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
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
2016
Jack London's Sleep.
Kryger M. Jack London's Sleep. Journal Of Clinical Sleep Medicine 2016, 12: 1545-1547. PMID: 27568902, PMCID: PMC5078710, DOI: 10.5664/jcsm.6286.Commentaries, Editorials and LettersEffects 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
Effects of suvorexant, an orexin receptor antagonist, on breathing during sleep in patients with chronic obstructive pulmonary disease
Sun H, Palcza J, Rosenberg R, Kryger M, Siringhaus T, Rowe J, Lines C, Wagner JA, Troyer MD. Effects of suvorexant, an orexin receptor antagonist, on breathing during sleep in patients with chronic obstructive pulmonary disease. Respiratory Medicine 2015, 109: 416-426. PMID: 25661282, DOI: 10.1016/j.rmed.2014.12.010.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overAzepinesCross-Over StudiesDouble-Blind MethodFemaleHumansMaleMiddle AgedOrexin Receptor AntagonistsPulmonary Disease, Chronic ObstructiveRespirationSeverity of Illness IndexSleepSleep Aids, PharmaceuticalSpirometryTreatment OutcomeTriazolesUnited StatesConceptsChronic obstructive pulmonary diseaseObstructive pulmonary diseaseSleep breathing disordersOrexin receptor antagonistPulmonary diseaseBreathing disordersReceptor antagonistModerate chronic obstructive pulmonary diseaseDay 4Effects of suvorexantModerate airflow limitationRespiratory depressant effectsApnea-hypopnea indexMaximum daily doseClinical research unitTotal sleep timeTreatment of insomniaMean AHICOPD patientsAirflow limitationHypopnea indexDaily doseMean SpO2Spirometry criteriaHypnotic medications
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
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
Positive 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 comfortAdherenceEfficacyMonths
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
2009
Sleep Breathing Disorders in the U.S. Female Population
Kapsimalis F, Kryger M. Sleep Breathing Disorders in the U.S. Female Population. Journal Of Women's Health 2009, 18: 1211-1219. PMID: 19627224, PMCID: PMC2825714, DOI: 10.1089/jwh.2008.1054.Peer-Reviewed Original ResearchConceptsObstructive sleep apnea syndromeU.S. female populationHigh riskBerlin questionnaireFemale populationCommon symptomsDaytime sleepinessMedical disordersPrimary care medical communityRestless legs syndrome symptomsChronic medical disordersSleep apnea syndromeSleep breathing disordersMenstrual cycle statusSleep onset insomniaSuch common symptomsNational Sleep FoundationAnnual telephone surveyHabitual snoringApnea syndromeBreathing disordersPostpartum womenCommon disorderSyndrome symptomsOnset insomnia
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 qualityAssociation 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 indexAssessment and Management of Patients with Obesity Hypoventilation Syndrome
Mokhlesi B, Kryger MH, Grunstein RR. Assessment and Management of Patients with Obesity Hypoventilation Syndrome. Annals Of The American Thoracic Society 2008, 5: 218-225. PMID: 18250215, PMCID: PMC2645254, DOI: 10.1513/pats.200708-122mg.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsObesity hypoventilation syndromeSleep-disordered breathingHypoventilation syndromeManagement of patientsAvailable treatment modalitiesRelated health care expendituresSerious cardiovascular diseaseHealth care expensesHealth care expendituresDaytime hypercapniaEucapnic patientsSignificant lungClinical characteristicsObese patientsSignificant morbidityEarly mortalityTreatment modalitiesEarly recognitionExtreme obesityCardiovascular diseaseHigh burdenEffective treatmentHigh riskHigh indexClinical practice
2007
The visual scoring of sleep in adults.
Silber MH, Ancoli-Israel S, Bonnet MH, Chokroverty S, Grigg-Damberger MM, Hirshkowitz M, Kapen S, Keenan SA, Kryger MH, Penzel T, Pressman MR, Iber C. The visual scoring of sleep in adults. Journal Of Clinical Sleep Medicine 2007, 3: 121-31. PMID: 17557422, DOI: 10.5664/jcsm.26814.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsSafety of ramelteon in individuals with mild to moderate obstructive sleep apnea
Kryger M, Wang-Weigand S, Roth T. Safety of ramelteon in individuals with mild to moderate obstructive sleep apnea. Sleep And Breathing 2007, 11: 159-164. PMID: 17294232, DOI: 10.1007/s11325-006-0096-4.Peer-Reviewed Original ResearchConceptsObstructive sleep apneaNext-day residual effectsApnea-hypopnea indexSleep apneaPost-sleep questionnaireAdverse eventsSelective MT1/MT2 receptor agonistMT1/MT2 receptor agonistMT2 receptor agonistSafety of ramelteonUrinary tract infectionArterial oxygen saturationControl of breathingRespiratory inductance plethysmographyRamelteon groupPlacebo groupTract infectionsCrossover studyWashout periodDepressant effectSleep QuestionnaireHypopneic eventsRespiratory effortInsomnia treatmentOxygen saturationDirectives de la Société Canadienne de Thoracologie: Diagnostic et Traitement des Troubles Respiratoires du Sommeil de L’Adulte
Fleetham J, Ayas N, Bradley D, Ferguson K, Fitzpatrick M, George C, Hanly P, Hill F, Kimoff J, Kryger M, Morrison D, Series F, Tsai W. Directives de la Société Canadienne de Thoracologie: Diagnostic et Traitement des Troubles Respiratoires du Sommeil de L’Adulte. Canadian Respiratory Journal 2007, 14: 31-36. PMID: 17315056, PMCID: PMC2690447, DOI: 10.1155/2007/592570.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus Statements
2006
Gender differences on polysomnographic findings in Greek subjects with obstructive sleep apnea syndrome
Vagiakis E, Kapsimalis F, Lagogianni I, Perraki H, Minaritzoglou A, Alexandropoulou K, Roussos C, Kryger M. Gender differences on polysomnographic findings in Greek subjects with obstructive sleep apnea syndrome. Sleep Medicine 2006, 7: 424-430. PMID: 16740405, DOI: 10.1016/j.sleep.2005.12.014.Peer-Reviewed Original ResearchConceptsObstructive sleep apnea syndromeApnea-hypopnea indexBody mass indexSleep apnea syndromeMale patientsApnea syndromeFemale patientsOnset latencyMean apnea-hypopnea indexSleep apnea hypopnea indexHigher apnea-hypopnea indexNon-rapid eye movement sleepSleep disorders centerREM onset latencyEye movement sleepAthens Medical SchoolPercent of menSleep efficiency indexTotal sleep timeGreek subjectsAspects of sleepSleep onset latencyNorth American clinicsEvangelismos HospitalNREM-AHI
2005
Symptoms of Obstructive Sleep Apnea in Patients with Nonalcoholic Fatty Liver Disease
Singh H, Pollock R, Uhanova J, Kryger M, Hawkins K, Minuk GY. Symptoms of Obstructive Sleep Apnea in Patients with Nonalcoholic Fatty Liver Disease. Digestive Diseases And Sciences 2005, 50: 2338-2343. PMID: 16416185, DOI: 10.1007/s10620-005-3058-y.Peer-Reviewed Original ResearchConceptsNonalcoholic fatty liver diseaseSymptoms of OSANonalcoholic fatty liverObstructive sleep apneaFatty liver diseaseNAFLD patientsNASH patientsNonalcoholic steatohepatitisRisk factorsLiver diseaseSleep apneaInsulin resistancePrevalence of OSASleep apnea questionnaireIndependent risk factorPrevalence of diabetesBody mass indexPeripheral insulin resistanceLiver biopsyFatty liverMass indexTriglyceride levelsQuestionnaire criteriaPrevalence ratesPatients