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 StatementsConceptsObstructive 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
2022
Comparison of Ring Pulse Oximetry Using Reflective Photoplethysmography and PSG in the Detection of OSA in Chinese Adults: A Pilot Study
Zhao R, Xue J, Zhang X, Peng M, Li J, Zhou B, Zhao L, Penzel T, Kryger M, Dong XS, Gao Z, Han F. Comparison of Ring Pulse Oximetry Using Reflective Photoplethysmography and PSG in the Detection of OSA in Chinese Adults: A Pilot Study. Nature And Science Of Sleep 2022, 14: 1427-1436. PMID: 36003191, PMCID: PMC9394522, DOI: 10.2147/nss.s367400.Peer-Reviewed Original ResearchEvents/hOxygen desaturation indexIntraclass correlation coefficientPulse oximetryChinese adultsThreshold of AHIObstructive sleep apneaDetection of OSAPositive likelihood ratioChinese Han subjectsOxygen desaturationDesaturation indexSleep apneaMean ageSimultaneous polysomnographyOxygen saturationPSG-AHIPolysomnographySleep laboratorySleep timePilot studyHan subjectsAHIOximetryCumulative percentage
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 ResearchConceptsApnea-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
2019
Centers for Medicare and Medicaid Services Positive Airway Pressure Adherence Criteria May Limit Treatment to Many Medicare Beneficiaries.
Naik S, Al-Halawani M, Kreinin I, Kryger M. Centers for Medicare and Medicaid Services Positive Airway Pressure Adherence Criteria May Limit Treatment to Many Medicare Beneficiaries. Journal Of Clinical Sleep Medicine 2019, 15: 245-251. PMID: 30736874, PMCID: PMC6374085, DOI: 10.5664/jcsm.7626.Peer-Reviewed Original ResearchConceptsEvents/hAdherence criteriaPAP treatmentObstructive sleep apnea treatmentPositive airway pressure devicesWithholding of therapyApnea-hypopnea indexObstructive sleep apneaSleep apnea treatmentMedicaid Services reimbursementAdherence reportsBaseline characteristicsPAP devicesPAP adherenceAdherent participantsApnea treatmentSleep apneaNonadherent participantsAdherence dataMedicare beneficiariesAdherence patternsCMS criteriaAdherence expectationsPatientsMonthsThe 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 StatementsConceptsHome 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 ResearchConceptsApnea/hypopnea indexObstructive sleep apneaMild obstructive sleep apneaSleep apneaAirflow disruptionIntraclass correlationAHI categoriesBaseline PSGHypopnea indexOSA patientsHighest tertileOSA categoriesArousal criteriaPatientsFlow limitationApneaDesaturationFlow scoreArousal eventsOverall kappaObstructionTraining periodHigher proportionElectroencephalographyScoring0479 Novel Flow Limitation/Obstruction With Recovery Breath (FLOW) Event Identifies Obstructive Burden In Mild Obstructive Sleep Apnea
Johnson K, Johnson D, Visintainer P, Kryger M, Thomas R, Linderauer P, Feldmann E. 0479 Novel Flow Limitation/Obstruction With Recovery Breath (FLOW) Event Identifies Obstructive Burden In Mild Obstructive Sleep Apnea. Sleep 2018, 41: a181-a181. DOI: 10.1093/sleep/zsy061.478.Peer-Reviewed Original ResearchMild obstructive sleep apneaObstructive sleep apneaHome sleep apnea testingRespiratory-related arousalsObstructive eventsSleep apneaMild OSA patientsApnea-hypopnea indexIdentification of patientsSleep apnea testingSeverity of diseaseFlow scoreOSA patientsApnea testingAdverse outcomesMild patientsPolysomnography studiesClinical significancePatientsSignificant gender differencesApneaDesaturationAirflow disruptionObstructionArousal data1134 A morbidly obese type I diabetic teenager with sleep apnea, nocturnal eating, and Cushingoid features. Where to start?
Hawkins M, Williams C, Kryger M. 1134 A morbidly obese type I diabetic teenager with sleep apnea, nocturnal eating, and Cushingoid features. Where to start? Sleep 2018, 41: a419-a420. DOI: 10.1093/sleep/zsy063.1133.Peer-Reviewed Original ResearchObstructive sleep apneaMorning glucose levelsNocturnal eatingSleep apneaGlucose levelsDocumentation of hypoglycemiaInsulin resistance riskApnea-hypopnea indexSetting of diabetesBody mass indexDoses of insulinDiagnosis of diabetesAge 5 yearsAdverse health conditionsSalivary cortisol levelsType ICushingoid featuresPAP therapyCushingoid appearanceNight sweatsHypopnea indexHypothalamic dysfunctionPrompt treatmentCushing's diseaseNight-time behavior
2016
Positive Airway Pressure Therapy for Obstructive Sleep Apnea
Weiss P, Kryger M. Positive Airway Pressure Therapy for Obstructive Sleep Apnea. Otolaryngologic Clinics Of North America 2016, 49: 1331-1341. PMID: 27720457, DOI: 10.1016/j.otc.2016.07.004.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsPositive airway pressureObstructive sleep apneaAirway pressureSleep apneaMild obstructive sleep apneaPositive airway pressure therapyContinuous positive airway pressureSevere obstructive sleep apneaObstructive sleep apnea syndromeSleep-related breathing disordersConcomitant cardiovascular disordersAirway pressure therapyFirst-line therapySleep apnea syndromeAdaptive support ventilationEvaluation of adherenceEffectiveness of treatmentApnea syndromeSupport ventilationBreathing disordersPressure therapyCardiovascular disordersApneaTherapyPressure supportEffects 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
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 arrest
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
2008
Epidemiology of obstructive sleep apnea: a population-based perspective
Lee W, Nagubadi S, Kryger MH, Mokhlesi B. Epidemiology of obstructive sleep apnea: a population-based perspective. Expert Review Of Respiratory Medicine 2008, 2: 349-364. PMID: 19690624, PMCID: PMC2727690, DOI: 10.1586/17476348.2.3.349.Peer-Reviewed Original ResearchObstructive sleep apneaSleep apneaAdult obstructive sleep apneaCongestive heart failureCoronary artery diseaseHealth care burdenPopulation-based studyPopulation-based perspectiveAdverse medical conditionsGlobal obesity epidemicSimilar prevalence ratesCardiovascular mortalityOSA populationArtery diseaseHeart failureOSA syndromeInsulin resistanceRisk factorsCare burdenNeurocognitive dysfunctionMedical conditionsPrevalence ratesObesity epidemicMethodologic differencesDiagnostic resourcesAssociation of Sleep Apnea Severity and Obesity with Insulin Resistance, C-Reactive Protein, and Leptin Levels in Male Patients with Obstructive Sleep Apnea
Kapsimalis F, Varouchakis G, Manousaki A, Daskas S, Nikita D, Kryger M, Gourgoulianis K. Association of Sleep Apnea Severity and Obesity with Insulin Resistance, C-Reactive Protein, and Leptin Levels in Male Patients with Obstructive Sleep Apnea. Lung 2008, 186: 209-217. PMID: 18365276, DOI: 10.1007/s00408-008-9082-x.Peer-Reviewed Original ResearchConceptsObstructive sleep apnea syndromeSleep apnea severityObstructive sleep apneaNon-OSA groupBody mass indexModerate OSAS groupCRP levelsInsulin resistanceApnea severityOSAS groupMale patientsLeptin levelsSleep apneaSevere obstructive sleep apnea syndromeHomeostasis model assessment methodSevere sleep apneaSevere OSAS groupSleep apnea syndromeC-reactive proteinTotal sleep timeNocturnal hypoxemiaApnea syndromeModel assessment methodHip ratioMass index
2007
Obstructive Sleep Apnea in Pregnancy
Kapsimalis F, Kryger M. Obstructive Sleep Apnea in Pregnancy. Sleep Medicine Clinics 2007, 2: 603-613. DOI: 10.1016/j.jsmc.2007.07.002.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsObstructive sleep apnea syndromeSleep-disordered breathingPregnant womenTreatment of OSASDiagnosis of OSASTreatment of SDBObese pregnant womenComplications of pregnancyOutcome of pregnancyObstructive sleep apneaSleep apnea syndromeManagement of pregnancyApnea syndromeSleep apneaHormonal alterationsFetal healthEarly recognitionHigh indexPregnancyNormal sleepRespiratory systemWomenTreatmentHypertensionApneaCytokines and pathological sleep
Kapsimalis F, Basta M, Varouchakis G, Gourgoulianis K, Vgontzas A, Kryger M. Cytokines and pathological sleep. Sleep Medicine 2007, 9: 603-614. PMID: 18024171, DOI: 10.1016/j.sleep.2007.08.019.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsMultiple biologic actionsObstructive sleep apneaExcessive daytime sleepinessNew biologic treatmentsChronic inflammatory diseaseHormonal regulatory mechanismsCardiovascular consequencesSleep apneaBiologic treatmentExcessive sleepinessSleep disturbancesDaytime sleepinessInflammatory diseasesSleep disordersCytokinesImmune systemBiologic actionsIntercellular mediatorsPathological sleepTarget tissuesSleepinessSleep lossImportant roleDisordersApnea