Publications by authors named "Alexandre R Abreu"

The field of artificial intelligence (AI) is rapidly expanding and has the potential to significantly impact the practice of sleep medicine. Sleep practitioners may be able to augment the efficiency and effectiveness of care delivery to patients by incorporating AI into clinical practice. However, AI must be implemented in a responsible manner, with a full appreciation of the technology's current limitations and evolving nature.

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Unlabelled: Alertness is a necessity for well-being and performance, and sleepiness is associated with cognitive and functional impairments that can have a negative impact on performance, health, mood, safety, and quality of life. In severe cases, sleepiness can lead to debilitation, injury, or death. Sleepiness is a marker of insufficient sleep and is the major patient-reported symptom associated with disorders of sleep and wakefulness such as narcolepsy and obstructive sleep apnea.

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Article Synopsis
  • Telehealth utilization surged during the COVID-19 pandemic, but its future is uncertain without permanent coverage and adequate reimbursement, which are crucial for its long-term viability and acceptance.
  • Telehealth enhances sleep health management by improving patient access, clinician efficiency, and safety, while addressing healthcare equity, making it particularly suitable for the field of sleep medicine.
  • The American Academy of Sleep Medicine advocates for telehealth as a vital component of high-quality care for sleep disorders and urges collaboration among stakeholders to strengthen its availability and accessibility.
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Background: Mild obstructive sleep apnoea (OSA) is a common disorder associated with daytime sleepiness and impaired quality of life. Given that adherence to positive airway pressure (PAP) therapy in OSA is suboptimal, alternative strategies are needed particularly for patients with mild OSA. Daytime neuromuscular electrical stimulation (NMES) of the tongue is a new therapeutic modality for mild OSA.

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Unlabelled: The period of the year from spring to fall, when clocks in most parts of the United States are set one hour ahead of standard time, is called daylight saving time, and its beginning and ending dates and times are set by federal law. The human biological clock is regulated by the timing of light and darkness, which then dictates sleep and wake rhythms. In daily life, the timing of exposure to light is generally linked to the social clock.

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Background: Sleep-disordered breathing (SDB) is a known risk factor for hypertension. Despite the well-established link between HIV infection and hypertension, it remains to be determined whether HIV infection modifies the association between SDB and hypertension.

Setting: The Multicenter AIDS Cohort Study.

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Unlabelled: The American Academy of Sleep Medicine (AASM) recommends that hypopneas be identified using a definition that is based on a ≥ 30% decrease in airflow associated with a ≥ 3% reduction in the oxygen saturation or an arousal (H3A) for diagnosis of obstructive sleep apnea (OSA) in adults. This conflicts with the Centers for Medicare & Medicaid Services definition, which requires a ≥ 4% decrease in the oxygen saturation to identify a hypopnea (H4) and does not acknowledge arousals. In 2018, the AASM Board of Directors constituted a Hypopnea Scoring Rule Task Force with a mandate to "create a strategy for adoption and implementation of the AASM recommended adult hypopnea scoring criteria among members, payers and device manufacturers.

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Study Objectives: Clinical benefit from positive pressure therapy is dependent on treatment adherence. Extreme weather events, such as floods, hurricanes, and tornadoes, can contribute to nonadherence by electricity loss and mandatory evacuation. We aimed to evaluate the concerns and behaviors of regular positive airway pressure users surrounding the extreme weather event Hurricane Irma.

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Epidemiology has identified an association between the use of pacifiers and protection from sudden infant death syndrome (SIDS). The use of pacifiers for SIDS prevention fails to gain adoption partly because there is no widely accepted physiologic mechanism to explain the epidemiologic association. Additionally, the scientific literature available on pacifier use focuses largely on the probable adverse effects.

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Obstructive sleep apnea (OSA) is a prevalent sleep related breathing disorder characterized by repetitive collapse of the upper airways leading to intermittent hypoxia and sleep disruption. Clinically relevant neurocognitive, metabolic and cardiovascular disease often occurs in OSA. Systemic hypertension, coronary artery disease, type 2 diabetes mellitus, cerebral vascular infarctions and atrial fibrillation are among the most often cited conditions with causal connections to OSA.

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Obstructive sleep apnea (OSA) is a chronic and heterogeneous disorder that leads to early mortality, stroke, and cardiovascular disease (CVD). OSA is defined by the apnea-hypopnea index, which is an index of OSA severity that combines apneas (pauses in breathing) and hypopneas (partial obstructions in breathing) associated with hypoxemia. Yet, other sleep metrics (i.

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Article Synopsis
  • - The study aimed to investigate whether obstructive sleep apnea syndrome (OSAS) is linked to the progression of glaucoma and how the severity of OSAS impacts the loss of visual field (VF).
  • - After analyzing 141 patients with both OSAS and glaucoma, only 25 were enrolled, revealing that 44% of eyes were "progressors" with more severe initial VF loss, but age and other factors were similar between progressors and non-progressors.
  • - Ultimately, the findings indicate no significant relationship between OSAS and glaucoma progression, as there was no correlation between the severity of OSAS and the rate of VF loss.
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Study Objectives: There is a paucity of information on the epidemiology of sleep disorders among US Hispanics. This study describes the frequency of sleep disordered breathing (SDB) risk, insomnia complaints, poor sleep quality, and daytime somnolence in a clinical cohort of ethnically diverse US Hispanics living in South Florida.

Methods: We explored the presence of sleep disorders in a cohort of Hispanics seen at primary care, pulmonary, and sleep clinics at the University of Miami and Miami Veterans Affair Medical Center.

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Placement and use of pulmonary artery catheters (PACs) carry potential risks. The authors describe a case of a patient who developed massive hemoptysis after placement of a PAC that caused a rupture of the pulmonary artery with pseudoaneurysm formation. Treatment was successfully achieved with transcatheter coil embolization.

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To study proteins secreted into the airway, we used secretions from primary human airway epithelial cells, re-differentiated at the air-liquid interface, and from patients intubated during surgery. A major protein of the cultured cell secretions was ethanol soluble. This protein was purified, analyzed by Edman degradation, matrix-assisted laser-desorption ionization time-of-flight mass spectroscopy of tryptic digests, and Western blots of two-dimensional electrophoresis gels using antisera against the purified preparation.

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