Publications by authors named "Johan Verbraecken"

Telemedicine (TM) as a means of remote patient-physician interaction is gaining popularity in nearly every field, and (respiratory) sleep medicine is no exception. Because obstructive sleep apnoea (OSA) is a chronic condition, and requires a continuous treatment and monitoring of therapy success, telematic communications could be useful to establish diagnostic and therapeutic strategies. This Statement summarises the evidence and efficacy of TM options in OSA.

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Isolated REM sleep behavior disorder (iRBD) is a prodromal marker of Parkinson's disease (PD) and related alpha-synucleinopathies. Identification of RBD is crucial for timely intervention and disease-modifying treatments. While video-polysomnography (vPSG) remains the diagnostic gold standard, its costly and resource-intensive nature limits its utility.

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Rationale: Both the site of upper airway collapse during drug-induced sleep endoscopy (DISE) and pathophysiological endotypic traits are associated with non-CPAP treatment outcomes for obstructive sleep apnea (OSA). Reduced hypoglossal nerve stimulation (HGNS) treatment efficacy has been associated with complete concentric collapse at the level of the palate (CCCp), lateral wall collapse, lower arousal threshold, and poor dilator muscle compensation. However, these predictors may not be independent.

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Study Objectives: The aim of this study is to assess the performance of six different consumer wearable sleep-tracking devices, namely the Fitbit Charge 5, Fitbit Sense, Withings Scanwatch, Garmin Vivosmart 4, Whoop 4.0, and the Apple Watch Series 8, for detecting sleep parameters compared to the gold standard, polysomnography (PSG).

Methods: Sixty-two adults (52 males and 10 females, mean age ±  = 46.

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Background: Sleep disturbances are common in patients with borderline personality disorder (BPD) and are associated with a poor prognosis and symptom severity. Research findings on sleep abnormalities in individuals with BPD have been inconsistent, with limited evidence linking subjective and objective measures.

Methods: We compared 44 women with BPD with 41 healthy controls.

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The shortage of drivers in Europe is at its worst level in decades. One aspect in addressing this issue is improving driver health in this demanding profession. A sustainable solution involves daily health monitoring via wearables.

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Background: Fragmented rapid eye movement (REM) sleep disrupts the overnight resolution of emotional distress, a process crucial for emotion regulation. Emotion dysregulation, which is common across psychiatric disorders, is often associated with sleep disturbances. This systematic review explores how REM sleep and nightmares affect emotion processing and regulation in individuals with psychiatric disorders where emotion dysregulation is a key concern, suggesting novel sleep-related treatment pathways.

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Study Objectives: Home sleep apnea testing based on peripheral arterial tonometry is increasingly being deployed because of its ability to test for multiple nights. However, home sleep apnea tests based on peripheral arterial tonometry do not have access to modalities such as airflow and cortical arousals and instead rely on alternative sources of information to detect respiratory events. This results in an a priori performance disadvantage.

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Article Synopsis
  • The study evaluates a modified "Baveno classification" for treating obstructive sleep apnoea (OSA) by incorporating a cardiovascular disease (CVD) risk score and considering severe breathing issues.
  • Researchers analyzed data from 8,625 OSA patients, categorizing them into risk groups and assessing the impact of treatment over 12-24 months using results from the Epworth Sleepiness Scale (ESS) and systolic blood pressure (SBP).
  • Findings show that treatment indications increased with higher CVD risk, and significant improvements in sleepiness and blood pressure were noted, supporting the importance of CVD assessment in OSA management.
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Study Objectives: This paper reports on the clinical evaluation of the sleep staging performance of a novel single-lead biopotential device.

Methods: One hundred and thirty-three patients suspected of obstructive sleep apnea were included in a multi-site cohort. All patients underwent polysomnography and received the study device, a single-lead biopotential measurement device attached to the forehead.

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Article Synopsis
  • Obstructive sleep apnea (OSA) often causes excessive daytime sleepiness (EDS), and pitolisant, a medication that targets histamine receptors, was tested for its efficacy in treating this issue in patients with moderate to severe OSA.
  • In a clinical trial with 361 participants, pitolisant was administered in varying doses up to 40 mg daily for 12 weeks, showing a significant reduction in EDS as measured by the Epworth Sleepiness Scale compared to a placebo.
  • The study found that pitolisant was well tolerated and improved not only daytime sleepiness but also reaction times and overall patient satisfaction, regardless of whether patients used continuous positive airway pressure (CPAP) therapy.
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Article Synopsis
  • Obstructive sleep apnoea (OSA) is a common condition that causes excessive daytime sleepiness despite treatment with CPAP therapy, prompting a study to evaluate the efficacy and safety of three approved medications: modafinil, solriamfetol, and pitolisant.
  • A systematic review identified 20 randomized controlled trials involving 4015 patients, analyzing the effectiveness of these drugs using various sleepiness and quality of life metrics, as well as safety profiles.
  • Findings indicated that solriamfetol and pitolisant showed significant improvements in reducing daytime sleepiness, while pitolisant was ranked highest for safety and overall benefit-risk balance compared to the other medications tested.
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Hypoglossal nerve stimulation (HGNS) has emerged as an effective treatment for obstructive sleep apnea (OSA). Identifying baseline characteristics that prospectively could predict treatment outcomes even better is crucial for optimizing patient selection and improving therapeutic success in the future. A systematic review was conducted following PRISMA guidelines.

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Obstructive sleep apnea (OSA) is a sleep disorder characterized by repetitive episodes of partial or complete obstruction of the upper airway during sleep. Continuous positive airway pressure (CPAP) is a method used as a first-line treatment for obstructive sleep apnea (OSA). However, intolerance and resistance to CPAP can limit its long-term effectiveness.

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Surgical interventions, like barbed reposition pharyngoplasty (BRP), are a valuable alternative for patients with obstructive sleep apnea (OSA) who are unable to tolerate continuous positive airway pressure (CPAP). However, predicting surgical success remains challenging, partly due to the contribution of non-anatomical factors. Therefore, combined medical treatment with acetazolamide, known to stabilize respiratory drive, may lead to superior surgical results.

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Hypoglossal nerve stimulation (HGNS) has emerged as a widespread and innovative treatment option for selected moderate-to-severe obstructive sleep apnea (OSA) patients who cannot be treated effectively with traditional treatment modalities. In this observational cohort study, the objective and subjective outcomes of Belgian OSA patients treated with HGNS therapy were analyzed at 6 and 12 months post-implantation. Thirty-nine patients implanted with a respiration-synchronized HGNS device at the Antwerp University Hospital w ere included in this study.

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Unlabelled: PURPOSE   : Continuous positive airway pressure (CPAP) is often the treatment of choice for obstructive sleep apnea (OSA). Short-term adherence and early perceived benefits are the best predictors of long-term adherence. The aim of this study was to determine the effect of telemonitoring in the first period of treatment with CPAP (auto-titrating PAP) on compliance and the long-term outcome.

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Background: Despite being the gold-standard method for objectively assessing sleep, polysomnography (PSG) faces several limitations as it is expensive, time-consuming, and labor-intensive; requires various equipment and technical expertise; and is impractical for long-term or in-home use. Consumer wrist-worn wearables are able to monitor sleep parameters and thus could be used as an alternative for PSG. Consequently, wearables gained immense popularity over the past few years, but their accuracy has been a major concern.

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Article Synopsis
  • Differences in the site of pharyngeal collapse can affect the effectiveness of treatments for obstructive sleep apnea (OSA), particularly for patients with complete concentric collapse at the palate (CCCp).
  • Researchers analyzed data from 182 OSA patients to identify specific characteristics in overnight polysomnography that could predict the presence of CCCp, focusing on six flow shape features.
  • Their findings revealed significant associations between certain polysomnographic characteristics and CCCp, leading to enhanced identification methods which were validated with a larger dataset of 466 patients.
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The accreditation of sleep centres aims to ensure high-quality diagnosis and management of sleep centres. European accreditation standards were introduced in 2006, and were aimed at centres offering inpatient polysomnography and vigilance tests (Mean Sleep Latency Test and Maintenance of Wakefulness Test). Since then, the practice of sleep medicine has evolved, with greater use of ambulatory polysomnography and polygraphy.

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Introduction: Custom-made titratable mandibular advancement device (MAD) treatment can nowadays be considered a promising first-line treatment in patients with mild to severe obstructive sleep apnea (OSA). Specific manufacturing designs and titration mechanisms of MAD are on the market, characterized by their titration approach, vertical opening, and materials selection. The wing-designed MAD (SomnoDent® Flex™, SomnoMed Ltd, Sydney, Australia) has a lateral screw mechanism to advance the lower jaw in incremental steps of 0.

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