Muscle dysfunction in chronic respiratory diseases
Muscle involvement is no longer regarded as a mere secondary consequence of chronic respiratory diseases, but rather as a central component of their pathophysiology and clinical impact. This issue of BRN Reviews focuses precisely on this systemic dimension of respiratory diseases, bringing together a series of reviews that explore the biological mechanisms, clinical manifestations, and […]
Pathophysiology underlying muscle dysfunction and its most relevant associated clinical factors in chronic obstructive pulmonary disease
Introduction Chronic obstructive pulmonary disease (COPD) is the third leading cause of mortality and a top-10 cause of disability worldwide.1 COPD is characterized by airflow limitation, resulting from airway inflammation and remodeling, together with destruction of lung parenchyma.2 Beyond respiratory impairments, approximately 50% of patients with severe COPD develop muscle dysfunction,3 primarily affecting the lower […]
Clinical drivers of skeletal muscle dysfunction in COPD and other chronic respiratory diseases
Introduction Muscle dysfunction in chronic respiratory diseases (CRDs) encompasses loss of maximal force and/or premature fatigability in respiratory and/or limb muscles. It is highly prevalent in chronic obstructive pulmonary disease (COPD) and occurs across other CRDs, often independently of airflow obstruction or restriction severity and traditional physiological metrics.1–21 Beyond symptoms, muscle dysfunction impairs daily activities, […]
Skeletal muscle dysfunction and sarcopenia in bronchiectasis: clinical and biological mechanisms
Introduction Bronchiectasis is a chronic and heterogeneous respiratory disease characterized by abnormal and permanent dilation of the bronchi, chronic cough, sputum production, recurrent respiratory infections, and progressive airflow limitation. Historically considered a localized airway disorder, bronchiectasis is now widely recognized as a systemic disease with important extrapulmonary manifestations that significantly influence functional status, quality of […]
Most relevant training modalities currently in use to treat skeletal muscle dysfunction in chronic obstructive pulmonary disease
Introduction Chronic respiratory diseases (CRDs), including chronic obstructive pulmonary disease (COPD), interstitial lung disease (ILD), and bronchiectasis, are increasingly recognised as multi-system conditions, with skeletal muscle dysfunction and sarcopenia representing key systemic manifestations that influence symptoms, exercise tolerance, and prognosis.1,2 In COPD, quadriceps muscles commonly exhibit reduced cross-sectional area, fibre-type shifts toward glycolytic phenotypes, diminished […]
Rethinking obstructive sleep apnoea: integrating precision medicine and technological advances across the lifespan
Obstructive sleep apnoea (OSA) has evolved from a traditionally underrecognized sleep disorder to a complex, multisystem disease with profound cardiovascular, metabolic, and neurocognitive implications. The five review articles included in this issue collectively reflect a paradigm shift in our understanding and management of OSA, highlighting the limitations of conventional approaches while emphasizing the emergence of […]
Co-morbid insomnia and sleep apnea and cardiovascular consequences: is the whole greater than each part?
Introduction Chronic insomnia and obstructive sleep apnea (OSA) are probably the main actors in the sleep field in terms not only of the high prevalence1,2 but also in promoting a myriad of consequences, including cardiometabolic complications3,4. While insomnia relies on the difficulty initiating sleep and/or maintaining sleep and/or waking up earlier than desired, despite adequate […]
Obstructive sleep apnea in obesity: traditional and emerging treatment strategies
Introduction Obstructive sleep apnea (OSA) is a highly prevalent disorder associated with a wide range of adverse health outcomes. Obesity is one of the most well-established risk factors for OSA, and its global prevalence has continued to rise over recent decades. In the adult population, the prevalence of OSA is estimated to be around 25%; […]
Approach to obstructive sleep apnea in children from a cardiovascular perspective
Introduction Exposure to risk factors during childhood may contribute to the development of future cardiovascular (CV) disease. Thus, obstructive sleep apnea (OSA) could act as a precipitating factor and be a modifiable risk factor. The use of new imaging tools, such as echocardiography, or the incorporation of new biological signals extracted from sleep studies or […]
New bio signals in sleep studies scoring
Introduction Obstructive sleep apnea (OSA) is a common sleep disorder affecting up to 1 billion adults worldwide1. Repetitive upper airway obstructions characterize OSA during sleep, leading to acute physiological changes, including intermittent nocturnal hypoxemia, sympathetic activation, intrathoracic pressure changes, arousals, and sleep fragmentation2–4. Furthermore, the nightly occurrence of these acute downstream effects of airway obstruction […]