For Physicians

Resources for Physicians

For your convenience, SleepApnea Surgicure has provided you, the physician, with the following useful information regarding sleep apnea and the surgical treatment for obstructive sleep apnea:

DIAGNOSIS, MEDICAL TREATMENT, ASSOCIATED COMORBIDITIES OF OSA

( Articles numbered 1-155 from bibliography of FMCSA Evidence Report Nov. 30, 2011 authored by MANILA Consulting Group, Inc. from FMCSA website on Obstructive Sleep Apnea and Commercial Motor Vehicle Driver Safety: Updated Review)
1. Young, T., P.E. Peppard, and D.J. Gottlieb, Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med, 2002. 165(9): p. 1217-39.
2. Caples, S.M., A.S. Gami, and V.K. Somers, Obstructive sleep apnea. Ann Intern Med, 2005. 142(3): p. 187-97.
3. Flemons, W.W., et al., Home diagnosis of sleep apnea: a systematic review of the literature. An evidence review cosponsored by the American Academy of Sleep Medicine, the American College of Chest Physicians, and the American Thoracic Society. Chest, 2003. 124(4): p. 1543-79.
4. Worsnop, C., R. Pierce, and R.D. McEvoy, Obstructive sleep apnoea. Aust N Z J Med, 1998. 28(4): p. 421-7.
5. McNicholas, W.T., Sleep apnoea and driving risk. European Respiratory Society Task Force on “Public Health and Medicolegal Implications of Sleep Apnoea”. Eur Respir J, 1999. 13(6): p. 1225-7.
6. Treadwell, J.R., et al., A system for rating the stability and strength of medical evidence. BMC Med Res Methodol, 2006. 6: p. 52.
7. Shadish, W.R. and C.K. Haddock, Combining estimates of effect size, in The handbook of research synthsis, H. Cooper and L.V. Hedges, Editors. 1994, Russell Sage Foundation: New Your. p. 261-277.
8. Parmar, M.K., V. Torri, and L. Stewart, Extracting summary statistics to perform meta-analyses of the published literature for survival endpoints. Stat Med, 1998. 17(24): p. 2815-34.
9. Hedges, L.V., Fixed effect models, in The handbook of research synthesis, H. Cooper and L.V. Hedges, Editors. 1994, Russell Sage Foundation: New York. p. 285-299.
10. Hedges, L.V. and J.L. Vevea, Fixed- and random-effects models in meta-analysis. Psychol Methods, 1998. 3(4): p. 486-504.
11. Raudenbush, S.W., Random effects models, in The handbook of research synthesis, H. Cooper and L.V. Hedges, Editors. 1994, Russell Sage Foundation: New York. p. 301-321.
12. Sutton, A.J., et al., eds. Methods for meta-analysis in medical researchq. 2001, John Wiley & Sons. 274.
13. Fleiss, J.L., Measures of effect size for categorical data, in The handbook of research synthesis, H. Cooper and L.V. Hedges, Editors. 1994, Russell Sage Foundation: New York. p. 245-260.
14. Moses, L.E., D. Shapiro, and B. Littenberg, Combining independent studies of a diagnostic test into a summary ROC curve: data-analytic approaches and some additional considerations. Stat Med, 1993. 12(14): p. 1293-316.
15. Littenberg, B. and L.E. Moses, Estimating diagnostic accuracy from multiple conflicting reports: a new meta-analytic method. Med Decis Making, 1993. 13(4): p. 313-21.
16. Gavaghan, D.J., R.A. Moore, and H.J. McQuay, An evaluation of homogeneity tests in meta-analyses in pain using simulations of individual patient data. Pain, 2000. 85(3): p. 415-24.
17. Takkouche, B., C. Cadarso-Suarez, and D. Spiegelman, Evaluation of old and new tests of heterogeneity in epidemiologic meta-analysis. Am J Epidemiol, 1999. 150(2): p. 206-15.
18. Higgins, J.P. and S.G. Thompson, Quantifying heterogeneity in a meta-analysis. Stat Med, 2002. 21(11): p. 1539-58.
19. Greenhouse, J.B. and S. Iyengar, Sensitivity analysis and diagnostics, in The handbook of research synthesis, H. Cooper and L.V. Hedges, Editors. 1995, Russell Sage FOundation: New York. p. 383-409.
20. Petitti, D.B., Approaches to heterogeneity in meta-analysis. Stat Med, 2001. 20(23): p. 3625-33.
21. Higgins, J.P., et al., Measuring inconsistency in meta-analyses. BMJ, 2003. 327(7414): p. 557-60.
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22. van Houwelingen, H.C., L.R. Arends, and T. Stijnen, Advanced methods in meta-analysis: multivariate approach and meta-regression. Stat Med, 2002. 21(4): p. 589-624.
23. Thompson, S.G. and J.P. Higgins, How should meta-regression analyses be undertaken and interpreted? Stat Med, 2002. 21(11): p. 1559-73.
24. Higgins, J.P. and S.G. Thompson, Controlling the risk of spurious findings from meta-regression. Stat Med, 2004. 23(11): p. 1663-82.
25. Duval, S. and R. Tweedie, Trim and fill: A simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics, 2000. 56(2): p. 455-63.
26. Sutton, A.J., et al., Empirical assessment of effect of publication bias on meta-analyses. BMJ, 2000. 320(7249): p. 1574-7.
27. Cooper, H. and L.V. Hedges, eds. The handbook of research synthesis. 1994, Russell Sage FOundation: New York. 573.
28. Ancoli-Israel, S., et al., Expert Panel Recommendations: Obstructive Sleep Apnea and Commercial Motor Vehicle Driver Safety. 2008.
29. Prevalence of Sleep Apnea Among Commercial Truck Drivers. [cited 2011 October 20]; Available from: http://www.atri-online.org/research/results/sleep_apnea_white_paper.pdf.
30. Cistulli, P.A. and R.R. Grunstein, Medical devices for the diagnosis and treatment of obstructive sleep apnea. Expert Rev Med Devices, 2005. 2(6): p. 749-63.
31. Evidence Report: Obstructive Sleep Apnea and Commercial Motor Vehicle Driver Safety (Comprehensive Review). 2007, The ECRI Institute.
32. Hartenbaum, N., et al., Sleep apnea and commercial motor vehicle operators: Statement from the joint task force of the American College of Chest Physicians, the American College of Occupational and Environmental Medicine, and the National Sleep Foundation. Chest, 2006. 130(3): p. 902-5.
33. Chervin, R.D., et al., Cost-utility of three approaches to the diagnosis of sleep apnea: polysomnography, home testing, and empirical therapy. Ann Intern Med, 1999. 130(6): p. 496-505.
34. Gurubhagavatula, I., et al., Occupational screening for obstructive sleep apnea in commercial drivers. Am J Respir Crit Care Med, 2004. 170(4): p. 371-6.
35. Parks, P., et al., Screening for obstructive sleep apnea during commercial driver medical examinations. J Occup Environ Med, 2009. 51(3): p. 275-82.
36. Young, T., et al., Predictors of sleep-disordered breathing in community-dwelling adults: the Sleep Heart Health Study. Arch Intern Med, 2002. 162(8): p. 893-900.
37. Ancoli-Israel, S., Epidemiology of sleep disorders. Clin Geriatr Med, 1989. 5(2): p. 347-62.
38. Young, T., J. Skatrud, and P.E. Peppard, Risk factors for obstructive sleep apnea in adults. JAMA, 2004. 291(16): p. 2013-6.
39. Dixon, J.B., et al., Daytime sleepiness in the obese: not as simple as obstructive sleep apnea. Obesity (Silver Spring), 2007. 15(10): p. 2504-11.
40. Friedman, M., et al., Clinical predictors of obstructive sleep apnea. Laryngoscope, 1999. 109(12): p. 1901-7.
41. Hoffstein, V. and S. Mateika, Differences in abdominal and neck circumferences in patients with and without obstructive sleep apnoea. Eur Respir J, 1992. 5(4): p. 377-81.
42. Cherniack, N.S., Sleep apnea and its causes. J Clin Invest, 1984. 73(6): p. 1501-6.
43. Harman, E.M., J.W. Wynne, and A.J. Block, The effect of weight loss on sleep-disordered breathing and oxygen desaturation in morbidly obese men. Chest, 1982. 82(3): p. 291-4.
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44. Phillips, B., et al., Sleep apnea: prevalence of risk factors in a general population. South Med J, 1989. 82(9): p. 1090-2.
45. Stradling, J.R. and J.H. Crosby, Predictors and prevalence of obstructive sleep apnoea and snoring in 1001 middle aged men. Thorax, 1991. 46(2): p. 85-90.
46. Chervin, R.D. and C. Guilleminault, Obstructive sleep apnea and related disorders. Neurol Clin, 1996. 14(3): p. 583-609.
47. Namyslowski, G., et al., Sleep study in patients with overweight and obesity. J Physiol Pharmacol, 2005. 56 Suppl 6: p. 59-65.
48. Kyzer, S. and I. Charuzi, Obstructive sleep apnea in the obese. World J Surg, 1998. 22(9): p. 998-1001.
49. Schafer, H., et al., Body fat distribution, serum leptin, and cardiovascular risk factors in men with obstructive sleep apnea. Chest, 2002. 122(3): p. 829-39.
50. Katz, I., et al., Do patients with obstructive sleep apnea have thick necks? Am Rev Respir Dis, 1990. 141(5 Pt 1): p. 1228-31.
51. Chaouat, A., et al., Association of chronic obstructive pulmonary disease and sleep apnea syndrome. Am J Respir Crit Care Med, 1995. 151(1): p. 82-6.
52. Ferguson, K.A., et al., The relationship between obesity and craniofacial structure in obstructive sleep apnea. Chest, 1995. 108(2): p. 375-81.
53. Nishimura, Y., et al., Obesity and obstructive sleep apnea syndrome. Acta Otolaryngol Suppl, 2003(550): p. 22-4.
54. Pillar, G., et al., Predictive value of specific risk factors, symptoms and signs, in diagnosing obstructive sleep apnoea and its severity. J Sleep Res, 1994. 3(4): p. 241-244.
55. Ward Flemons, W. and W.T. McNicholas, Clinical prediction of the sleep apnea syndrome. Sleep Med Rev, 1997. 1(1): p. 19-32.
56. Davies, R.J., N.J. Ali, and J.R. Stradling, Neck circumference and other clinical features in the diagnosis of the obstructive sleep apnoea syndrome. Thorax, 1992. 47(2): p. 101-5.
57. Ogretmenoglu, O., et al., Body fat composition: a predictive factor for obstructive sleep apnea. Laryngoscope, 2005. 115(8): p. 1493-8.
58. Santaolalla Montoya, F., et al., The predictive value of clinical and epidemiological parameters in the identification of patients with obstructive sleep apnoea (OSA): a clinical prediction algorithm in the evaluation of OSA. Eur Arch Otorhinolaryngol, 2007. 264(6): p. 637-43.
59. Cao, J., et al., [The primary diagnostic significance of the epworth sleepiness scale in patients with obstructive sleep apnea syndrome]. Zhonghua Jie He He Hu Xi Za Zhi, 2002. 25(3): p. 154-5.
60. Johns, M.W., A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep, 1991. 14(6): p. 540-5.
61. Johns, M.W., Reliability and factor analysis of the Epworth Sleepiness Scale. Sleep, 1992. 15(4): p. 376-81.
62. Uribe Echevarria, E.M., et al., [Epworth drowsiness scale value in obstructive sleep apnea syndrome]. Medicina (B Aires), 2000. 60(6): p. 902-6.
63. Sher, A.E., et al., Predictive value of Muller maneuver in selection of patients for uvulopalatopharyngoplasty. Laryngoscope, 1985. 95(12): p. 1483-7.
64. Schwab, R.J. and A.N. Goldberg, Upper airway assessment: radiographic and other imaging techniques. Otolaryngol Clin North Am, 1998. 31(6): p. 931-68.
65. Rivlin, J., et al., Upper airway morphology in patients with idiopathic obstructive sleep apnea. Am Rev Respir Dis, 1984. 129(3): p. 355-60.
Sleep Apnea and CMV Driver Safety– Update 2011
66. Roux, F., C. D’Ambrosio, and V. Mohsenin, Sleep-related breathing disorders and cardiovascular disease. Am J Med, 2000. 108(5): p. 396-402.
67. Kapuniai, L.E., et al., Identifying sleep apnea from self-reports. Sleep, 1988. 11(5): p. 430-6.
68. Bliwise, D.L., J.C. Nekich, and W.C. Dement, Relative validity of self-reported snoring as a symptom of sleep apnea in a sleep clinic population. Chest, 1991. 99(3): p. 600-8.
69. Grunstein, R., et al., Snoring and sleep apnoea in men: association with central obesity and hypertension. Int J Obes Relat Metab Disord, 1993. 17(9): p. 533-40.
70. Shinohara, E., et al., Visceral fat accumulation as an important risk factor for obstructive sleep apnoea syndrome in obese subjects. J Intern Med, 1997. 241(1): p. 11-8.
71. Chen, N.H., et al., A two-tier screening model using quality-of-life measures and pulse oximetry to screen adults with sleep-disordered breathing. Sleep Breath, 2010.
72. Crocker, B.D., et al., Estimation of the probability of disturbed breathing during sleep before a sleep study. Am Rev Respir Dis, 1990. 142(1): p. 14-8.
73. Dixon, J.B., L.M. Schachter, and P.E. O’Brien, Predicting sleep apnea and excessive day sleepiness in the severely obese: indicators for polysomnography. Chest, 2003. 123(4): p. 1134-41.
74. Khoo, S.M., et al., Diagnostic characteristics of clinical prediction models for obstructive sleep apnea in different clinic populations. Sleep Breath, 2010.
75. Morris, L.G., et al., Rapid risk stratification for obstructive sleep apnea, based on snoring severity and body mass index. Otolaryngol Head Neck Surg, 2008. 139(5): p. 615-8.
76. Pradhan, P.S., R.E. Gliklich, and J. Winkelman, Screening for obstructive sleep apnea in patients presenting for snoring surgery. Laryngoscope, 1996. 106(11): p. 1393-7.
77. Rauscher, H., W. Popp, and H. Zwick, Model for investigating snorers with suspected sleep apnoea. Thorax, 1993. 48(3): p. 275-9.
78. Rowley, J.A., L.S. Aboussouan, and M.S. Badr, The use of clinical prediction formulas in the evaluation of obstructive sleep apnea. Sleep, 2000. 23(7): p. 929-38.
79. Sharma, S.K., et al., A stepped approach for prediction of obstructive sleep apnea in overtly asymptomatic obese subjects: a hospital based study. Sleep Med, 2004. 5(4): p. 351-7.
80. Sharma, S.K., et al., Prediction of obstructive sleep apnea in patients presenting to a tertiary care center. Sleep Breath, 2006. 10(3): p. 147-54.
81. Viner, S., J.P. Szalai, and V. Hoffstein, Are history and physical examination a good screening test for sleep apnea? Ann Intern Med, 1991. 115(5): p. 356-9.
82. Whiting, P., et al., The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol, 2003. 3: p. 25.
83. Greenland, S., Quality scores are useless and potentially misleading: Reply to “Re: A critical look at some popular analytic methods”. American Journal of Epidemiology, 1994. 140(3): p. 300-302.
84. Kuna, S.T., Portable-monitor testing: an alternative strategy for managing patients with obstructive sleep apnea. Respir Care. 55(9): p. 1196-215.
85. Portier, F., et al., Evaluation of home versus laboratory polysomnography in the diagnosis of sleep apnea syndrome. Am J Respir Crit Care Med, 2000. 162(3 Pt 1): p. 814-8.
86. Le Bon O, H.G., Tecco J, et al., Mild to moderate sleep respiratory events: one negative night may not be enough. Chest, 2000. 118(2): p. 353-359.
87. Adams, N., et al., Relation of measures of sleep-disordered breathing to neuropsychological functioning. Am J Respir Crit Care Med, 2001. 163(7): p. 1626-31.
88. Bennett, L.S., et al., Health status in obstructive sleep apnea: relationship with sleep fragmentation and daytine sleepiness, and effects of continuous positive airway pressure treatment. Am J Respir Crit Care Med, 1999. 159(6): p. 1884-90.
Sleep Apnea and CMV Driver Safety– Update 2011
89. Bennett, L.S., et al., Sleep fragmentation indices as predictors of daytime sleepiness and nCPAP response in obstructive sleep apnea. Am J Respir Crit Care Med, 1998. 158(3): p. 778-86.
90. Gottlieb, D.J., et al., Relation of sleepiness to respiratory disturbance index: the Sleep Heart Health Study. Am J Respir Crit Care Med, 1999. 159(2): p. 502-7.
91. Kingshott, R.N., et al., Predictors of improvements in daytime function outcomes with CPAP therapy. Am J Respir Crit Care Med, 2000. 161(3 Pt 1): p. 866-71.
92. Olson, L.G., et al., A community study of snoring and sleep-disordered breathing. Prevalence. Am J Respir Crit Care Med, 1995. 152(2): p. 711-6.
93. Barbe, F., et al., Treatment with continuous positive airway pressure is not effective in patients with sleep apnea but no daytime sleepiness. a randomized, controlled trial. Ann Intern Med, 2001. 134(11): p. 1015-23.
94. Roure, N., et al., Daytime sleepiness and polysomnography in obstructive sleep apnea patients. Sleep Med, 2008. 9(7): p. 727-31.
95. Wiegand, D.M., R.J. Hanowski, and S.E. McDonald, Commercial drivers’ health: a naturalistic study of body mass index, fatigue, and involvement in safety-critical events. Traffic Inj Prev, 2009. 10(6): p. 573-9.
96. Smith, B. and B.A. Phillips, Truckers drive their own assessment for obstructive sleep apnea: a collaborative approach to online self-assessment for obstructive sleep apnea. J Clin Sleep Med. 7(3): p. 241-5.
97. Talmage, J.B., et al., Consensus criteria for screening commercial drivers for obstructive sleep apnea: evidence of efficacy. J Occup Environ Med, 2008. 50(3): p. 324-9.
98. Polit, D.F. and C.T. Beck, Nursing Research: Principles and Methods. 7th ed. 2004, Philadelphia, PA: Lippincott Williams & Wilkins.
99. Hartenbaum, N., et al., Sleep apnea and commercial motor vehicle operators: statement from the joint Task Force of the American College of Chest Physicians, American College of Occupational and Environmental Medicine, and the National Sleep Foundation. J Occup Environ Med, 2006. 48(9 Suppl): p. S4-37.
100. Kiely, J.L., et al., Comparison of a limited computerized diagnostic system (ResCare Autoset) with polysomnography in the diagnosis of obstructive sleep apnoea syndrome. Eur Respir J, 1996. 9(11): p. 2360-4.
101. Reichert, J.A., et al., Comparison of the NovaSom QSG, a new sleep apnea home-diagnostic system, and polysomnography. Sleep Med, 2003. 4(3): p. 213-8.
102. Parra, O., et al., Should patients with sleep apnoea/hypopnoea syndrome be diagnosed and managed on the basis of home sleep studies? Eur Respir J, 1997. 10(8): p. 1720-4.
103. Verse, T., et al., Validation of the POLY-MESAM seven-channel ambulatory recording unit. Chest, 2000. 117(6): p. 1613-8.
104. Fietze, I., et al., Automated analysis of data is inferior to visual analysis of ambulatory sleep apnea monitoring. Respiration, 2002. 69(3): p. 235-41.
105. White, D.P., et al., Assessment of accuracy and analysis time of a novel device to monitor sleep and breathing in the home. Sleep, 1995. 18(2): p. 115-26.
106. Shochat, T., et al., The SleepStrip: an apnoea screener for the early detection of sleep apnoea syndrome. Eur Respir J, 2002. 19(1): p. 121-6.
107. Practice parameters for the use of portable recording in the assessment of obstructive sleep apnea. Standards of Practice Committee of the American Sleep Disorders Association. Sleep, 1994. 17(4): p. 372-7.
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108. Chesson, A.L., Jr., et al., The indications for polysomnography and related procedures. Sleep, 1997. 20(6): p. 423-87.
109. Ross, S.D., et al., Systematic review and meta-analysis of the literature regarding the diagnosis of sleep apnea. Sleep, 2000. 23(4): p. 519-32.
110. Decision Memo for Continuous Positive Airway Pressure (CPAP) Therapy for Obstructive Sleep Apnea (OSA) (CAG-00093R). 2005; Available from: http://www.cms.hhs.gov/mcd/viewdecisionmemo.asp?id=110
111. Portable monitoring in the diagnosis of obstructive sleep apnea. J Clin Sleep Med, 2006. 2(3): p. 274.
112. Trikalinos, T., et al., Home diagnosis of obstructive sleep apnea-hypopnea syndrome, A.f.H.R.a. Quality, Editor. 2007, AHRQ: Rockville.
113. Lux, L., B. Boehlecke, and K.N. Lohr, Effectiveness of portable monitoring devices for diagnosing obstructive sleep apnea: Update of a systematic review., Agency for Healthcare Research and Quality, Editor. 2004, AHRQ: Rockville, MD.
114. Collop, N.A., et al., Clinical guidelines for the use of unattended portable monitors in the diagnosis of obstructive sleep apnea in adult patients. Portable Monitoring Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med, 2007. 3(7): p. 737-47.
115. Ghegan, M.D., et al., Laboratory versus portable sleep studies: a meta-analysis. Laryngoscope, 2006. 116(6): p. 859-64.
116. Joint Nordic Project, Obstructive Sleep Apnoea Syndrome. A Systematic Literature Review. 2007: Norrkoping, Sweden.
117. Thurnheer, R., et al., Respiratory polygraphy in sleep apnoea diagnosis. Report of the Swiss respiratory polygraphy registry and systematic review of the literature. Swiss Med Wkly, 2007. 137(5-6): p. 97-102.
118. Tice, J.A., Portable devices used for home testing in obstructive sleep apnea. 2009: San Francisco.
119. Tregear, S., M. Tiller, and J. Fontarrosa, Obstructive sleep apnea and commercial motor vehicle driver safety, Federal Motor Carrier Safety Administration, Editor. 2007.
120. Berry, R.B., et al., Portable monitoring and autotitration versus polysomnography for the diagnosis and treatment of sleep apnea. Sleep, 2008. 31(10): p. 1423-31.
121. Skomro, R.P., et al., Outcomes of home-based diagnosis and treatment of obstructive sleep apnea. Chest, 2010. 138(2): p. 257-63.
122. Whitelaw, W.A., R.F. Brant, and W.W. Flemons, Clinical usefulness of home oximetry compared with polysomnography for assessment of sleep apnea. Am J Respir Crit Care Med, 2005. 171(2): p. 188-93.
123. Mulgrew, A.T., et al., Diagnosis and initial management of obstructive sleep apnea without polysomnography: a randomized validation study. Ann Intern Med, 2007. 146(3): p. 157-66.
124. Watkins, M.R., et al., Correlation between screening for obstructive sleep apnea using a portable device versus polysomnography testing in a commercial driving population. J Occup Environ Med, 2009. 51(10): p. 1145-50.
125. Pittman, S.D., et al., Using a wrist-worn device based on peripheral arterial tonometry to diagnose obstructive sleep apnea: in-laboratory and ambulatory validation. Sleep, 2004. 27(5): p. 923-33.
126. Golpe, R., A. Jimenez, and R. Carpizo, Home sleep studies in the assessment of sleep apnea/hypopnea syndrome. Chest, 2002. 122(4): p. 1156-61.
127. Baltzan, M.A., et al., Accuracy of oximetry with thermistor (OxiFlow) for diagnosis of obstructive sleep apnea and hypopnea. Sleep, 2000. 23(1): p. 61-9.
Sleep Apnea and CMV Driver Safety– Update 2011
128. Ryan, P.J., et al., Validation of British Thoracic Society guidelines for the diagnosis of the sleep apnoea/hypopnoea syndrome: can polysomnography be avoided? Thorax, 1995. 50(9): p. 972-5.
129. Series, F., et al., Utility of nocturnal home oximetry for case finding in patients with suspected sleep apnea hypopnea syndrome. Ann Intern Med, 1993. 119(6): p. 449-53.
130. Executive summary on the systematic review and practice parameters for portable monitoring in the investigation of suspected sleep apnea in adults. Am J Respir Crit Care Med, 2004. 169(10): p. 1160-3.
131. Blackman, A., C. McGregor, and R. Dales, Canadian Sleep Society/Canadian Thoracic Society position paper on the use of portable monitoring for the diagnosis of obstructive sleep apnea/hypopnea in adults. Can Respir J, 2010. 17(5): p. 229-32.
132. Chesson, A.L., Jr., R.B. Berry, and A. Pack, Practice parameters for the use of portable monitoring devices in the investigation of suspected obstructive sleep apnea in adults. Sleep, 2003. 26(7): p. 907-13.
133. Collop, N.A., Portable monitoring for the diagnosis of obstructive sleep apnea. Curr Opin Pulm Med, 2008. 14(6): p. 525-9.
134. Kuna, S.T., Portable-monitor testing: an alternative strategy for managing patients with obstructive sleep apnea. Respir Care, 2010. 55(9): p. 1196-215.
135. Marcos, J.V., et al., Automated detection of obstructive sleep apnoea syndrome from oxygen saturation recordings using linear discriminant analysis. Med Biol Eng Comput, 2010. 48(9): p. 895-902.
136. Marcos, J.V., et al., Applying neural network classifiers in the diagnosis of the obstructive sleep apnea syndrome from nocturnal pulse oximetric recordings. Conf Proc IEEE Eng Med Biol Soc, 2007. 2007: p. 5174-7.
137. Marcos, J.V., et al., Radial basis function classifiers to help in the diagnosis of the obstructive sleep apnoea syndrome from nocturnal oximetry. Med Biol Eng Comput, 2008. 46(4): p. 323-32.
138. Marcos, J.V., et al., A classification algorithm based on spectral features from nocturnal oximetry and support vector machines to assist in the diagnosis of obstructive sleep apnea. Conf Proc IEEE Eng Med Biol Soc, 2009. 2009: p. 5547-50.
139. Marcos, J.V., et al., Assessment of four statistical pattern recognition techniques to assist in obstructive sleep apnoea diagnosis from nocturnal oximetry. Med Eng Phys, 2009. 31(8): p. 971-8.
140. Marcos, J.V., et al., Utility of multilayer perceptron neural network classifiers in the diagnosis of the obstructive sleep apnoea syndrome from nocturnal oximetry. Comput Methods Programs Biomed, 2008. 92(1): p. 79-89.
141. Marcos, J.V., et al., The classification of oximetry signals using Bayesian neural networks to assist in the detection of obstructive sleep apnoea syndrome. Physiol Meas, 2010. 31(3): p. 375-94.
142. Mendez, M.O., et al., Sleep apnea screening by autoregressive models from a single ECG lead. IEEE Trans Biomed Eng, 2009. 56(12): p. 2838-50.
143. Mendez, M.O., et al., Detection of sleep apnea from surface ECG based on features extracted by an autoregressive model. Conf Proc IEEE Eng Med Biol Soc, 2007. 2007: p. 6106-9.
144. Morillo, D.S., et al., Poincare analysis of an overnight arterial oxygen saturation signal applied to the diagnosis of sleep apnea hypopnea syndrome. Physiol Meas, 2009. 30(4): p. 405-20.
145. Ndegwa, S., M. Clark, and C. Argaez, Portable monitoring devices for diagnosis of obstructive sleep apnea at home: Review of accuaracy, cost-effectiveness, guidelines, and coverage in Canada., C.A.f.D.a.T.i. Health, Editor. 2009: Ottawa.
Sleep Apnea and CMV Driver Safety– Update 2011
146. Polese, J.F., et al., Portable monitoring devices in the diagnosis of obstructive sleep apnea: current status, advantages, and limitations. J Bras Pneumol, 2010. 36(4): p. 498-505.
147. Poupard, L., et al., Use of high-frequency peak in spectral analysis of heart rate increment to improve screening of obstructive sleep apnoea. Sleep Breath, 2010.
148. Ramachandran, S.K. and L.A. Josephs, A meta-analysis of clinical screening tests for obstructive sleep apnea. Anesthesiology, 2009. 110(4): p. 928-39.
149. Roche, F., et al., Analysis of the interbeat interval increment to detect obstructive sleep apnoea/hypopnoea. Eur Respir J, 2007. 29(6): p. 1206-11.
150. Salisbury, J.I. and Y. Sun, Rapid screening test for sleep apnea using a nonlinear and nonstationary signal processing technique. Med Eng Phys, 2007. 29(3): p. 336-43.
151. Stein, P.K., et al., A simple method to identify sleep apnea using Holter recordings. J Cardiovasc Electrophysiol, 2003. 14(5): p. 467-73.
152. Sun, J., et al., Identification of obstructive sleep apnea syndrome by ambulatory electrocardiography: clinical evaluation of time-domain and frequency-domain analyses of heart rate variability in Chinese patients. Cell Biochem Biophys, 2011. 59(3): p. 165-70.
153. Sunwoo, B. and S.T. Kuna, Ambulatory management of patients with sleep apnea: is there a place for portable monitor testing? Clin Chest Med, 2010. 31(2): p. 299-308.
154. Suzuki, T., et al., Development of a sleep apnea event detection method using photoplethysmography. Conf Proc IEEE Eng Med Biol Soc, 2010. 2010: p. 5258-61.
155. Tsai, W.H., et al., A decision rule for diagnostic testing in obstructive sleep apnea. Am J Respir Crit Care

(Following Articles bibliography from Itamar Medical)

Ancoli-Israel S, Kripke D, Klauber M, Mason W, Fell R, Kaplan O. Sleep-disordered breathing in community-dwelling elderly. Sleep 1991;14: 486-495.

Campos-Rodriguez F, Pena-Grian N, Reyes-Nunez N, et al. Mortality in obstructive sleep apnea-hypopnea patients treated with positive airway pressure. Chest. 2005;128:624-633.

Hla KM, Young TB, Bidwell T, Palta M, Skatrud JB, Dempsey J. Sleep apnea and hypertension. A population-based study. Ann Intern Med. Mar 1 1994;120(5):382-8.

Kapur V, Blough DK, Sandblom RE, et al. (September 1999). “The medical cost of undiagnosed sleep apnea”. Sleep 22 (6): 749-55.

Loube DI, Poceta JS, Morales MC, Peacock MD, Mitler MM. Self-reported snoring in pregnancy: association with fetal outcome. Chest 1996;109:885-889.

Marshall NS, Wong KK, Liu PY, Cullen SR, Knuiman MW, Grunstein RR. Sleep apnea as an independent risk factor for all-cause mortality: the Busselton Health Study. Sleep. 2008;31:1079-1085.

Medscape. com. Obstructive Sleep Apnea: An Expert Interview With Christopher Lettieri, MD.

N. A. Shah, M. D. , N. A. Botros, M. D. , H. K. Yaggi, M. D. , M. , V. Mohsenin, M. D. , New Haven, Connecticut (May 20, 2007). “Sleep Apnea Increases Risk of Heart Attack or Death by 30%”. American Thoracic Society.

Pagel JF. Obstructive sleep apnea (OSA) in primary care: evidence-based practice. J Am Board Fam Med. 2007;20:392-398.

Peppard PE, Szklo-Coxe M, Hla KM, Young T. Longitudinal association of sleep-related breathing disorder and depression. Arch Intern Med. 2006;166:1709-1715.

Strohl K, Redline S. Recognition of obstructive sleep apnea. Am J RespirCrit Care Med 1996;154

PUBLICATIONS

1. Kuvin JT, Patel RP, Sliney KA, Pandian NG, Sheffy J, Schnall RP, Karas RH, & Udelson JE. Assessment of Peripheral Vascular Endothelial Function with Finger Arterial Pulse Wave Amplitude. American Heart Journal 2003; 146(1):168-174. (Art17)

2. Bonetti PO, Barsness GW, Keelan PC, Schnell TI, Pummper GM, Kuvin JT, Schnall RP, Holmes DR, Higano ST, & Lerman A. Enhanced External Counterpulsation Improves Endothelial Function in Patients with Symptomatic Coronary Artery Disease. JACC 2003; 41(10):1761-1768. (Art20)

3. Fisher N, Hughes M, Gerhard-Herman M, & Hollenberg NK. Flavanol-rich cocoa induces nitric-oxide-dependent vasodilation in healthy humans. Journal of Hypertension 2003; 21(12):2281-2286. (Art23)

4. Iani C, Gopher D, & Lavie P. Effects of task difficulty and invested mental effort on peripheral vasoconstriction. Psychophysiology 2004; 41(5):789-798. (Art29)

5. Bonetti PO, Pumper GM, Higano ST, Holmes DR Jr, Kuvin JT, & Lerman A. Noninvasive Identification of Patients with Early Coronary Atherosclerosis by Assessment of Digital Reactive Hyperemia. JACC 2004; 44(11):2137-2141. (Art30)

6. Bonetti PO et al. A noninvasive Test for Endothelial Dysfunction. Nature Clinical Practice Cardiovascular Medicine 2005; 2(2):64-65. (Art32)

7. Itzhaki S , Lavie L, Pillar G, Tal G, & Lavie P. Endothelial Dysfunction in Obstructive Sleep Apnea Measured by Peripheral Arterial Tone Response in the Finger to Reactive Hyperemia. SLEEP 2005; 28(5):594-600. (Art33)

8. Yinon D, Lowenstein L, Suraya S, Beloosesky R, Zmora O, Malhotra A, & Pillar G. Pre- eclampsia toxemia is associated with sleep disordered breathing and endothelial dysfunction. European Respiratory Journal 2006; 27(2):328-333. (Art35)

9. Schroeter H, Hiess C, Balzer J, Kleinbongard P, Keen C, Hollenberg N, Sies H, Kwik-Uribe C, Schmitz H, & Kelm M. (-)- Epicatechin Mediates Beneficial Effects of Flavanol-Rich Cocoa on Vascular Function in Humans. PNAS 2006; 103(4):1024-1029. (Art36)

10. Mahmud FH, Earing MG, Lee RA, Lteif AN, Driscoll DJ, & Lerman A. Altered Endothelial Function in Asymptomatic Male Adolescents with Type I Diabetes. Congenital Heart Disease 2006; 1(3):98-103. (Art38)

11. Nohira A, Gerhard-Herman M, Creager MA, Hurley S, Mitra D, & Ganz P. The Role of Nitric Oxide in Regulation of Digital pulse Volume Amplitude in Humans. J Appl Physiology 2006; 101(2):545-8. (Art39)

12. Coll B, Aragones G, Parr S, Villaverde CA, & Masana L. Ezetimibe effectively decreases LDL Cholesterol in HIV-infected patients. Aids 2006; 20(12):1675-1677 Research letter. (Art40)

13. Fisher ND, & Hollenberg NK. Aging and vascular responses to flavanol-rich cocoa. Journal of Hypertens 2006; 24(8):1575-1580. (Art41)

14. Itzhaki S, Dorchin H, Clark GT, Lavie l, Lavie P, & Pillar G. The Effects of One Year Treatment with a Herbst Mandibular Advancement Splint on Sleep Apnea, Oxidative Stress and Endothelial Function. Chest 2007; 131:740-749. (Art42)

15. Lowenstein L, Damti A, Pillar G, Shott S, & Blumenfeld Z. Evaluation of Endothelial Function in women with Polycystic Ovary Syndrome. European Journal of Obstetrics & Gynecology and Reproductive Biology 2007; 134(2):208-12. (Art45)

16. Kuvin JT, Mammen A, Mooney P, Alsheikh-Ali A, & Karas RH. Assessment of Peripheral Vascular Endothelial Function in the Ambulatory Setting. Vascular Medicine 2007; 12(1):13-16. (Art46)

17. Haller MJ, Stein J, Shuster J, Theriaque D, Silverstein J, Schatz DA, Earing MG Lerman A, & Mahmud FH. Peripheral Artery Tonometry Demonstrates Altered Endothelial Function In Children With Type 1 Diabetes Pediatric Diabetes. Pediatric Diabetes 2007; 8(4):193—198. (Art48)

18. Miller VM, & Mulvagh SL. Sex steroids and endothelial function: translating basic science to clinical practice. Science Direct 2007; 28(6):263-70. (Art49)

19. Shachor-Meyouhas Y, Pillar G, & Shehadeh N. Uncontrolled Type 1 Diabetes Mellitus and Endothelial Dysfunction in Adolescents. IMAJ 2007; 9:637-640. (Art50)

20. Haller MJ, Silverstein JH, & Shuster JJ. Correlation between radial artery tonometry- and fingertip tonometry-derived augmentation index in children with type 1 diabetes. Diabetes Vasc Dis Research letter 2007; 4(1):66. (Art51)

PUBLICATIONS CONTINUED

21. Tarlovsky Y, Yechiam E, Ofek E, & Grunwald A. Peripheral Arterial Tone: A missing channel in polygraph examination?. American Journal of Forensic Psychology 2008; 26(2). (Art53)

22. Iani C, Gopher D, Grunwald AJ, & Lavie P. Peripheral arterial tone as an on-line measure of load in a simulated flight task. Ergonomics 2007; 50(7):1026-35. (Art55)

23. Yeo TW, Lampah DA, Gitawati R, Tjitra E, Kenangalem E, McNeil YR, Darcy CJ, Granger DL, Weinberg JB, Lopansri BK, Price RN, Duffull SB, Celermajer DS, & Anstey NM. Impaired nitric oxide bioavailability and L -arginine—reversible endothelial dysfunction in adults with falciparum malaria. JEM 2007; 204(11): 2693-2704. (Art57)

24. Lee PY, Li Y, Richards HB, Chan FS, Zhuang H, Narain S, Butfiloski EJ, Sobel ES, Reeves WH, & Segal MS. Type I interferon as a novel risk factor for endothelial progenitor cell depletion and endothelial dysfunction in systemic lupus Erythematosus. Arthritis & Rheumatism 2007; 56(11): 3759-3769. (Art58)

25. Hollenberg NK, & Fisher NDL. Is It the Dark in Dark Chocolate?. Circulation 2007; 116: 2360-2362. (Art59)

ITAMAR WATCH – PAT200 ACADEMIC STUDIES

1. Schnall RP, Shlitner A, Sheffy J, Kedar R, & Lavie P. Periodic, Profound Peripheral Vasoconstriction — A New Marker of obstructive Sleep Apnea. SLEEP 1999; 22(7):939-46. (Art1)

2. Lavie P, Shlitner A, Sheffy J, & Schnall RP. Peripheral Arterial Tonometry: A novel and sensitive non-invasive monitor of brief arousals during sleep. IMAJ 2000; 2(3):246-7. (Art2)

3. Lavie P, Schnall RP, Sheffy J, & Shlitner A. Peripheral Vasoconstriction during REM sleep detected by a novel plethysmographic method. Nature Medicine 2000; 6(6):606. (Art3)

4. Penzel T, Brandenburg U, Fricke R, & Peter JH. New methods for the non-invasive assessment of sympathetic activity during sleep. Somnologie 2002; 6(2):69-73. (Art6)

5. Dvir I, Adler Y, Freimark D, & Lavie P. Evidence for fractal correlation properties in the variations of peripheral arterial tone during REM sleep. American Journal of Physiology 2002; 283(1):H434-H439. (Art7)

6. Pillar G, Bar A, Shlitner A, Schnall RP, Sheffy J, & Lavie P. Autonomic Arousal Index (AAI): An Automated Detection based on Peripheral Arterial Tonometry. SLEEP 2002; 25(5):543-549. (Art8)

7. Freimark D, Adler Y, Sheffy J, Schechter D, Schwammenthal E, Motro M, & Lavie P. Oscillations in peripheral arterial tone in CHF patients: A new marker for Cheyne-Stokes breathing. Cardiology 2002; 98(1-2):21-4. (Art11)

8. O’Donnell CP, Allan L, Atkinson P, & Schwartz AR. The effect of upper airway obstruction and arousal on Peripheral Arterial Tonometry in Obstructive Sleep Apnea. Am J Respir Crit Care Med 2002; 166(7):965-71. (Art12)

9. Pillar G, Bar A, Bettito M, Schnall R, Dvir I, Sheffy J, & Lavie P. An automatic ambulatory device for detection of AASM defined arousals from sleep: the WP100. Sleep Medicine2003; 4(3):207-212. (Art15)

10. Bar A, Pillar G, Dvir I, Sheffy J, Schnall RP, & Lavie P. Evaluation of a Portable Device Based on Peripheral Arterial Tone for Unattended Home Sleep Studies. Chest 2003; 123(3): 695-703. (Art16)

11. Pillar G, Schuscheim G, Weiss R, Malhotra A, McCowen KC, Shlitner A, Peled N, & Shehadeh N. Interactions between hypoglycemia and sleep architecture in children with type 1 diabetes mellitus. J Pediatr 2003; 142(2):163-168. (Art18)

12. Ayas N TA, Pittman S, MacDonald M, & White D. Assessment of a Wrist-worn Device in the Detection of Obstructive Sleep Apnea. Sleep Medicine 2003; 4(5):435-442. (Art21)

13. Margel D, White D, & Pillar G. long-Term intermittent exposure to high ambient CO2 causes respiratory disturbances during sleep in submariners. Chest 2003; 124(5):1716-1723. (Art22)

14. Zou D, Grote L, Eder ND, Peker Y, & Hedner J. Obstructive Apneic Events Induce Alpha-receptor Mediated Digital Vasoconstriction. SLEEP 2004; 27(3):485-489. (Art25)

15. Tauman R, O’Brien ML, Mast TB, Holbrook CH, & Gozal D. Peripheral Arterial Tonometry Events and EEG Arousals in Children. SLEEP 2004; 27(3):502-506. (Art26)

16. Pittman SD, Ayas NT, MacDonald MM, Malhotra A, Fogel RB, & White DP. Using a Wrist-Worn Device Based on Peripheral Arterial Tonometry to Diagnose Obstructive Sleep Apnea: In-Laboratory and Ambulatory Validation. SLEEP 2004; 27(5):923-933. (Art27)

17. Hedner J, Pillar G, Pittman DS, Zou D, Grote L, & White D. A Novel adaptive wrist actigraphy algorithm for Sleep-Wake assessment in sleep apnea patients. SLEEP 2004; 27(8):1560-1566. (Art28)

18. Penzel T, Kesper K, Pinnow I, Becker HF, & Vogelmeier C. Peripheral arterial tonometry, oximetry and actigraphy for ambulatory recording of sleep apnea. Physiol Meas 2004; 25(4):1025-1036. (Art31)

19. Penzel T, Kesper K, Pinnow I, Becker HF, & Vogelmeier C. Peripheral arterial tonometry, oximetry and actigraphy for ambulatory recording of sleep apnea. Physiol Meas 2004; 25(4):1025-1036. (Art31)

20. Zou D, Grote L, Peker Y, Lindblad U, & Hedner J. Validation a Portable Monitoring Device for Sleep Apnea Diagnosis in a Population Base Cohort Using Synchronized Home Polysomnography. SLEEP 2006; 29(3):367-374. (Art34)

21. Yinon D, Lowenstein L, Suraya S, Beloosesky R, Zmora O, Malhotra A, & Pillar G. Pre- eclampsia toxemia is associated with sleep disordered breathing and endothelial dysfunction. European Respiratory Journal 2006; 27(2):328-333. (Art35)

22. Pittman SD, Pillar G, Berry RB, Malhotra A, MacDonald MM, & White DP. Follow-Up Assessment of CPAP Efficacy in Patients with Obstructive Sleep Apnea using an Ambulatory Device Based on Peripheral Arterial Tonometry. Sleep and Breathing 2006; 10(3):123-131. (Art37)

23. Itzhaki S, Dorchin H, Clark GT, Lavie l, Lavie P, & Pillar G. The Effects of One Year Treatment with a Herbst Mandibular Advancement Splint on Sleep Apnea, Oxidative Stress and Endothelial Function. Chest 2007; 131:740-749. (Art42)

24. Townsend D, Sharma A, Brauer E, Scattarelli D, McEiver J, Eiken T, & Freiberg M. Assessing Efficacy, Outcomes , and Cost Savings for Patients with Obstructive Sleep Apnea Using Two Diagnostic and Treatment Strategies. Sleep Diagnosis and Therapy 2007; 17):1-8. (Art43)

25. Herscovici S, Peer A, Papyan S, & Lavie p. Detecting REM sleep from the finger: automatic REM sleep algorithm based on Peripheral Arterial Tone (PAT) and actigraphy. Physiol Meas 2007; 28(2): 129-140. (Art44)

____________________________________________________________________________________________

OUR NOTE:  Recently released and updated American College of Physicians Recent Practice Guidelines for the treatment of obstructive sleep apnea (OSA) including an extensive and excellent academic bibliography for further reference and research.

Summary of the American College of Physicians guideline on management of OSA in adults.

+Image not available.

Recommendation 1: ACP recommends that all overweight and obese patients diagnosed with OSA should be encouraged to lose weight. (Grade: strong recommendation; low-quality evidence)

Obesity is a risk factor for OSA, and evidence showed that intensive weight-loss interventions help reduce AHI scores and improve OSA symptoms. Weight loss is also associated with many other health benefits other than for OSA. Other factors, such as alcohol and opioid use, may be associated with adverse outcomes in patients with sleep apnea, but these factors were not addressed in the evidence review.

Recommendation 2: ACP recommends continuous positive airway pressure treatment as initial therapy for patients diagnosed with OSA. (Grade: strong recommendation; moderate-quality evidence)

In patients with excessive daytime sleepiness who have been diagnosed with OSA, CPAP is the most extensively studied therapy. This treatment has been shown to improve ESS scores, reduce AHI and arousal index scores, and increase oxygen saturation. However, CPAP has not been shown to increase quality of life. Evidence on the effect of CPAP on cardiovascular disease, hypertension, and type 2 diabetes was insufficient. Studies have evaluated various alternative CPAP modifications. Fixed and auto-CPAP, as well as C-Flex, have similar adherence and efficacy. Data were insufficient to determine the comparative efficacy of other CPAP modifications. Greater AHI and ESS scores were generally associated with better adherence to CPAP.

Recommendation 3: ACP recommends mandibular advancement devices as an alternative therapy to continuous positive airway pressure treatment for patients diagnosed with OSA who prefer mandibular advancement devices or for those with adverse effects associated with continuous positive airway pressure treatment. (Grade: weak recommendation; low-quality evidence)

Evidence showed that MADs have been used as an alternative to CPAP for treatment of OSA. Patients had AHI scores between 18 and 40 events per hour. Evidence to suggest which patients would benefit most from MADs was insufficient. However, MADs can be considered in patients with adverse effects or for those who do not tolerate or adhere to CPAP.

Pharmacologic agents were evaluated as primary agents for OSA management, and current evidence from 1 study for each drug was insufficient to recommend the use of any of the agents. Pharmacologic agents included mirtazapine, xylometazoline, fluticasone, paroxetine, pantoprazole, steroid plus CPAP, acetazolamide, and protriptyline.

Clinicians should target evaluation and treatment of OSA to patients with unexplained daytime sleepiness. Assessment of effectiveness is based primarily on improvement of daytime sleepiness; however, the effect on other clinical outcomes, including hypertension, cardiovascular events, and death, is uncertain. Adherence to therapies, especially CPAP, is important for effective OSA treatment. Clinicians should keep patient preferences and adherence, specific reasons for nonadherence, and costs in mind before initiating CPAP. They should encourage weight loss in obese patients because obesity is associated with increased risk for OSA, and weight loss may reduce OSA symptoms and has many other health benefits. Pharmacologic therapy is not currently supported by evidence and should not be prescribed for OSA treatment. Surgical treatments are associated with risks and serious adverse effects. Current evidence evaluating surgery was limited and insufficient to show the benefits of surgery as treatment of OSA and thus should not be used as initial treatment.

Grahic Jump Location

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Engleman HM, Martin SE, Kingshott RN, Mackay TW, Deary IJ, Douglas NJ. Randomised placebo controlled trial of daytime function after continuous positive airway pressure (CPAP) therapy for the sleep apnoea/hypopnoea syndrome. Thorax. 1998; 53:341-5.
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Lojander J, Maasilta P, Partinen M, Brander PE, Salmi T, Lehtonen H. Nasal-CPAP, surgery, and conservative management for treatment of obstructive sleep apnea syndrome. A randomized study. Chest. 1996; 110:114-9.
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Barbé F, Durán-Cantolla J, Capote F, de la Peña M, Chiner E, Masa JF, et al, Spanish Sleep and Breathing Group. Long-term effect of continuous positive airway pressure in hypertensive patients with sleep apnea. Am J Respir Crit Care Med. 2010; 181:718-26.
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Comondore VR, Cheema R, Fox J, Butt A, John Mancini GB, Fleetham JA, et al. The impact of CPAP on cardiovascular biomarkers in minimally symptomatic patients with obstructive sleep apnea: a pilot feasibility randomized crossover trial. Lung. 2009; 187:17-22.
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Drager LF, Bortolotto LA, Figueiredo AC, Krieger EM, Lorenzi GF. Effects of continuous positive airway pressure on early signs of atherosclerosis in obstructive sleep apnea. Am J Respir Crit Care Med. 2007; 176:706-12.
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Engleman HM, Gough K, Martin SE, Kingshott RN, Padfield PL, Douglas NJ. Ambulatory blood pressure on and off continuous positive airway pressure therapy for the sleep apnea/hypopnea syndrome: effects in “non-dippers.”. Sleep. 1996; 19:378-81.
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Kaneko Y, Floras JS, Usui K, Plante J, Tkacova R, Kubo T, et al. Cardiovascular effects of continuous positive airway pressure in patients with heart failure and obstructive sleep apnea. N Engl J Med. 2003; 348:1233-41.
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Barbé F, Durán-Cantolla J, Sánchez-de-la-Torre M, Mart|íinez-Alonso M, Carmona C, Barceló A, et al, Spanish Sleep and Breathing Network. Effect of continuous positive airway pressure on the incidence of hypertension and cardiovascular events in nonsleepy patients with obstructive sleep apnea: a randomized controlled trial. JAMA. 2012; 307:2161-8.
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Minnerup J, Ritter MA, Wersching H, Kemmling A, Okegwo A, Schmidt A, et al. Continuous positive airway pressure ventilation for acute ischemic stroke: a randomized feasibility study. Stroke. 2012; 43:1137-9.
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Parra O, Sánchez-Armengol A, Bonnin M, Arboix A, Campos-Rodr|íiguez F, Pérez-Ronchel J, et al. Early treatment of obstructive apnoea and stroke outcome: a randomised controlled trial. Eur Respir J. 2011; 37:1128-36.
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Campos-Rodriguez F, Martinez-Garcia MA, de la Cruz-Moron I, Almeida-Gonzalez C, Catalan-Serra P, Montserrat JM. Cardiovascular mortality in women with obstructive sleep apnea with or without continuous positive airway pressure treatment: a cohort study. Ann Intern Med. 2012; 156:115-22.
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Korostovtseva LS, Sviryaev YV, Zvartau NE, Konradi AO, Kalinkin AL. Prognosis and cardiovascular morbidity and mortality in prospective study of hypertensive patients with obstructive sleep apnea syndrome in St Petersburg, Russia. Med Sci Monit. 2011; 17:CR146-53.
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Campos-Rodriguez F, Peña-Griñan N, Reyes-Nuñez N, De la Cruz-Moron I, Perez-Ronchel J, De la Vega-Gallardo F, et al. Mortality in obstructive sleep apnea-hypopnea patients treated with positive airway pressure. Chest. 2005; 128:624-33.
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Doherty LS, Kiely JL, Swan V, McNicholas WT. Long-term effects of nasal continuous positive airway pressure therapy on cardiovascular outcomes in sleep apnea syndrome. Chest. 2005; 127:2076-84.
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Marti S, Sampol G, Muñoz X, Torres F, Roca A, Lloberes P, et al. Mortality in severe sleep apnoea/hypopnoea syndrome patients: impact of treatment. Eur Respir J. 2002; 20:1511-8.
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Veale D, Chailleux E, Hoorelbeke-Ramon A, Reybet-Degas O, Humeau-Chapuis MP, Alluin-Aigouy F, et al. Mortality of sleep apnoea patients treated by nasal continuous positive airway pressure registered in the ANTADIR observatory. Association Nationale pour le Traitement A Domicile de l’Insuffisance Respiratoire chronique. Eur Respir J. 2000; 15:326-31.
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Buchner NJ, Sanner BM, Borgel J, Rump LC. Continuous positive airway pressure treatment of mild to moderate obstructive sleep apnea reduces cardiovascular risk. Am J Respir Crit Care Med. 2007; 176:1274-80.
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Marin JM, Carrizo SJ, Vicente E, Agusti AG. Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet. 2005; 365:1046-53.
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38
Nakamura H, Kanemura T, Takara C, Tsukayama A, Tohyama K, Matsumoto T, et al. A retrospective analysis of 4000 patients with obstructive sleep apnea in Okinawa, Japan. Sleep Biol Rhythms. 2009;7:103-12.
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Morrish E, Shneerson JM, Smith IE. Why does gender influence survival in obstructive sleep apnoea? Respir Med. 2008; 102:1231-6.
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