daha dikkatli olunması gerekmektedir.
Obstructive sleep apnea syndrome (OSAS) is frequently seen in the society. OSAS affects the incidence and severity of cardiovascular diseases such as coronary artery disease, hypertension, heart failure, pulmonary hypertension, cardiac aritmias through endothelial dysfunction and sympathetic discharge. OSAS also frequently accompanies respiratory diseases such as COPD, obesity hypoventilation syndrome and pulmonary infections and affects the clinical course of these diseases, leading to increased morbidity and mortality. OSAS also causes various difficulties in intubation and extubation in intensive care. With appropriate therapy of OSAS patients, it is possible to prevent these respiratory and cardiovascular mortality and morbidity in such patients. In these patients, it is vital to take difficult airway precautions during intubation and more care should be taken during extubation as well as intubation.
Referanslar
Köktürk O. Uykuda solunum bozuklukları. Tarihçe, tanımlar, hastalık spektrumu ve boyutu. Tuberk Toraks 1998;46:187-92.
Guilleminault C, Eldridge FL, Simmons FB, et. al. Sleepapnea in eightchildren. Pediatrics1976;58: 23-30.
Patel NP, Schwab RJ.Sleepapneasyndromes. In:Fishman AP, editor. FishmanPulmonaryDiseasesandDisorders. NewYork: McGraw-Hill BookCompany; 2008. p.1698.
Jennum P, Riha RL. Epidemiology of sleepapnoea/hypopnoeasyndromeandsleep-disorderedbreathing. Eur Respir J 2009; 33:907.
Young T, Peppard PE, Gottlieb DJ. Epidemiology of obstructivesleepapnea: A populationhealthperspective. Am jRespirCritCareMed 2002; 165:1217
Bolona, E.; Hahn, P.Y.; Afessa, B. Intensivecareunitandhospitalmortality in patientswithobstructivesleepapnea. J. Crit. Care2015, 30, 178–180.
Chen, X.; Wang, R.; Zee, P.; et. al.Racial/EthnicDifferences in SleepDisturbances: The Multi-EthnicStudy of Atherosclerosis (MESA). Sleep2015, 38, 877–888.
BaHammam, A.; Syed, S.; Al-Mughairy, A. Sleep-relatedbreathingdisorders in obesepatientspresentingwithacuterespiratoryfailure. Respir. Med.2005, 99, 718–725.
Meoli A.L., Rosen C.L., Kristo D., et. al.UpperAirway Management of theAdultPatientwithObstructiveSleepApnea in thePerioperativePeriod -AvoidingComplications; Sleep ·2004
Bailly, S.; Galerneau, L.M.; Ruckly, S.; et al. Impact of obstructivesleepapnea on theobesityparadox in criticallyillpatients. J. Crit. Care2020, 56, 120–124.
Lin, P.; Li, X.; Zhang, J.; et. al.AssociationbetweenObstructiveSleepApneaandReducedMortality in CriticallyIllPatients: A PropensityScore-Based Analysis. Int. J. Gen. Med.2021, 14, 4723–4729.
Köktürk O, Çiftçi TU. Uykuda solunum bozukluklarında yeni tanımlamalar. TuberkToraks 2002;50:527-35.
Epstein LJ, Kristo D, Strollo PJ, et. al. ClinicalGuidelineforthe Evaluation, Management, andLong-termCare of ObstructiveSleepApnea in Adults. J ClinSleepMed 2009; 5:263
Hudgel DW, Martin RJ, Johnson B, et. al. Mechanics of therespiratorysystemandbreathingduringsleep in normal humans. J ApplPhysiol 1984; 56:133.
Kay A, Trinder J, Kim Y. Individualdifferences in relationshipbetweenupperairwayresistanceandventilationduringsleep. J ApplPhysiol 1995; 79:411.
Badr MS. Pathophysiology of upperairwayobstructionduringsleep. ClinChestMed. 1998; 46: 193.
Fenik, V, Kubin, I, Okabe, S, et al. Differentialsensitivity of laryngealandphyarngealmotoneuronstoiontophoreticapplication of serotonin. Neuroscience 1997; 81:873.
Veasey SC, Panckeri KA, Hoffman EA et. al. Theeffects of serotonin antagonists in an animal model of sleep-disorderedbreathing. Am J RespirCritCareMed1996; 153:776.
White DP. Thepathogenesis of obstructivesleepapnea: advances in thepast 100 years. Am J Respir Cell Mol Biol 2006;34(1):1.
McGinley BM, Schwartz AR, Schneider H et. al. Upperairwayneuromuscularcompensationduringsleep is defective in obstructivesleepapnea. J ApplPhysiol 2008; 105(1):197.
Patil SP, Schneider H, Marx JJ et. al. Neuromechanicalcontrol of upperairwaypatencyduringsleep. J ApplPhysiol 2007;102(2):547.
Fogel RB, Trinder J, Malhotra A et. al. Within-breathcontrol of genioglossalmuscleactivation in humans: effect of sleep-wakestate. J Physiol2003; 550:899.
Mezzanotte WS, Tangel DJ, White DP. Wakinggenioglossalelectromyogram in sleepapneapatientsversus normal controls (a neuromuscularcompensatorymechanism). JClinInvest1992; 89:1571.
Martin SE, Marshall I, Douglas NJ. Theeffect of posture on airwaycaliberwiththesleep-apnea/hypopneasyndrome. Am J RespirCritCareMed1995; 152:721.
Stanchina ML, Malhotra A, Fogel RB et. al. Theinfluence of lungvolume on pharyngealmechanics, collapsibility, andgenioglossusmuscleactivationduringsleep. Sleep2003; 26:851.
Issa FG, Sullivan CE. Alcoholsnoringandsleepapnea. J NeurolNeurosurgPsych1982; 45:353.
Schwab RJ, Gupta KB, Gefter WB et. al.Upperairwayanatomy in normal andpatientswithsleepdisorderedbreathing. Significance of the lateral pharyngealwalls. Am J RespirCritCareMed1995;152:1673.
Morrison DL, Launois SH, Isono S et. al.Pharyngealnarrowingandclosingpressures in patientswithobstructivesleepapnea. AmRevRespirDis1993; 148:606.
Castronovo V, Canessa N, Strambi LF et. al.Brain activationchangesbeforeandafter PAP treatment in obstructivesleepapnea. Sleep 2009;32(9):1161.
Marshall NS, Wong KK, Liu PY et. al.Sleepapnea as an independent risk factorforall-causemortality: theBusseltonHealthStudy. Sleep2008; 31:1079.
Bixler EO, Vgontzas AN, Lin HM et. al.Prevalence of sleep-disorderedbreathing in women: effects of gender. Am J RespirCritCareMed2001; 163:608-613.
AARC-APT (AmericanAssociation of RespiratoryCare-Association of PolysomnographyTechnologists) clinicalpracticeguideline. Polysomnography. RespirCare1995; 40:1336.
Strohl KP, Redline S. Recognition of obstructivesleepapnea. Am J RespirCritCareMed1996;154(2Pt 1): 279-89.
Kanji, S.; Williamson, D.R.; Yaghchi, et. al.Epidemiologyandmanagement of atrialfibrillation in medicalandnoncardiacsurgicaladultintensivecareunitpatients. J. Crit. Care2012, 27, e321–e328.
Yoshida, T.; Fujii, T.; Uchinoet. al.M. Epidemiology, prevention, andtreatment of new-onsetatrialfibrillation in criticallyill: A systematicreview. J.IntensiveCare2015, 3, 19.
Lin, C.M.; Davidson, T.M.; Ancoli-Israel, S. Genderdifferences in obstructivesleepapneaandtreatmentimplications. SleepMed. Rev. 2008, 12, 481–496.
Traaen, G.M.; Øverland, B.; Aakerøy, L.; et al. Prevalence, risk factors, andtype of sleepapnea in patientswithparoxysmalatrialfibrillation. Int J. Cardiol. HeartVasc.2020, 26, 100447.
May, A.M.; VanWagoner, D.R.; Mehra, R. OSA andCardiacArrhythmogenesis: MechanisticInsights. Chest2017, 151, 225–241.
Dou, L.; Lan, H.; Reynolds, et. al.AssociationbetweenObstructiveSleepApneaandAcuteKidneyInjury in CriticallyIllPatients: A Propensity-MatchedStudy. Nephron2017, 135, 137–146.
Shukla, A.; Aizer, A.; Holmes, D.; et. al.Effect of ObstructiveSleepApneaTreatment on AtrialFibrillationRecurrence: A Meta-Analysis. JACC Clin. Electrophysiol.2015, 1, 41–51.
Abe, H.; Takahashi, M.; Yaegashi, et. al.Efficacyofcontinuouspositiveairwaypressure on arrhythmias in obstructivesleepapneapatients. HeartVessels2010, 25, 63–69.
Gami, A.S.; Olson, E.J.; Shen, W.Ket. al.Obstructivesleepapneaandthe risk of suddencardiacdeath: A longitudinalstudy of 10,701 adults. J. Am. Coll. Cardiol. 2013, 62, 610–616.
Mehra, R.; Benjamin, E.J.; Shahar, E.; et. al.Association of nocturnalarrhythmiaswithsleep-disorderedbreathing: TheSleepHeartHealthStudy. Am. J. Respir. Crit. CareMed.2006, 173, 910–916.
Raghuram, A.; Clay, R.; Kumbam, A.;et. al.A systematicreview of theassociationbetweenobstructivesleepapneaandventriculararrhythmias. J. Clin. SleepMed.2014, 10, 1155–1160.
Alonso-Fernández, A.; García-Río, F.; Racionero, M.A.;et. al.Cardiacrhythmdisturbancesand ST-segment depressionepisodes in patientswithobstructivesleepapnea-hypopneasyndromeanditsmechanisms. Chest2005, 127, 15–22.
Rossi, V.A.; Stradling, J.R.; Kohler, M. Effects of obstructivesleepapnoea on heartrhythm. Eur. Respir. J.2013, 41, 1439–1451
Becker, H.; Brandenburg, U.; Conradt, R.; et. al.Influence of nCPAPtherapy on bradycardicarrhythmias in sleepapnea. Pneumologie1993, 47 (Suppl. S4), 706–710.
Ryan, C.M.; Usui, K.; Floras, J.Set. al.Effect of continuouspositiveairwaypressure on ventricularectopy in heartfailurepatientswithobstructivesleepapnoea. Thorax2005, 60, 781–785.
Simantirakis, E.N.; Schiza, S.I.; Marketou, M.E.; et. al.Severe bradyarrhythmias in patientswithsleepapnoea: Theeffect of continuouspositiveairwaypressuretreatment: A long-termevaluationusing an insertablelooprecorder. Eur. Heart J.2004, 25, 1070–1076.
Bradley, T.D.; Floras, J.S. Sleepapneaandheartfailure: Part, I.I. centralsleepapnea. Circulation2003, 107, 1822–1826.
Khattak, H.K.; Hayat, F.; Pamboukian, S.V.; et. al.ObstructiveSleepApnea in HeartFailure: Review of Prevalence, TreatmentwithContinuousPositiveAirwayPressure, andPrognosis. Tex. HeartInst. J.2018, 45, 151–161.
Kaneko, Y.; Floras, J.S.; Usui, Ket. al.Cardiovasculareffects of continuouspositiveairwaypressure in patientswithheartfailureandobstructivesleepapnea. N. Engl. J. Med. 2003, 348, 1233–1241.
Parker, J.D.; Brooks, D.; Kozar, L.F.; et. al.Acuteandchroniceffects of airwayobstruction on canine leftventricularperformance. Am. J. Respir. Crit. CareMed. 1999, 160, 1888–1896.
Chiu, K.L.; Ryan, C.M.; Shiota, S.; et. al.Fluidshiftbylower body positivepressureincreasespharyngealresistance in healthysubjects. Am. J. Respir. Crit. CareMed. 2006, 174, 1378–1383.
Chenuel, B.J.; Smith, C.A.; Skatrud, J.B.; et. al.Increasedpropensityforapnea in responsetoacuteelevations in leftatrialpressureduringsleep in thedog. J. Appl. Physiol. 2006, 101, 76–83.
Chen, L.; Einbinder, E.; Zhang, Q.; et. al.Oxidativestressandleftventricularfunctionwithchronicintermittenthypoxia in rats. Am. J. Respir. Crit. CareMed. 2005, 172, 915–920.
Oldenburg, O.; Wellmann, B.; Buchholz, A.; et. al.Nocturnalhypoxaemia is associatedwithincreasedmortality in stableheartfailurepatients. Eur. Heart J.2016, 37, 1695–1703.
Otto, M.E.; Belohlavek, M.; Romero-Corral, A.; et. al.Comparison of cardiacstructuralandfunctionalchanges in obeseotherwisehealthyadultswithversuswithoutobstructivesleepapnea. Am. J. Cardiol. 2007, 99, 1298–1302.
Fletcher, E.C. Sympatheticoveractivity in theetiology of hypertension of obstructivesleepapnea. Sleep J. SleepSleepDisord. Res. 2003, 26, 15–19.
Bendjelid, K.; Schütz, N.; Suter, P.M.; et. al. Doescontinuouspositiveairwaypressurebyface mask improve patients withacutecardiogenicpulmonaryedemaduetoleftventriculardiastolicdysfunction? Chest2005, 127, 1053–1058.
Tkacova, R.; Rankin, F.; Fitzgerald, F.S.; et. al.Effects of continuouspositiveairwaypressure on obstructivesleepapneaandleftventricularafterload in patientswithheartfailure. Circulation1998, 98, 2269–2275.
Mansfield, D.R.; Gollogly, N.C.; Kaye, D.Met. al.Controlledtrial of continuouspositiveairwaypressure in obstructivesleepapneaandheartfailure. Am. J. Respir. Crit. CareMed.2004, 169, 361–366.
Gray, A.; Goodacre, S.; Newby, D.E.; et. al.NoninvasiveVentilation in AcuteCardiogenicPulmonaryEdema. N. Engl. J. Med. 2008, 359, 142–151.
Johnson, C.B.; Beanlands, R.S.; Yoshinaga, K.; et. al.Acuteandchroniceffects of continuouspositiveairwaypressuretherapy on leftventricularsystolicanddiastolicfunction in patientswithobstructivesleepapneaandcongestiveheartfailure. Can. J. Cardiol. 2008, 24, 697–704.
Cowie, M.R.;Woehrle, H.;Wegscheider, K.; et al. AdaptiveServo-Ventilationfor Central SleepApnea in SystolicHeartFailure. N. Engl. J. Med. 2015, 373, 1095–1105.
Shah, N.A.; Yaggi, H.K.; Concato, J.; et. al.Obstructivesleepapnea as a risk factorforcoronaryeventsorcardiovasculardeath. SleepBreath. 2010, 14, 131–136.
Nakashima, H.; Katayama, T.; Takagi, C.; et. al.Obstructivesleepapnoeainhibitstherecovery of leftventricularfunction in patientswithacutemyocardialinfarction. Eur. Heart J.2006, 27, 2317–2322.
Yumino, D.; Tsurumi, Y.; Takagi, A.et. al.Impact of obstructivesleepapnea on clinicalandangiographicoutcomesfollowingpercutaneouscoronaryintervention in patientswithacutecoronarysyndrome. Am. J. Cardiol.2007, 99, 26–30.
Lee, C.H.; Sethi, R.; Li, R.; et al. ObstructiveSleepApneaandCardiovascular EventsAfterPercutaneousCoronaryIntervention. Circulation2016, 133, 2008–2017.
Cepeda-Valery, B.; Acharjee, S.; Romero-Corral, A.; et. al. Obstructivesleepapneaandacutecoronarysyndromes: Etiology, risk, andmanagement. Curr. Cardiol. Rep. 2014, 16, 535.
Sánchez-de-la-Torre, M.; Sánchez-de-la-Torre, A.; Bertran, S.; et al. Effect of obstructivesleepapnoeaanditstreatmentwithcontinuouspositiveairwaypressure on theprevalence of cardiovascularevents in patientswithacutecoronarysyndrome (ISAACC study): A randomisedcontrolledtrial. Lancet Respir. Med.2020, 8, 359–367.
McEvoy, R.D.; Antic, N.A.; Heeley, E.; et al. CPAP forPrevention of CardiovascularEvents in ObstructiveSleepApnea. N. Engl. J. Med. 2016, 375, 919–931.
Quan,W.; Zheng, D.; Douglas McEvoy, R.; et al. High Risk CharacteristicsforRecurrentCardiovascularEventsamong PatientswithObstructiveSleepApnoea in the SAVE Study. EClinicalMedicine2018, 2–3, 59–65.
Lisan, Q.; Van Sloten, T.; MarquesVidal, P.; et. al.Association of PositiveAirwayPressurePrescriptionwithMortality in PatientswithObesityand Severe ObstructiveSleepApnea: TheSleepHeartHealthStudy. JAMA Otolaryngol. HeadNeck. Surg. 2019, 145, 509–515.
Seiler, A.; Camilo, M.; Korostovtseva, L.; et. al.Prevalence of sleepdisorderedbreathingafterstrokeand TIA: A meta-analysis. Neurology2019, 92, e648–e654.
Yaggi, H.K.; Concato, J.; Kernan, W.N.;et. al. Obstructivesleepapnea as a risk factorforstrokeanddeath. N. Engl. J. Med.2005, 353, 2034–2041
Lyons, O.D.; Ryan, C.M. SleepApneaandStroke. Can. J. Cardiol. 2015, 31, 918–927.
Brill, A.K.; Horvath, T.; Seiler, A.; et. al.. CPAP as treatment of sleepapneaafterstroke: A meta-analysis of randomizedtrials. Neurology2018, 90, e1222–e1230.
Chaouat, A.; Weitzenblum, E.; Krieger, J.; et. al. Pulmonaryhemodynamics in theobstructivesleepapneasyndrome. Results in 220 consecutivepatients. Chest1996, 109, 380–386.
Yamakawa, H.; Shiomi, T.; Sasanabe, R.; et. al.Pulmonaryhypertension in patientswith severe obstructivesleepapnea. PsychiatryClin. Neurosci. 2002, 56, 311–312
Kauppert, C.A.; Dvorak, I.; Kollert, F.; et. al. Pulmonaryhypertension in obesity-hypoventilationsyndrome. Respir. Med.2013, 107, 2061–2070.
Kholdani, C.; Fares, W.H.; Mohsenin, V. Pulmonaryhypertension in obstructivesleepapnea: Is it clinicallysignificant? A criticalanalysis of theassociationandpathophysiology. PulmCirc. 2015, 5, 220–227.
Yeghiazarians, Y.; Jneid, H.; Tietjens, J.R.; et. al.ObstructiveSleepApneaandCardiovascularDisease: A Scientific Statement fromtheAmericanHeartAssociation. Circulation2021, 144, e56–e67.
Wahab, A.; Chowdhury, A.; Jain, N.K.; et al. CardiovascularComplications of ObstructiveSleepApnea in theIntensiveCareUnitand Beyond. Medicina2022, 58, 1390.
Mullin, C.J.; Ventetuolo, C.E. Critical Care Management of thePatientwithPulmonaryHypertension. Clin. Chest. Med. 2021, 42, 155–165.
Lippi, G.; Mattiuzzi, C.; Franchini, M. Sleepapneaandvenousthromboembolism. A systematicreview. Thromb. Haemost. 2015, 114, 958–963.
McNicholas WT. Comorbidobstructivesleepapnoeaandchronicobstructivepulmonarydiseaseandthe risk of cardiovasculardisease. J ThoracDis 2018; 10: Suppl. 34, S4253–S4261.
Bouloukaki I, Fanaridis M, Testelmans D, et al. Overlapsbetweenobstructivesleepapnoeaandotherrespiratorydiseases, including COPD, asthmaandinterstitiallungdisease. Breathe 2022; 18: 220073 [DOI: 10.1183/20734735.0073-2022].
Shawon MS, Perret JL, Senaratna CV, et al. Currentevidence on prevalenceandclinicaloutcomes of co-morbidobstructivesleepapneaandchronicobstructivepulmonarydisease: a systematicreview. SleepMedRev 2017; 32: 58–68.
Suri TM, Suri JC. A review of therapiesfortheoverlapsyndrome of obstructivesleepapneaandchronicobstructivepulmonarydisease. FASEB Bioadv 2021; 3: 683–693
Shah AJ, Quek E, Alqahtani JS, et al. Cardiovascularoutcomes in patientswith COPD-OSA overlapsyndrome: a systematicreviewand meta-analysis. SleepMedRev 2022; 63: 101627.
Akinnusi M, El-Masri AR, Lawson Y, et al. Association of overlapsyndromewithincidentatrialfibrillation. InternEmergMed 2021; 16: 633–642.
Isono S. Obstructivesleepapnea of obeseadults: pathophysiologyandperioperativeairwaymanagement. Anesthesiology. 2009;110:908–921.
Ellard, L, Wong, DT. Preoperativeairwayevaluation. CurrAnesthesiolRep. 2020;10:19–27.
Nagappa M, Wong DT, Cozowicz C, et. al. Is obstructivesleepapneaassociatedwithdifficultairway? Evidencefrom a systematicreviewand meta-analysis of prospectiveandretrospectivecohortstudies. PLoSOne. 2018;13:e0204904.
Chung F, Yegneswaran B, Herrera F, et. al. Patientswithdifficultintubationmayneedreferraltosleepclinics. AnesthAnalg. 2008;107:915–920.
Memtsoudis SG, Cozowicz C, Nagappa M, et al. Society of AnesthesiaandSleepMedicineGuideline on intraoperativemanagement of adultpatientswithobstructivesleepapnea. AnesthAnalg. 2018;127:967–987.
Johnston KD, Rai MR. Conscioussedationforawakefibreopticintubation: a review of theliterature. Can J Anaesth. 2013;60:584–599.
Alhomary M, Ramadan E, Curran E, et. al.Videolaryngoscopy vs. fibreopticbronchoscopyforawaketrachealintubation: a systematicreviewand meta-analysis. Anaesthesia. 2018;73:1151–1161.
deRaaff CAL, Gorter-Stam MAW, de Vries N, et al. Perioperativemanagement of obstructivesleepapnea in bariatricsurgery: a consensusguideline. SurgObesRelatDis. 2017;13:1095–1109.
Apfelbaum JL, Hagberg CA, Caplan RA, et al; AmericanSociety of AnesthesiologistsTask Force on Management of theDifficultAirway. Practiceguidelinesformanagement of thedifficultairway: an updatedreportbytheAmericanSociety of AnesthesiologistsTask Force on Management of theDifficultAirway. Anesthesiology. 2013;118:251–270.
Frerk C, Mitchell VS, McNarry AF, et al; DifficultAirwaySocietyintubationguidelinesworkinggroup. DifficultAirwaySociety 2015 guidelinesformanagement of unanticipateddifficultintubation in adults. Br J Anaesth. 2015;115:827–848.
Wise SK, Wise JC, DelGaudio JM. Gastroesophagealrefluxandlaryngopharyngealreflux in patientswithsleep-disorderedbreathing. OtolaryngolHeadNeckSurg. 2006;135:253–257.
Seet E, Chung F. Management of sleepapnea in adults - functionalalgorithmsfortheperioperativeperiod: continuingprofessionaldevelopment. Can J Anaesth. 2010;57:849–864.
AmericanSociety of AnesthesiologistsTask Force on Perioperative Management of patientswithobstructivesleepapnea. Practiceguidelinesfortheperioperativemanagement of patientswithobstructivesleepapnea: an updatedreportbytheAmericanSociety of AnesthesiologistsTask Force on Perioperative Management of patientswithobstructivesleepapnea. Anesthesiology. 2014;120:268–286.
Popat M, Mitchell V, Dravid R, et. al.; DifficultAirwaySocietyExtubationGuidelinesGroup. DifficultAirwaySocietyGuidelinesforthemanagement of trachealextubation. Anaesthesia. 2012;67:318–340.
Tuomilehto HP, Seppa JM, Partinen MM et. al.Lifestyleinterventionwithweightreduction: first-linetreatment in mildobstructivesleepapnea. Am J RespirCritCareMed2009; 179:320.
Rasheid S, Banasiak M, Gallagher SF et. al..Gastric bypass is an effectivetreatmentforobstructivesleepapnea in patientswithclinicallysignificantobesity. ObesSurg2003; 13:58.
Buchwald H, Avidor Y, Braunwald E et. al..Bariatricsurgery: a systematicreviewand meta-analysis. JAMA 2004; 292:1724.
Grunstein RR, Stenlof K, Hedner JA et. al. Two yearreduction in sleepapneasymptomsandassociateddiabetesincidenceafterweightloss in severe obesity. Sleep2007; 30:703.
Ferguson KA, Cartwright R, Rogers R, et. al. Oral appliancesforsnoringandobstructivesleepapnea: a review. Sleep2006; 29:244.
Aloia MS, Arnedt JT, Stepnowsky C, et. al. Predictingtreatmentadherence in obstructivesleepapneausingprinciples of behaviorchange. J ClinSleepMed2005; 1(4):346.
McArdle N, Devereux G, Heidarnejad H et. al.Long-termuse of CPAP therapyforsleepapnea/hypopneasyndrome. Am J RespirCritCareMed 1999; 159 (4 Pt 1):1108.
Berthon-Jones M. Feasibility of a self-setting CPAP machine. Sleep1993; 16:S120.
Meurice JC, Marc I, Series F. Efficiency of auto-cpap in thetreatment of obstructivesleepapneasyndrome. Am J RespirCritCareMed1996; 153:794.
Nigro, C.A.; González, S.; Arce, A.; et. al..Accuracy of a novelauto-CPAP devicetoevaluatetheresidualapnea-hypopneaindex in patientswithobstructivesleepapnea. SleepBreath. 2015, 19, 569–578.
Senn, O.; Brack, T.; Matthews, F.; et. al. RandomizedShort-term Trial of Two AutoCPAPDevicesversusFixedContinuousPositiveAirwayPressurefortheTreatment of SleepApnea. Am. J. Respir. Crit. CareMed. 2003, 168, 1506–1511.
Bloch, K.E.; Huber, F.; Furian, M.; et. al.Nussbaumer-Ochsner, Y.; Senn, O.; Russi, E.W.; Kohler, M.; Schoch, O.D.; et al. Autoadjustedversusfixed CPAP forobstructivesleepapnoea: A multicentre, randomisedequivalencetrial. Thorax 2018, 73, 174–184.
Rosen, C.L.; Auckley, D.; Benca, R.; et. al.A MultisiteRandomized Trial of PortableSleepStudiesandPositiveAirwayPressureAutotitrationVersusLaboratory-BasedPolysomnographyfortheDiagnosisandTreatment of ObstructiveSleepApnea: TheHomePAPStudy. Sleep 2012, 35, 757–767.
Konikkara, J.; Tavella, R.; Willes, L.; et. al. S. Earlyrecognition of obstructivesleepapnea in patientshospitalizedwith COPD exacerbation is associatedwithreducedreadmission. Hosp. Pract. 2016, 44, 41–47
Engleman HM, Kingshott RN, Wraith PK et. al. Randomizedplacebo-controlledcrossovertrial of continuouspositiveairwaypressureformildsleepApnea/Hypopneasyndrome. Am J RespirCritCareMed 1999; 159(2):461.
Bennett LS, Barbour C, Langford B, et. al. Healthstatus in obstructivesleepapnea: relationshipwithsleepfragmentationanddaytinesleepiness, andeffects of continuouspositiveairwaypressuretreatment. Am J RespirCritCareMed 1999;159(6):1884.
Bahammam A, Delaive K, Ronald J et. al. Healthcareutilization in maleswithobstructivesleepapneasyndrome two yearsafterdiagnosisandtreatment. Sleep 1999;22(6):740.
Faccenda JF, Mackay TW, Boon NA, et. al.Randomizedplacebo-controlledtrial of continuouspositiveairwaypressure on bloodpressure in thesleepapnea-hypopneasyndrome. Am J RespirCritCareMed 2001;163(2):344.
Pepperell JC, Ramdassingh-Dow S, Crosthwaite N et. al. Ambulatorybloodpressure after therapeutic and subtherapeuticnasalcontinuouspositiveairwaypressureforobstructivesleepapnoea: a randomisedparalleltrial. Lancet 2002;359(9302):204.
Becker HF, Jerrentrup A, Ploch T et. al. Effect of nasalcontinuouspositiveairwaypressuretreatment on bloodpressure in patientswithobstructivesleepapnea. Circulation 2003;107(1):68.
Marin JM, Carrizo SJ, Vicente E, et. al. Long-termcardiovascularoutcomes in men withobstructivesleepapnoea-hypopnoeawithorwithouttreatmentwithcontinuouspositiveairwaypressure: an observationalstudy. Lancet 2005; 365(9464):1046.
Martinez-Garcia MA, Soler-Cataluna JJ, Ejarque-Martinez L et. al. Continuouspositiveairwaypressuretreatmentreducesmortality in patientswithischemicstrokeandobstructivesleepapnea: a 5-year follow-upstudy. Am J RespirCritCareMed 2009; 180(1):36.
Kazimierczak A, Krezesinski P, Kryzanowski K, et. al. Sleepdisorderedbreathing in patientswithheartfailure: newtrends in therapy. BiomedResInt. 2013:ID459613.
Roca, O.; Riera, J.; Torres, F.; et. al. High-flowoxygentherapy in acuterespiratoryfailure. RespirCare 2010, 55, 408–413.
Frat, J.P.; Thille, A.W.; Mercat, A.; et al. High-flowoxygenthroughnasalcannula in acutehypoxemicrespiratoryfailure. N. Engl. J. Med. 2015, 372, 2185–2196.
McGinley, B.M.; Patil, S.P.; Kirkness, J.Pet. al. A NasalCannula Can Be UsedtoTreatObstructiveSleepApnea. Am. J. Respir. Crit. CareMed. 2007, 176, 194–200.
Ho, C.-H.; Chen, C.-L.; Yu, C.-C.; et. al.High-flownasalcannulaventilationtherapyforobstructivesleepapnea in ischemicstrokepatientsrequiringnasogastrictubefeeding: A preliminarystudy. Sci. Rep. 2020, 10, 8524.
Gobindram, A.; Singh, P.A.; Quek, K.H. Postoperativeuse of highflownasalinsufflationforobstructivesleepapnea. Korean J. Anesthesiol. 2019, 72, 610–613.
Sakaguchi, Y.; Nozaki-Taguchi, N.; Hasegawa, M.; et. al. Combination Therapy of High-flowNasalCannulaandUpper-body ElevationforPostoperativeSleep-disorderedBreathing: RandomizedCrossover Trial. Anesthesiology 2022, 137, 15–27.
Momomura SI. Treatment of Cheyne-Stokesrespiration-centralsleepapnea in patientswithheartfailure. J Cardiol. 2012;59:110-6.
Shin-ichi M. Treatment of Cheyne-Stokesrespiration-centralsleepapnea in patientswithheartfailure. J Cardiol.2012;59:110-6.
Teschler H, Dohring J, Wang YM, et. al.M. Adaptivepressuresupportservo-ventilation: a noveltreatmentforCheyne-Stokesrespiration in heartfailure. Am J RespirCritCareMed. 2001;164:614-9.
Sharma BK, Bakker JP, McSharry DG, et. al.Adaptiveservoventilationfortreatment of sleepdisorderedbreathing in heartfailure: a systematicreviewand meta-analysis. Chest. 2012;142:1211-21.
Storre JH, Seuthe B, Fietcher R, et al. Averagevolume-assuredpressuresupport in obesityhypoventilation. Chest. 2006;130:815-21.
Li KK. Surgicaltherapyforadultobstructivesleepapnea. SleepMedRev2005;9:201.
Sher AE. Upperairwaysurgeryforobstructivesleepapnea. SleepMedRev Jun 2002;6(3):195.
Baguet J-P, Barone-Rochette G, Tamisier R, et al. Mechanisms of cardiacdysfunction in obstructivesleepapnea. NatRevCardiol2012;9:679–88.
Alexopoulou C, Bolaki M, Akoumianaki E, et al. Sleepquality in survivors of criticalillness. SleepBreath2019;23:463–71.
Javaheri S, Barbe F, Campos-Rodriguez F, et al. Sleepapnea: types, mechanisms, andclinicalcardiovascularconsequences. J AmCollCardiol2017;69:841–58.
Fonseca MIP, Pereira T, Caseiro P. Deathanddisability in patientswithsleepapnea--a meta-analysis. ArqBrasCardiol2015;104:58–66.
Wang H, Shao G, Rong L, et al. Associationbetweencomorbidsleepapnoea–hypopnoeasyndromeandprognosis of intensivecarepatients: a retrospectivecohortstudy. BMJ Open 2021;11:e048886. doi:10.1136/ bmjopen-2021-048886
Pépin JL, Timsit JF, Tamisier R, et al. Preventionandcare of respiratoryfailure in obesepatients. Lancet RespirMed2016;4:407–18.
Garrouste-Orgeas M, Troché G, Azoulay E, et al. Body massindex. anadditionalprognosticfactor in ICU patients. IntensiveCareMed2004;30:437–43.
Tremblay A, Bandi V. Impact of body massindex on outcomesfollowingcriticalcare. Chest2003;123:1202–7.
Floras JS, Apnea S. Sleepapneaandcardiovasculardisease: an enigmatic risk factor. CircRes2018;122:1741–6
