Positive airway pressure

Purpose of Review Sleep-disordered breathing results in physiological changes that may affect various organs of the body, including the cardiovascular system. In this article, we critically review studies that have examined the prevalence and pathophysiology of pulmonary hypertension (PH) and left ventricular diastolic dysfunction (LVDD) in patients with obesity hypoventilation syndrome (OHS) and the impact of positive airway pressure therapy on cardiac function in patients with OHS.
Recent Findings Although data regarding the prevalence of PH and LVDD in patients with OHS are limited, the available data indicate that these entities are common in patients with OHS. Previous studies have reported that the prevalence rates of PH and LVDD among patients with OHS are 50–88%and 50–70%, respectively. Several mechanisms have been proposed to explain the cardiovascular complications experienced by patients with OHS, including obesity, recurrent obstructive events, sustained hypoxemia, and systemic inflammation. However, there is limited evidence regarding the effects of positive airway pressure
therapy on PH and LVDD in this patient population. Nonetheless, recent studies have suggested that positive airway pressure therapy improves pulmonary artery pressure and LVDD in patients with OHS.
Summary Available data suggest that PH and LVDD are common in patients with OHS. Recent research has suggested that positive airway pressure therapy improves PAP and LVDD in patients with OHS and severe OSA.

The emergence of COVID-19 brought all healthcare services around the globe to immense strain; hospitals abandoned elective care for acute care. Like all other elective services, sleep medicine services suffered a partial deadlock due to the closing down of the sleep disorders diagnostic and therapeutic services, although clinical consultations and follow-ups, carried on remotely, allowed some mitigation. Since there is dire need to resume the services, we tried to formulate the principles and guidelines to work in this exigent healthcare setting. Principles and guidelines are based on epidemiological and infection control guidelines besides recommendations of various healthcare organizations and sleep societies, after a requisite web search to extract the data.

An Online Webinar Workshop-University Sleep Disorders Center, King Saud University

Link to the recorded Webinar: https://www.youtube.com/watch?v=FdMUTIynulk
Objectives:

1) Ensure resuming of Sleep Medicine Services in spite of the COVID-19 pandemic

2) Implement best practice guidelines

3) Triage the patients for Sleep Medicine Services

4) Practice and propagate epidemiological updates

5) Practice and propagate infection control guidelines

6) Practice and propagate safe handling of equipment

7) Practice and propagate disinfection protocols for the equipment

The emergence of COVID-19 brought all health care services around the globe to immense strain; hospitals abandoned elective care for acute care. Like all other elective services, sleep medicine services suffered a partial deadlock due to the closing down of the sleep disorders diagnostic and therapeutic services, although clinical consultations and follow-ups, carried on remotely, allowed some mitigation. Since there is dire need to resume the services, we tried to formulate the principles and guidelines to work in this exigent healthcare setting. Principles and guidelines are based on epidemiological and infection control guidelines besides recommendations of various healthcare organizations and sleep societies, after a requisite web search to extract the data.