This site is intended for healthcare professionals
Sleep Apnea Learning Zone

Sleep and Breathing

Read time: 110 mins
Last updated:12th Mar 2020
The Sleep and Breathing conference is the largest pan-European meeting of its kind and offers an integrated approach to the investigation and treatment of sleep disorders.

Clinical update in sleep apnea’  features presentations from David White, Winfried Randerath and Elisa Perger. The ‘Positional obstructive sleep apnea and its treatment’  symposium includes presentations from Raphaël Heinzer and Nico de Vries.

Watch their presentations to learn more about central sleep apnea (CSA) and positional obstructive sleep apnea (POSA) and their treatment.

This section of the Sleep Apnea Learning Zone contains presentations from two industry symposia at the 2019 meeting in Marseille, France (11–13 April).

sleep and breathing conference 2019 logo

Sleep and Breathing 2019 - Marseille, France 11–13 April 2019

Clinical update in sleep apnea

Professor David White, Professor Winfried Randerath and Dr Elisa Perger discuss the phenotyping of sleep apnea patients, the challenges of managing Cheyne-Stokes respiration and updates from the ADVENT-HF trial related to compliance with Servo ventilation treatment in patients with heart failure.

Select one of the three videos below to watch, learn and test your knowledge with our short quiz.

OSA phenotyping: is there value in guiding future therapies?

Professor David White gives an introduction to obstructive sleep apnea (OSA) phenotyping in terms of the four traits of OSA; airway anatomy, upper airway muscle function, respiratory arousal threshold and loop gain, a measure of ventilatory control. While continuous positive airway pressure (CPAP) is effective in virtually all patients with OSA, phenotyping patients for all these traits has the potential for guiding treatment choice in the future. 

Watch the symposium video below and answer the questions to test your understanding.

 
 

Short quiz

You must be logged in to submit this form. If you are logged in and still cannot post, make sure "Do not track" in your browser settings is disabled.
Have you learned something new from this video that will positively change the way you practice now, or in the future?
Of the following physiologic traits, which is not currently recognised as a modifiable variable in the pathophysiology of obstructive sleep apnea?

Challenges in managing Cheyne-Stokes Respiration

Professor Winfried Randerath gives an overview of the factors to be considered in managing periodic breathing in heart failure patients. The consequences of periodic breathing are hypoxia-hypocapnia, increased chemosensitivity and sympathetic activation. Watch to learn how measures of respiration instability help to predict patient outcomes and the role of adaptive servo-ventilation.

Watch the symposium video below and answer the questions to test your understanding.

 

Short quiz

You must be logged in to submit this form. If you are logged in and still cannot post, make sure "Do not track" in your browser settings is disabled.
Have you learned something new from this video that will positively change the way you practice now, or in the future?
Which of the following is true?
Which of the following is true?
Which of the following is true?

Compliance with adaptive servo-ventilation therapy in heart failure patients with sleep disordered breathing

Dr Elisa Perger presents on the challenges of treating patients with heart failure and sleep-disordered breathing (SDB) which result in poor survival outcome. Auto servo-ventilation (ASV) has been developed to treat SDB in patients with heart failure and is more efficient that CPAP at reversing central sleep apnea (CSA). Previous trials of CPAP and ASV in OSA and CSA have suffered from poor compliance (<4 h per night) in the latter parts of the trial but watch the video to find out if this is also the case in the ongoing ADVENT-HF trial which analyses the effects of ASV on mortality and morbidity in patients with CSA and OSA and heart failure.

Watch the symposium video below and answer the questions to test your understanding.

 

Short quiz

You must be logged in to submit this form. If you are logged in and still cannot post, make sure "Do not track" in your browser settings is disabled.
Have you learned something new from this video that will positively change the way you practice now, or in the future?
Which kind of sleep apnea (OSA or CSA) is expected in patients with heart failure?
What was the objective of the ADVENT-HF trial?
Many previous trials have demonstrated poor adherence to PAP treatment, did a preliminary analysis of the ADVENT-HF trial show improved adherence to >4 H per night?
Welcome:

Positional obstructive sleep apnea and its treatment

In this symposium chaired by Professor David White, Dr Raphaël Heinzer and Professor Nico de Vries present on positional obstructive sleep apnea (POSA) and highlight the clinical evidence showing that it should be treated differently to obstructive sleep apnea (OSA).

Select one of the two videos below to watch, learn and test your knowledge with our short quiz. 

Prevalence and pathophysiology of positional sleep apnea

Dr Raphaël Heinzer describes the exacerbation of obstructive sleep apnea (OSA) in the supine position. Positional obstructive sleep apnea (POSA) is found in about 75% of patients with OSA, watch this video to learn about the main characteristics of POSA and its pathophysiology including the effects of obesity, lung volume, upper airway size and head position.

Watch the symposium video below and answer the questions to test your understanding.

Short quiz

You must be logged in to submit this form. If you are logged in and still cannot post, make sure "Do not track" in your browser settings is disabled.
Have you learned something new from this video that will positively change the way you practice now, or in the future?
True or False: Positional Obstructive Sleep Apnes (POSA) is a subset of OSA in which the patient experiences apneic events when sleeping on their back?
True of False: POSA can be diagnosed through a sleep study?

Overview of OSA and POSA, clinical imperatives

Early-stage OSA is usually positional and if not treated it will usually progress. It is however reversible and while old-school positional therapies have low compliance (likely due to being uncomfortable and disturbing sleep quality), Professor Nico de Vries describes how modern sleep position trainers (SPT) show much better long-term compliance and clinically relevant improvement. SPT have the potential to become the fourth OSA treatment modality in addition to continuous positive upper airway pressure (CPAP), oral devices and upper airway surgery, alone or in combination. Professor David White also describes encouraging data for SPT from a crossover trial comparing SPT and CPAP which suggests that SPT should be a first-line therapy for POSA.

Watch the symposium video below and answer the questions to test your understanding.

Overview of OSA and POSA, clinical imperatives

You must be logged in to submit this form. If you are logged in and still cannot post, make sure "Do not track" in your browser settings is disabled.
Have you learned something new from this video that will positively change the way you practice now, or in the future?
Multiple or single choice
Will you consider treating your POSA patients with a sleep positioning device?
Does clinical evidence suggest that a sleep positioning device is non-inferior to CPAP in reducing the AHI in POSA patients?
Welcome:
Welcome:

Developed by EPG Health for Medthority in collaboration with Philips, with content provided by Philips.