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1. Noncontact Detection of Sleep Apnea Using Radar and Expectation-Maximization Algorithm

Author

Koda, Takato, Okumura, Shigeaki, Taki, Hirofumi, Hamada, Satoshi, Sunadome, Hironobu, Sato, Susumu, Chin, Kazuo, and Sakamoto, Takuya

Subjects
Electrical Engineering and Systems Science - Signal Processing
Abstract

Sleep apnea syndrome requires early diagnosis because this syndrome can lead to a variety of health problems. If sleep apnea events can be detected in a noncontact manner using radar, we can then avoid the discomfort caused by the contact-type sensors that are used in conventional polysomnography. This study proposes a novel radar-based method for accurate detection of sleep apnea events. The proposed method uses the expectation-maximization algorithm to extract the respiratory features that form normal and abnormal breathing patterns, resulting in an adaptive apnea detection capability without any requirement for empirical parameters. We conducted an experimental quantitative evaluation of the proposed method by performing polysomnography and radar measurements simultaneously in five patients with the symptoms of sleep apnea syndrome. Through these experiments, we show that the proposed method can detect the number of apnea and hypopnea events per hour with an error of 4.8 times/hour; this represents an improvement in the accuracy by 1.8 times when compared with the conventional threshold-based method and demonstrates the effectiveness of our proposed method., Comment: 8 pages, 12 figures, 3 tables. This work is going to be submitted to the IEEE for possible publication

Published
2023

4. Hyperfructosemia in sleep disordered breathing: metabolome analysis of Nagahama study

Author

Nakatsuka, Yoshinari, Murase, Kimihiko, Sonomura, Kazuhiro, Tabara, Yasuharu, Nagasaki, Tadao, Hamada, Satoshi, Matsumoto, Takeshi, Minami, Takuma, Kanai, Osamu, Takeyama, Hirofumi, Sunadome, Hironobu, Takahashi, Naomi, Nakamoto, Isuzu, Tanizawa, Kiminobu, Handa, Tomohiro, Sato, Taka-Aki, Komenami, Naoko, Wakamura, Tomoko, Morita, Satoshi, Takeuchi, Osamu, Nakayama, Takeo, Hirai, Toyohiro, Kamatani, Yoichiro, Matsuda, Fumihiko, and Chin, Kazuo

Published
2023
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7. Acetazolamide for OSA and Central Sleep Apnea A Comprehensive Systematic Review and Meta-Analysis

Author

Schmickl, Christopher N, Landry, Shane A, Orr, Jeremy E, Chin, Kazuo, Murase, Kimihiko, Verbraecken, Johan, Javaheri, Shahrokh, Edwards, Bradley A, Owens, Robert L, and Malhotra, Atul

Subjects
Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Lung, Sleep Research, Acetazolamide, Carbonic Anhydrase Inhibitors, Humans, Sleep Apnea, Central, Sleep Apnea, Obstructive, Treatment Outcome, acetazolamide, apnea-hypopnea index, sleep apnea, Clinical Sciences, Respiratory System, Cardiovascular medicine and haematology, Clinical sciences
Abstract

BackgroundTherapy options for OSA and central sleep apnea (CSA) are limited, thus many patients remain untreated. Clinically, acetazolamide is sometimes used for CSA; however, given overlapping pathophysiologic properties of OSA and CSA, we hypothesized that acetazolamide is equally effective for both types. Prior reviews focused on specific subtypes of sleep apnea, study designs, and languages, thus including few studies (typically ≤3) limiting insights.Research questionHow efficacious is acetazolamide for sleep apnea, and is its effect modified by sleep apnea type or acetazolamide dose?Study design and methodsWe queried MEDLINE, EMBASE, and ClinicalTrials.gov from inception until March 11, 2019. Any study in which adults with OSA/CSA received oral acetazolamide vs no acetazolamide (control) that reported sleep apnea-related outcomes was eligible, independent of study design or language. Two reviewers independently assessed eligibility and abstracted data. Primary outcomes were apnea-hypopnea index (AHI) and oxygen saturation nadir. Quality of evidence (QoE) was rated with the use of Grades of Recommendation Assessment, Development and Evaluation methods.ResultsWe included 28 studies (13 OSA/15 CSA; NSubjects,Acetazolamide = 542; NSubjects,Control = 553) that enabled meta-analyses for 24 outcomes. Acetazolamide doses ranged from 36 to 1000 mg/d and treatment duration from 1 to 90 d (median, 6 d). Overall, acetazolamide vs control lowered the AHI by -0.7 effect sizes (95% CI, -0.83 to -0.58; I2 = 0%; moderate QoE) that corresponded to a reduction of 37.7% (95% CI, -44.7 to -31.3) or 13.8/h (95% CI, -16.3 to -11.4; AHIControl = 36.5/h). The AHI reduction was similar in OSA vs CSA, but significantly greater with higher doses (at least up to 500 mg/d). Furthermore, acetazolamide improved oxygen saturation nadir by +4.4% (95% CI, 2.3 to 6.5; I2 = 63%; no evidence of effect modification; very low QoE) and several secondary outcomes that included sleep quality measures and BP (mostly low QoE).InterpretationShort-term acetazolamide improved both OSA and CSA. Rigorous studies with long-term follow up are warranted to assess Acetazolamide's value for the chronic treatment of patients with sleep apnea.Clinical trial registrationPROSPERO (CRD42019147504).

Published
2020

11. Sleep Apnea Syndrome (SAS) Clinical Practice Guidelines 2020

Author

Akashiba, Tsuneto, Inoue, Yuichi, Uchimura, Naohisa, Ohi, Motoharu, Kasai, Takatoshi, Kawana, Fusae, Sakurai, Shigeru, Takegami, Misa, Tachikawa, Ryo, Tanigawa, Takeshi, Chiba, Shintaro, Chin, Kazuo, Tsuiki, Satoru, Tonogi, Morio, Nakamura, Hiroshi, Nakayama, Takeo, Narui, Koji, Yagi, Tomoko, Yamauchi, Motoo, Yamashiro, Yoshihiro, Yoshida, Masahiro, Oga, Toru, Tomita, Yasuhiro, Hamada, Satoshi, Murase, Kimihiko, Mori, Hiroyuki, Wada, Hiroo, Uchiyama, Makoto, Ogawa, Hiromasa, Sato, Kazumichi, Nakata, Seiichi, Mishima, Kazuo, and Momomura, Shin-Ichi

Published
2022
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12. Aquaporin-3 potentiates allergic airway inflammation in ovalbumin-induced murine asthma.

Author

Ikezoe, Kohei, Oga, Toru, Honda, Tetsuya, Hara-Chikuma, Mariko, Ma, Xiaojun, Tsuruyama, Tatsuaki, Uno, Kazuko, Fuchikami, Jun-Ichi, Tanizawa, Kiminobu, Handa, Tomohiro, Taguchi, Yoshio, Verkman, Alan S, Narumiya, Shuh, Mishima, Michiaki, and Chin, Kazuo

Subjects
Lymph Nodes, Spleen, CD4-Positive T-Lymphocytes, Macrophages, Alveolar, Bronchoalveolar Lavage Fluid, Animals, Mice, Inbred C57BL, Asthma, Pneumonia, Hypersensitivity, Hydrogen Peroxide, Ovalbumin, RNA, Messenger, Chemokines, Cell Count, Cell Membrane Permeability, Gene Expression Regulation, Aquaporin 3, Macrophages, Alveolar, Mice, Inbred C57BL, RNA, Messenger
Abstract

Oxidative stress plays a pivotal role in the pathogenesis of asthma. Aquaporin-3 (AQP3) is a small transmembrane water/glycerol channel that may facilitate the membrane uptake of hydrogen peroxide (H2O2). Here we report that AQP3 potentiates ovalbumin (OVA)-induced murine asthma by mediating both chemokine production from alveolar macrophages and T cell trafficking. AQP3 deficient (AQP3(-/-)) mice exhibited significantly reduced airway inflammation compared to wild-type mice. Adoptive transfer experiments showed reduced airway eosinophilic inflammation in mice receiving OVA-sensitized splenocytes from AQP3(-/-) mice compared with wild-type mice after OVA challenge, consistently with fewer CD4(+) T cells from AQP3(-/-) mice migrating to the lung than from wild-type mice. Additionally, in vivo and vitro experiments indicated that AQP3 induced the production of some chemokines such as CCL24 and CCL22 through regulating the amount of cellular H2O2 in M2 polarized alveolar macrophages. These results imply a critical role of AQP3 in asthma, and AQP3 may be a novel therapeutic target.

Published
2016

15. Cutaneous T-cell-attracting chemokine as a novel biomarker for predicting prognosis of idiopathic pulmonary fibrosis: a prospective observational study

Author

Niwamoto, Takafumi, Handa, Tomohiro, Murase, Yuko, Nakatsuka, Yoshinari, Tanizawa, Kiminobu, Taguchi, Yoshio, Tomioka, Hiromi, Tomii, Keisuke, Kita, Hideo, Uyama, Michihiro, Tsuchiya, Michiko, Emura, Masahito, Kawamura, Tetsuji, Arai, Naoki, Arita, Machiko, Uno, Kazuko, Yoshizawa, Akihiko, Uozumi, Ryuji, Yamaguchi, Izumi, Matsuda, Fumihiko, Chin, Kazuo, and Hirai, Toyohiro

Published
2021
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19. Increased blood eosinophils and airflow obstruction as new-onset asthma predictors in the elderly: The Nagahama study

Author

Nishi, Kenta, primary, Nagasaki, Tadao, additional, Matsumoto, Hisako, additional, Oguma, Tsuyoshi, additional, Terada, Satoru, additional, Nomura, Natsuko, additional, Kogo, Mariko, additional, Tashima, Noriyuki, additional, Sunadome, Hironobu, additional, Murase, Kimihiko, additional, Matsumoto, Takeshi, additional, Kawaguchi, Takahisa, additional, Tabara, Yasuharu, additional, Matsuda, Fumihiko, additional, Sato, Susumu, additional, Chin, Kazuo, additional, and Hirai, Toyohiro, additional

Published
2023
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20. Associations between Sleep-Disordered Breathing and Serum Uric Acid and Their Sex Differences: The Nagahama Study

Author

Sunadome, Hironobu, primary, Murase, Kimihiko, additional, Tabara, Yasuharu, additional, Matsumoto, Takeshi, additional, Minami, Takuma, additional, Kanai, Osamu, additional, Nagasaki, Tadao, additional, Takahashi, Naomi, additional, Hamada, Satoshi, additional, Tanizawa, Kiminobu, additional, Togawa, Jumpei, additional, Uiji, Sayaka, additional, Wakamura, Tomoko, additional, Komenami, Naoko, additional, Setoh, Kazuya, additional, Kawaguchi, Takahisa, additional, Morita, Satoshi, additional, Takahashi, Yoshimitsu, additional, Nakayama, Takeo, additional, Hirai, Toyohiro, additional, Sato, Susumu, additional, Matsuda, Fumihiko, additional, and Chin, Kazuo, additional

Published
2023
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21. The long-term outcome of interstitial lung disease with anti-aminoacyl-tRNA synthetase antibodies

Author

Tanizawa, Kiminobu, Handa, Tomohiro, Nakashima, Ran, Kubo, Takeshi, Hosono, Yuji, Watanabe, Kizuku, Aihara, Kensaku, Ikezoe, Kohei, Sokai, Akihiko, Nakatsuka, Yoshinari, Taguchi, Yoshio, Hatta, Kazuhiro, Noma, Satoshi, Kobashi, Yoichiro, Yoshizawa, Akihiko, Oga, Toru, Hirai, Toyohiro, Chin, Kazuo, Nagai, Sonoko, Izumi, Takateru, Mimori, Tsuneyo, and Mishima, Michiaki

Published
2017
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25. Evaluation of elevated plasma fatty acids as relevant factors for adult-onset asthma: The Nagahama Study

Author

Tashima, Noriyuki, primary, Matsumoto, Hisako, additional, Nishi, Kenta, additional, Terada, Satoru, additional, Kogo, Mariko, additional, Nomura, Natsuko, additional, Morimoto, Chie, additional, Sunadome, Hironobu, additional, Nagasaki, Tadao, additional, Oguma, Tsuyoshi, additional, Nakatsuka, Yoshinari, additional, Murase, Kimihiko, additional, Kawaguchi, Takahisa, additional, Tabara, Yasuharu, additional, Chin, Kazuo, additional, Sonomura, Kazuhiro, additional, Matsuda, Fumihiko, additional, and Hirai, Toyohiro, additional

Published
2023
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29. Clinical significance of radiological pleuroparenchymal fibroelastosis pattern in interstitial lung disease patients registered for lung transplantation: a retrospective cohort study

Author

Tanizawa, Kiminobu, Handa, Tomohiro, Kubo, Takeshi, Chen-Yoshikawa, Toyofumi F., Aoyama, Akihiro, Motoyama, Hideki, Hijiya, Kyoko, Yoshizawa, Akihiko, Oshima, Yohei, Ikezoe, Kohei, Tokuda, Shinsaku, Nakatsuka, Yoshinari, Murase, Yuko, Nagai, Sonoko, Muro, Shigeo, Oga, Toru, Chin, Kazuo, Hirai, Toyohiro, and Date, Hiroshi

Published
2018
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33. Evaluation of respiratory rate monitoring performance using a home oxygen monitoring device among patients with interstitial lung disease and chronic obstructive pulmonary disease

Author

30805817, 20639140, 30706677, 60362480, Hamada, Satoshi, Handa, Tomohiro, Tanabe, Naoya, Sato, Susumu, Tanizawa, Kiminobu, Sato, Atsuyasu, Morita, Satoshi, Chin, Kazuo, Hirai, Toyohiro, 30805817, 20639140, 30706677, 60362480, Hamada, Satoshi, Handa, Tomohiro, Tanabe, Naoya, Sato, Susumu, Tanizawa, Kiminobu, Sato, Atsuyasu, Morita, Satoshi, Chin, Kazuo, and Hirai, Toyohiro

Abstract

Background: Home monitoring devices have been developed to measure adherence to home oxygen therapy. In this study, we evaluated the performance of TeleOx®, a commercially available remote monitoring device, in comparison with polysomnography (PSG) in patients with interstitial lung disease (ILD) and chronic obstructive pulmonary disease (COPD) and the factors that affected TeleOx® correct use. Methods: TeleOx® was connected on the patient or concentrator side. The oxygen flow rates were set at 1, 3, and 5 L/min. Intraclass correlation coefficient (ICC) (2, 1) was used to determine the agreement between respiratory rate measured using TeleOx® and that measured using PSG, and the minimum acceptable level of reliability was >0.7. Results: In total, 22 patients (16 with ILD and 6 with COPD) were assessed. In patients with ILD, the detection rate of patients’ respiration assessed using TeleOx® did not change according to the device’s position. It increased from 53.5% to 79.0% by changing the position from the concentrator to the patient side in patients with COPD. The ICC (2, 1) value indicated that TeleOx® had acceptable reliability at oxygen flow rates of 1 and 3 L/min regardless of the device’s position in patients with ILD (the concentrator side: 0.9 and 0.82, respectively; the patient side: 0.95 and 0.82, respectively), whereas that did only at the oxygen flow rate of 1 L/min and in connecting TeleOx® on the patient side in patients with COPD (0.73). Conclusion: The monitoring performance of TeleOx® differed according to its position, oxygen flow rates, and patients’ diseases.

Published
2022

34. Identification of Respiratory Sounds Collected from Microphones Embedded in Mobile Phones

Author

60856384, 00378639, 40360698, Fukuyama, Keita, Sugiyama, Osamu, Chin, Kazuo, Satou, Susumu, Matsumoto, Shigemi, Muto, Manabu, 60856384, 00378639, 40360698, Fukuyama, Keita, Sugiyama, Osamu, Chin, Kazuo, Satou, Susumu, Matsumoto, Shigemi, and Muto, Manabu

Abstract

Sudden deterioration of condition in patients with various diseases, such as cardiopulmonary arrest, may result in poor outcome even after resuscitation. Early detection of deterioration is important in medical and long-term care settings, regardless of the acute or chronic phase of disease. Early detection and appropriate interventions are essential before resuscitating measures are required. Among the vital signs that indicate the general condition of a patient, respiratory rate has a greater ability to predict serious events such as thromboembolism and sepsis than heart rate and blood pressure, even in early stages. Despite its importance, however, respiratory rate is frequently overlooked and not measured, making it a neglected vital sign. To facilitate the measurement of respiratory rate, a non-invasive method of detecting respiratory sounds was developed based on deep learning technology, using a built-in microphone in a smartphone. Smartphones attached to the bed headboards of 20 participants undergoing polysomnography (PSG) at Kyoto University Hospital recorded respiratory sounds. Sound data were synchronized with overnight respiratory information. After excluding periods of abnormal breathing on the PSG report, sound data were processed for each 1-minute period. Expiration sound was determined using the pressure flow sensor signal on PSG. Finally, a model to identify the expiration section from the sound information was created using a deep learning algorithm from the convolutional Long Short Term Memory network. The accuracy of the learning model in identifying the expiratory section was 0.791, indicating that respiratory rate can be determined using the microphone in a smartphone. By collecting data from more patients and improving the accuracy of this method, respiratory rates could be more easily monitored in all situations, both inside and outside the hospital.

Published
2022

40. Low Levels of PaO₂ after Long-term Noninvasive Ventilation are a Poor Prognostic Factor in Patients with Restrictive Thoracic Disease

Author

Chihara, Yuichi, Tsuboi, Tomomasa, Sumi, Kensuke, Sato, Atsuo, Oga, Toru, and Chin, Kazuo

Subjects
noninvasive ventilation, oxygen therapy, chronic respiratory failure, restrictive thoracic disease
Abstract

Objective: The effects of partial pressure of arterial oxygen (PaO₂) after introducing long-term noninvasive ventilation (NIV) on the prognosis of patients with restrictive thoracic disease and chronic respiratory failure are not exactly known. Methods: Data from 141 patients with restrictive thoracic disease under long-term nocturnal NIV were retrospectively examined. We divided the patients into 2 groups according to the daytime PaO₂ value while breathing spontaneously with prescribed oxygen at 12 months after introducing NIV: PaO₂≥80 Torr group (n=76) and PaO₂

Published
2019

42. Prostaglandin [F.sup.2α] receptor signaling facilitates bleomycin-induced pulmonary fibrosis independently of transforming growth factor-β

Author

Oga, Toru, Matsuoka, Toshiyuki, Yao, Chengcan, Nonomura, Kimiko, Kitaoka, Shiho, Sakata, Daiji, Kita, Yoshihiro, Tanizawa, Kiminobu, Taguchi, Yoshio, Chin, Kazuo, Mishima, Michiaki, Shimizu, Takao, and Narumiya, Shuh

Subjects
Pulmonary fibrosis -- Care and treatment -- Research, Hormone receptors -- Health aspects -- Research, Transforming growth factors -- Health aspects -- Research, Immunosuppression -- Health aspects -- Research, Biological sciences, Health
Abstract

Idiopathic pulmonary fibrosis (IPF) is a progressive disease characterized by fibroblast proliferation and excess deposition of collagen and other extracellular matrix (ECM) proteins, which lead to distorted lung architecture and function (1). Given that anti-inflammatory or immunosuppressive therapy currently used for IPF does not improve disease progression therapies targeted to blocking the mechanisms of fibrogenesis are needed (1). Although transforming growth factor-β. (TGF-β) functions are crucial in fibrosis (2,3), antagonizing this pathway in bleomycin-induced pulmonary fibrosis, an animal model of IPF, does not prevent fibrosis completely (4-7), indicating an additional pathway also has a key role in fibrogenesis. Given that the loss of cytosolic phospholipase [A.sub.2] [(cPLA.sub.2)] suppresses bleomycin-induced pulmonary fibrosis (8), we examined the roles of prostaglandins using mice lacking each prostoaglandin receptor (9-15). Here we show that loss of prostaglandin F (PGF) receptor (FP) selectively attenuates pulmonary fibrosis while maintaining similar levels of alveolar inflammation and TGF-β. stimulation as compared to wild-type (WT) mice, and that FP deficiency and inhibition of TGF-β. signaling additively decrease fibrosis. Furthermore, [PGF.sub.2α] is abundant in bronchoalveolar lavage fluid (BALF) of subjects with IPF and stimulates proliferation and collagen production of lung fibroblasts via FP, independently of TGF-β These findings show that [PGF.sub.2α]-FP signaling facilitates pulmonary fibrosis independently of TGF-β and suggests this signaling pathway as a therapeutic target for IPF., [cPLA.sub.2] cleaves phospholipids in response to stimuli and releases arachidonic acid, which is metabolized by cyclooxygenase (COX) to produce prostaglandins and by 5-lipoxygenase to produce leukotrienes. Prostaglandins, including [PGD.sub.2], [PGE.sub.2], [...]

Published
2009
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43. Additional file 1 of Patient-reported dyspnea and health predict waitlist mortality in patients waiting for lung transplantation in Japan

Author

Ikeda, Masaki, Oga, Toru, Toyofumi F. Chen-Yoshikawa, Tokuno, Junko, Oto, Takahiro, Okawa, Tomoyo, Okada, Yoshinori, Akiba, Miki, Satona Tanaka, Yamada, Yoshito, Yojiro Yutaka, Ohsumi, Akihiro, Nakajima, Daisuke, Masatsugu Hamaji, Isomi, Maki, Chin, Kazuo, and Date, Hiroshi

Subjects
respiratory system
Abstract

Additional file 1: Table S1. Multivariable Fine–Gray proportional hazards analysis of the relationship between patient-reported outcomes and mortality in waitlisted patients, excluding those who underwent living-donor lung lobar transplantation after registration.

Published
2021
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44. Additional file 1 of Cutaneous T-cell-attracting chemokine as a novel biomarker for predicting prognosis of idiopathic pulmonary fibrosis: a prospective observational study

Author

Niwamoto, Takafumi, Handa, Tomohiro, Murase, Yuko, Nakatsuka, Yoshinari, Tanizawa, Kiminobu, Taguchi, Yoshio, Tomioka, Hiromi, Tomii, Keisuke, Kita, Hideo, Uyama, Michihiro, Tsuchiya, Michiko, Emura, Masahito, Kawamura, Tetsuji, Arai, Naoki, Arita, Machiko, Uno, Kazuko, Yoshizawa, Akihiko, Uozumi, Ryuji, Yamaguchi, Izumi, Matsuda, Fumihiko, Chin, Kazuo, and Hirai, Toyohiro

Subjects
respiratory system, respiratory tract diseases
Abstract

Additional file 1: Table S1. Results of 48-plex measurement in the sera of IPF patients (discovery cohort) and controls and the bronchoalveolar lavage fluid of IPF patients. Measurements (median and IQR) of 48 cytokines in the discovery cohort sera (n = 100) and the control group sera (n = 32), p-values for between-group comparisons, and the measurements of BALF in the discovery cohort (n = 30).

Published
2021
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45. Additional file 3 of Patient-reported dyspnea and health predict waitlist mortality in patients waiting for lung transplantation in Japan

Author

Ikeda, Masaki, Oga, Toru, Toyofumi F. Chen-Yoshikawa, Tokuno, Junko, Oto, Takahiro, Okawa, Tomoyo, Okada, Yoshinori, Akiba, Miki, Satona Tanaka, Yamada, Yoshito, Yojiro Yutaka, Ohsumi, Akihiro, Nakajima, Daisuke, Masatsugu Hamaji, Isomi, Maki, Chin, Kazuo, and Date, Hiroshi

Abstract

Additional file 3: Table S2. Multivariable Fine–Gray proportional hazards analysis of the relationship of LAS and patient-reported outcomes with mortality in patients waiting for lung transplantation.

Published
2021
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46. Impacts of lipid-related metabolites, adiposity, and genetic background on blood eosinophil counts: the Nagahama study

Author

Nishi, Kenta, primary, Matsumoto, Hisako, additional, Tashima, Noriyuki, additional, Terada, Satoru, additional, Nomura, Natsuko, additional, Kogo, Mariko, additional, Morimoto, Chie, additional, Sunadome, Hironobu, additional, Nagasaki, Tadao, additional, Oguma, Tsuyoshi, additional, Nakatsuka, Yoshinari, additional, Murase, Kimihiko, additional, Kawaguchi, Takahisa, additional, Tabara, Yasuharu, additional, Sonomura, Kazuhiro, additional, Matsuda, Fumihiko, additional, Chin, Kazuo, additional, and Hirai, Toyohiro, additional

Published
2021
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47. Markers of cardiovascular disease risk in sleep-disordered breathing with or without comorbidities: the Nagahama Study

Author

Nakatsuka, Yoshinari, primary, Murase, Kimihiko, additional, Matsumoto, Takeshi, additional, Tabara, Yasuharu, additional, Nakamoto, Isuzu, additional, Minami, Takuma, additional, Takahashi, Naomi, additional, Takeyama, Hirofumi, additional, Kanai, Osamu, additional, Hamada, Satoshi, additional, Tanizawa, Kiminobu, additional, Handa, Tomohiro, additional, Wakamura, Tomoko, additional, Komenami, Naoko, additional, Morita, Satoshi, additional, Nakayama, Takeo, additional, Hirai, Toyohiro, additional, Matsuda, Fumihiko, additional, and Chin, Kazuo, additional

Published
2021
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48. Acetazolamide for OSA and Central Sleep Apnea: A Comprehensive Systematic Review and Meta-Analysis

Author

Schmickl, Christopher N., Landry, Shane A., Orr, Jeremy E., Chin, Kazuo, Murase, Kimihiko, Verbraecken, Johan, Javaheri, Shahrokh, Edwards, Bradley A., Owens, Robert L., and Malhotra, Atul

Subjects
Sleep Apnea, Obstructive, Clinical Trials and Supportive Activities, Clinical Sciences, Respiratory System, Neurosciences, apnea-hypopnea index, respiratory tract diseases, Acetazolamide, Treatment Outcome, Clinical Research, Humans, Human medicine, Carbonic Anhydrase Inhibitors, Sleep Research, Central, Lung
Abstract

BackgroundTherapy options for OSA and central sleep apnea (CSA) are limited, thus many patients remain untreated. Clinically, acetazolamide is sometimes used for CSA; however, given overlapping pathophysiologic properties of OSA and CSA, we hypothesized that acetazolamide is equally effective for both types. Prior reviews focused on specific subtypes of sleep apnea, study designs, and languages, thus including few studies (typically≤3) limiting insights.Research questionHow efficacious is acetazolamide for sleep apnea, and is its effect modified by sleep apnea type or acetazolamide dose?Study design and methodsWe queried MEDLINE, EMBASE, and ClinicalTrials.gov from inception until March 11, 2019. Any study in which adults with OSA/CSA received oral acetazolamide vsno acetazolamide (control) that reported sleep apnea-related outcomes was eligible, independent of study design or language. Two reviewers independently assessed eligibility and abstracted data. Primary outcomes were apnea-hypopnea index (AHI) and oxygen saturation nadir. Quality of evidence (QoE) was rated with the use of Grades of Recommendation Assessment, Development and Evaluation methods.ResultsWe included 28 studies (13 OSA/15 CSA; NSubjects,Acetazolamide= 542; NSubjects,Control= 553) that enabled meta-analyses for 24 outcomes. Acetazolamide doses ranged from 36 to 1000mg/d and treatment duration from 1 to 90d (median, 6 d). Overall, acetazolamide vscontrol lowered the AHI by -0.7 effect sizes (95%CI, -0.83 to -0.58; I2= 0%; moderate QoE) that corresponded to a reduction of 37.7%(95%CI, -44.7 to -31.3) or 13.8/h (95%CI, -16.3 to -11.4; AHIControl= 36.5/h). The AHI reduction was similar in OSA vsCSA, but significantly greater with higher doses (at least up to 500mg/d). Furthermore, acetazolamide improved oxygen saturation nadir by+4.4%(95%CI, 2.3 to 6.5; I2= 63%; no evidence of effect modification; very low QoE) and several secondary outcomes that included sleep quality measures and BP (mostly low QoE).InterpretationShort-term acetazolamide improved both OSA and CSA. Rigorous studies with long-term follow up are warranted to assess Acetazolamide's value for the chronic treatment of patients with sleep apnea.Clinical trial registrationPROSPERO (CRD42019147504).

Published
2020

49. Sleep disordered breathing and metabolic comorbidities across gender and menopausal status in East Asians; the Nagahama Study

Author

Matsumoto, Takeshi, Murase, Kimihiko, Tabara, Yasuharu, Minami, Takuma, Kanai, Osamu, Takeyama, Hirofumi, Takahashi, Naomi, Hamada, Satoshi, Tanizawa, Kiminobu, Wakamura, Tomoko, Komenami, Naoko, Setoh, Kazuya, Kawaguchi, Takahisa, Tsutsumi, Takanobu, Morita, Satoshi, Takahashi, Yoshimitsu, Nakayama, Takeo, Hirai, Toyohiro, Matsuda, Fumihiko, and Chin, Kazuo

Subjects
obesity, hypertension, diabetes, Sleep disordered breathing, sex difference, mental disorders, dyslipidemia, menopause, cardiovascular diseases, general population, metabolic syndrome, nervous system diseases, respiratory tract diseases
Abstract

It is well known that the prevalence of sleep disordered breathing (SDB) is increased in patients with obesity or metabolic comorbidities. However, the way in which the prevalence of SDB increases in relation to comorbidities according to the severity of obesity remains unclear. This cross-sectional study evaluated 7713 community participants with nocturnal oximetry ≥2 nights. SDB was assessed by the 3% oxygen desaturation index corrected for sleep duration obtained by wrist actigraphy (Acti-ODI3%). SDB severity was defined by Acti-ODI3%. Obesity was defined as body mass index ≥25 kg·/m−2. The prevalence of SDB was 41.0% (95% CI 39.9–42.1), 46.9% (45.8–48.0), 10.1% (9.5–10.8), and 2.0% (1.7–2.3) in normal, mild, moderate, and severe SDB, respectively, with notable sex differences evident (men >post-menopausal women >pre-menopausal women). Comorbidities such as hypertension, diabetes, and metabolic syndrome were independently associated with the prevalence of moderate-to-severe SDB, and coincidence of any one of these with obesity was associated with a higher probability of moderate-to-severe SDB (OR 8.2, 95% CI 6.6–10.2; 7.8, 5.6–10.9; 6.7, 5.2–8.6, respectively). Dyslipidemia in addition to obesity was not additively associated with the prevalence of moderate to-severe SDB. The number of antihypertensive drugs was associated with SDB (p for trend, 生活習慣病に睡眠時無呼吸症候群がひそむことを解明 --アジア最大資料数のながはまコホートより--. 京都大学プレスリリース. 2020-05-19.

Published
2020

50. Radar-Based Automatic Detection of Sleep Apnea Using Support Vector Machine

Author

Koda, Takato, Sakamoto, Takuya, Okumura, Shigeaki, Taki, Hirofumi, Hamada, Satoshi, Chin, Kazuo, Koda, Takato, Sakamoto, Takuya, Okumura, Shigeaki, Taki, Hirofumi, Hamada, Satoshi, and Chin, Kazuo

Abstract

Early diagnosis of sleep-apnea-related breathing problems helps to avoid the increased risk they can cause. In this study, we performed simultaneous radar measurements and polysomnography on patients with sleep apnea. A support vector machine algorithm was applied to the radar data to automatically detect sleep apnea events. Support vector machine parameters were optimized using the relationship between the radar and polysomnography data. The support vector machine was found to be effective in noncontact detection of central/mixed sleep apnea events using radar data. The proposed approach achieved an accuracy of 79.5%, a recall of 71.2%, and a precision of 71.2%.

Published
2021

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