2023
International Consensus Statement on Obstructive Sleep Apnea
Chang JL, Goldberg AN, Alt JA, Mohammed A, Ashbrook L, Auckley D, Ayappa I, Bakhtiar H, Barrera J, Bartley B, Billings M, Boon M, Bosschieter P, Braverman I, Brodie K, Cabrera‐Muffly C, Caesar R, Cahali M, Cai Y, Cao M, Capasso R, Caples S, Chahine L, Chang C, Chang K, Chaudhary N, Cheong C, Chowdhuri S, Cistulli P, Claman D, Collen J, Coughlin K, Creamer J, Davis E, Dupuy‐McCauley K, Durr M, Dutt M, Ali M, Elkassabany N, Epstein L, Fiala J, Freedman N, Gill K, Gillespie M, Golisch L, Gooneratne N, Gottlieb D, Green K, Gulati A, Gurubhagavatula I, Hayward N, Hoff P, Hoffmann O, Holfinger S, Hsia J, Huntley C, Huoh K, Huyett P, Inala S, Ishman S, Jella T, Jobanputra A, Johnson A, Junna M, Kado J, Kaffenberger T, Kapur V, Kezirian E, Khan M, Kirsch D, Kominsky A, Kryger M, Krystal A, Kushida C, Kuzniar T, Lam D, Lettieri C, Lim D, Lin H, Liu S, MacKay S, Magalang U, Malhotra A, Mansukhani M, Maurer J, May A, Mitchell R, Mokhlesi B, Mullins A, Nada E, Naik S, Nokes B, Olson M, Pack A, Pang E, Pang K, Patil S, Van de Perck E, Piccirillo J, Pien G, Piper A, Plawecki A, Quigg M, Ravesloot M, Redline S, Rotenberg B, Ryden A, Sarmiento K, Sbeih F, Schell A, Schmickl C, Schotland H, Schwab R, Seo J, Shah N, Shelgikar A, Shochat I, Soose R, Steele T, Stephens E, Stepnowsky C, Strohl K, Sutherland K, Suurna M, Thaler E, Thapa S, Vanderveken O, de Vries N, Weaver E, Weir I, Wolfe L, Woodson B, Won C, Xu J, Yalamanchi P, Yaremchuk K, Yeghiazarians Y, Yu J, Zeidler M, Rosen I. International Consensus Statement on Obstructive Sleep Apnea. International Forum Of Allergy & Rhinology 2023, 13: 1061-1482. PMID: 36068685, PMCID: PMC10359192, DOI: 10.1002/alr.23079.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsMeSH KeywordsAdultContinuous Positive Airway PressureHumansPolysomnographyRisk FactorsSleep Apnea, ObstructiveConceptsObstructive sleep apneaEvidence-based reviewPositive airway pressureInternational consensus statementSleep apneaConsensus statementAdult OSA patientsMultiple treatment modalitiesSleep apnea evaluationAirway pressureOSA patientsPAP adherenceSurgical treatmentEvidence-based practiceOSA treatmentLongitudinal careTreatment modalitiesClinical managementRisk factorsHealth risk outcomesStudy qualitySyndrome definitionCurrent evidenceRecommendation formatOSA disease
2021
Can the complete blood count be used as a reliable screening tool for obstructive sleep apnea?
Cummins E, Waseem R, Piyasena D, Wang CY, Suen C, Ryan C, Wong J, Kryger M, Chung F. Can the complete blood count be used as a reliable screening tool for obstructive sleep apnea? Sleep And Breathing 2021, 26: 613-620. PMID: 34185230, DOI: 10.1007/s11325-021-02383-3.Peer-Reviewed Original ResearchMeSH KeywordsBlood Cell CountHumansHypoxiaPolysomnographyRetrospective StudiesSleep Apnea, ObstructiveConceptsApnea-hypopnea indexComplete blood countMean SpO2Intermittent hypoxiaBlood countScreening toolObstructive sleep apneaMean oxygen saturationBody mass indexMethodsThis retrospective studyNormal clinical rangeObstructive sleep apnea screeningHome sleep studiesReliable screening toolSleep apnea screeningSevere OSAOSA severityRed blood cellsSurgical patientsIndependent predictorsMass indexSleep apneaAHI scoreRetrospective studySleep studies
2020
Home PAP devices in patients infected with COVID-19.
Kryger M, Thomas R. Home PAP devices in patients infected with COVID-19. Journal Of Clinical Sleep Medicine 2020, 16: 1217-1219. PMID: 32268933, PMCID: PMC7954070, DOI: 10.5664/jcsm.8490.Peer-Reviewed Original ResearchHow much is too much after all? Primary snoring as a remaining unsolved issue.
Meira E Cruz M, Soca R, Kryger M. How much is too much after all? Primary snoring as a remaining unsolved issue. Journal Of Clinical Sleep Medicine 2020, 16: 991. PMID: 32223883, PMCID: PMC7849670, DOI: 10.5664/jcsm.8442.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus Statements
2019
The role of home sleep testing for evaluation of patients with excessive daytime sleepiness: focus on obstructive sleep apnea and narcolepsy
Rosenberg R, Hirshkowitz M, Rapoport DM, Kryger M. The role of home sleep testing for evaluation of patients with excessive daytime sleepiness: focus on obstructive sleep apnea and narcolepsy. Sleep Medicine 2019, 56: 80-89. PMID: 30803831, DOI: 10.1016/j.sleep.2019.01.014.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsMeSH KeywordsAdultComorbidityDisorders of Excessive SomnolenceHumansMonitoring, AmbulatoryNarcolepsyPolysomnographySleep Apnea, ObstructiveConceptsHome sleep apnea testingObstructive sleep apneaExcessive daytime sleepinessSleep disordersSleep apneaEvaluation of EDSLow cerebrospinal fluid (CSF) hypocretin (orexin) levelsCerebrospinal fluid hypocretin levelsEvaluation of patientsDifferential clinical characteristicsDiagnosis of narcolepsySleep apnea testingHome sleep testingClinical characteristicsExcessive daytimeHypocretin levelsSleep testingApnea testingConsensus guidelinesLaboratory polysomnographyNarcolepsy diagnosisDaytime sleepinessCommon complaintMedical conditionsSubstantial burden
2018
Flow limitation/obstruction with recovery breath (FLOW) event for improved scoring of mild obstructive sleep apnea without electroencephalography
Johnson KG, Johnson DC, Thomas RJ, Feldmann E, Lindenauer PK, Visintainer P, Kryger MH. Flow limitation/obstruction with recovery breath (FLOW) event for improved scoring of mild obstructive sleep apnea without electroencephalography. Sleep Medicine 2018, 67: 249-255. PMID: 30583916, PMCID: PMC6548700, DOI: 10.1016/j.sleep.2018.11.014.Peer-Reviewed Original ResearchMeSH KeywordsArousalFemaleHumansMalePolysomnographyReproducibility of ResultsRespiratory SystemSleep Apnea, ObstructiveSnoringConceptsApnea/hypopnea indexObstructive sleep apneaMild obstructive sleep apneaSleep apneaAirflow disruptionIntraclass correlationAHI categoriesBaseline PSGHypopnea indexOSA patientsHighest tertileOSA categoriesArousal criteriaPatientsFlow limitationApneaDesaturationFlow scoreArousal eventsOverall kappaObstructionTraining periodHigher proportionElectroencephalographyScoring
2016
Effects of Suvorexant, an Orexin Receptor Antagonist, on Respiration during Sleep In Patients with Obstructive Sleep Apnea.
Sun H, Palcza J, Card D, Gipson A, Rosenberg R, Kryger M, Lines C, Wagner JA, Troyer MD. Effects of Suvorexant, an Orexin Receptor Antagonist, on Respiration during Sleep In Patients with Obstructive Sleep Apnea. Journal Of Clinical Sleep Medicine 2016, 12: 9-17. PMID: 26194728, PMCID: PMC4702197, DOI: 10.5664/jcsm.5382.Peer-Reviewed Original ResearchConceptsObstructive sleep apneaOrexin receptor antagonistMean AHIRespiratory effectsSleep apneaMultiple dosesReceptor antagonistIntra-individual variabilityModerate obstructive sleep apneaEffects of suvorexantLowest effective doseSleep laboratory studiesTotal sleep timeMean SpO2Single doseRespiratory functionOxygen saturationPulse oximetryPlaceboPatientsSleep timeAHIDay 4Mean increaseSuvorexant
2015
The Use of a Fully Automated Automatic Adaptive Servoventilation Algorithm in the Acute and Long-term Treatment of Central Sleep Apnea
Javaheri S, Winslow D, McCullough P, Wylie P, Kryger MH. The Use of a Fully Automated Automatic Adaptive Servoventilation Algorithm in the Acute and Long-term Treatment of Central Sleep Apnea. CHEST Journal 2015, 148: 1454-1461. PMID: 25950507, DOI: 10.1378/chest.14-2966.Peer-Reviewed Original ResearchConceptsCentral apnea indexApnea-hypopnea indexCentral sleep apneaSleep apneaSleep qualityComplex sleep-disordered breathingASV deviceASV titrationAdaptive servoventilation devicesCongestive heart failureMonths of treatmentSleep-disordered breathingEpworth Sleepiness ScaleLong-term treatmentImproved sleep qualityMixed sleep apneaBetter sleep qualityApnea indexHeart failureObservational trialObstructive apneaBreathing disordersInspiratory pressureArousal indexDaytime sleepiness
2014
A Matched Cohort Study of Postoperative Outcomes in Obstructive Sleep Apnea
Mutter TC, Chateau D, Moffatt M, Ramsey C, Roos LL, Kryger M. A Matched Cohort Study of Postoperative Outcomes in Obstructive Sleep Apnea. Anesthesiology 2014, 121: 707-718. PMID: 25247853, DOI: 10.1097/aln.0000000000000407.Peer-Reviewed Original ResearchConceptsContinuous positive airway pressure therapyPositive airway pressure therapyObstructive sleep apneaAirway pressure therapySleep apneaPressure therapyOSA patientsCardiovascular complicationsPostoperative outcomesDiagnosis of OSAUndiagnosed obstructive sleep apneaAdult OSA patientsImportant risk modifiersPostoperative cardiovascular complicationsMatched Cohort StudyHealth administrative dataType of surgeryLarger efficacy trialPostoperative complicationsRespiratory complicationsCohort studyOSA severityPostoperative dayPreoperative diagnosisCardiac arrestEvaluation of a new pediatric positive airway pressure mask.
Kushida CA, Halbower AC, Kryger MH, Pelayo R, Assalone V, Cardell CY, Huston S, Willes L, Wimms AJ, Mendoza J. Evaluation of a new pediatric positive airway pressure mask. Journal Of Clinical Sleep Medicine 2014, 10: 979-84. PMID: 25142768, PMCID: PMC4153116, DOI: 10.5664/jcsm.4030.Peer-Reviewed Original ResearchConceptsContinuous positive airway pressurePAP therapyPositive airway pressure maskPositive airway pressureParents/guardiansAirway pressureBaseline polysomnographyCPAP maskChildren's earsPressure maskPatientsAge groupsChildren's sleepUpper lipPolysomnographyChildrenTherapySleepEarYearsAHIClinicClinicians
2013
The use of combined thermal/pressure polyvinylidene fluoride film airflow sensor in polysomnography
Kryger M, Eiken T, Qin L. The use of combined thermal/pressure polyvinylidene fluoride film airflow sensor in polysomnography. Sleep And Breathing 2013, 17: 1267-1273. PMID: 23716021, DOI: 10.1007/s11325-013-0832-5.Peer-Reviewed Original Research
2012
Respiratory Event Detection by a Positive Airway Pressure Device
Berry RB, Kushida CA, Kryger MH, Soto-Calderon H, Staley B, Kuna ST. Respiratory Event Detection by a Positive Airway Pressure Device. Sleep 2012, 35: 361-367. PMID: 22379242, PMCID: PMC3274337, DOI: 10.5665/sleep.1696.Peer-Reviewed Original ResearchConceptsObstructive sleep apneaEvents/hrPositive airway pressure devicesApnea indexHypopnea indexPAP devicesRespiratory eventsSleep disorders centerPressure deviceBetter treatment efficacyRespiratory event detectionOxygen desaturationSleep apneaPAP treatmentBland-Altman analysisDisorders CenterPolysomnographyTreatment efficacyAHIInadequate treatmentManual scoringHypopnea detectionTrue negative eventsHrTreatment
2011
Is Laryngeal Descent Associated With Increased Risk for Obstructive Sleep Apnea?
Yamashiro Y, Kryger M. Is Laryngeal Descent Associated With Increased Risk for Obstructive Sleep Apnea? CHEST Journal 2011, 141: 1407-1413. PMID: 22016482, DOI: 10.1378/chest.10-3238.Peer-Reviewed Original ResearchConceptsObstructive sleep apneaAirway lengthSleep apneaJapanese patientsVocal cordsUpper airway lengthLogistic regression analysisMultislice CT scanOSA severityConsecutive patientsUpper airwayRisk factorsCT scanBMIPatientsALVCAHILow laryngeal positionLaryngeal positionCollapsible segmentApneaRegression analysisCordLarynxWomenLong-term use of a nasal expiratory positive airway pressure (EPAP) device as a treatment for obstructive sleep apnea (OSA).
Kryger MH, Berry RB, Massie CA. Long-term use of a nasal expiratory positive airway pressure (EPAP) device as a treatment for obstructive sleep apnea (OSA). Journal Of Clinical Sleep Medicine 2011, 7: 449-53b. PMID: 22003339, PMCID: PMC3190843, DOI: 10.5664/jcsm.1304.Peer-Reviewed Original ResearchConceptsObstructive sleep apneaPositive airway pressure devicesMonths of treatmentSleep apneaObstructive sleep apnea hypopneaOpen-label extensionPositive clinical responseEvents/hLong-term adherenceSleep disorders centerEpworth Sleepiness ScaleSleep apnea hypopneaPressure deviceLong-term useAHI reductionClinical responseMonth 3Randomized studyApnea hypopneaMedian AHITrial nameClinical trialsMonths 1Disorders CenterSham trialsPositive Airway Pressure Initiation: A Randomized Controlled Trial to Assess the Impact of Therapy Mode and Titration Process on Efficacy, Adherence, and Outcomes
Kushida CA, Berry RB, Blau A, Crabtree T, Fietze I, Kryger MH, Kuna ST, Pegram GV, Penzel T. Positive Airway Pressure Initiation: A Randomized Controlled Trial to Assess the Impact of Therapy Mode and Titration Process on Efficacy, Adherence, and Outcomes. Sleep 2011, 34: 1083-1092. PMID: 21804670, PMCID: PMC3138163, DOI: 10.5665/sleep.1166.Peer-Reviewed Original ResearchConceptsContinuous positive airway pressurePositive airway pressureMinimum oxygen saturationAirway pressureFunctional outcomeOxygen saturationVeterans Affairs Medical CenterPositive pressure treatmentApnea-hypopnea indexObstructive sleep apneaSevere OSAMulticenter trialTreatment satisfactionControlled TrialsSleep apneaMajor efficacyStudy treatmentOutcome measuresMedical CenterSleep qualityTherapy modesMask comfortAdherenceEfficacyMonthsA Novel Nasal Expiratory Positive Airway Pressure (EPAP) Device for the Treatment of Obstructive Sleep Apnea: A Randomized Controlled Trial
Berry RB, Kryger MH, Massie CA. A Novel Nasal Expiratory Positive Airway Pressure (EPAP) Device for the Treatment of Obstructive Sleep Apnea: A Randomized Controlled Trial. Sleep 2011, 34: 479-485. PMID: 21461326, PMCID: PMC3065258, DOI: 10.1093/sleep/34.4.479.Peer-Reviewed Original ResearchConceptsObstructive sleep apneaPositive airway pressure devicesSleep apneaSham deviceWeek 1Double-blind clinical trialSevere obstructive sleep apneaMonths of treatmentSleep disorders centerEpworth Sleepiness ScalePressure deviceSubjective daytime sleepinessNon-consecutive nightsControlled TrialsMonth 3Sham treatmentClinical trialsDaytime sleepinessITT groupDisorders CenterSleepiness ScaleAHI valuesApneaMedian percentageAHI
2010
Prediction of obstructive sleep apnea syndrome in a large Greek population
Bouloukaki I, Kapsimalis F, Mermigkis C, Kryger M, Tzanakis N, Panagou P, Moniaki V, Vlachaki EM, Varouchakis G, Siafakas NM, Schiza SE. Prediction of obstructive sleep apnea syndrome in a large Greek population. Sleep And Breathing 2010, 15: 657-664. PMID: 20872180, DOI: 10.1007/s11325-010-0416-6.Peer-Reviewed Original ResearchConceptsObstructive sleep apnea syndromeApnea-hypopnea indexBody mass indexSleep apnea syndromeApnea syndromeSignificant clinical predictorsInitiation of treatmentLogistic regression analysisSelf-reported symptomsEDS severityNinety patientsSleepiness severityClinical predictorsIndependent predictorsPSG evaluationMass indexDiagnostic polysomnographyHip circumferenceClinical indicesScore 10High riskAnthropometric measurementsScore 4Predictive valuePatients
2008
The effects of ramelteon on respiration during sleep in subjects with moderate to severe chronic obstructive pulmonary disease
Kryger M, Roth T, Wang-Weigand S, Zhang J. The effects of ramelteon on respiration during sleep in subjects with moderate to severe chronic obstructive pulmonary disease. Sleep And Breathing 2008, 13: 79-84. PMID: 18584227, DOI: 10.1007/s11325-008-0196-4.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultComorbidityCross-Over StudiesDouble-Blind MethodFemaleHumansIndenesMaleOximetryPolysomnographyPulmonary Disease, Chronic ObstructiveReceptors, MelatoninSeverity of Illness IndexSleep Apnea SyndromesSleep Apnea, ObstructiveSleep Initiation and Maintenance DisordersSleep StagesYoung AdultConceptsSevere chronic obstructive pulmonary diseaseChronic obstructive pulmonary diseaseEffects of ramelteonObstructive pulmonary diseasePulmonary diseaseMean SaO2Respiratory depressant effectsApnea-hypopnea indexPoor sleep qualityTotal sleep timeMelatonin receptor agonistResultsNo significant differencesSignificant differencesAbnormal breathing eventsRamelteon 8Primary endpointAdverse eventsPersistent sleepCrossover studyDepressant effectPolysomnographic monitoringReceptor agonistRespiratory effortInsomnia treatmentSleep quality
2007
Effect of Ramelteon, a selective MT1/MT2-receptor agonist, on respiration during sleep in mild to moderate COPD
Kryger M, Wang-Weigand S, Zhang J, Roth T. Effect of Ramelteon, a selective MT1/MT2-receptor agonist, on respiration during sleep in mild to moderate COPD. Sleep And Breathing 2007, 12: 243-250. PMID: 18060441, DOI: 10.1007/s11325-007-0156-4.Peer-Reviewed Original ResearchConceptsModerate chronic obstructive pulmonary diseaseChronic obstructive pulmonary diseaseAbnormal breathing eventsSelective MT1/MT2 receptor agonistMT1/MT2 receptor agonistMean apnea-hypopnea indexBreathing eventsEffects of ramelteonMT2 receptor agonistSingle bedtime doseApnea-hypopnea indexObstructive pulmonary diseaseNumber of awakeningsTotal sleep timeMelatonin receptor agonistBedtime dosePlacebo groupAdverse eventsPulmonary diseaseCrossover studyPhysical examinationReceptor agonistSleep efficiencySleep durationSleep timeSleep apnea: Clinical investigations in humans
Banno K, Kryger MH. Sleep apnea: Clinical investigations in humans. Sleep Medicine 2007, 8: 400-426. PMID: 17478121, DOI: 10.1016/j.sleep.2007.03.003.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsObstructive sleep apnea syndromeCentral sleep apnea syndromeContinuous positive airway pressureSleep apnea syndromeApnea syndromeApneic episodesTreatment of OSASDiagnosis of SASUpper airway obstructionPositive airway pressureMuscles of respirationCessation of breathingCentral nervous systemAirway obstructionAirway pressureHeart failureOral appliancesRespiratory driveImpaired qualityAbnormal breathingSubjective symptomsDaytime sleepinessCommon disorderMetabolic dysfunctionSleep disruption