Search

Background Sleep apnea syndrome has gained significant recognition over the last decade as a potential cause of substantial childhood morbidity. This study aimed to evaluate the impact of the Apnea Hypopnea Index (AHI), Respiratory Distress Index (RDI), and Oxygen Desaturation Index (ODI) among adolescents with sleep apnea syndrome. Objectives The objective of this study is to compare the impact of Nadi Shuddhi Pranayama with routine treatment modalities on the AHI, RDI, and ODI among adolescents with sleep apnea syndrome. Specifically, the study aims to evaluate the effectiveness of Nadi Shuddhi Pranayama in improving AHI, RDI, and ODI in this population. Methods This study was an interventional case-control study and enrolled 34 adolescents aged 10 to 18 years who were diagnosed with sleep apnea syndrome. The participants were divided into two groups: the Nadi Shuddhi Pranayama group (n=17) and the control group (n=17). Baseline assessments included the collection of demographic information, medical history, and polysomnography results to determine the AHI, RDI, and ODI. Follow-up assessments were conducted post-intervention to measure changes in the AHI, RDI, and ODI. Results There were no significant differences between groups in terms of age (p = 0.176) or gender distribution (p = 0.300). After the intervention period, participants in the Nadi Shuddhi Pranayama group showed significant improvements in the Apnea Hypopnea Index compared to the standard care group (p = 0.007). However, there were no significant differences in the Respiratory Distress Index (p = 0.547) or Oxygen Desaturation Index (p = 0.304) between the groups post-intervention. Subgroup analysis based on severity categories (Mild, Normal) for the Apnea Hypopnea Index showed a significant difference between the Nadi Shuddhi Pranayama and standard care groups (p = 0.037). However, there were no significant differences in the Respiratory Distress Index (p = 0.300) and Oxygen Desaturation Index (p = 0.169) between the groups in this subgroup. Conclusion These findings suggest that Nadi Shuddhi Pranayama may improve the Apnea Hypopnea Index in adolescents with sleep apnea, particularly in those with mild symptoms, but did not significantly affect the Respiratory Distress Index or Oxygen Desaturation Index., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Institutional Ethics Committee issued approval 133/06/2023/IEC/SMCH. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Yelkur et al.)

Background Myofunctional therapy has shown promise in addressing sleep-disordered breathing. This study aimed to investigate the efficacy of myofascial exercise and voluntary breathing techniques in reducing the apnea-hypopnea index (AHI) among adolescents. Methodology In this randomized controlled study, adolescents aged 13-18 with sleep-disordered breathing were randomly assigned to one of three groups (n=40 per group): myofascial exercise, voluntary breathing techniques, and a standard care control group. Baseline assessments, including the AHI and sleep quality, were conducted before the interventions. A polysomnography (PSG) sleep study was performed in a sleep laboratory, with recordings conducted over six to eight hours during the night to calculate the AHI. The myofascial exercise and voluntary breathing technique groups received their respective interventions, while the control group received standard care. Post-intervention assessments were conducted to measure changes in AHI and other outcomes. Results The study found no significant differences in age, BMI, and gender among the three groups. However, significant differences were observed in AHI and sleep quality measures. The control group's AHI was 8.72 ± 1.78, whereas the myofascial exercise group (4.82 ± 1.42) and the voluntary breathing group (6.81 ± 1.83) exhibited more substantial reductions (p < 0.001). Similarly, while baseline sleep quality scores did not differ, significant improvements were observed in all groups post-intervention, with more substantial enhancements in the myofascial exercise (4.38 ± 1.19) and voluntary breathing (7.23 ± 1.76) groups. The analysis of baseline AHI categories revealed no significant differences, but at follow-up, significant variations emerged among the groups, indicating greater reductions in AHI categories in the myofascial exercise and voluntary breathing groups compared to the control group. Conclusion These findings indicate that incorporating myofascial exercises or voluntary breathing techniques into treatment plans for adolescents with sleep-disordered breathing can result in significant improvements in AHI and overall sleep quality., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Institutional Ethics Committee of Saveetha Medical College and Hospital issued approval 133/06/2023/IEC/SMCH. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Yelkur et al.)

Insulin and insulin-like growth factor 1 (IGF1) signaling is transduced by insulin receptor substrate 1 (IRS1) and IRS2. To elucidate physiological and redundant roles of insulin and IGF1 signaling in adult hearts, we generated mice with inducible cardiomyocyte-specific deletion of insulin and IGF1 receptors or IRS1 and IRS2. Both models developed dilated cardiomyopathy, and most mice died by 8 weeks post-gene deletion. Heart failure was characterized by cardiomyocyte loss and disarray, increased proapoptotic signaling, and increased autophagy. Suppression of autophagy by activating mTOR signaling did not prevent heart failure. Transcriptional profiling revealed reduced serum response factor (SRF) transcriptional activity and decreased mRNA levels of genes encoding sarcomere and gap junction proteins as early as 3 days post-gene deletion, in concert with ultrastructural evidence of sarcomere disruption and intercalated discs within 1 week after gene deletion. These data confirm conserved roles for constitutive insulin and IGF1 signaling in suppressing autophagic and apoptotic signaling in the adult heart. The present study also identifies an unexpected role for insulin and IGF1 signaling in regulating an SRF-mediated transcriptional program, which maintains expression of genes encoding proteins that support sarcomere integrity in the adult heart, reduction of which results in rapid development of heart failure.