| Selected Publications： |
◆Akashiba T, *Chin K, et al. The Japanese Respiratory Society Noninvasive Positive Pressure Ventilation (NPPV) Guidelines (second revised edition). Respir Investig. 2017; 55:83-92.
◆*Tachikawa R, Ikeda K, Minami T, Matsumoto T, Hamada S, Murase K, Tanizawa K, Inouchi M, Oga T, Akamizu T, Mishima M, Chin K. Changes in energy metabolism after continuous positive airway pressure for obstructive sleep apnea Am J Respir Crit Care Med 2017; 194:729-38.
◆Chihara Y, *Chin K, Aritake K, Harada Y, Toyama Y, Murase K, Yoshimura C,Hitomi T, Oga T, Mishima M, Urade Y. A urine biomarker for severe OSA: Lipocaline-Type prostaglandin D synthase. Eur Respir J 2013; 42:1563-74
◆Murase K, Chihara Y, Takahashi K, Okamoto S, Segawa H, Fukuda K, Tanaka K, Uemoto S, Mishima M, *Chin K. The use of noninvasive ventilation for pediatric patients following liver transplantation: Decrease in the need for reintubation. Liver Transpl 2012;18:1217-25
◆*Chin K, Oga T, Takahashi K, Takegami M, Nakayama-Ashida Y, Wakamura T, Sumi K, Nakamura T, Horita S, Oka Y, Minami I, Fukuhara S, Kadotani H. Associations between obstructive sleep apnea, metabolic syndrome and sleep duration, as measured with an actigraph, in an urban male working population in Japan. Sleep 2010; 33:89-95.
◆*Chin K, Shimizu K, Nakamura T, Narai N, Masuzaki H, Ogawa Y, Mishima M, Nakamura T, Nakao K, Ohi M. Changes in intra-abdominal visceral fat and serum leptin levels in patients with obstructive sleep apnea syndrome following nasal continuous positive airway pressure. Circulation 1999; 100:706-712.
◆*Chin K, Ohi M, Kita H, Noguchi T, Otsuka N, Tsuboi T, Mishima M, Kuno K. Effects of NCPAP therapy on fibrinogen levels in obstructive sleep apnea syndrome. Am J Respir Crit Care Med 1996;153:1972-1976.
*: corresponding author
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| Abstract： |
The prevalence of obstructive sleep apnea (OSA) has been increasing worldwide. From 1993 to 2010, survey reports of the diagnosis of sleep apnea increased 14.6-fold, from 420,000 to 6.37 million per year in the U.S.A. (Andrew M, et al. Ann Am Thorac Soc 2016). In Japan, the number of OSA patients using continuous positive airway pressure (CPAP) treatment is now more than 400,000 in 2016 and increases by 40,000 per year in recent 3 years. Therefore, we should recognize the coexistence of OSA and common diseases. It is possible that patients with airway diseases such as chronic obstructive pulmonary disease (COPD) and bronchial asthma have OSA concomitantly. Recent data showed that patients with OSA and the other life-related diseases such as hypertension and metabolic syndrome become resistant to treatment or experience exacerbations of the concomitant disease if OSA is not treated. Indeed, it was reported that patients with OSA and COPD, which is called overlap syndrome, had a greater number of exacerbations and poorer prognosis than those with only COPD. With the progression of COPD, patients become not only hypoxemic but hypercapnic. First when patients with COPD reach the hypoxemic stage, we prescribe oxygen therapy. But when they enter the hypercapnic stage, the management of sleep-related hypoventilation (SRD) especially during rapid eye movement (REM) sleep becomes an important issue. At that stage, bi-level positive airway pressure (bi-level PAP) is usually used. To prescribe adequate treatments with oxygen, CPAP or bi-level PAP with or without supplement oxygen, it is important that clinicians understand sleep disordered breathing (apnea, hypopnea and SRD). It is said that patients with asthma sometimes hyperventilate. It should be recognized that post-hyperventilation apnea, usually central sleep apnea, can easily occur, if the patients enter the sleep following hyperventilation.
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