17 results on '"Pepin J"'
Search Results
2. Evaluation of autoCPAP devices in home treatment of sleep apnea/hypopnea syndrome.
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Meurice JC, Cornette A, Philip-Joet F, Pepin JL, Escourrou P, Ingrand P, and Veale D
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- Body Mass Index, Equipment Design, Female, Humans, Male, Middle Aged, Patient Compliance statistics & numerical data, Polysomnography, Prospective Studies, Quality of Life psychology, Severity of Illness Index, Sleep Apnea Syndromes diagnosis, Surveys and Questionnaires, Automation instrumentation, Continuous Positive Airway Pressure instrumentation, Home Care Services, Sleep Apnea Syndromes therapy
- Abstract
Background and Purpose: Quality of life (QOL) and sleepiness for patients with sleep apnea/hypopnea syndrome (SAHS) might improve with continuous positive airway pressure devices working in auto-adjust mode (autoCPAP) by allowing pressure modulations following patient needs. Clinical comparisons between devices driven by different algorithms are needed., Methods: We compared the clinical effectiveness of fixed pressure CPAP and four different autoCPAP devices by assessing compliance and QOL (36-item short-form health survey [SF-36]). SAHS patients were randomly allocated to five groups. Polysomnography (PSG) was performed to titrate the effective pressure in the constant CPAP group and evaluate residual apnea/hypopnea index (AHI) under autoCPAP. Follow-up consisted of clinical visits at three and six months by homecare technicians who assessed compliance, symptom scores and SF-36 scores. A laboratory-based PSG using the same CPAP/autoCPAP device as at home was performed at six months., Results: Eighty-three patients (mean age 56+/-10 yrs) with mean body mass index (BMI) 30.8+/-5.3 kg/m(2) and severe SAHS (mean AHI: 52.3+/-17.8/h) were included. There were no differences in clinical symptoms or QOL scores, and similar clinical and PSG improvements were seen in all groups. CPAP use was >5 h per night, without any significant difference between groups., Conclusions: AutoCPAP is equally as effective as fixed CPAP for long-term home treatment in severe SAHS patients.
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- 2007
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3. Identification of quality of life concerns of patients with obstructive sleep apnoea at the time of initiation of continuous positive airway pressure: a discourse analysis.
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Veale D, Poussin G, Benes F, Pepin JL, and Levy P
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- Adult, Female, France, Humans, Interviews as Topic, Male, Middle Aged, Sleep Apnea Syndromes psychology, Quality of Life, Sickness Impact Profile, Sleep Apnea Syndromes physiopathology
- Abstract
Background: Obstructive sleep apnoea syndrome (OSAS) is a common condition with multiple symptoms dominated by daytime somnolence. Thus many worries and concerns of patients remain hidden. Treatment by nasal continuous positive airway pressure (CPAP) can be imposing for the individual. An analysis of the freely expressed concerns of such patients is required., Objective: To seek an in-depth analysis of how patients live with sleep apnoea by allowing them an open discourse and analysing the text of their statements., Design: A trained psychologist conducted semi-directive interviews with patients attending a pulmonary rehabilitation and convalescent unit around the themes of sleep, health and treatment. An analysis of content and of discourse was carried out by textual analysis and by propositional analysis of discourse (PAD) with the aid of dedicated computer programs (Tropes, Sphinx Lexica)., Results: Thirty patients with severe sleep apnoea were interviewed of whom 15 were initiating treatment with CPAP. Patients spoke of abnormal fatigue (22 mentions) and somnolence (21 times). Many have problems with obesity (25 instances), snoring related problems (12). There were 30 mentions of depression with a relationship to alcohol and anti-depressives. Twenty six times the theme of nocturnal waking was raised. There were many instances of problems with CPAP (nasal mask and noise problems raised 21 times). Patients have problems with relationships and sex because of OSAS. Other concerns were loss of memory and fear of dying., Conclusion: In a non-directed conversation OSAS patients express concerns not revealed in the standard medical paradigm and such concerns should be addressed in assessing treatment or evaluating quality of life (QOL).
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- 2002
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4. Simultaneous laboratory-based comparison of ResMed Autoset with polysomnography in the diagnosis of sleep apnoea/hypopnoea syndrome.
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Mayer P, Meurice JC, Philip-Joet F, Cornette A, Rakotonanahary D, Meslier N, Pepin JL, Lévy P, and Veale D
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- Adult, Aged, Female, Humans, Hypoventilation diagnosis, Male, Middle Aged, Predictive Value of Tests, Probability, Prospective Studies, Sensitivity and Specificity, Diagnosis, Computer-Assisted, Polysomnography methods, Sleep Apnea Syndromes diagnosis
- Abstract
ResMed Autoset (AS) is a simplified diagnosis system for obstructive sleep apnoea/hypopnoea syndrome (OSAS) based on the respiratory flow/time relationship by pressure variation measured through simple nasal prongs. A multicentre prospective trial was used to compare AS and polysomnography (PSG) for diagnosing 95 patients, with suspected OSAS. Physicians gave a pretest probability of the patient having OSAS. The apnoea/hypopnoea index (AHI) was compared between the two methods of diagnosis for the whole population and for subgroups according to the pretest probability. Twenty-four patients had AHI < 15 events x h(-1) on PSG and 19 AHI 15-30, and 52 patients had AHI > or = 30. Correlation between AHI assessed by AS and PSG was r=0.87 for total sleep time (TST), p<0.0001. A Bland and Altman plot gave an agreement between the two methods of +/-40%. For a threshold of AHI > or = 15 events x h(-1) to diagnose OSAS, AS has a sensitivity of 92%, specificity of 79%, positive predictive value of 93% and negative predictive value of 76%. With a pretest probability > or = 80%, sensitivity and positive predictive value were 98 and 100% respectively. Of six false negative, four had a high pretest probability (> 80%) or Epworth score > or = 10. Using these parameters as a criterion for proceeding to PSG after a negative AS study would mean that two apnoeic patients (AHI 20 and 17 events x h(-1) by PSG) would escape detection. The Autoset is useful for the detection of obstructive sleep apnoea but with high pretest probability and a negative Autoset result polysomnography should be performed.
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- 1998
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5. Auto-CPAP: an effective and low-cost procedure in the management of OSAS?
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Lévy P and Pepin JL
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- Clinical Trials as Topic, Cost-Benefit Analysis, Humans, Masks, Positive-Pressure Respiration economics, Positive-Pressure Respiration instrumentation, Sleep Apnea Syndromes therapy
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- 1998
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6. Cognitive executive dysfunction in patients with obstructive sleep apnea syndrome (OSAS) after CPAP treatment.
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Naegele B, Pepin JL, Levy P, Bonnet C, Pellat J, and Feuerstein C
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- Adult, Cognition Disorders diagnosis, Cognition Disorders physiopathology, Frontal Lobe physiopathology, Humans, Learning physiology, Male, Middle Aged, Neuropsychological Tests, Time Factors, Cognition Disorders etiology, Positive-Pressure Respiration methods, Sleep Apnea Syndromes complications, Sleep Apnea Syndromes therapy
- Abstract
We have previously described impairments of cognitive executive functions in 17 patients with OSAS in comparison with 17 normal controls, as assessed by various frontal-lobe-related tests. In the present study, 10 of these OSAS patients treated with continuous positive airway pressure (CPAP) were reevaluated after 4-6 months of treatment. Neuropsychological tasks explored attention, short-term memory span, learning abilities, planning capacities, categorizing activities, and verbal fluency. Patients were found to have normalized most of their cognitive executive and learning disabilities, but all the short-term memory tests remained unchanged. These findings are discussed in light of the contribution of the frontal-lobe-related systems to short-term memory functions, and the eventual pathogenic role played by sleep fragmentation and nocturnal hypoxemia, which are related to the occurrence of apneic and hypopneic events. In conclusion, short-term memory impairment was persistent in OSAS patients despite CPAP treatment for 4-6 months.
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- 1998
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7. Somnofluoroscopy, computed tomography, and cephalometry in the assessment of the airway in obstructive sleep apnoea.
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Pepin JL, Ferretti G, Veale D, Romand P, Coulomb M, Brambilla C, and Lévy PA
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- Adult, Aged, Cephalometry, Cervical Vertebrae diagnostic imaging, Electroencephalography, Female, Fluoroscopy, Humans, Hyoid Bone diagnostic imaging, Male, Middle Aged, Palate, Soft diagnostic imaging, Pharynx diagnostic imaging, Tomography, X-Ray Computed, Tongue diagnostic imaging, Video Recording, Sleep Apnea Syndromes diagnosis
- Abstract
Background: Assessments of the upper airways in patients with the obstructive sleep apnoea syndrome are usually carried out on awake patients who are upright. The dynamics of the airway in a patient who is asleep and lying down may be different., Methods: Somnofluoroscopy, computed tomography of the upper airway, and cephalometry were carried out in 11 patients with the obstructive sleep apnoea syndrome (10 male; mean (SD) age 53 (10) years) to examine the airway while they were awake and asleep., Results: At somnofluoroscopy 10 patients were in stage 2 sleep and only one in REM sleep. At least five obstructive events were visualised by lateral fluoroscopy in each patient. Imaging allowed observation of the dynamics of airway collapse, which began in the oropharynx in all cases, progressing to the hypopharynx in 10 cases and to the laryngopharynx in five. At fluoroscopy the soft palate was seen to hook up during airway occlusion in 10 patients, thereby increasing its cross sectional area. It was then sucked down into the hypopharynx. Somnofluoroscopic and cephalometric findings agreed, eight of the 10 patients with hypopharyngeal collapse shown by somnofluoroscopy having an inferiorly placed hyoid bone according to cephalometry (distance from the mandibular plane to the hyoid bone (MP-H distance) increased); the one patient with no hypopharyngeal collapse had a normal MP-H. By contrast, six of the 11 patients had a normal or supranormal hypopharyngeal cross sectional area of the airway on the computed tomogram., Conclusions: Somnofluoroscopy allows examination of the dynamics of airway closure in this disorder and shows the important role of the soft palate in acting as a plug in the oropharynx. Dynamic studies are required to determine the pattern of pharyngeal obstruction in obstructive sleep apnoea.
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- 1992
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8. [Can oximetry contribute to the detection of apnea? The use of a mathematical analysis of the oximetry signal].
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Pepin JL, Levy P, Lepaulle B, Bonnet C, Romand P, Pison C, Wuyam B, Colonna M, Paramelle B, and Brambilla C
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- Apnea blood, Electrocardiography, Electroencephalography, Electromyography, Electrooculography, Humans, Lung Diseases, Obstructive blood, Lung Diseases, Obstructive diagnosis, Oxygen blood, Prospective Studies, Retrospective Studies, Sleep Apnea Syndromes blood, Apnea diagnosis, Blood Gas Monitoring, Transcutaneous methods, Sleep Apnea Syndromes diagnosis
- Abstract
The aim of this study was to test the efficacy of nocturnal oximetry as a means of continuous recording of SaO2 in the identification of apnoeic events in the recognition of non-apnoeic desaturation. The oscillations of SaO2 in relation to successive periods of apnoea during the course of the sleep apnoea syndrome (SAS) or with apnoeic episodes in patients with chronic airflow obstruction (BPCO) or restricted disease, were identified using a new delta index quantifying the variations of SaO2 during the night. 26 successive patients in whom there was an indication for nocturnal oximetry were included in a prospective study comparing nocturnal oximetry and polysomnography during 34 nights. In the apnoeic patients we found a strong correlation (r = .85. p. less than .01) between the apnoeic period and the delta index. In BPCO the number of apnoea was correlated with the delta index (r = .96. p. less than .01). A minimal threshold of the delta index fixed at 1.5 was satisfactory for detecting apnoea if the initial SaO2 was less than 93%. The value of the adequate for affected detection ought to be fixed at .8 (95% sensitivity) when the initial SaO2 was greater than 93%. A detection of apnoeic events thus seems possible by this method.
- Published
- 1990
9. Sleep apnoea management in Europe during the COVID-19 pandemic: data from the European Sleep Apnoea Database (ESADA)
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Grote L, McNicholas WT, Hedner J, ESADA collaborators (Anttalainen U, Saaresranta T, Basoglu OK, Gunduz C, Tasbakan S, Bouloukaki I, Schiza SE, Bonsignore MR, Marrone O, Petitjean M, Roisman G, Fietze I, Laharnar N, Penzel T, Zou D, Kent BD, Ryan S, Kvamme JA, Bailly S, Pepin J-L, Tamisier R, Lombardi C, Parati G, Pataka A, Plywaczewski R, Sliwinski P, Pretl M, Riha R, Staats R, Steiropoulos P, Joppa P, Verbraecken J, Petiet E, Trakada G, Ludka O, Buskova J, Hein H, Drummond M, van Zeller M, Dogas Z, Galic T, Gouveris H, Mihaicuta S, Randerath W, Herkenrath S, Fanfulla F, Testelmans D, Ege Üniversitesi, Grote L., McNicholas W.T., Hedner J., Anttalainen U., Saaresranta T., Basoglu O.K., Gunduz C., Tasbakan S., Bouloukaki I., Schiza S.E., Bonsignore M.R., Marrone O., Petitjean M., Roisman G., Fietze I., Laharnar N., Penzel T., Zou D., Kent B.D., Ryan S., Kvamme J.A., Bailly S., Pepin J.-L., Tamisier R., Lombardi C., Parati G., Pataka A., Plywaczewski R., Sliwinski P., Pretl M., Riha R., Staats R., Steiropoulos P., Joppa P., Verbraecken J., Petiet E., Trakada G., Ludka O., Buskova J., Hein H., Drummond M., van Zeller M., Dogas Z., Galic T., Gouveris H., Mihaicuta S., Randerath W., Herkenrath S., Fanfulla F., Testelmans D., Grote, L, Mcnicholas, W, Hedner, J, Anttalainen, U, Saaresranta, T, Basoglu, O, Gunduz, C, Tasbakan, S, Bouloukaki, I, Schiza, S, Bonsignore, M, Marrone, O, Petitjean, M, Roisman, G, Fietze, I, Laharnar, N, Penzel, T, Zou, D, Kent, B, Ryan, S, Kvamme, J, Bailly, S, Pepin, J, Tamisier, R, Lombardi, C, Parati, G, Pataka, A, Plywaczewski, R, Sliwinski, P, Pretl, M, Riha, R, Staats, R, Steiropoulos, P, Joppa, P, Verbraecken, J, Petiet, E, Trakada, G, Ludka, O, Buskova, J, Hein, H, Drummond, M, van Zeller, M, Dogas, Z, Galic, T, Gouveris, H, Mihaicuta, S, Randerath, W, Herkenrath, S, Fanfulla, F, and Testelmans, D
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Pulmonary and Respiratory Medicine ,Pediatrics ,medicine.medical_specialty ,Databases, Factual ,Polysomnography ,medicine.medical_treatment ,Pneumonia, Viral ,Personnel Staffing and Scheduling ,Disease ,Covid ,sleep laboratory ,Betacoronavirus ,03 medical and health sciences ,Sleep Apnea Syndrome ,Sleep Apnea Syndromes ,0302 clinical medicine ,Surveys and Questionnaires ,mental disorders ,Research Letter ,medicine ,Humans ,cardiovascular diseases ,030212 general & internal medicine ,Continuous positive airway pressure ,Pandemics ,Sleep Medicine Specialty ,Continuous Positive Airway Pressure ,medicine.diagnostic_test ,Coronavirus Infection ,SARS-CoV-2 ,business.industry ,Sleep apnea ,COVID-19 ,Atrial fibrillation ,medicine.disease ,Comorbidity ,Obesity ,Telemedicine ,Europe ,030228 respiratory system ,Heart failure ,Coronavirus Infections ,business ,Delivery of Health Care ,management - Abstract
Sleep disordered breathing (SDB) is highly prevalent with a male to female predominance of two to one, and is more common in middle-aged and elderly subjects [1]. Affected patients often present with comorbidities such as obesity, cardiovascular disease (systemic hypertension, heart failure, atrial fibrillation), and diabetes mellitus Type II [2]. The strong overlap between the profile for SDB patients and the identified risk factors for adverse outcomes of COVID-19 infection that include age, male gender, and cardio-metabolic comorbidity [3] suggest that SDB patients may benefit from effective therapy if confronted with COVID-19 infection [4].
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- 2020
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10. Clinical phenotypes and comorbidity in European sleep apnoea patients
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Saaresranta T., Hedner J., Bonsignore M. R., Riha R. L., McNicholas W. T., Penzel T., Anttalainen U., Kvamme J. A., Pretl M., Sliwinski P., Verbraecken J., Grote L., Barbe F., Basoglu B., Bielicki P., Dorkova Z., Escourrou P., Fietze I., Esquinas C., Hayes L., Kumor M., Kurki S., Lavie L., Lavie P., Levy P., Lombardi C., Marrone O., Masa J. F., Montserrat J. M., Parati G., Pataka A., Pepin J. L., Plywaczewski R., Rodenstein D., Roisman G., Ryan S., Schulz R., Tkacova R., Staats R., Steiropoulos P., Varoneckas G., Vitols A., Vrints H., Zielinski J., Saaresranta, T, Hedner, J, Bonsignore, M, Riha, R, Mcnicholas, W, Penzel, T, Anttalainen, U, Kvamme, J, Pretl, M, Sliwinski, P, Verbraecken, J, Grote, L, Barbe, F, Basoglu, B, Bielicki, P, Dorkova, Z, Escourrou, P, Fietze, I, Esquinas, C, Hayes, L, Kumor, M, Kurki, S, Lavie, L, Lavie, P, Levy, P, Lombardi, C, Marrone, O, Masa, J, Montserrat, J, Parati, G, Pataka, A, Pepin, J, Plywaczewski, R, Rodenstein, D, Roisman, G, Ryan, S, Schulz, R, Tkacova, R, Staats, R, Steiropoulos, P, Varoneckas, G, Vitols, A, Vrints, H, Zielinski, J, ESADA Study Group, Ege Üniversitesi, ESADA Study Grp, UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, UCL - (SLuc) Service de pneumologie, Saaresranta, T., Hedner, J., Bonsignore, M., Riha, R., Mcnicholas, W., Penzel, T., Anttalainen, U., Kvamme, J., Pretl, M., Sliwinski, P., Verbraecken, J., Grote, L., Barbé, F., Basoglu, B., Bielicki, P., Dorkova, Z., Escourrou, P., Fietze, I., Esquinas, C., Hayes, L., Kumor, M., Kurki, S., Lavie, L., Lavie, P., Levy, P., Lombardi, C., Marrone, O., Masa, J., Montserrat, J., Parati, G., Pataka, A., Pépin, J., Plywaczewski, R., Rodenstein, D., Roisman, G., Ryan, S., Schulz, R., Tkacova, R., Staats, R., Steiropoulos, P., Varoneckas, G., Vitols, A., Vrints, H., and Zielinski, J.
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Male ,Pulmonology ,Physiology ,Apnea ,medicine.medical_treatment ,lcsh:Medicine ,Comorbidity ,Polysomnography ,Cardiovascular Medicine ,Medicine (all) ,Biochemistry, Genetics and Molecular Biology (all) ,Agricultural and Biological Sciences (all) ,THERAPY ,Body Mass Index ,0302 clinical medicine ,Risk Factors ,Positive airway pressure ,Medicine and Health Sciences ,Insomnia ,Medicine ,Prospective Studies ,Continuous positive airway pressure ,lcsh:Science ,Prospective cohort study ,Clinical Neurophysiology ,Aged, 80 and over ,Hypersomnia ,Multidisciplinary ,medicine.diagnostic_test ,Sleep apnea ,Middle Aged ,DEPRESSION ,PREVALENCE ,ComputingMilieux_MANAGEMENTOFCOMPUTINGANDINFORMATIONSYSTEMS ,Phenotype ,Neurology ,Physiological Parameters ,Cardiovascular Diseases ,CARDIOVASCULAR-DISEASE ,Female ,InformationSystems_MISCELLANEOUS ,medicine.symptom ,Engineering sciences. Technology ,Hypopnea ,INSOMNIA SYMPTOMS ,Research Article ,Adult ,medicine.medical_specialty ,Sleep Apnea ,Adolescent ,POSITIVE AIRWAY PRESSURE ,Settore MED/10 - Malattie Dell'Apparato Respiratorio ,White People ,Young Adult ,03 medical and health sciences ,Sleep Apnea Syndromes ,DAYTIME ,stomatognathic system ,Comorbiditat ,Diagnostic Medicine ,Internal medicine ,mental disorders ,Humans ,COMMON ,Aged ,HYPOPNEA ,HYPERTENSION ,business.industry ,lcsh:R ,Body Weight ,ComputerSystemsOrganization_COMPUTER-COMMUNICATIONNETWORKS ,Biology and Life Sciences ,ta3121 ,medicine.disease ,Dyssomnias ,respiratory tract diseases ,nervous system diseases ,ComputingMethodologies_PATTERNRECOGNITION ,030228 respiratory system ,Physical therapy ,lcsh:Q ,Sleep Disorders ,Physiological Processes ,Sleep ,business ,030217 neurology & neurosurgery ,Follow-Up Studies - Abstract
PubMed ID: 27701416, Background Clinical presentation phenotypes of obstructive sleep apnoea (OSA) and their association with comorbidity as well as impact on adherence to continuous positive airway pressure (CPAP) treatment have not been established. Methods A prospective follow-up cohort of adult patients with OSA (apnoea-hypopnoea index (AHI) of ?5/h) from 17 European countries and Israel (n = 6,555) was divided into four clinical presentation phenotypes based on daytime symptoms labelled as excessive daytime sleepiness ("EDS") and nocturnal sleep problems other than OSA (labelled as "insomnia"): 1) EDS (daytime+/nighttime-), 2) EDS/insomnia (daytime+/nighttime+), 3) non-EDS/noninsomnia (daytime-/nighttime-), 4) and insomnia (daytime-/nighttime+) phenotype. Results The EDS phenotype comprised 20.7%, the non-EDS/non-insomnia type 25.8%, the EDS/ insomnia type 23.7%, and the insomnia phenotype 29.8% of the entire cohort. Thus, clinical presentation phenotypes with insomnia symptoms were dominant with 53.5%, but only 5.6% had physician diagnosed insomnia. Cardiovascular comorbidity was less prevalent in the EDS and most common in the insomnia phenotype (48.9% vs. 56.8%, p
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- 2016
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11. Hyperlipidaemia prevalence and cholesterol control in obstructive sleep apnoea: Data from the European sleep apnea database (ESADA).
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Gunduz, C., Basoglu, O. K., Hedner, J., Bonsignore, M. R., Hein, H., Staats, R., Bouloukaki, I., Roisman, G., Pataka, A., Sliwinski, P., Ludka, O., Pepin, J. L., Grote, L., Steiropoulos, P., Verbraecken, J., Petiet, E., Trakada, G., Montserrat, JM, Fietze, I, and Penzel, T
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HYPERLIPIDEMIA ,SLEEP apnea syndromes ,DISEASE risk factors ,APNEA ,BODY mass index - Abstract
Background and objective: Obstructive sleep apnoea (OSA) and hyperlipidaemia are independent risk factors for cardiovascular disease. This study investigates the association between OSA and prevalence of hyperlipidaemia in patients of the European Sleep Apnea Database (ESADA) cohort. Methods: The cross‐sectional analysis included 11 892 patients (age 51.9 ± 12.5 years, 70% male, body mass index (BMI) 31.3 ± 6.6 kg/m2, mean oxygen desaturation index (ODI) 23.7 ± 25.5 events/h) investigated for OSA. The independent odds ratio (OR) for hyperlipidaemia in relation to measures of OSA (ODI, apnoea‐hypopnoea index, mean and lowest oxygen saturation) was determined by means of general linear model analysis with adjustment for important confounders such as age, BMI, comorbidities and study site. Results: Hyperlipidaemia prevalence increased from 15.1% in subjects without OSA to 26.1% in those with severe OSA, P < 0.001. Corresponding numbers in patients with diabetes were 8.5% and 41.5%, P < 0.001. Compared with ODI quartile I, patients in ODI quartiles II‐IV had an adjusted OR (95% CI) of 1.33 (1.15–1.55), 1.37 (1.17–1.61) and 1.33 (1.12–1.58) (P < 0.001), respectively, for hyperlipidaemia. Obesity was defined as a significant risk factor for hyperlipidaemia. Subgroups of OSA patients with cardio‐metabolic comorbidities demonstrated higher prevalence of HL. In addition, differences in hyperlipidaemia prevalence were reported in European geographical regions with the highest prevalence in Central Europe. Conclusion: Obstructive sleep apnoea, in particular intermittent hypoxia, was independently associated with the prevalence of hyperlipidaemia diagnosis. [ABSTRACT FROM AUTHOR]
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- 2019
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12. B016 Impact of a 14-night intermittent hypoxia (IH) exposure on metabolic and cardiopulmonary adaptations to exercise in healthy subjects.
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Tonini, J., Michallet, A.-S., Flore, P., Nespoulet, H., Pepin, J.-L., Wuyam, B., Levy, P., and Tamisier, R.
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EXERCISE tests ,HYPOXEMIA ,SLEEP apnea syndromes ,METABOLIC disorders ,BLOOD circulation disorders ,HYPERTENSION ,CARDIOPULMONARY system ,PHYSIOLOGICAL adaptation ,PATIENTS - Abstract
Introduction: Modifications in exercise tolerance have been reported in obstructive sleep apnea (OSA) patients. Also specific mechanisms have been speculated related to intermittent hypoxia (IH), hypertension, obesity or metabolic disturbance associated to OSA may play a significant role in exercise limitation. In order to eliminate these confounding factors we aimed to evaluate the effects of IH exposure during 14 nights in healthy subjects on exercise capacity, cardio-respiratory response and substrate oxidation during exercise. Methods: 12 healthy subjects (BMI: 21.8 0.5kg.m-2) were exposed to repetitive sequences of hypoxia — re-oxygenation during sleep in a hypoxic tent with appropriate cyclic re-oxygenation (rate: 30 desaturations.h-1). Maximal and sub-maximal exercise tests were performed before and after exposure in order to investigate cardiorespiratory variables and substrate oxidation parameters. Results: IH did not modify maximal exercise parameters (VO2, heart rate, power output) nor ventilatory threshold (VTh). But this was achieved with a significant PETCO2 reduction and a VE/VCO2 increase during both maximal (Pre IH vs Post IH at VTh and Max, p<0.05) and sub-maximal (Pre vs Post at 30 % and 60 % Pmax, p<0.05) exercise tests, indicating hyperventilation. At the 1
st min recovery after submaximal exercise test, diastolic arterial blood pressure (DBP) was higher after IH exposure (Pre: 60±3 vs Post: 78±2mmHg) in favour of a delayed DBP recovery following acute exercise. During sub-maximal exercise, subjects reached maximal lipid oxidation at higher power output and presented a decreased blood lactate at the same percentage of relative power after IH exposure. Conclusion: Exposure to 14 days of nocturnal IH is associated with an increased ventilatory response to subsequent exercise at sea level. Furthermore, delayed DBP recovery after exercise is in favor of early IH-induced cardiovascular modifications. This observation related to muscular exercise adaptations confirms the efficacy of the model in reproducing early cardiovascular alterations occurring in OSAS. Moreover, this model induces metabolic adaptations as soon as 14 nights of exposure. [Copyright &y& Elsevier]- Published
- 2009
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13. Periodic limb movements during sleep and blood pressure changes in sleep apnoea: Data from the European Sleep Apnoea Database
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Lombardi C, Parati G, Soranna D, Zambon A, Sliwinski P, Roisman G, Pepin JL, Schiza S, Riha R, Joppa P, Fietze I, Hedner J, Grote L, European Sleep Apnoea Database (ESADA) Collaborators (ESADA Collaborators: Anttalainen U, Barbé F, Bonsignore MR, Basoglu OK, Bielicki P, Dogas Z, Dorkova Z, Escourrou P, Hein H, Kvamme JA, Levy P, Marrone O, Masa JF, McNicholas WT, Montserrat JM, Pataka A, Penzel T, Petiet E, Pépin JL, Plywaczewski R, Pretl M, Riha RL, Ryan S, Saaresranta T, Schulz R, Tasbakan MS, Tkacova R, Staats R, Steiropoulos P, Varoneckas G, Verbraecken J), Lombardi C., Parati G., Soranna D., Zambon A., Sliwinski P., Roisman G., Pepin J.-L., Schiza S., Riha R., Joppa P., Fietze I., Hedner J., Grote L., Anttalainen U., Barbe F., Bonsignore M.R., Basoglu O.K., Bielicki P., Dogas Z., Dorkova Z., Escourrou P., Hein H., Kvamme J.A., Levy P., Marrone O., Masa J.F., McNicholas W.T., Montserrat J.M., Pataka A., Penzel T., Petiet E., Pepin J.L., Plywaczewski R., Pretl M., Riha R.L., Ryan S., Saaresranta T., Schulz R., Tasbakan M.S., Tkacova R., Staats R., Steiropoulos P., Varoneckas G., Verbraecken J., Università degli Studi di Milano-Bicocca = University of Milano-Bicocca (UNIMIB), Institute of Tuberculosis and Lung Diseases [Warsaw, Poland] (ITLD), AP-HP - Hôpital Antoine Béclère [Clamart], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hypoxie et PhysioPathologie (HP2), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes (UGA), Centre Hospitalier Universitaire [Grenoble] (CHU), University of Crete [Heraklion] (UOC), Royal Infirmary of Edinburgh, Univerzitnej nemocnice L. Pasteura Košice [Košice, Slovakia]. (UNLPK), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], University of Gothenburg (GU), Sahlgrenska Academy at University of Gothenburg [Göteborg], European Sleep Apnoea Database (ESADA) Collaborators: Anttalainen U, Barbé F, Bonsignore Mr, Basoglu Ok, Bielicki P, Dogas Z, Dorkova Z, Escourrou P, Fietze I, Grote L, Hedner J, Hein H, Joppa P, Kvamme Ja, Levy P, Lombardi C, Marrone O, Masa Jf, McNicholas Wt, Montserrat Jm, Parati G, Pataka A, Penzel T, Petiet E, Pépin Jl, Plywaczewski R, Pretl M, Riha Rl, Roisman G, Ryan S, Saaresranta T, Schiza S, Schulz R, Sliwinski P, Pepin Jl, Tasbakan Ms, Tkacova R, Staats R, Steiropoulos P, Varoneckas G, Verbraecken J, SALAS, Danielle, Lombardi, C, Parati, G, Soranna, D, Zambon, A, Sliwinski, P, Roisman, G, Pepin, J, Schiza, S, Riha, R, Joppa, P, Fietze, I, Hedner, J, Grote, L, Anttalainen, U, Barbe, F, Bonsignore, M, Basoglu, O, Bielicki, P, Dogas, Z, Dorkova, Z, Escourrou, P, Hein, H, Kvamme, J, Levy, P, Marrone, O, Masa, J, Mcnicholas, W, Montserrat, J, Pataka, A, Penzel, T, Petiet, E, Plywaczewski, R, Pretl, M, Ryan, S, Saaresranta, T, Schulz, R, Tasbakan, M, Tkacova, R, Staats, R, Steiropoulos, P, Varoneckas, G, and Verbraecken, J
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Male ,Pulmonary and Respiratory Medicine ,Multivariate statistics ,medicine.medical_specialty ,obstructive sleep apnoea ,Systole ,Movement ,[SDV]Life Sciences [q-bio] ,Blood Pressure ,Comorbidity ,Settore MED/10 - Malattie Dell'Apparato Respiratorio ,Cohort Studies ,03 medical and health sciences ,Sleep Apnea Syndromes ,0302 clinical medicine ,Diastole ,cardiovascular disease ,Diabetes mellitus ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,sleep disorder ,Sleep disorder ,Univariate analysis ,business.industry ,Confounding ,Extremities ,clinical epidemiology ,Middle Aged ,medicine.disease ,Sleep in non-human animals ,Europe ,[SDV] Life Sciences [q-bio] ,Cross-Sectional Studies ,Blood pressure ,Databases as Topic ,030228 respiratory system ,Cohort ,Female ,Sleep ,business - Abstract
International audience; Background and objective: OSA and PLMS are known to induce acute BP swings during sleep. Our current study aimed to address the independent effect of PLMS on BP in an unselected OSA patient cohort.Methods: This cross-sectional analysis included 1487 patients (1110 males, no previous hypertension diagnosis or treatment, mean age: 52.5 years, mean BMI: 30.5 kg/m2 ) with significant OSA (defined as AHI ≥ 10) recruited from the European Sleep Apnoea Cohort. Patients underwent overnight PSG. Patients were stratified into two groups: patients with significant PLMS (PLMSI > 25 events/hour of sleep) and patients without significant PLMS (PLMSI < 25 events/hour of sleep). SBP, DBP and PP were the variables of interest. For each of these, a multivariate regression linear model was fitted to evaluate the relationship between PLMS and outcome adjusting for sociodemographic and clinical covariates (gender, age, BMI, AHI, ESS, diabetes, smoking and sleep efficiency).Results: The univariate analysis of SBP showed an increment of BP equal to 4.70 mm Hg (P < 0.001) in patients with significant PLMS compared to patients without significant PLMS. This increment remained significant after implementing a multivariate regression model (2.64 mm Hg, P = 0.044). No significant increment of BP was observed for DBP and PP.Conclusion: PLMS is associated with a rise in SBP regardless of AHI, independent of clinical and sociodemographic confounders. A PLMS phenotype may carry an increased risk for cardiovascular disease in OSA patients.
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- 2020
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14. Nocturnal hypoxemia, blood pressure, vascular status and chronic mountain sickness in the highest city in the world
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Perger, Elisa, Baillieul, Sébastien, Esteve, François, Pichon, Aurélien, Bilo, Gzregorz, Soranna, Davide, Doutreleau, Stéphane, Savina, Yann, Ulliel-Roche, Mathilde, Brugniaux, Julien V., Stauffer, Emeric, Oberholzer, Laura, Howe, Connor, Hannco, Ivan, Lombardi, Carolina, Tamisier, Renaud, Pepin, Jean-Louis, Verges, Samuel, Parati, Gianfranco, Perger, E, Baillieul, S, Esteve, F, Pichon, A, Bilo, G, Soranna, D, Doutreleau, S, Savina, Y, Ulliel-Roche, M, Brugniaux, J, Stauffer, E, Oberholzer, L, Howe, C, Hannco, I, Lombardi, C, Tamisier, R, Pepin, J, Verges, S, and Parati, G
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Male ,Blood Pressure ,General Medicine ,Altitude Sickness ,Pulse Wave Analysis ,Carotid Intima-Media Thickness ,sleep disordered breathing ,Cross-Sectional Studies ,Sleep Apnea Syndromes ,Chronic Disease ,Hypertension ,Quality of Life ,Humans ,blood pressure variability ,chronic mountain sickne ,Hypoxia ,sleep apnoea ,high-altitude - Abstract
Chronic mountain sickness (CMS) is a condition characterized by excessive erythrocytosis in response to chronic hypobaric hypoxia. CMS frequently triggers cardiorespiratory diseases such as pulmonary hypertension and right or left heart failure. Ambient hypoxia might be further amplified night-time by intermittent hypoxia related to sleep-disordered breathing (SDB) so that sleep disturbance may be an important feature of CMS. Our aim was to characterize in a cross-sectional study nocturnal hypoxaemia, SDB, blood pressure (BP), arterial stiffness and carotid intima-media thickness (CIMT) in highlanders living at extreme altitude. Men aged 18 to 55 years were prospectively recruited. Home sleep apnoea test, questionnaires (short-form health survey; Montreal cognitive assessment; Pittsburgh Sleep Questionnaire Index and the Insomnia severity index), 24-h ambulatory BP monitoring, CIMT and arterial stiffness were evaluated in 3 groups: i) Andean lowlanders (sea-level); ii) highlanders living at 3,800 m and iii) highlanders living at 5,100 m. Analyses were conducted in sub-groups according to 1) CMS severity 2) healthy subjects living at the three different altitude. Ninety-two males were evaluated at their living altitudes. Among the 54 highlanders living at 5,100 m, subjects with CMS showed lower mean nocturnal oxygen saturation (SpO2), SpO2 nadir, lower pulse wave velocity and higher nocturnal BP variability than those with no-CMS. Lower nocturnal SpO2 nadir was associated with higher CMS severity (ß= −0.14, p=.009). Among the 55 healthy subjects, healthy highlanders at 5,100 m were characterized by lower scores on quality of life and sleep quality scales and lower mean SpO2 compared to lowlanders. Lower nocturnal SpO2 and higher nocturnal BP variability are associated with CMS severity in individuals living permanently at high altitude. The role of lower SpO2 and higher nocturnal BP variability in the cardiovascular progression of CMS and in the overall prognosis of the disease need to be evaluated in further studies.
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- 2022
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15. A global consensus regarding the evaluation and management of sleepiness in obstructive sleep apnoea: results of a Delphi process.
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Steier, J., Bogan, R., Cano-Pumarega, I., Fleetham, J., Insalaco, G., Lal, C., Pepin, J.-L., Randerath, W., Redline, S., and Malhotra, A.
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SLEEP apnea syndromes , *DROWSINESS - Published
- 2022
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16. Sleep laboratories reopening and COVID-19 : a European perspective
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Anita K. Simonds, Winfried Randerath, Sophia E. Schiza, Maria R. Bonsignore, Joseph M. Montserrat, Jean-Louis Pépin, Ludger Grote, R. Ersu, Francesco Fanfulla, Dries Testelmans, Johan Verbraecken, Schiza S., Simonds A., Randerath W., Fanfulla F., Testelmans D., Grote L., Montserrat J.M., Pepin J.-L., Verbraecken J., Ersu R., Bonsignore M.R., and SALAS, Danielle
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Telemedicine ,MEDLINE ,Settore MED/10 - Malattie Dell'Apparato Respiratorio ,health personnel ,Phase (combat) ,Sleep medicine ,03 medical and health sciences ,0302 clinical medicine ,Sleep Apnea Syndromes ,Epidemiology ,Positive airway pressure ,medicine ,Pulmonary Medicine ,Humans ,Intensive care medicine ,business.industry ,Safety precaution ,Perspective (graphical) ,COVID-19 ,[SDV] Life Sciences [q-bio] ,Europe ,030228 respiratory system ,Perspective ,Sleep (system call) ,patient ,telemedicine ,Human medicine ,business ,Laboratories ,030217 neurology & neurosurgery - Abstract
The clinical activities regarding sleep disordered breathing (SDB) have been sharply interrupted during the initial phase of the COVID-19 epidemic throughout Europe. In the last months, activities have gradually restarted, according to epidemiological phase of COVID-19 and National recommendations. The recent increase in cases throughout Europe obliges to reconsider management strategies of SDB accordingly. Diagnosis of SDB and initiation of treatment pose some specific problems to be addressed to preserve safety of the patients and health personnel. This perspective document by a group of European sleep experts aims at summarising some different approaches followed in Europe and United States, which reflect National recommendations according to the epidemiological phase of the COVID-19 infection. Respiratory sleep medicine will likely change in the near future, and use of telemedicine will grow to avoid unnecessary risks and continue to provide optimal care to the patients. The document also covers pediatric sleep studies and indications for titration of noninvasive ventilation, as well as precautions to be followed by patients who are already on positive airway pressure treatment. A single consensus document developed by the European Respiratory Society and National Societies would be desirable to harmonise SDB management throughout Europe., Specific precautions should be applied for starting activities in respiratory Sleep Centres during the COVID-19 epidemic
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- 2021
17. Gait abnormalities in obstructive sleep apnea and impact of continuous positive airway pressure.
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Allali, G., Perrig, S., Cleusix, M., Herrmann, F. R., Adler, D., Gex, G., Armand, S., Janssens, J. P., Pepin, J. L., and Assal, F.
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GAIT disorders , *SLEEP apnea syndromes , *SLEEP apnea syndrome treatment , *VERBAL behavior testing , *CONTINUOUS positive airway pressure , *AIRWAY (Anatomy) , *PATIENTS - Abstract
We aimed to determine the effect of continuous positive airway pressure (CPAP) on gait in obstructive sleep apnea (OSA) patients. Gait during single and dual tasks was recorded in 15 OSA patients at baseline and after 8 weeks of CPAP therapy. Step and stance time improved after CPAP. We showed a specific dual-task effect in the condition of verbal fluency. Eight weeks of CPAP seems to improve gait of OSA patients that are specifically disturbed by the dual task of verbal fluency. [ABSTRACT FROM AUTHOR]
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- 2014
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