A5091311035- Obstructive Sleep Apnea Research
- Neuroscience of respiration and sleep
- Sleep and Wakefulness Research
- Tracheal and airway disorders
- Sleep and related disorders
- Cardiovascular and Diving-Related Complications
- Respiratory Support and Mechanisms
- Airway Management and Intubation Techniques
- Dysphagia Assessment and Management
- Cardiovascular Syncope and Autonomic Disorders
- COVID-19 and Mental Health
- Sleep and Work-Related Fatigue
- Congenital Heart Disease Studies
- Chronic Obstructive Pulmonary Disease (COPD) Research
- Pulmonary Hypertension Research and Treatments
- Voice and Speech Disorders
- Delphi Technique in Research
- Occupational Health and Burnout
- Heart Rate Variability and Autonomic Control
- Nasal Surgery and Airway Studies
- Long-Term Effects of COVID-19
- Salivary Gland Disorders and Functions
- Child Nutrition and Feeding Issues
- Bone health and osteoporosis research
- Magnesium in Health and Disease
Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
2016-2025
Instituto do Coração
2016-2025
Universidade de São Paulo
2014-2024
Instituto do Sono
2015-2024
Weatherford College
2022
Brazilian Medical Association
2022
University of California System
2020
University of California, San Diego
2020
Cornell University
2020
Canadian Sleep & Circadian Network
2020
Upper airway muscle function plays a major role in maintenance of the upper patency and contributes to genesis obstructive sleep apnea syndrome (OSAS). Preliminary results suggested that oropharyngeal exercises derived from speech therapy may be an effective treatment option for patients with moderate OSAS.To determine impact OSAS.Thirty-one OSAS were randomized 3 months daily ( approximately 30 min) sham (n = 15, control) or set 16), consisting involving tongue, soft palate, lateral...
A low respiratory arousal threshold (ArTH) is one of several traits involved in obstructive sleep apnea pathogenesis and may be a therapeutic target; however, there no simple way to identify patients without invasive measurements.To determine the physiologic determinates ArTH develop clinical tool that can with ArTH.Anthropometric data were collected 146 participants who underwent overnight polysomnography an epiglottic catheter measure (nadir pressure before arousal). The was measured from...
The COVID-19 pandemic has challenged the population of affected areas in multiple dimensions. Adolescents have been especially with school closure and home confinement. impact on sleep habits quality life among adolescents not adequately characterized. We hypothesized that induced an evening shift daily rhythm adversely high students.Students were questioned about their usual bed wake-up times answered Pittsburgh Sleep Quality Index Questionnaire, Epworth Sleepiness Scale, Horne-Osteberg...
Upper airway anatomy plays a major role in obstructive sleep apnea (OSA) pathogenesis. An inferiorly displaced hyoid as measured by the mandibular plane to distance (MPH) has been consistently associated with OSA. The is also common landmark for pharyngeal length, upper volume, and tongue base. Tongue dimensions, obesity are OSA severity, although link between these anatomical variables collapsibility less well known. We hypothesized that body mass index (BMI), neck waist circumferences,...
Obstructive sleep apnoea (OSA) is characterised by pharyngeal obstruction occurring at different sites. Endoscopic studies reveal that epiglottic collapse renders patients higher risk of failed oral appliance therapy or accentuated on continuous positive airway pressure. Diagnosing currently requires invasive (imaging and endoscopy). As an alternative, we propose can be detected from the distinct airflow patterns it produces during sleep. 23 OSA underwent natural endoscopy. 1232 breaths...
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The critical closing pressure (Pcrit) is the airway at which collapses and reflects anatomical contribution to genesis of obstructive sleep apnea. Pcrit usually determined during non-rapid eye movement night, but has been under midazolam sedation day in absence stage monitoring. Indeed, little known about effects on architecture. Moreover, deeper with can decrease upper muscle activity increase collapsibility compared natural sleep. not systematically usual method performed Therefore, this...
Background Obstructive sleep apnea (OSA) is common among patients with coronary artery disease. However, OSA remains largely under recognized. The lack of clinical suspicion and difficulties to access full polysomnography (PSG) are limiting factors. aim this study was evaluate, referred bypass grafting (CABG): (i) the prevalence OSA, (ii) association symptoms, (iii) performance overnight unattended portable monitoring (PM) as an alternative method for diagnosis OSA. Methods Consecutive CABG...
Key points Changes in the level of inspired oxygen have dramatic effects on pathophysiology obstructive sleep apnoea (OSA): hyperoxia reduces severity OSA some but not all patients, whereas hypoxia transforms events into central events. Given that is likely to result from interaction key pathophysiological traits, including a compromised pharyngeal anatomy, inadequate upper airway muscle function, large ventilatory response disturbance ventilation (high loop gain) and low arousal threshold,...
Pharyngeal critical closing pressure (Pcrit) or collapsibility is a major determinant of obstructive sleep apnea (OSA) and may be used to predict the success/failure non-continuous positive airway (CPAP) therapies. Since its assessment involves overnight manipulation CPAP, we sought validate peak inspiratory flow during natural (without CPAP) as simple surrogate measurement collapsibility. Fourteen patients with OSA attended polysomnography pneumotachograph airflow. The middle third night...
•Some patients with obstructive sleep apnoea (OSA) respond well to oral appliance therapy, whereas others do not for reasons that are unclear. •In the present study, we used gold-standard measurements demonstrate a posteriorly-located tongue (natural endoscopy) exhibit preferential improvement in collapsibility (lowered critical closing pressure) appliances. •We also show both and less severe (predicted responder phenotype) greater improvements severity of (i.e. reduction event frequency by...
Cognitive behavioral therapy for insomnia (CBT-I) improves obstructive sleep apnea (OSA) severity in comorbid and (COMISA), though the mechanisms underlying this change are unstudied. CBT-I, which promotes continuity reduces hyperarousal, may improve OSA by raising respiratory arousal threshold. We aimed to investigate effect of CBT-I on its impact threshold other endotype traits. In single-arm trial, 25 patients with COMISA (13F:12M, Mage=53.7, SDage=8.7 years) completed a seven-week...
Obstructive sleep apnea (OSA) and the metabolic syndrome (MS) are independently associated with increased cardiovascular risk. The objective of present study was to determine prevalence OSA among consecutive patients MS whether is impaired glycemic control. Fifty a recent diagnosis no previous underwent polysomnography anthropometric laboratory measurements. (apnea‐hypopnea index ≥15 events per hour sleep) 68% in same range all other individual components MS. Moreover, levels glucose ( P...
In some patients, obstructive sleep apnea (OSA) can be resolved with improvement in pharyngeal patency by sleeping lateral rather than supine, possibly as gravitational effects on the tongue are relieved. Here we tested hypothesis that depends anatomical structure causing collapse, patients tongue-related obstruction and epiglottic collapse exhibiting preferential improvements.Twenty-four OSA underwent upper airway endoscopy during natural to determine associated obstruction, simultaneous...
There is a growing interest to develop simple method characterize the mechanisms leading upper airway collapse in order guide treatment options patients with obstructive sleep apnea (OSA). Critical closing pressure (Pcrit) during able predict anatomical component of OSA. However, Pcrit laborious that only used for research purposes. The application negative expiratory (NEP) assess collapsibility can be easily performed wakefulness. We hypothesized NEP will be, similarly Pcrit, associated...