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  1. Article ; Online: Ventilatory Burden: Development of a New Approach to Better Quantify Obstructive Sleep Apnea Severity and Its Impacts.

    Lechat, Bastien / Eckert, Danny J

    American journal of respiratory and critical care medicine

    2023  Volume 208, Issue 11, Page(s) 1153–1155

    MeSH term(s) Humans ; Sleep Apnea, Obstructive/diagnosis ; Sleep Apnea, Obstructive/therapy ; Sleep Apnea, Obstructive/physiopathology ; Respiration ; Heart/physiopathology
    Language English
    Publishing date 2023-11-06
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 1180953-x
    ISSN 1535-4970 ; 0003-0805 ; 1073-449X
    ISSN (online) 1535-4970
    ISSN 0003-0805 ; 1073-449X
    DOI 10.1164/rccm.202310-1718ED
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Obstructive sleep apnea endotypes and their postoperative relevance.

    Altree, Thomas J / Eckert, Danny J

    International anesthesiology clinics

    2022  Volume 60, Issue 2, Page(s) 1–7

    MeSH term(s) Humans ; Postoperative Complications/prevention & control ; Sleep Apnea, Obstructive/surgery
    Language English
    Publishing date 2022-02-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 210757-0
    ISSN 1537-1913 ; 0020-5907
    ISSN (online) 1537-1913
    ISSN 0020-5907
    DOI 10.1097/AIA.0000000000000357
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  3. Article ; Online: Hypoxia and Sleep-disordered Breathing: Friend or Foe?

    Eckert, Danny J / Sands, Scott A

    American journal of respiratory and critical care medicine

    2022  Volume 205, Issue 8, Page(s) 869–872

    MeSH term(s) Humans ; Hypoxia/etiology ; Sleep Apnea Syndromes/complications
    Language English
    Publishing date 2022-02-23
    Publishing country United States
    Document type Editorial ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Comment
    ZDB-ID 1180953-x
    ISSN 1535-4970 ; 0003-0805 ; 1073-449X
    ISSN (online) 1535-4970
    ISSN 0003-0805 ; 1073-449X
    DOI 10.1164/rccm.202201-0113ED
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  4. Article ; Online: The scent of love is in the air(way): a potential drug target for sleep apnea?

    Osman, Amal M / Altree, Thomas J / Eckert, Danny J

    Sleep

    2023  Volume 46, Issue 4

    MeSH term(s) Humans ; Oxytocin ; Odorants ; Sleep Apnea Syndromes/physiopathology ; Sleep Apnea, Obstructive ; Respiratory System/physiopathology
    Chemical Substances Oxytocin (50-56-6)
    Language English
    Publishing date 2023-02-01
    Publishing country United States
    Document type Editorial ; Research Support, Non-U.S. Gov't ; Comment
    ZDB-ID 424441-2
    ISSN 1550-9109 ; 0161-8105
    ISSN (online) 1550-9109
    ISSN 0161-8105
    DOI 10.1093/sleep/zsad019
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  5. Article: Plant-based and vegetarian diets are associated with reduced obstructive sleep apnoea risk.

    Melaku, Yohannes Adama / Zhao, Lijun / Adams, Robert / Eckert, Danny J

    ERJ open research

    2024  Volume 10, Issue 2

    Abstract: Introduction: Obstructive sleep apnoea (OSA) and obesity commonly coexist. Weight loss and exercise are recommended management options for OSA. However, most of the current evidence on diet and OSA is focused on calorie restriction rather than diet ... ...

    Abstract Introduction: Obstructive sleep apnoea (OSA) and obesity commonly coexist. Weight loss and exercise are recommended management options for OSA. However, most of the current evidence on diet and OSA is focused on calorie restriction rather than diet quality. The aim of the present study was to determine the association of plant-based dietary indices (PDI) with OSA risk.
    Methods: Cross-sectional data from 14 210 participants of the National Health and Nutrition Examination Survey who provided dietary information using the 24-hour recall method were used. PDI - including healthy (hPDI), unhealthy (uPDI) and pro-vegetarian diet index (PVDI) - were determined. OSA risk was determined using the STOP-BANG questionnaire. Logistic regression was used to determine the relationship between dietary indices and OSA risk.
    Results: Higher adherence to PDI (odds ratio (OR)
    Conclusions: Higher adherence to a healthy plant-based diet is associated with reduced OSA risk, while an unhealthy plant-based diet has a positive association. The magnitude of these associations differs by sex. Further longitudinal studies are warranted.
    Language English
    Publishing date 2024-03-04
    Publishing country England
    Document type Journal Article
    ZDB-ID 2827830-6
    ISSN 2312-0541
    ISSN 2312-0541
    DOI 10.1183/23120541.00739-2023
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  6. Article ; Online: Pharmacological management of co-morbid obstructive sleep apnoea and insomnia.

    Thomas, Emma / Micic, Gorica / Adams, Robert / Eckert, Danny J

    Expert opinion on pharmacotherapy

    2024  Volume 24, Issue 18, Page(s) 1963–1973

    Abstract: Introduction: Clinical presentation of both insomnia and obstructive sleep apnea (COMISA) is common. Approximately 30% of clinical cohorts with OSA have insomnia symptoms and vice versa. The underlying pathophysiology of COMISA is multifactorial. This ... ...

    Abstract Introduction: Clinical presentation of both insomnia and obstructive sleep apnea (COMISA) is common. Approximately 30% of clinical cohorts with OSA have insomnia symptoms and vice versa. The underlying pathophysiology of COMISA is multifactorial. This poses a complex clinical challenge. Currently, there are no clinical guidelines or recommendations outside of continuous positive airway pressure (CPAP) therapy and cognitive behavioral therapy for insomnia (CBTi). Clinically translatable precision medicine approaches to characterize individual causes or endotypes may help optimize future pharmacological management of COMISA.
    Areas covered: This review article provides an up-to-date account of COMISA and its consequences, the underlying pathophysiology of sleep apnea, insomnia and COMISA, current treatment approaches and limitations, pharmacotherapy targets and future priorities.
    Expert opinion: There are multiple promising emerging therapies, but clinical trial data specifically in COMISA populations are lacking. This is a priority for future investigation to inform development of evidence-based guidelines. Pharmacotherapies, particularly for insomnia, do not target the underlying causes of the disorder thus, are indicated for short-term use only and should remain second line. Future multidisciplinary research should be directed toward the multifactorial nature of COMISA and the challenges of adapting COMISA treatment in clinical practice and overcoming the practical barriers that health-care providers and consumers encounter.
    MeSH term(s) Humans ; Sleep Initiation and Maintenance Disorders/drug therapy ; Sleep Apnea, Obstructive/complications ; Sleep Apnea, Obstructive/drug therapy ; Sleep Apnea, Obstructive/epidemiology ; Sleep Apnea Syndromes ; Comorbidity ; Continuous Positive Airway Pressure
    Language English
    Publishing date 2024-01-05
    Publishing country England
    Document type Review ; Journal Article
    ZDB-ID 2001535-5
    ISSN 1744-7666 ; 1465-6566
    ISSN (online) 1744-7666
    ISSN 1465-6566
    DOI 10.1080/14656566.2023.2292186
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  7. Article ; Online: Opioid Use Disorder, Sleep Deficiency, and Ventilatory Control: Bidirectional Mechanisms and Therapeutic Targets.

    Eckert, Danny J / Yaggi, H Klar

    American journal of respiratory and critical care medicine

    2022  Volume 206, Issue 8, Page(s) 937–949

    Abstract: Opioid use continues to rise globally. So too do the associated adverse consequences. Opioid use disorder (OUD) is a chronic and relapsing brain disease characterized by loss of control over opioid use and impairments in cognitive function, mood, pain ... ...

    Abstract Opioid use continues to rise globally. So too do the associated adverse consequences. Opioid use disorder (OUD) is a chronic and relapsing brain disease characterized by loss of control over opioid use and impairments in cognitive function, mood, pain perception, and autonomic activity. Sleep deficiency, a term that encompasses insufficient or disrupted sleep due to multiple potential causes, including sleep disorders, circadian disruption, and poor sleep quality or structure due to other medical conditions and pain, is present in 75% of patients with OUD. Sleep deficiency accompanies OUD across the spectrum of this addiction. The focus of this concise clinical review is to highlight the bidirectional mechanisms between OUD and sleep deficiency and the potential to target sleep deficiency with therapeutic interventions to promote long-term, healthy recovery among patients in OUD treatment. In addition, current knowledge on the effects of opioids on sleep quality, sleep architecture, sleep-disordered breathing, sleep apnea endotypes, ventilatory control, and implications for therapy and clinical practice are highlighted. Finally, an actionable research agenda is provided to evaluate the basic mechanisms of the relationship between sleep deficiency and OUD and the potential for behavioral, pharmacologic, and positive airway pressure treatments targeting sleep deficiency to improve OUD treatment outcomes.
    MeSH term(s) Analgesics, Opioid/adverse effects ; Analgesics, Opioid/therapeutic use ; Humans ; Opioid-Related Disorders/complications ; Opioid-Related Disorders/therapy ; Sleep ; Sleep Apnea Syndromes/etiology ; Sleep Apnea Syndromes/therapy ; Sleep Wake Disorders/drug therapy ; Sleep Wake Disorders/etiology
    Chemical Substances Analgesics, Opioid
    Language English
    Publishing date 2022-06-02
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
    ZDB-ID 1180953-x
    ISSN 1535-4970 ; 0003-0805 ; 1073-449X
    ISSN (online) 1535-4970
    ISSN 0003-0805 ; 1073-449X
    DOI 10.1164/rccm.202108-2014CI
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  8. Article ; Online: Phenotypic approaches to positional therapy for obstructive sleep apnoea.

    Eckert, Danny J

    Sleep medicine reviews

    2017  Volume 37, Page(s) 175–176

    MeSH term(s) Humans ; Polysomnography ; Sleep Apnea, Obstructive
    Language English
    Publishing date 2017-06-23
    Publishing country England
    Document type Letter ; Research Support, Non-U.S. Gov't ; Comment
    ZDB-ID 1414211-9
    ISSN 1532-2955 ; 1087-0792
    ISSN (online) 1532-2955
    ISSN 1087-0792
    DOI 10.1016/j.smrv.2017.06.007
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  9. Article ; Online: Low-Dose Morphine Does Not Cause Sleepiness in COPD: A Secondary Analysis of a Randomized Trial.

    Altree, Thomas J / Toson, Barbara / Loffler, Kelly A / Ekström, Magnus / Currow, David C / Eckert, Danny J

    American journal of respiratory and critical care medicine

    2024  

    Abstract: Rationale: Regular, low-dose, sustained-release morphine is frequently prescribed for persistent breathlessness in chronic obstructive pulmonary disease (COPD). However, effects on daytime sleepiness, perceived sleep quality and daytime function have ... ...

    Abstract Rationale: Regular, low-dose, sustained-release morphine is frequently prescribed for persistent breathlessness in chronic obstructive pulmonary disease (COPD). However, effects on daytime sleepiness, perceived sleep quality and daytime function have not been rigorously investigated.
    Objectives: Determine the effects of regular, low-dose, sustained-release morphine on sleep parameters in COPD.
    Methods: Pre-specified secondary analyses of validated sleep questionnaire data from a randomized trial of daily, low-dose, sustained -release morphine versus placebo over four weeks commencing at 8mg or 16mg/day with blinded up-titration over two weeks to a maximum of 32mg/day. Primary outcomes for these analyses were week-1 Epworth Sleepiness Scale (ESS) and Karolinska Sleepiness Scale (KSS) responses on morphine versus placebo. Secondary outcomes included Leeds Sleep Evaluation Questionnaire (LSEQ) scores (end of weeks 1 and 4), KSS and ESS beyond week-1 and associations between breathlessness, morphine, and questionnaire scores.
    Measurements and main results: 156 people were randomized. Week-1 sleepiness scores were not different on morphine versus placebo (∆ESS [95%CI] versus placebo: 8mg group: -0.59 [-1.99, 0.81], p=0.41; 16mg group: -0.72 [-2.33, 0.9], p=0.38; ∆KSS versus placebo: 8mg group: 0.11 [-0.7, 0.9], p=0.78; 16mg group: -0.41 [-1.31, 0.49], p=0.37). This neutral effect persisted at later timepoints. In addition, participants who reported reduced breathlessness with morphine at 4 weeks also had improvement in LSEQ domain scores including perceived sleep quality and daytime function.
    Conclusions: Regular, low-dose morphine does not worsen sleepiness when used for breathlessness in COPD. Individual improvements in breathlessness with morphine may be related to improvements in sleep.
    Language English
    Publishing date 2024-03-13
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1180953-x
    ISSN 1535-4970 ; 0003-0805 ; 1073-449X
    ISSN (online) 1535-4970
    ISSN 0003-0805 ; 1073-449X
    DOI 10.1164/rccm.202310-1780OC
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  10. Article ; Online: Effects of hypnotics on obstructive sleep apnea endotypes and severity: Novel insights into pathophysiology and treatment.

    Carter, Sophie G / Eckert, Danny J

    Sleep medicine reviews

    2021  Volume 58, Page(s) 101492

    Abstract: Impaired upper airway anatomy is the main cause of obstructive sleep apnea (OSA). However, there are other important non-anatomical contributors or "endotypes" including ventilatory control instability, poor pharyngeal dilator muscle responsiveness and ... ...

    Abstract Impaired upper airway anatomy is the main cause of obstructive sleep apnea (OSA). However, there are other important non-anatomical contributors or "endotypes" including ventilatory control instability, poor pharyngeal dilator muscle responsiveness and waking up too easily to minor respiratory events (low arousal threshold). Recent studies have focused on the potential to target specific OSA causes with novel treatments to reduce OSA severity and improve efficacy with existing non-CPAP therapies which are often suboptimal (e.g., mandibular advancement splints). One novel target is pharmacotherapy with hypnotics to increase the threshold for arousal and reduce OSA severity in the approximately 30% of patients who have a low arousal threshold endotype. This increasing body of work has produced varied and at times unexpected findings which have challenged previous knowledge on the effects of hypnotics on upper airway physiology and breathing during sleep in people with OSA. This review provides a concise overview of the latest research that has investigated the effects of common hypnotics/sedative agents on upper airway physiology and OSA severity and potential implications for OSA pathophysiology, treatment and safety. This includes a summary of the latest knowledge on the effects of hypnotics on OSA endotypes. Priorities for future research are also highlighted.
    MeSH term(s) Arousal ; Continuous Positive Airway Pressure ; Humans ; Hypnotics and Sedatives/pharmacology ; Hypnotics and Sedatives/therapeutic use ; Sleep ; Sleep Apnea, Obstructive
    Chemical Substances Hypnotics and Sedatives
    Language English
    Publishing date 2021-04-22
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 1414211-9
    ISSN 1532-2955 ; 1087-0792
    ISSN (online) 1532-2955
    ISSN 1087-0792
    DOI 10.1016/j.smrv.2021.101492
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