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Sample records for apnea syndrome osas

  1. Lack of effect of sleep apnea on oxidative stress in obstructive sleep apnea syndrome (OSAS patients.

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    M Simiakakis

    Full Text Available PURPOSE: The aim of this study was to evaluate markers of systemic oxidative stress and antioxidant capacity in subjects with and without OSAS in order to investigate the most important factors that determine the oxidant-antioxidant status. METHODS: A total of 66 subjects referred to our Sleep laboratory were examined by full polysomnography. Oxidative stress and antioxidant activity were assessed by measurement of the derivatives of reactive oxygen metabolites (d-ROMs and the biological antioxidant capacity (BAP in blood samples taken in the morning after the sleep study. Known risk factors for oxidative stress, such as age, sex, obesity, smoking, hypelipidemia, and hypertension, were investigated as possible confounding factors. RESULTS: 42 patients with OSAS (Apnea-Hypopnea index >15 events/hour were compared with 24 controls (AHI<5. The levels of d-ROMS were significantly higher (p = 0.005 in the control group but the levels of antioxidant capacity were significantly lower (p = 0.004 in OSAS patients. The most important factors predicting the variance of oxidative stress were obesity, smoking habit, and sex. Parameters of sleep apnea severity were not associated with oxidative stress. Minimal oxygen desaturation and smoking habit were the most important predicting factors of BAP levels. CONCLUSION: Obesity, smoking, and sex are the most important determinants of oxidative stress in OSAS subjects. Sleep apnea might enhance oxidative stress by the reduction of antioxidant capacity of blood due to nocturnal hypoxia.

  2. The Tongue Muscle Training (ZMT® in nCPAP Patients with Obstructive Sleep Apnea Syndrome (OSAS

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    Gessmann H.-W.

    2013-06-01

    Full Text Available Obstructive Sleep Apnea Syndrome is treated not only with the help of nCPAP but by other means which help to support the sufficient level of pharyngeal airways. In course of our experiment we investigated changes in parameters of breath during night sleep in patients with high indices of obstructive Sleep Apnea Syndrome after the tongue muscle training. 40 patients with OSAS treated only with the help of nCPAP underwent a 5-week course of electrical stimulation of upper pharyngeal muscles. This type of treatment was supposed to result in dilatation of pharyngeal airways and cure of occlusion and obstruction. Parameters of breath during the night sleep before- and after the treatment were detected with the help of somno-poligraphic investigations and compared. Indices of apnea and hypopnea decreased in 26 of 40 patients, which is more than half of the probands. We recommended the patients with a diagnosed OSAS without a risk of recurrence to add tongue muscle training to nCPAP. In case the course of nCPAP therapy is launched it helped achieve sufficient improvement of parameters affecting breath during the night sleep and in many cases decrease respiratory pressure of nCPAP therapy or its complete cessation.

  3. Italian recommendations on dental support in the treatment of adult obstructive sleep apnea syndrome (OSAS)

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    Levrini, Luca; Sacchi, Franco; Milano, Francesca; Polimeni, Antonella; Cozza, Paolo; Bernkopf, Edoardo; Segù, Marzia; Zucconi, Marco; Vicini, Claudio; Brunello, Enrico

    2015-01-01

    Summary Background The aim of the present article is to present a set of proposed clinical recommendations aimed at Italian dentists involved in the management of patients with obstructive sleep apnea syndrome or snoring. Methods With the purpose of creating a study group, some of the most important Italian scientific societies operating in fields relevant to the issue of sleep medicine in dentistry were asked to appoint a representative. Each member of the study group was required to answer questions regarding the clinical management of OSAS and snoring. Results Oral appliances can be used to treat: - simple snoring, in patients who do not respond to, or do not appear to be suitable candidates for behavioral measures such as weight loss or positional therapy; - mild or moderate OSAS, in patients who prefer OAs to continuous positive airway pressure (CPAP) or who are not suitable candidates for CPAP, because of its failure or failure of behavioral approaches like weight loss or positional therapy; - severe OSAS, in patients who do not respond to or do not tolerate CPAP and in whom no indication for either maxillofacial or ENT surgery appears applicable. Conclusions The application of oral appliances is highly desirable in cases of simple snoring or mild to moderate OSAS, whereas considerable caution is warranted when treating severe OSAS. It is fundamental to ensure that the patient understands his problem and, at the same time, to present all the various treatment options. PMID:26941893

  4. Depression and Obstructive Sleep Apnea (OSA

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    O'Hara Ruth

    2005-06-01

    Full Text Available Abstract For over two decades clinical studies have been conducted which suggest the existence of a relationship between depression and Obstructive Sleep Apnea (OSA. Recently, Ohayon underscored the evidence for a link between these two disorders in the general population, showing that 800 out of 100,000 individuals had both, a breathing-related sleep disorder and a major depressive disorder, with up to 20% of the subjects presenting with one of these disorders also having the other. In some populations, depending on age, gender and other demographic and health characteristics, the prevalence of both disorders may be even higher: OSA may affect more than 50% of individuals over the age of 65, and significant depressive symptoms may be present in as many as 26% of a community-dwelling population of older adults. In clinical practice, the presence of depressive symptomatology is often considered in patients with OSA, and may be accounted for and followed-up when considering treatment approaches and response to treatment. On the other hand, sleep problems and specifically OSA are rarely assessed on a regular basis in patients with a depressive disorder. However, OSA might not only be associated with a depressive syndrome, but its presence may also be responsible for failure to respond to appropriate pharmacological treatment. Furthermore, an undiagnosed OSA might be exacerbated by adjunct treatments to antidepressant medications, such as benzodiazepines. Increased awareness of the relationship between depression and OSA might significantly improve diagnostic accuracy as well as treatment outcome for both disorders. In this review, we will summarize important findings in the current literature regarding the association between depression and OSA, and the possible mechanisms by which both disorders interact. Implications for clinical practice will be discussed.

  5. Treatment of obese patients with obstructive sleep apnea syndrome (OSAS): effect of weight loss and interference of otorhinolaryngoiatric pathology.

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    Pasquali, R; Colella, P; Cirignotta, F; Mondini, S; Gerardi, R; Buratti, P; Rinaldi Ceroni, A; Tartari, F; Schiavina, M; Melchionda, N

    1990-03-01

    The role of weight loss in the therapy of obstructive sleep apnea syndrome (OSAS) was investigated in 23 affected patients with various degrees of obesity (body mass index range 26.6-61.0) free of cranio-facial malformations. Weight loss resulted 18.5 +/- 14.7 (s.d.) kg and was significantly correlated with baseline BMI value (r = 0.94; P less than 0.0001). Weight loss significantly reduced the number of apneas + hypopneas per hour of sleep ((A + H)I) from 66.5 +/- 23.0 to 33.0 +/- 26.2 (P less than 0.0001) and improved the mean of oxygen desaturation peaks during apneas (mSaO2) from 81.9 +/- 6.9 to 87.6 +/- 3.9; P less than 0.001). A significant correlation was found between weight loss and changes in the (A + H)I (r = -0.55; P less than 0.01) and the mSaO2 (r = 0.46; P less than 0.05). The (A + H)I significantly improved in both patients who lost more than 10 kg (basal BMI: 42.3 +/- 10.0) and in those who lost less than 10 kg (basal BMI: 30.2 +/- 2.3), whereas the mSaO2 improved only in the former. Obese patients with moderate to heavy ORL pathological findings had worse pretreatment and final OSAS parameters than those with absent or mild ORL lesions. However, both groups showed a significant, although quantitatively different, improvement of the (A + H)I and mSaO2 after weight loss. Compared to those who were cured or improved after the treatment, patients who failed to obtain significant effects on OSAS clinical presentation also had a significantly higher prevalence of ORL pathology. It is concluded that: (1) weight loss improves parameters and clinical presentation of OSAS in the majority of affected obese patients; (2) a relationship exists between the entity of weight loss and that of improvement of the syndrome; (3) weight loss must be encouraged even in patients with mild to moderate overweight; (4) the presence of ORL pathology may represent a confusing factor in the interpretation of the results obtained after weight loss.

  6. The rheological properties of blood and the risk of cardiovascular disease in patients with obstructive sleep apnea syndrome (OSAS

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    Władysław Pierzchała

    2011-07-01

    Full Text Available Obstructive sleep apnea (OSA is an important public health concern, which affects around 2–4% of the population. Left untreated, it causes a decrease not only in quality of life, but also of life expectancy. Despite the fact that knowledge about the mechanisms of development of cardiovascular disease in patients with OSA is still incomplete, observations confirm a relationship between sleep disordered breathing and the rheological properties of blood. One possible consequence of an increased incidence of cardiovascular disease may be a rise in mortality in OSA patients. Continuously improved research methods are allowing for an increasingly more accurate understanding of the significance of observed changes. (Folia Histochemica et Cytobiologica 2011, Vol. 49, No. 2, 206–210

  7. A pilot study to compare the cerebral hemodynamics between patients with obstructive sleep apnea syndrome (OSA) and periodic limb movement syndrome (PLMS) during nocturnal sleep with near-infrared spectroscopy (NIRS)

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    Zhang, Zhongxing; Schneider, Maja; Laures, Marco; Fritschi, Ursula; Hügli, Gordana; Lehner, Isabella; Qi, Ming; Khatami, Ramin

    2014-03-01

    Obstructive sleep apnea syndrome (OSA) and periodic limb movement in sleep syndrome (PLMS) are two common sleep disorders. Previous studies showed that OSA and PLMS share common features, such as increased cardio-vascular risk, both apnea events and limb movements occur periodically, they are usually associated with cortical arousals, and both of them can induce declines in peripheral oxygen saturation measured with pulse oximetry. However, the question whether apnea events and limb movements also show similar characteristics in cerebral hemodynamic and oxygenation has never been addressed. In this pilot study, we will first time compare the cerebral hemodynamic changes induced by apnea events and limb movements in patients with OSA (n=4) and PLMS (n=4) with NIRS. In patients with OSA, we found periodic oscillations in HbO2, HHb, and blood volume induced by apnea/hypopnea events, HbO2 and HHb showed reverse changing trends. By contrast, the periodic oscillations linked to limb movements were only found in HbO2 and blood volume in patients with PLMS. These findings of different cerebral hemodynamics patterns between apnea events and limb movements may indicate different regulations of nervous system between these two sleep disorders.

  8. Obstructive sleep apnea syndrome and cardiovascular problems

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    Zuhal Arıtürk Atılgan

    2011-06-01

    Full Text Available Obstructive sleep apnea syndrome (OSAS is defined as repeated episodes of upper airway occlusion during sleep with consequent excessive daytime sleepiness. Recently, relationship has been found between cardiovascular disease and OSAS. Therefore OSAS has become more popular today. OSAS is associated with the pathogenesis of cardiovascular disease. A large number of studies have demonstrated that OSAS is an independent risk factor of cardiovascular morbidity and mortality. Sleep apnea was shown to be associated with hypertension, ischemic heart disease, stroke, pulmonary hypertension, cardiac arrhythmia, and cardiovascular mortality

  9. Adipocytokines in sleep apnea syndrome

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    Wysocka E

    2009-12-01

    Full Text Available Abstract Objective Biomarkers of adipose tissue may affect glucose and lipid metabolism and present pro-inflammatory properties, thus could be involved in the pathobiochemistry of cardiovascular disease (CVD. The coexistence of sleep apnea syndrome (OSA and metabolic risk factors of CVD is worth explaining. The aim of the study was to compare the serum adipocytokines in subjects with and without OSA, who had all elevated body mass index (BMI. Methods Overweight (BMI: 25.0-29.9 kg/m2 and obese (BMI: 30.0-39.9 kg/m2 OSA-suspected Caucasian males, aged 30-63, with no acute disease or chronic disorder underwent polysomnographic evaluation to select OSA-positive (AHI ≥ 5 and OSA-negative (AHI Results A decreased resistin level was observed in Over-OSA-Pos vs. Over-OSA-Neg subjects (P = 0.037 as well as in Obese-OSA-Pos vs. Obese-OSA-Neg (P = 0.045. No differences in leptin concentrations were observed. A positive correlation between leptin and BMI was in both overweight subgroups and a negative one between resistin and fasting glucose was in both obese subgroups. Conclusions OSA may decrease the serum resistin level in subjects with excess body mass and also may contribute to glucose metabolism, but has no influence on the leptin level.

  10. [The sleep obstructive apnea and hypopnea syndromes].

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    Cambron, L; Roelants, F; Deflandre, E; Raskin, S; Poirrier, R

    2004-01-01

    Since two decades, sleep breathing disorders are more wisely recognized by the Belgian medical community. Among these, the Obstructive Sleep Apnea Syndrome (OSA) is the best known but its frontiers with others syndromes such as the Upper Airway Resistance Syndrome (UARS), the Central Sleep Apnea Syndrome (CSAS) or the Overlap Syndrome are still matter of discussion. Its causes are plurifactorial, and many recent publications draw the attention to its long term effects in the cardiovascular and neuropsychiatric fields. This article summarizes the present definitions and features associated with OSA, from clinical and neurophysiological perspectives, and the different consequences to which untreated or underdiagnosed patients are exposed.

  11. Obstructive sleep apnea in Treacher Collins syndrome.

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    Akre, Harriet; Øverland, Britt; Åsten, Pamela; Skogedal, Nina; Heimdal, Ketil

    2012-01-01

    The aim of the present study was to investigate the prevalence of obstructive sleep apnea syndrome (OSAS) among the Norwegian population with Treacher Collins syndrome (TCS). A secondary aim was to establish whether TCS phenotype severity is associated with OSAS severity. A prospective case study design was used. Individuals who were 5 years old and above with a known diagnosis of TCS in Norway were invited to participate in a study. The study included genetic testing, medical and dental examinations and polysomnography. All participants demonstrated disturbed respiration during sleep; 18/19 met the diagnostic criteria for OSAS. Subjectively evaluated snoring was not a reliable predictor of OSAS. We found no significant association between TCS phenotype severity and the severity of OSAS. OSAS is common in TCS, but there is no association with the phenotype severity. Individuals diagnosed with TCS must undergo sleep studies to identify the presence of OSAS.

  12. OSAS 患者甲功检查的可行性及病例分析%Feasibility Study about Thyroid Function Testing in Obstructive Sleep Apnea Syndrome is Checked and Cases Reports

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    牛红丽; 马利军; 王海播; 张瑞

    2016-01-01

    。临床上遇到中重度 OSAS 患者不要忽略是否存在甲减的临床表现。另外,所有甲减都应考虑存在 OSAS的可能性,尤其是出现打鼾、白天嗜睡等症状时。相关医务人员了解 OSAS 和甲减的基本知识、临床检测技术和相关治疗措施,减少对甲减的漏诊误诊。%Objective To study the relationship between obstructive sleep apnea syndrome (OSAS)and hypothyroidism ,to evaluate the prevalence of hypothyroidism. To confirm the feasibility study about thyroid function testing in OSAS is checked. Methods A retrospective analysis of cases of sleep apnea and with hypothyroidism and review of the literature. 60 patients with proven OSAS (apnea index [AHl]>15) and thyroid function testing. Results 1 Hypothyroidism has been shown to be frequently related with OSAS and many clinically apparent similariti. the prevalence of hypothyroidism was no significant difference,pothyroidism prevalence rate of all groups of patients with OSAS, with age, the incidence rate increased. OSAS patients, 2.0% prevalence of hypothyroidism, hypothyroidism, the prevalence of OSAS in patients up to 52% or more. 2. This study of 60 cases of hospitalized patients with moderate to severe OSAS were found in 5 cases of hypothyroidism, accounting for 8.3%, 10% female patients, over 50 years the incidence rate of 20%. 2 patients had typical clinical symptoms of hypothyroidism, in six months to one year significantly increased apnea. 3 patients without typical symptoms of hypothyroidism, including 1 with pituitary tumor, active acromegaly, and 1 with metabolic syndrome and subclinical hypothyroidism, and 1 case of only daytime sleepiness, nocturnal snoring, apnea. Hypothyroidism and / or ventilator treatment, hypothyroidism, sleep apnea symptoms and reduced. 3.5 cases of patients 3 months after discharge follow-up results: adhere to the ventilation in the treatment in 4 cases, the disease improved, OSAS was significantly reduced, while receiving both treatments in 2 cases

  13. Sleep apnea syndrome in endocrine clinics.

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    Ceccato, F; Bernkopf, E; Scaroni, C

    2015-08-01

    Obstructive sleep apnea syndrome (OSAS) is a chronic condition with a high prevalence (up to 7 % of the general population) characterized by frequent episodes of upper airway collapse while sleeping. Left untreated, OSAS can cause severe complications, including systemic hypertension, cardiovascular disease, stroke, and abnormal glucose metabolism. This review aims to summarize the close links between OSAS, endocrinology, and metabolism. In patients with metabolic syndrome, OSAS is an independent risk factor for the onset of type 2 diabetes and a worsening glycemic control. The accumulation of adipose tissue in the neck and limited chest wall dynamics, hypoxia, and local micro-inflammation link visceral obesity closely with OSAS. There is now an abundance of convincing data indicating that promoting lifestyle changes, improving sleep hygiene, and adjusting diet can ameliorate both metabolic syndrome and OSAS, especially in obese patients. The incidence of OSAS in acromegaly is high, though GH treatments seem to be unrelated to the onset of apnea in GH-deficient individuals. Prospective studies have suggested an association between hypertension and OSAS because intermittent nocturnal hypoxia prompts an increase in sympathetic tone, endothelial dysfunction, and vascular inflammation: aldosterone excess may have a pathophysiological role, and some authors have reported that treating OSAS leads to a modest, but significant, reduction in blood pressure.

  14. Obstructive Sleep Apnea Syndrome, Periodic Limb Movements and Related Factors

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    Osman Özgür Yalın

    2015-09-01

    Full Text Available OBJECTIVE: Obstructive sleep apnea syndrome (OSAS is characterized by nocturnal repetitive apnea episodes. Periodic limb movements (PLMs is nocturnal, stereotypic, repetitive movements of the lower extremities. The aim of this study was to investigate the presence of periodic limb movements in OSAS patients and correlation of PLM with OSAS severity. METHODS: One hundred and forty one OSAS suspected patients was enrolled into the study. All subjects’ blood pressure, heart rate measurements and neurologic examinations were made by the same neurologist. Sociodemographic characteristics were recorded. One night polysomnography (PSG was performed to all patients and results were analyzed. Apnea Hypopnea Index (AHI ≥ 5 subjects were accepted as OSAS, and PLM Index (PLMI ≥ 5 subjects were accepted as having PLM. RESULTS: One hundred and two patients were diagnosed as OSAS. The control group consisted of 39 patients who had normal polysomnographic findings. OSAS patients’ were older and body mass index (BMI were higher than the control group. Systolic blood pressure was higher in OSAS group. Alcohol use was determined as a risk factor for OSAS. PLM were more common in OSAS group than the control group (% 30,3 - % 10,2. PLM frequency was associated with the severity of OSAS. CONCLUSION: In OSAS patients presence of PLM was related with OSAS severity, higher systolic and diastolic blood pressure and REM sleep depletion. PLM in OSAS patients could be regarded as an indicator of disease severity and also could aware clinician for increased complication rates.

  15. [Obstructive sleep apnea syndromes].

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    Poirrier, R

    1993-01-01

    Snoring and excessive sleepiness are the hallmarks of obstructive sleep apnea syndrome but other clinical manifestations are present and a precise assessment of the disease involves clear definitions of the various kinds of apnea. Several pathogenetic factors (functional, anatomical, neurological, genetical) are still being discussed. However new insights of the pathophysiology of apneas allow more reliable treatments. Central nervous and cardiovascular complications as well as the traumatic morbidity, associated with excessive daytime sleepiness, make it a major public health problem.

  16. Obstructive sleep apnea hypopnea syndrome:a proinflammatory disorder

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    HAN Fang

    2007-01-01

    @@ Obstructive sleep apnea hypopnea syndrome (OSAHS) is a rather frequent disorder affecting 2%-4% of the general population. Large cohort studies have confirmed that obstructive sleep apnea (OSA) is an independent risk factor for cardiovascular disease (CVD), including myocardial infarction, hypertension, stroke and so on. For example, Sleep Heart Health Study (SHHS) demonstrated that the prevalence of CVD (including myocardial infarction, angina, coronary revascularization, heart failure, stroke) was 1.42 times greater in patients with OSA (apnea/hypopnea index (AHI)>11 events/hour) than in those without OSA.1 However, the exact mechanisms linking sleep apnea to cardiovascular morbidity remain unclear. Two studies2,3 published in this issue of the Journal measured a series of subclinical inflammatory factors in patients with OSA, and added new evidence linking sleep apnea to cardiovascular morbidity.

  17. Pathophysiologic mechanisms of cardiovascular disease in obstructive sleep apnea syndrome

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    Carlos Zamarrón; Luis Valdés Cuadrado; Rodolfo Álvarez-Sala

    2013-01-01

    Obstructive sleep apnea syndrome (OSAS) is a highly prevalent sleep disorder, characterized by repeated disruptions of breathing during sleep. This disease has many potential consequences including excessive daytime sleepiness, neurocognitive deterioration, endocrinologic and metabolic effects, and decreased quality of life. Patients with OSAS experience repetitive episodes of hypoxia and reoxygenation during transient cessation of breathing that provoke systemic effects. Furthermore, there m...

  18. Comparison of full-night and ambulatory polysomnography with ApneaGraph in the subjects with obstructive sleep apnea syndrome.

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    Karaloğlu, Furkan; Kemaloğlu, Yusuf K; Yilmaz, Metin; Ulukavak Çiftçi, Tansu; Çiftçi, Bülent; Bakkal, Faruk K

    2017-01-01

    The localization of the obstruction is crucial in determining the appropriate surgical treatment for obstructive sleep apnea syndrome (OSAS); ApneaGraph has been introduced for diagnosis of OSAS and localization of airway obstruction level. This study aims to evaluate the diagnostic value of ApneaGraph for both clinical staging and site of obstruction. Thirty male OSAS patients were prospectively enrolled in this clinical trial. The following parameter were included to the study: Body mass indexes and neck circumferences of the subjects, Epworth sleepiness scale, site of obstruction detected by flexible endoscopy and ApneaGraph, apnea hypopnea index (AHI), apnea index, hypopnea index, maximal oxygen desaturation and average oxygen saturation which were detected by both polysomnography (PSG) and ApneaGraph devices. Our data presented that, although AHI measured by ApneaGraph and PSG were significantly correlated; severity stages of the subjects were different in 44 % of the subjects when based on AHI of ApneaGraph, compared to PSG. Majority of the changes were from severe OSAS to mild or moderate levels. Similar dominant collapse levels were detected in 64 % of the subjects by both devices. It was seen that transpalatal obstruction was better correlated between ApneaGraph and flexible endoscopy. As a conclusion, we might assume that ApneaGraph can be used as a screener for OSAS and it appears to be a more reliable device to confirm dominancy of palatal level obstruction.

  19. Obstructive sleep apnea - adults

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    Sleep apnea - obstructive - adults; Apnea - obstructive sleep apnea syndrome - adults; Sleep-disordered breathing - adults; OSA - adults ... When you sleep, all of the muscles in your body become more relaxed. This includes the muscles that help keep your ...

  20. Health Promotion in Obstructive Sleep Apnea Syndrome

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    Corrêa, Camila de Castro; Blasca, Wanderléia Quinhoneiro; Berretin-Felix, Giédre

    2015-01-01

    Introduction Obstructive sleep apnea syndrome (OSAS), which is commonly underdiagnosed, has a high occurrence in the world population. Health education concerning sleep disorders and OSAS should be implemented. Objectives The objective was to identify studies related to preventive actions on sleep disorders, with emphasis on OSAS. Data Synthesis A literature review was conducted using Lilacs, Medline, PubMed, and Scopus by combining the following keywords: “Health Promotion,” “Sleep Disorders,” “Primary Prevention,” “Health Education,” and “Obstructive Sleep Apnea Syndromes.” Initially, 1,055 papers, from 1968 to 2013, were located, with the majority from the Scopus database. The inclusion criteria were applied, and four articles published between 2006 and 2012 were included in the present study. Conclusions The studies on preventive actions in sleep disorders, with emphasis on OSAS, involved the general population and professionals and students in the health field and led to increased knowledge on sleep disorders and more appropriate practices. PMID:25992174

  1. TREATMENT OF SLEEP APNEA SYNDROME DUE TO ANKYLOSIS OF TMJ USING ORTHOGNATHIC SURGERY TECHNIQUE%正颌外科技术治疗TMJ后OSAS

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    于擘; 顾晓明; 张良; 门志光

    2002-01-01

    Objective To evaluate orthognathic surgery in the treatment of sleep apnea syndrome (SAS) resulted from ankylosis of TMJ. Methods Firstly, the arthroplasty was carried out to relieve the TMJ ankylosis and to open mouth according to design. The mandibles of 14 patients with SAS were advanced by "L"-osteotomy of ramus at the affected side and a sagittal split ramus osteotomy at normal side combined with TMJ arthroplasty. Results After operation, maximal mouth opening of the 14 patients reached 2.5cm-3.5cm. The follow-up 2 years later showed the maximal mouth opening was kept between 2.5cm and 3.2cm. AHI of all the patients were less than 20 postoperatively. Snoring while asleep disappeared in 12 patients and their SaO2 increased by 18.45% in average (P<0.01), which fell into the normal range. No patients were waken up by suffocation. Continuous SaO2 increased from 58% to over 95% in average. Conclusion The obstruction of the upper airway can be relieved through orthognathic surgery. Thus the hypoxemia of the patients was relieved or corrected. This technique is effective in the treatment of SAS due to TMJ ankylosis.%目的评估正颌外科技术矫治14例颞颌关节强直所致OSAS的效果.方法手术采用患侧关节成形,下颌升支、体部的"L"形半层截骨及健侧矢状截骨术,将患侧下颌升支加高固定,下颌前部整体前移.结果 14例颞颌关节强直伴OSAS患者术后张口度达2.5~3.5cm,术后2年随访张口度仍维持在2.5~3.2cm之间.所有患者的AHI指数下降了20以上,12例患者的打鼾症状消失,持续血氧饱和度平均提高了18.45%(P<0.01),达到了正常人的范围,持续血氧饱和度最低值由术前的58%提高至术后的95%以上,OSAS得以治愈.结论颞颌关节强直伴OSAS患者通过正颌外科手术可以在关节成形的同时,解决患者下颌后缩的缺陷,解除上气道狭窄,从而缓解或纠正患者的低氧血症.

  2. Do Obstructive Sleep Apnea Syndrome Patients Underestimate Their Daytime Symptoms before Continuous Positive Airway Pressure Treatment?

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    Gabrielle Leclerc

    2014-01-01

    Full Text Available BACKGROUND: Daytime somnolence is an important feature of the obstructive sleep apnea (OSA hypopnea syndrome and is usually subjectively assessed using the Epworth Sleepiness Scale (ESS.

  3. Urodynamic changes in a female case of obstructive sleep apnea syndrome with enuresis: 7 years' follow-up

    Institute of Scientific and Technical Information of China (English)

    CAO Xia; HU Ke; CHEN Xue-qin; XIANYU Yun-yan; Lü Sheng-qi; LI Qing-quan

    2010-01-01

    @@ Obstructive sleep apnea syndrome (OSAS) is characterized by repetitive upper airway occlusion resulting in apnea lasting 10 seconds or more. Clinical manifestations include snoring, daytime somnolence,intellectual deficiency, sexual impotence, and nocturnal polyuria. Enuresis associated with OSAS is suggested to be more common in children than in adults.1

  4. Heart rate recovery in patients with obstructive sleep apnea syndrome

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    KARAŞEN, Rıza Murat; ÇİFTÇİ, Bülent; Acar,Baran; YALÇIN, Ahmet Arif; GÜVEN, Selma FIRAT

    2014-01-01

    To demonstrate the effects of obstructive sleep apnea syndrome (OSAS) on baroregulatory function by using heart rate recovery (HRR) parameters. Materials and methods: Fifty-four moderate and severe OSAS patients were included in the study. HRR was defined as the difference in heart rate between peak exercise and 1 min later; a value of 18 beats/min was considered abnormal. OSAS patients were enrolled in the study as group 1 (normal HRR; n = 12) and group 2 (abnormal HRR, n = 42). Left ventr...

  5. Heart rate recovery in patients with obstructive sleep apnea syndrome

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    KARAŞEN, Rıza Murat; ÇİFTÇİ, Bülent; Baran ACAR; YALÇIN, Ahmet Arif; GÜVEN, Selma FIRAT

    2012-01-01

    To demonstrate the effects of obstructive sleep apnea syndrome (OSAS) on baroregulatory function by using heart rate recovery (HRR) parameters. Materials and methods: Fifty-four moderate and severe OSAS patients were included in the study. HRR was defined as the difference in heart rate between peak exercise and 1 min later; a value of 18 beats/min was considered abnormal. OSAS patients were enrolled in the study as group 1 (normal HRR; n = 12) and group 2 (abnormal HRR, n = 42). Left ventr...

  6. Maxillomandibular Advancement in Obstructive Sleep Apnea Syndrome Patients: a Restrospective Study on the Sagittal Cephalometric Variables

    OpenAIRE

    2013-01-01

    ABSTRACT Objectives The present retrospective study analyzes sagittal cephalometric changes in patients affected by obstructive sleep apnea syndrome submitted to maxillomandubular advancement. Material and Methods 15 adult sleep apnea syndrome (OSAS) patients diagnosed by polysomnography (PSG) and treated with maxillomandubular advancement (MMA) were included in this study. Pre- (T1) and postsurgical (T2) PSG studies assessing the apnea/hypopnea index (AHI) and the lowest oxygen saturation (L...

  7. Pathophysiologic Mechanisms of Cardiovascular Disease in Obstructive Sleep Apnea Syndrome

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    Carlos Zamarrón

    2013-01-01

    Full Text Available Obstructive sleep apnea syndrome (OSAS is a highly prevalent sleep disorder, characterized by repeated disruptions of breathing during sleep. This disease has many potential consequences including excessive daytime sleepiness, neurocognitive deterioration, endocrinologic and metabolic effects, and decreased quality of life. Patients with OSAS experience repetitive episodes of hypoxia and reoxygenation during transient cessation of breathing that provoke systemic effects. Furthermore, there may be increased levels of biomarkers linked to endocrine-metabolic and cardiovascular alterations. Epidemiological studies have identified OSAS as an independent comorbid factor in cardiovascular and cerebrovascular diseases, and physiopathological links may exist with onset and progression of heart failure. In addition, OSAS is associated with other disorders and comorbidities which worsen cardiovascular consequences, such as obesity, diabetes, and metabolic syndrome. Metabolic syndrome is an emerging public health problem that represents a constellation of cardiovascular risk factors. Both OSAS and metabolic syndrome may exert negative synergistic effects on the cardiovascular system through multiple mechanisms (e.g., hypoxemia, sleep disruption, activation of the sympathetic nervous system, and inflammatory activation. It has been found that CPAP therapy for OSAS provides an objective improvement in symptoms and cardiac function, decreases cardiovascular risk, improves insulin sensitivity, and normalises biomarkers. OSAS contributes to the pathogenesis of cardiovascular disease independently and by interaction with comorbidities. The present review focuses on indirect and direct evidence regarding mechanisms implicated in cardiovascular disease among OSAS patients.

  8. Influence of smoking on sleep and obstructive sleep apnea syndrome.

    Science.gov (United States)

    Deleanu, Oana-Claudia; Pocora, Diana; Mihălcuţă, Stefan; Ulmeanu, Ruxandra; Zaharie, Ana-Maria; Mihălţan, Florin Dumitru

    2016-01-01

    The various ill effects that tobacco smoking has on health have been largely studied, particularly on vascular, neoplastic, and respiratory diseases. Lately, the discussion about the negative impact of cigarette smoking moved towards sleep medicine. Tobacco consumption has been associated with sleep disordered architecture, both during regular intake and after withdrawal. Its effects on sleep disordered breathing (SDB) and especially obstructive sleep apnea syndrome (OSAS) still remain a matter of debate. It is unclear whether smoking represents a risk factor for OSAS or whether smoking cessation has any beneficial effects on OSAS and its therapy. There seems to be a synergistic effect between smoking and OSAS, both causing an increase in cardiovascular morbidity. Future studies are needed in order to establish the strength of this association. We aim to review the literature regarding the consequences of smoking on sleep architecture and SDB, adding emphasis on OSAS clinical implications and treatment.

  9. Asthma Control and Its Relationship with Obstructive Sleep Apnea (OSA in Older Adults

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    Mihaela Teodorescu

    2013-01-01

    Full Text Available Background/Objectives. Asthma in older individuals is poorly understood. We aimed to characterize the older asthma phenotype and test its association with obstructive sleep apnea (OSA. Design. Cross-sectional. Setting. Pulmonary and Asthma/Allergy clinics. Participants. 659 asthma subjects aged 18–59 years (younger and 154 aged 60–75 (older. Measurements. Sleep Apnea scale of Sleep Disorders Questionnaire (SA-SDQ, asthma severity step (1–4, severe if step 3 or 4, established OSA diagnosis, continuous positive airway pressure (CPAP use, and comorbidities. Results. Older versus younger had worse control, as assessed by asthma step, lung function, and inhaled corticosteroid use. Among older subjects, after controlling for known asthma aggravators, OSA diagnosis was the only factor robustly associated with severe asthma: on average, OSA was associated with nearly 7 times greater likelihood of severe asthma in an older individual (OR=6.67. This relationship was of greater magnitude than in younger subjects (OR=2.16. CPAP use attenuated the likelihood of severe asthma in older subjects by 91% (P=0.005, much more than in the younger asthmatics. Conclusion. Diagnosed OSA increases the risk for worse asthma control in older patients, while CPAP therapy may have greater impact on asthma outcomes. Unrecognized OSA may be a reason for poor asthma control, particularly among older patients.

  10. Can you die from obstructive sleep apnoea syndrome (OSAS)?

    LENUS (Irish Health Repository)

    O'Carroll, G

    2015-02-01

    Studies suggest an independent association between Obstructive Sleep Apnoea Syndrome (OSAS) and cardiovascular death. The purpose of our study is to examine doctors\\' awareness of this association and to determine whether this correlates with recording of OSAS on death certificates. We contacted the Central Statistics Office (CSO) and obtained relevant mention of OSAS on death certificates. We surveyed doctors on their view of OSAS-related deaths, CSO data from 2008-2011 reveal two deaths with OSAS documented as a direct cause and 52 deaths with OSAS as a contributory cause. Seventy-five doctors\\' surveyed (41%) believe OSAS can be a direct cause of death and 177 (96%) believe OSAS can be an indirect cause of death. Only 22 (12%) had putdown OSAS as a cause of death. OSAS is seldom recorded on death certificates. This is at odds with epidemiological forecasts and contrary to an opinion poll from a selection of doctors.

  11. Correlation between hippocampal sulcus width and severity of obstructive sleep apnea syndrome.

    Science.gov (United States)

    Akhan, Galip; Songu, Murat; Ayik, Sibel Oktem; Altay, Canan; Kalemci, Serdar

    2015-12-01

    The aim of the present study was to evaluate the relationship between obstructive sleep apnea syndrome (OSAS) severity and the hippocampal sulcus width in a cohort of subjects with OSAS and controls. A total of 149 OSAS patients and 60 nonapneic controls were included in the study. Overnight polysomnograpy was performed in all patients. Hippocampal sulcus width of the patients was measured by a radiologist blinded to the diagnosis of the patients. Other variables noted for each patient were as follows: gender, age, body mass index, apnea hypopnea index, Epworth sleepiness scale, sleep efficacy, mean saturation, lowest O2 saturation, longest apnea duration, neck circumference, waist circumference, hip circumference. A total of 149 OSAS patients were divided into three groups: mild OSAS (n = 54), moderate OSAS (n = 40), severe OSAS (n = 55) groups. The control group consisted of patients with AHI sulcus width was 1.6 ± 0.83 mm in the control group; while 1.9 ± 0.81 mm in mild OSAS, 2.1 ± 0.60 mm in moderate OSAS, and 2.9 ± 0.58 mm in severe OSAS groups (p sulcus width. Our findings demonstrated that severity of OSAS might be associated with various pathologic mechanisms including increased hippocampal sulcus width.

  12. Treatment effect of uvulopalatopharyngoplasty on autonomic nervous activity during sleep in patients with obstructive sleep apnea syndrome

    Institute of Scientific and Technical Information of China (English)

    蒋光峰; 孙炜; 李娜; 孙彦; 张念凯

    2004-01-01

    @@ Obstructive sleep apnea syndrome (OSAS) is characterized by repetitive episodes of upper airway obstruction during sleep. The prevalence of OSAS in middle-aged population is about 2%-4%.1 Many OSAS patients can be accompanied by serious cardiovascular complications, such as hypertension.2 The aim of this study was to find the changes of autonomic nervous system (ANS) during sleep, and the impact of surgical treatment on heart rate variability (HRV) in OSAS patients.

  13. Complex Sleep Apnea Syndrome

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    Muhammad Talha Khan

    2014-01-01

    Full Text Available Complex sleep apnea is the term used to describe a form of sleep disordered breathing in which repeated central apneas (>5/hour persist or emerge when obstructive events are extinguished with positive airway pressure (PAP and for which there is not a clear cause for the central apneas such as narcotics or systolic heart failure. The driving forces in the pathophysiology are felt to be ventilator instability associated oscillation in PaCO2 arterial partial pressure of Carbon Dioxide, continuous cositive airway pressure (CPAP related increased CO2 carbon dioxide elimination, and activation of airway and pulmonary stretch receptors triggering these central apneas. The prevalence ranges from 0.56% to 18% with no clear predictive characteristics as compared to simple obstructive sleep apnea. Prognosis is similar to obstructive sleep apnea. The central apnea component in most patients on followup using CPAP therap, has resolved. For those with continued central apneas on simple CPAP therapy, other treatment options include bilevel PAP, adaptive servoventilation, permissive flow limitation and/or drugs.

  14. [Epworth drowsiness scale value in obstructive sleep apnea syndrome].

    Science.gov (United States)

    Uribe Echevarría, E M; Alvarez, D; Giobellina, R; Uribe Echevarría, A M

    2000-01-01

    Hypersomnia is one of the most consulted symptoms among patients evaluated at sleep disorder centers and it is frequently related to obstructive sleep apnea syndrome (OSAS). Our hypothesis is that Epworth sleepiness scale (ESS) is the parameter with the greatest predictive value in the OSAS diagnosis. We compared patients with OSAS diagnosis to a control group. In both groups we compared ESS with body mass index (BMI), neck circumference (NC), waist perimeter (WP). Anthropometric index (BMI, NC and WC), were similar in both groups (p < 0.10). When we analyzed ESS, a score greater than 10 was observed in the OSAS group, with a significant difference between groups (p < 0.001). Epworth sleepiness scale yielded 60% of sensibility, 82% of specificity and a positive predictive value of 85%. The negative predictive value was 52%. Confidence index was 70%. The relationship between OSAS and ESS scale was significant (Pearson Chi-Square value 7.5). Odds Ratio for apneas was 15 and its confidence interval was lower than 1.5 and upper than 141. We conclude that with ESS score exceeding 10 points OSAS should be suspected.

  15. Survey of children with obstructive sleep apnea syndrome in Hong Kong of China

    Institute of Scientific and Technical Information of China (English)

    周建偉; 吳國强; 郭嘉莉; 张美盈

    2004-01-01

    Background Obstructive sleep apnea affects up to 2.9% of children. This study was to determine demographic and clinical characteristics of a group of children with obstructive sleep apnea syndrome (OSAS) as defined by sleep polysomnography (PSG).Methods A prospective study was conducted in a public-funded general hospital in Hong Kong of China. Children confirmed to have OSAS by PSG were followed up between January 1997 and December 1998. Tonsillectomy and adenoidectomy (T&A) was offered to those with moderate to severe OSAS, and medication was offered to those with mild OSAS. All children were followed up regularly in the sleep clinic and sleep PSG was repeated for those with marked relapse in symptoms.Results Eighty-nine children (64 boys and 25 girls, mean age 7 years) were confirmed to have OSAS out of 352 children who underwent PSG during the study period. The most common symptoms of OSAS were snoring (100%) and sweating (81%) during sleep and nasal blockage (61%) and sleepiness (34%) during daytime. Severe OSAS occurred in 15 children. Moderate OSAS occurred in 33 children. Forty-one children had mild OSAS. Forty-nine children underwent T&A, 5 (boys, <5 years) out of whom were found to have recurrent OSAS within 1 year. Conclusion A male predominance has been found in a group of Hong Kong children with OSAS. Boys undergoing T&A at an early age (<5 years) will be more likely to develop repeated OSAS.

  16. Pure Obstructive Sleep Apnea Syndrome and Erectile Dysfunction

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    Cenk Gürbüz

    2011-11-01

    Full Text Available Objective: The aim of this study is to investigate the existence of erectile dysfunction in patients with obstructive sleep apnea syndrome (OSAS in which the other possible causes of erectile dysfunction were eliminated.Material and Methods: The study group consisted of 24 patients diagnosed as OSAS with polysomnographic evaluation, and 15 non-apneic controls (mean age; 41.0±8.8 and 42.3±7.9 year respectively whose comorbidities which might be associated with erectile dysfunction were excluded. Daytime sleepiness was evaluated by Epworth Sleepiness Scale (ESS and measurement of erectile function was performed by International Index of Erectile Function.Results: The rate of erectile dysfunction in OSAS and control groups were 54.2% and 33.3% respectively (p=0.204. The difference between mean erectile function scores of patient and control groups was non-significant (26.1±4.5 and 26.3±4.3 respectively, p=0.900. There was no correlation between erectile function scores and apnea hypnoea index (r=-0.140; p=0.395.Conclusion: Findings obtained from this study suggest that the high incidence of erectile dysfunction reported in OSAS patients seems to be related with concomitant comorbidities such as diabetes, atherosclerosis and neuroendocrine disorders rather than sleep apnea.

  17. Ocorrência da síndrome da apneia obstrutiva do sono (SAOS em crianças respiradoras orais Obstructive sleep apnea syndrome (OSAS in mouth breathing children

    Directory of Open Access Journals (Sweden)

    Suemy Cioffi Izu

    2010-10-01

    Full Text Available É bem estabelecido que a respiração oral em crianças está relacionada à hipertrofia adenoamigdaliana, que é a principal causa de apneia do sono nesta população. Apesar da importância deste tema, há poucos estudos que comprovam a relação entre SAOS e respiração oral. OBJETIVO: Determinar a prevalência de distúrbios respiratórios do sono em crianças respiradoras orais e sua correlação com achados otorrinolaringológicos. MATERIAL E MÉTODO: Foram avaliados retrospectivamente 248 prontuários de crianças respiradoras orais do serviço de Otorrinolaringologia Pediátrica de uma grande instituição entre 2000 e 2006, analisando os achados otorrinolaringológicos, polissonografia, nasofibroscopia e/ou radiografia em perfil do Cavum. O principal dado polissonográfico utilizado foi o índice de apneia (IA. Classificou-se como ronco primário aqueles com IA1. Desenho Científico: Coorte retrospectivo. RESULTADOS: Dos 248 pacientes incluídos, 144 (58% apresentavam ronco primário e 104 (42% apresentavam SAOS. Os achados otorrinolaringológicos mais frequentes foram Hipertrofia adenoamigdaliana (n=152; 61,2%, Hipertrofia de tonsila palatina (n=17; 6,8% Hipertrofia da tonsila faríngea (n=37; 14,9%, Rinite Alérgica (n=155; 62,5% e Otite Secretora (36; 14,5%. CONCLUSÕES: Ronco Primário e SAOS são frequentes em crianças respiradoras orais. A afecção otorrinolaringológica mais encontrada em crianças com SAOS é a hipertrofia adenoamigdaliana acompanhada ou não de rinite alérgica.It is well known that mouth breathing is associated with adenotonsillar hypertrophy - which is the main cause of obstructive sleep apnea among children. Despite the importance of this matter, there are only a handful of studies showing the relationship between OSAS and mouth breathing. AIM: to determine the prevalence of obstructive sleep disorders in mouth breathing children and study its correlation with otorhinolaryngological findings. STUDY

  18. [Evaluation of sleep apnea syndromes].

    Science.gov (United States)

    Poirrier, R

    1993-01-01

    The evaluation of sleep apnea syndrome is based on polysomnography. Different sensor and recording techniques are reported. Some widely used neurophysiological and cardiorespiratory analysis criteria are proposed. Many sleep laboratories develop ambulatory and automatized methods for screening breathing disorders associated with sleep. The main principles of these approaches are briefly reviewed.

  19. Predictors of obstructive sleep apnea in males with metabolic syndrome

    Directory of Open Access Journals (Sweden)

    Nikolaos Papanas

    2010-04-01

    Full Text Available Nikolaos Papanas1, Paschalis Steiropoulos2, Evangelia Nena2, Argyris Tzouvelekis2, Athanasios Skarlatos2, Maria Konsta2, Vasileios Vasdekis3, Efstratios Maltezos1, Demosthenes Bouros21Outpatient Clinic of Obesity, Diabetes and Metabolism, Second Department of Internal Medicine, Medical School, Democritus University of Thrace, Alexandroupolis, Greece; 2Sleep Laboratory, Department of Pneumonology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece; 3Department of Statistics, Athens University of Economic and Business, Athens, GreeceAbstract: The aim of the present study was to examine the prevalence of metabolic syndrome (MS and its components among obstructive sleep apnea (OSA patients vs controls, as well as to investigate which of these components are strongly associated with the presence of OSA in subjects reporting symptoms indicating sleep-disordered breathing. Included were 83 consecutive male subjects, without known concomitant diseases, who visited an outpatient clinic of obesity, diabetes and metabolism. Based on polysomnography, these were divided into two groups: OSA patients (n = 53 and controls (n = 30. Parameters indicating MS, according to the NCEP ATP III criteria (blood pressure, waist circumference, glucose, triglycerides, and HDL-cholesterol levels were evaluated in both groups. The criteria for MS were fulfilled in 49 participants. Presence of MS was significantly correlated with the presence of OSA. However, after adjustment for BMI, only serum glucose was significantly associated with the presence of OSA (P = 0.002. Conversely, the presence of MS was associated with a significant reduction in percentage of slow-wave sleep (P = 0.030. In conclusion, these results provide further evidence for the association between OSA and MS. Between subjects with MS, elevated serum glucose levels indicate a higher probability for the presence of OSA. Keywords: diabetes mellitus, glucose, metabolic syndrome

  20. Sleep apnea hypopnea syndrome and liver injury

    Institute of Scientific and Technical Information of China (English)

    TIAN Jian-li; ZHANG Yun; CHEN Bao-yuan

    2010-01-01

    Objective A general review was made of studies involving: (1) the relationship between sleep apnea hypopneasyndrome/sleep apnea style intermittent hypoxia and liver injury and (2) the mechanism that causes the liver injury.Data sources The data used in this review were mainly from Medline and PubMed published in English from 1993 toFebruary 2009. The search term was "sleep apnea hypopnea syndrome".Study selection (1) Clinical and laboratory evidence that sleep apnea hypopnea syndrome and sleep apnea styleintermittent hypoxia leads to liver injury; (2) the mechanism that causes the liver injury.Results The effect of sleep apnea hypopnea syndrome and sleep apnea style intermittent hypoxia on the liver functionis characterized by serum aminotransferase elevation. The liver histological injury includes hepatic steatosis, hepatocyteballooning, lobular inflammation, lobular necrosis, and liver fibrosis. Sleep apnea hypopnea syndrome and sleep apneastyle intermittent hypoxia can cause insulin resistance and oxidative stress.Conclusions Sleep apnea hypopnea syndrome and sleep apnea style intermittent hypoxia can lead to chronic liverinjury, which, in most cases, is shown as nonalcoholic fatty liver disease. Insulin resistance and oxidative stress causedby sleep apnea hypopnea syndrome and sleep apnea style intermittent hypoxia play an important role in the mechanismof chronic liver disease development.

  1. Support vector machines for automated recognition of obstructive sleep apnea syndrome from ECG recordings.

    Science.gov (United States)

    Khandoker, Ahsan H; Palaniswami, Marimuthu; Karmakar, Chandan K

    2009-01-01

    Obstructive sleep apnea syndrome (OSAS) is associated with cardiovascular morbidity as well as excessive daytime sleepiness and poor quality of life. In this study, we apply a machine learning technique [support vector machines (SVMs)] for automated recognition of OSAS types from their nocturnal ECG recordings. A total of 125 sets of nocturnal ECG recordings acquired from normal subjects (OSAS - ) and subjects with OSAS (OSAS +), each of approximately 8 h in duration, were analyzed. Features extracted from successive wavelet coefficient levels after wavelet decomposition of signals due to heart rate variability (HRV) from RR intervals and ECG-derived respiration (EDR) from R waves of QRS amplitudes were used as inputs to the SVMs to recognize OSAS +/- subjects. Using leave-one-out technique, the maximum accuracy of classification for 83 training sets was found to be 100% for SVMs using a subset of selected combination of HRV and EDR features. Independent test results on 42 subjects showed that it correctly recognized 24 out of 26 OSAS + subjects and 15 out of 16 OSAS - subjects (accuracy = 92.85%; Cohen's kappa value of 0.85). For estimating the relative severity of OSAS, the posterior probabilities of SVM outputs were calculated and compared with respective apnea/hypopnea index. These results suggest superior performance of SVMs in OSAS recognition supported by wavelet-based features of ECG. The results demonstrate considerable potential in applying SVMs in an ECG-based screening device that can aid a sleep specialist in the initial assessment of patients with suspected OSAS.

  2. Lower grade chronic inflammation is associated with obstructive sleep apnea syndrome in type 2 diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    朱宏霞

    2014-01-01

    Objective To investigate whether the existence of obstructive sleep apnea syndrome(OSAS)in patients with type 2 diabetes(T2DM) is associated with low grade chronic inflammation.Methods Fifty-four patients hospitalized for poor glycemic control from 12/2008 to 12/2009 were divided into 2 groups,OSAS group(T2DM with OSAS,27 cases)and NOSAS group(T2DM without OSAS,27 cases).The control group consisted of 26people from a health check-up program without diabetes

  3. Evaluation of carotid artery elasticity in patients with obstructive sleep apnea syndrome using quantitative arterial stiffness technique

    Institute of Scientific and Technical Information of China (English)

    俞飞虹

    2012-01-01

    Objective To explore the changes and clinical value of carotid elasticity index in patients with obstructive sleep apnea syndrome (OSAS) by quantitative arterial stiffness(OAS) technique. Methods Seventy-two OSAS patients were divided into 2 groups according to whether there was coexisting hypertension

  4. Increased serum levels of C-reactive protein and matrix metalloproteinase-9 in obstructive sleep apnea syndrome

    Institute of Scientific and Technical Information of China (English)

    YE Jin; LIU Hui; LI Yuan; LIU Xian; ZHU Jie-ming

    2007-01-01

    Background Obstructive sleep apnea syndrome (OSAS), characterized by intermittent hypoxia/reoxygenation (IHR),has been identified as an independent risk factor for cardiovascular diseases (CVD). The CVD biomarkers associated with OSAS have not been thoroughly investigated.Methods Fifty-one men with OSAS recently diagnosed by polysomnography were classified into two groups according to the severity of apnea: moderate to severe OSAS group (n= 28) and mild OSAS group (n= 23). Twenty-five obese men,of comparable age and body mass index (BMI), without OSAS were chosen as control subjects. Serum metabolic variables, C-reactive protein (CRP) and matrix metalloproteinase-9 (MMP-9) were measured. Spearman correlation and regression analysis were performed.Results Serum concentrations of CRP and MMP-9 were significantly higher in 51 OSAS patients than in 25 control subjects. Levels of CRP and MMP-9 were significantly higher in patients with moderate to severe OSAS than in patients with mild OSAS or in obese control subjects. A positive correlation was found between levels of CRP and MMP-9 in OSAS patients. Regression analysis showed that after adjusting for age and BMI, apnea/hypopnea index (AHI) significantly correlated with serum concentrations of CRP and MMP-9 in patients with OSAS.Conclusions AHI, mirroring the frequency of IHR, was a predictor of enhanced circulating CVD biomarkers MMP-9 and CRP. Our data support the theory that IHR contributes to the upregulation of the inflammatory factors in OSAS patients.

  5. OSAS 对不同年龄阶段儿童呼吸、睡眠特征和认知能力损害影响比较%Study on sleep and respiratory characteristics and effect on neurocognitive in children with obstructive sleep apnea syndrome in different age

    Institute of Scientific and Technical Information of China (English)

    张英; 马清云; 刘新涛; 兰玉书; 吕银杰

    2015-01-01

    Objective To investigate the Sleep and Respiratory Characteristics and Effect on neurocognitive in childrenwith obstructive sleep apnea syndrome in different age. Methods From January 2014 to January 2015,the 70 cases of children with obstructive sleep apnea syn-drome in our hospital were divided into school age group(39 cases)and preschool group(31 cases),the other 70 cases of medical healthy chil-dren were selected as control group,the three groups of nighttime sleep and respiratory parameters and evaluate its cognitive abilities were ana-lyzed. Results Compared with two groups of preschool children,sleep structureand efficiency,NREM and REM sleep time periods compared proportion,had no significant difference( P ﹥ 0. 05),but the arousal index and AHI OSAS group were significantly more than the control group ( P ﹤ 0. 05);Compared two groups of school - age children sleep structure,sleep OSAS group I,II period of time than control group significantly extended( P ﹤ 0. 05),and the SWS periods of time were significantly shorter( P ﹤ 0. 05),compared to the proportion of REM,no difference( P ﹥ 0. 05),in addition,the arousal index and AHI and OSAS group were significantly more than the control group( P ﹤ 0. 05);OSAS group be-havior ability score was significantly higher than that of control group( P ﹤ 0. 05),the cognitive ability to score and IQ score is significantly lower than that of control group( P ﹤ 0. 05),and graphical pin test error scores are obviously higher than that of control group( P ﹤ 0. 05). Conclu-sion Preschool and school - age children with OSAS sleep are affected,school - age children with OSAS sleep structure change is more apparent, protracted sleep I,II,SWS period shorten,sleep structure changes obviously,and wake up index,AHI increase during sleep,the behavior of the children cognitive ability and appear some obstacles,in a timely manner to make a diagnosis and give treatment pre - operation is of great signifi-cance for their

  6. Obstructive sleep apnea syndrome and fatty liver: Association or causal link?

    Institute of Scientific and Technical Information of China (English)

    Mohamed; H; Ahmed; Christopher; D; Byrne

    2010-01-01

    Obstructive sleep apnea (OSA) is a complex disorder that consists of upper airway obstruction, chronic intermittent hypoxia and sleep fragmentation. OSA is well known to be associated with hypoxia, insulin resistance and glucose intolerance, and these factors can occur in the presence or absence of obesity and metabolic syndrome. Although it is well established that insulin resistance, glucose intolerance and obesity occur frequently with non-alcoholic fatty liver disease (NAFLD), it is now becoming apparen...

  7. Investigation of the relationship between mean platelet volume and obstructive sleep apnea syndrome

    Directory of Open Access Journals (Sweden)

    Ersin Şükrü Erden

    2013-12-01

    Full Text Available Objective: Obstructive sleep apnea syndrome (OSAS is characterized by recurrent upper airway obstruction and intermittent hypoxia during sleep. Intermittent hypoxia and increased inflammatory activity plays a role in increased risk of cardiovascular disease in the OSAS. OSAS is an important cause of morbidity and mortality and cardiovascular disorders are the most important complications of OSAS. Mean platelet volume (MPV is a marker of platelet activation and function, and increased platelet volume is associated with increased platelet activity. Different diseases related with inflammation, hypoxia, vascular injury, thrombosis and atherosclerosis were found to be associated with MPV. In this study, we aimed to investigate the relationship between OSAS and MPV. Methods: In this retrospective study, data of sex and age matched 33 patients with moderate OSAS, 34 patients with severe OSAS and 30 healthy subjects were evaluated. Results: The mean MPV was found in control, moderate OSAS and severe OSAS groups as 7.83±1.00, 8.26±1.40 and 8.94±1.20 (fL respectively. The mean MPV value was significantly higher in severe OSAS group than control subjects (p=0.001. In correlation analysis, there were positive correlation between MPV with apnea-hypopnea index and total sleep time, and negative correlation between MPV with platelet count and minimum oxygen saturation (Respectively, p=0.003 / R=0.295, p=0.030 / R=0.221, p=0.011 / R= -0.257, p=0.019 / R= -0.238. Conclusion: In this study, the increased MPV was associated with severe OSAS and the results of this study suggest that the platelet activation is increased in OSAS. Hypoxia caused by OSAS, due to the activated platelets, may play a role in the development of cardiovascular diseases which is an important cause of morbidity and mortality in OSAS. J Clin Exp Invest 2013; 4 (4: 492-496

  8. Sleep structure in patients with periodic limb movements and obstructive sleep apnea syndrome.

    Science.gov (United States)

    Iriarte, Jorge; Murie-Fernandez, Manuel; Toledo, Estefania; Urrestarazu, Elena; Alegre, Manuel; Viteri, Cesar; Salvador, Javier; Baptista, Peter; Alcaide, Belen; Artieda, Julio

    2009-08-01

    Periodic limb movements (PLM) and obstructive sleep apnea syndrome (OSAS) are two frequent sleep disorders which often occur in the same patient. The goal of this study was to know the influence of the presence of PLM in the sleep architecture in patients with and without OSAS. Two hundred twenty consecutive patients (69 women and 151 men) participated in this transversal study. They were patients with clinical suspicion of dysomnia, including snoring, OSAS, and PLM. All of them underwent a full polysomnography and were interviewed using questionnaires about the sleep quality. The sleep parameters (percentage of sleep stages, rapid eye movement latency, sleep efficiency, awakenings, PLM presence, apnea-hypopnea index) were calculated and compared between groups. Descriptive statistics and nonparametric distribution techniques were used for the analysis. Patients with PLM when compared with patients with OSAS had lower sleep efficiency and less rapid eye movement percentage. The presence of PLM in patients with sleep apnea was less relevant being responsible only for an increase in the rapid eye movement latency and a decrease in the duration of the three to four sleep stages. However, the presence of OSAS was related to a better sleep efficiency (patients with PLM plus OSAS had a better sleep efficiency than patients with only PLM). PLM alters the structure of sleep. In patients with sleep apnea, the presence of PLM is less relevant.

  9. A study to investigate the relationship between difficult intubation and prediction criterion of difficult intubation in patients with obstructive sleep apnea syndrome

    OpenAIRE

    Omer Kurtipek; Berrin Isik; Mustafa Arslan; Yusuf Unal; Yusuf Kizil; Yusuf Kemaloglu

    2012-01-01

    Background and Aim: Obstructive sleep apnea (OSA) syndrome is predisposed to the development of upper airway obstruction during sleep, and it poses considerable problem for anesthetic management. Difficult intubation (DI) is an important problem for management of anesthesia. In this clinical research, we aim to investigate the relationship between DI and prediction criteria of DI in cases with OSA. Materials and Methods: We studied 40 [OSA (Group O, n = 20) and non-OSA, (Group C, n = 20)] ASA...

  10. COGNITIVE AND EMOTIONAL IMPAIRMENT IN OBSTRUCTIVE SLEEP APNEA SYNDROME

    Institute of Scientific and Technical Information of China (English)

    Bin Peng; Shun-wei Li; Hong Kang; Xi-zhen Huang

    2004-01-01

    Objective To evaluate the emotional and cognitive status in patients with obstructive sleep apnea syndrome (OSAS),using neuropsychological tests and evoked-related potential (P3).Methods Sixteen patients diagnosed of OSAS were tested by Hamilton rating scale for anxiety (HRSA) and Hamilton rating scale for depression (HRSD). Other three groups, OSAS patient group (n = 21), snoring group (n = 21), and control group (n = 21), were administered polysomnography (PSG), auditory evoked event-related potential (P3), and clinic memory test. The results were analyzed using general linear model (GLM) analysis and Post Hoc test.Results Twelve OSAS patients' scores of HRSA and HRSD were beyond the normal range, 26.42 ± 4.48 and 22.08 ±3.97 respectively. The auditory P3 latency in OSAS group was 363.1 ± 22.9 ms (Fz), 368.57 ± 28.03 ms (Cz), in snoring group 336.57 ± 31.08 ms (Fz), 339.81 ± 31.76 ms (Cz), in control group 340.8 ± 28.7 ms (Fz), 338.29 ± 29.21 ms (Cz).There were significant differences between OSAS group and snoring group, as well as control group (P < 0.05). No significant difference was seen between snoring group and control group. No significant difference was noted in P3 amplitude among three groups. Memory quotient (MQ) reduced in snoring group compared with control group.Conclusions Emotional disturbances are common clinical features in OSAS patients. Abnormal auditory P3 latency indicates the cognitive dysfunction in OSAS patients. Nocturnal hypoxaemia may play an important role on it. Snorers should be monitored because of the tendency to develop cognitive impairment.

  11. Correlation among obstructive sleep apnea syndrome, coronary atherosclerosis and coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    LU Gan; XU Zhuo-wen; ZHANG Yu-lin; YANG Zhi-jian; ZHANG Xi-long; YIN Kai-sheng

    2007-01-01

    @@ Epidemiologic investigations have shown that the morbidity of obstructive sleep apnea syndrome (OSAS) among adults is 2%-4%, among the population aged 30 years and over is 4.63%, and among patients with hypertension or coronary atherosclerostic disease (CAD) is as high as 30%-50%.

  12. Neuroendocrine Alterations in Obese Patients with Sleep Apnea Syndrome

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    Fabio Lanfranco

    2010-01-01

    Full Text Available Obstructive sleep apnea syndrome (OSAS is a serious, prevalent condition that has significant morbidity and mortality when untreated. It is strongly associated with obesity and is characterized by changes in the serum levels or secretory patterns of several hormones. Obese patients with OSAS show a reduction of both spontaneous and stimulated growth hormone (GH secretion coupled to reduced insulin-like growth factor-I (IGF-I concentrations and impaired peripheral sensitivity to GH. Hypoxemia and chronic sleep fragmentation could affect the sleep-entrained prolactin (PRL rhythm. A disrupted Hypothalamus-Pituitary-Adrenal (HPA axis activity has been described in OSAS. Some derangement in Thyroid-Stimulating Hormone (TSH secretion has been demonstrated by some authors, whereas a normal thyroid activity has been described by others. Changes of gonadal axis are common in patients with OSAS, who frequently show a hypogonadotropic hypogonadism. Altogether, hormonal abnormalities may be considered as adaptive changes which indicate how a local upper airway dysfunction induces systemic consequences. The understanding of the complex interactions between hormones and OSAS may allow a multi-disciplinary approach to obese patients with this disturbance and lead to an effective management that improves quality of life and prevents associated morbidity or death.

  13. Is obstructive sleep apnea syndrome a risk factor for pulmonary thromboembolism?

    Institute of Scientific and Technical Information of China (English)

    Kezban Ozmen Suner; Ali Nihat Annakkaya; Umran Toru; Talha Dumlu; Ege Gulec Balbay; Peri Arbak; Leyla Yilmaz Aydin; Hasan Suner

    2012-01-01

    Background In many studies,obstructive sleep apnea (OSA) has been shown to be an independent risk factor for cardiovascular disease.Conversely,there are few reports establishing possible relation between OSA and venous thromboembolism (VTE).In this study,the aim is to evaluate OSA via polysomnography in patients with pulmonary embolism and drawing the attention of clinicians to the presence of obstructive sleep apnea syndrome (OSAS) may be a risk factor for pulmonary embolism.Methods Fifty consecutive patients who were diagnosed with pulmonary embolism (PE) were evaluated prospectively for OSAS.Polysomnographic examination was conducted on 30 volunteer patients.The frequency of OSAS in PE was determined and PE cases were compared to each other after being divided into two groups based on the presence of a major risk factor.Results The study consisted of a total of 30 patients (14 females and 16 males).In 56.7% of the patients (17/30),OSAS was determined.The percent of cases with moderate and severe OSAS (apnea hipoapnea index>15) was 26.7%(8/30).Patients who had pulmonary thromboembolism (PTE) without any known major VTE risk (n=20),were compared to patients with VTE risk factors (n=10),and significantly higher rates of OSAS were seen (70% and 30% respectively;P=-0.045).The mean age of the group with major PE risk factors was lower than the group without major PE risk factors (52 years old and 66 years old,respectively; P=0.015),however,weight was greater in the group with major PE risk factors (88 kg and 81 kg,respectively; P=0.025).By multivariate Logistic regression analysis,in the group without any visible major risk factors,the only independent risk factor for PE was OSAS (P=0.049).Conclusions In patients with PTE,OSA rates were much higher than in the general population.Moreover,the rate for patients with clinically significant moderate and severe OSA was quite high.PTE patients with OSA symptoms (not syndromes) and without known major risk factor

  14. Obstructive sleep apnea syndrome and cognitive impairment: effects of CPAP

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    Alessandra Giordano

    2011-10-01

    Full Text Available Obstructive Sleep Apnea Syndrome (OSAS is a sleep disorder characterised by repetitive episodes of upper airway obstruction (apnea or reduced airflow (hypopnoea despite persistent respiratory effort. Apnea is defined as the cessation of breathing for at least 10 seconds during sleep, while hypopnoea is defined as at least 30% reduction in airflow for 10 seconds associated with oxygen desaturation and sleep fragmentation. The presence in the general population is about 4%. The principal symptoms are: excessive daytime sleepiness (EDS, snoring, dry throat, morning headache, night sweats, gastro-esophageal reflux, and increased blood pressure.Long term complications can be: increased cardio-cerebrovascular risk and cognitive impairment such as deficiency in attention, vigilance, visual abilities, thought, speech, perception and short term memory.Continuous Positive Airway Pressure (CPAP is currently the best non-invasive therapy for OSAS.CPAP guarantees the opening of upper airways using pulmonary reflexive mechanisms increasing lung volume during exhalation and resistance reduction, decreasing electromyografical muscular activity around airways.The causes of cognitive impairments and their possible reversibility after CPAP treatment have been analysed in numerous studies. The findings, albeit controversial, show that memory, attention and executive functions are the most compromised cognitive functions.The necessity of increasing the patient compliance with ventilotherapy is evident, in order to prevent cognitive deterioration and, when possible, rehabilitate the compromised functions, a difficult task for executive functions.

  15. Impact of obstructive apnea syndrome on upper airway respiratory muscles.

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    Svanborg, Eva

    2005-07-28

    This article reviews studies of upper airway muscles in humans, with emphasis on muscle fiber structural and electrophysiological changes observed in patients with obstructive sleep apnea syndrome (OSAS). The concept of OSAS as a progressive disease is discussed and also possible causes. These include local nervous lesions in the upper airway, both motor and sensory. Previous muscle biopsy studies have given evidence for motor neuron lesions such as, e.g., the phenomenon of type grouping in histological sections. New data obtained with concentric needle EMG recordings from the palatopharyngeus muscles are also presented. In 10/12 OSAS patients there were typical findings indicating motor neuropathy (reduced EMG activity at maximal voluntary effort, long and polyphasic motor-unit potentials and, in two cases, spontaneous denervation activity), whereas such findings were only present in 3/15 patients with habitual snoring. This supports the hypothesis that progression from habitual snoring to the clinical disease of OSAS could be attributed to peripheral neurogenic lesions.

  16. Information processing speed in obstructive sleep apnea syndrome: a review.

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    Kilpinen, R; Saunamäki, T; Jehkonen, M

    2014-04-01

    To provide a comprehensive review of studies on information processing speed in patients with obstructive sleep apnea syndrome (OSAS) as compared to healthy controls and normative data, and to determine whether continuous positive airway pressure (CPAP) treatment improves information processing speed. A systematic review was performed on studies drawn from Medline and PsycINFO (January 1990-December 2011) and identified from lists of references in these studies. After inclusion criteria, 159 articles were left for abstract review, and after exclusion criteria 44 articles were fully reviewed. The number of patients in the studies reviewed ranged from 10 to 157 and the study samples consisted mainly of men. Half of the studies reported that patients with OSAS showed reduced information processing speed when compared to healthy controls. Reduced information processing speed was seen more often (75%) when compared to norm-referenced data. Psychomotor speed seemed to be particularly liable to change. CPAP treatment improved processing speed, but the improvement was marginal when compared to placebo or conservative treatment. Patients with OSAS are affected by reduced information processing speed, which may persist despite CPAP treatment. Information processing is usually assessed as part of other cognitive functioning, not as a cognitive domain per se. However, it is important to take account of information processing speed when assessing other aspects of cognitive functioning. This will make it possible to determine whether cognitive decline in patients with OSAS is based on lower-level or higher-level cognitive processes or both.

  17. Elevated Serum Liver Enzymes in Patients with Obstructive Sleep Apnea-hypopnea Syndrome

    Institute of Scientific and Technical Information of China (English)

    Jie Li; Yan-Lin Zhang; Rui Chen; Yi Wang; Kang-Ping Xiong; Jun-Ying Huang; Fei Han

    2015-01-01

    Background: Obstructive sleep apnea-hypopnea syndrome (OSAS) is associated with elevated liver enzymes and fatty liver.The purpose of this study was to measure serum liver enzyme levels in patients evaluated by polysomnography (PSG) and the factors associated with liver injury in OSAS patients.Methods: All patients referred to PSG for evaluation of sleep apnea symptoms between June 2011 and November 2014 were included in this study.Demographic data and PSG parameters were recorded.Serum alanine aminotransferase, aspartate aminotransferase, and gamma-glutamyl transferase levels were systematically measured.OSAS patients were divided into mild, moderate, and severe groups according to the apnea-hypopnea index (AHI) values of 5-14 events/h, 15-29 events/h, and ≥30 events/h.Results: A total of 540 patients were enrolled in this study;among these patients, 386 were male.Elevated liver enzymes were present in 42.3% of OSAS patients (32.4% in mild/moderate group;51.0% in severe group) and 28.1% patients without OSAS.Patients with OSAS had higher body mass index (BMI) (P < 0.01).In the bivariate correlation, the liver enzymes level was negatively correlated with age and the lowest arterial oxygen saturation (SaO2), and was positively correlated with BMI, oxygen desaturation index, percent of total time with oxygen saturation level <90% (TS90%), AHI, total cholesterol (TC), and triglyceride (TG).In logistic regression analysis, Age,BMI, TS90%, TC, and TG were included in the regression equation.Conclusions: Our data suggest that OSAS is a risk factor for elevated liver enzymes.The severity of OSAS is correlated with liver enzyme levels;we hypothesize that hypoxia is one of main causes of liver damage in patients with OSAS.

  18. The effect of the severity of obstructive sleep apnea syndrome on telomere length

    Science.gov (United States)

    Tempaku, Priscila Farias; Mazzotti, Diego Robles; Hirotsu, Camila; Andersen, Monica Levy; Xavier, Gabriela; Maurya, Pawan Kumar; Rizzo, Lucas Bortolotto; Brietzke, Elisa; Belangero, Sintia Iole; Bittencourt, Lia; Tufik, Sergio

    2016-01-01

    Aging is associated with an increase in the prevalence of obstructive sleep apnea syndrome (OSAS) as well as the shortening of telomeres. It is known that OSAS-related factors are stimuli that can contribute to the acceleration of cellular senescence. Thus, the present study aimed to compare the leukocyte telomere length (LTL) between OSAS patients and controls, as well as to verify the correlation between LTL and sleep parameters. We used DNA extracted of 928 individuals from EPISONO to measure the LTL by the quantitative real-time polymerase chain reaction. All individuals were subjected to one full-night polysomnography. LTL was significantly shorter in OSAS patients compared to controls. The results showed negative correlations between LTL and the following variables: apnea-hypopnea index, respiratory disturbance index, desaturation index and wake after sleep onset. LTL was positively correlated with sleep efficiency, total sleep time, basal, minimum and maximum oxygen saturation. Lastly, it was observed that OSAS severity was associated with shorter LTL even after adjusting for sex, age, years of schooling, body mass index, diabetes, stroke and heart attack. In conclusion, our study indicates the presence of an association between LTL and OSAS and a significant impact of severity of OSAS in telomeres shortening. PMID:27690344

  19. [The role of maxillofacial surgery in obstructive sleep hypopnea and apnea syndrome].

    Science.gov (United States)

    Gilon, Yves; Raskin, Sylviane; Heymans, Olivier; Poirrier, Robert

    2002-01-01

    One of the most common symptoms of obstructive sleep apnea syndrome (OSAS) is daytime drowsiness. It is associated with a high cardiovascular morbidity and mortality, and an elevated incidence of car crashes. In general, young patients don't want conservative treatment because symptomatic and to prevent secondary effects. In this article, we briefly define sleep disorders and the interest of cephalometric examination. We describe the different treatment possibilities and stress the important role of orthognathic surgery in this syndrome.

  20. Association between obstructive sleep apnea (OSA and depression and the effect of continuous positive airway pressure (CPAP treatment

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    El-Sherbini AM

    2011-12-01

    Full Text Available Amr Makram El-Sherbini1, Adel Salah Bediwy2, Ashraf El-Mitwalli31Department of Psychiatry, Elminia University Hospital, Faculty of Medicine, Elminia, 2Chest Department, Faculty of Medicine, Tanta University, 3Department of Neurology, Mansoura School of Medicine, University of Mansoura, Mansoura, EgyptBackground: Obstructive sleep apnea (OSA is a relatively common disorder which has a negative impact on the psychological well-being of affected individuals.Objective: To assess the association between OSA and depression as well as the effect of treatment with continuous positive airway pressure (CPAP.Methods: A total of 37 newly diagnosed individuals with OSA underwent an overnight polysomnography and were assessed using the Epworth Sleepiness Scale (ESS, the Hamilton Depression Rating Scale (HDRS, and the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Patients were assessed before and after 2 months of CPAP use.Results: Of the 37 patients included in the study, 21 (56.7% had clinically relevant depression as indicated by a score >10 on the HDRS and eleven patients (29.7% met the diagnostic criteria for a major depressive episode using the Structured Clinical Interview. Scores on the HDRS were correlated with the Apnea Hypoxia Index, ESS scores, and oxygen saturation. Patients showed a significant reduction in depressive symptoms and improvement in ESS scores after CPAP treatment.Conclusion: Patients with OSA should be screened carefully for depressive disorders. CPAP should be tried first before starting other treatment modalities for depression.Keywords: obstructive sleep apnea, depression in OSA, CPAP and depression

  1. Management of obstructive sleep apnea syndrome secondary to temporomandibular joint ankylosis by mandibular elongation using distraction osteogenesis

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    Yadavalli Guruprasad

    2012-01-01

    Full Text Available Obstructive sleep apnea syndrome (OSAS is associated with repetitive nocturnal upper airway obstruction leading to daytime sleepiness, cardiovascular derangements, and can be a debilitating, even life-threatening condition. The most favorable treatment for patients with OSAS is multidisciplinary care by a team that represents various dental and medical disciplines. Prescribed therapies might include weight loss, behavior modification, oral appliances, soft tissue surgery, skeletal surgery, or some combination of approaches. Osteogenesis by mandibular distraction has proved effective in children in the treatment of obstructive apnea syndrome associated with congenital malformations. In the adult, the possibility of using distraction osteogenesis in the management of OSAS remains to be defined. We report a case of an adult patient treated for OSAS secondary to temporomandibular joint ankylosis by mandibular distraction followed by interpositional arthroplasty.

  2. Comparison of Low Resolution Electromagnetic Tomography Imaging Between Subjects With Mild and Severe Obstructive Sleep Apnea Syndrome: A Preliminary Study

    OpenAIRE

    Lee, Hyun-Kwon; Park, Doo-Heum; Shin, Hyun-Sil; Hong, Seok-Chan

    2008-01-01

    Objective The purpose of this study was to identify the regions of the brain associated with recurrent nocturnal chronic hypoxic episodes in patients with untreated obstructive sleep apnea syndrome (OSAS) using low-resolution electromagnetic tomography (LORETA) and quantitative electroencephalography (QEEG). Methods Nocturnal polysomnograph (NPSG) and subsequent morning electroencephalograph (EEG) were measured in 20 subjects with OSAS. Mild (n=10 ages 39.5±12.1 years) and severe (n=10 ages 4...

  3. A Comparison of Personality Characteristics and Psychiatric Symptomatology between Upper Airway Resistance Syndrome and Obstructive Sleep Apnea Syndrome

    Science.gov (United States)

    So, Soo-Jung; Kang, Seung-Gul; Cho, Chul-Hyun; Yoon, Ho-Kyoung; Kim, Leen

    2015-01-01

    Objective To investigate the personality characteristics of patients with upper airway resistance syndrome (UARS) and those of patients with obstructive sleep apnea syndrome (OSAS). Methods Eighty-eight patients with UARS and 365 patients with OSAS participated. All patients had a diagnostic full-night attended polysomnography (PSG) and completed the Athens Insomnia Scale (AIS), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Symptom Checklist-90-Revision (SCL-90-R) and Eysenck Personality Questionnaire (EPQ). Results The UARS group scored significantly higher than the OSAS group on the ESS, AIS, and PSQI (psubscales in the UARS group were significantly higher than those in the OSA group (all plie) (p<0.001) than those with OSA. UARS patients also showed higher scores on EPQ-P (psychoticism) (p=0.002) and EPQ-N (neuroticism) (p<0.001) than OSAS patients. Conclusion Our results suggest that patients with UARS have worse subjective sleep quality than OSAS patients in spite of their better PSG findings. UARS patients tend to have more neurotic and sensitive personalities than patients with OSAS, which may be a cause of the clinical features of UARS. PMID:25866518

  4. Comparison of the efficiency of rhinomanometry and E.N.T examination in diagnosis of obstructive sleep apnea syndrome

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    Babak Amra

    2009-04-01

    Full Text Available ntroduction: Considering the high prevalence of obstructive sleep apnea syndrome (OSAS and its complications, proper diagnosis and treatment is particularly important. Since the standard diagnostic test for OSAS is polysomnography, which is not widely available, finding a simple, available, and cheap diagnostic method is very helpful. The aim of this study was to evaluate the efficiency of anterior rhinomanometry and upper respiratory tract examination in diagnosis of the OSAS. Materials and Methods: In this observational analytic study, all patients referred to BAMDAD sleep clinic for polysomnography from Feb 2007 to Jul 2007 were evaluated by anterior rhinomanometry as well as upper respiratory tract examination and results were compared with each other. Results: Of 66 patients participated in our study, 31 patients were in the normal group, 19 in mild apnea group, and 16 in moderate to severe apnea group. The results of ENT examination showed clear obstruction in 22 patients. 12 of them were in moderate to severe apnea group, and 9 of them in mild apnea group. Only one patient with abnormal examination was in the normal group. The respiratory tract resistance which was measured by anterior rhinomanometry showed no significant association with positive results of polysomnography. Conclusion: Our study showed that although anterior rhinomanometry is invalid for diagnosis of OSAS, ENT examination (such as noctural oxymetry can be a useful diagnostic method for OSAS.  

  5. The correlation of anxiety and depression with obstructive sleep apnea syndrome

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    Fariborz Rezaeitalab

    2014-01-01

    Full Text Available Background: Obstructive sleep apnea syndrome (OSAS is a common sleep disorder characterized by repeated upper airway obstruction during sleep. While respiratory pauses followed by loud snoring and daytime sleepiness are the main symptoms of OSAS, the patients may complain from sleep disruption, headache, mood disturbance, irritability, and memory impairment. However, the association of sleep apnea with anxiety and depression is not completely understood. Adherence to continuous positive airway pressure (CPAP, the treatment of choice for OSAS, may be influenced by psychological conditions, especially claustrophobia. The aim of this study was to evaluate the association of OSAS with anxiety and depression symptoms. This study also investigated the association of anxiety with body mass index (BMI and the severity of OSAS. Materials and Methods: We conducted a cross-sectional study on 178 adult individuals diagnosed with OSAS at the sleep laboratory between September 2008 and May 2012. The participants were interviewed according to a checklist regarding both their chief complaints and other associated symptoms. The psychological status was assessed according to Beck anxiety inventory (BAI and Beck depression inventory (BDI scoring. The severity of breathing disorder was classified as mild, moderate, and severe based on apnea-hypopnea index (AHI which was ascertained by overnight polysomnography. Daytime sleepiness was assessed by Epworth sleepiness scale (ESS. Results: The mean (SD age of participants was 50.33 years. In terms of sex, 85.5% of the study population were males and14.4% were females. We found no relation between sex and the symptoms of OSAS. Regarding the frequency of anxiety and depression symptoms, 53.9% of the individuals had some degree of anxiety, while 46.1% demonstrated depressive symptoms. In terms of OSAS severity, this study showed that OSAS severity was associated with the frequency of anxiety, chocking, and sleepiness (P

  6. Distraction osteogenesis as a treatment of obstructive sleep apnea syndrome

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    Tsui, Wai Kin; Yang, Yanqi; Cheung, Lim Kwong; Leung, Yiu Yan

    2016-01-01

    Abstract Background: To conduct a systematic review to answer the clinical question “What are the effectiveness of mandibular distraction osteogenesis (MDO) and its complications to treat patients with obstructive sleep apnea syndrome (OSAS)?”. Methods: A systematic search including a computer search with specific keywords, reference list search, and manual search were done. Relevant articles on MDO were assessed and selected in 3 rounds for final review based on 5 predefined inclusion criteria and followed by a round of critical appraisal. Different types of distraction and their treatment outcomes of OSAS were recorded with standardized form and analyzed. Results: Twelve articles were included in the final review. A total of 256 patients aged 7 days to 60 years were treated with either external or internal MDO, with a mean follow-up period of 6 to 37 months. The average distraction distance of 12 to 29 mm was achieved with various distraction protocols. The success rate for adult patients was 100%, and cure rates were ranged from 82% to 100%. The definition of success or cure for OSAS in children or infants was not defined. Therefore, there were no clearly reported success or cure rates for children/infants in the included studies. However, all studies reported that these patients showed significant improvement in OSAS, with many of them who avoided tracheostomy or had the tracheostomy decannulated. The complication rates were ranged from 0% to 21.4%, with most being from local wound infections or neurosensory disturbances. Conclusion: This systematic review showed that MDO was effective in resolving OSAS in adults with retrognathic mandible. MDO also showed promising results in infants or children with OSAS. From the results of this systematic review, we recommend to define the criteria of success or cure for OSAS surgery in children and infants. We also recommend setting up randomized controlled trials to compare MDO with traditional maxillomandibular

  7. Inflammatory Markers in Middle-Aged Obese Subjects: Does Obstructive Sleep Apnea Syndrome Play a Role?

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    Paschalis Steiropoulos

    2010-01-01

    Full Text Available Background. Obstructive Sleep Apnea Syndrome (OSAS is associated with inflammation, but obesity may be a confounding factor. Thus, the aim of this study was to explore differences in serum levels of inflammation markers between obese individuals with or without OSAS. Methods. Healthy individuals (n=61 from an outpatient obesity clinic were examined by polysomnography and blood analysis, for measurement of TNF-α, IL-6, CRP, and fibrinogen levels. According to Apnea-Hypopnea Index (AHI, participants were divided into two BMI-matched groups: controls (AHI < 15/h, n=23 and OSAS patients (AHI ≥ 15/h, n=38. Results. OSAS patients had significantly higher TNF-α levels (P<.001 while no other difference in the examined inflammation markers was recorded between groups. Overall, TNF-α levels were correlated with neck circumference (P<.001, AHI (P=.002, and Oxygen Desaturation Index (P=.002. Conclusions. Obese OSAS patients have elevated TNF-α levels compared to BMI-matched controls, suggesting a role of OSAS in promoting inflammation, possibly mediated by TNF-a.

  8. Left Ventricular Mass index and Pulmonary Artery Pressure in Patients with the Obstructive Sleep Apnea Syndrome

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    Seyed Hashem Sezavar

    2016-07-01

    Full Text Available Background: Sleep apnea is accompanied by some cardiovascular complications. It has even been hypothesized that sleep apnea, itself, can induce some of these complications. Given such controversies, we assessed the left ventricular mass index (LVMI and systolic pulmonary artery pressure in patients with sleep apnea.Methods: Through convenience sampling, 56 patients with the obstructive sleep apnea syndrome (OSAS were included in the present descriptive cross-sectional study. Patients with any past history of hypertension and diabetes mellitus were excluded. The apnea severity was assessed via the polysomnography-derived apnea-hypopnea index (AHI. All the patients underwent transthoracic echocardiography. In this cross-sectional study - data regarding age, gender, smoking, systolic and diastolic blood pressures, polysomnographic parameters (AHI, severity of disease, mean heart rate, mean oxygen saturation [SaO2], lowest SaO2, and duration of SaO2 below 90% [d.SaO2 < 90%], and  echocardiographic parameters (systolic pulmonary artery pressure and LVMI were accumulated and processed.Results: Fifty-two men and 14 women at a mean age of 49.29 ± 11.79 years participated in this study. Systolic and was significantly high in the severe group compared with the mild group (128.21 ± 9.73 mmHg vs. 119.23 ± 12.5 mmHg; p value = 0.007. The LVMI was increased parallel to an increase in the severity of the OSAS, but that increase was not statistically significant (p value = 0.161. The d.SaO2 < 90% was positively correlated with the LVMI, and this relationship remained true after adjustment for the body mass index (r = 0.27; p value = 0.042.Conclusion: Severe OSAS was accompanied by a higher blood pressure. The LVMI did not differ significantly between the patients with the OSAS and those who did not suffer from other risk factors of cardiac diseases.

  9. Is Mean Platelet Volume Really a Severity Marker for Obstructive Sleep Apnea Syndrome without Comorbidities?

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    Sinem Nedime Sökücü

    2014-01-01

    Full Text Available Obstructive sleep apnea syndrome (OSAS is a common disorder that can lead to significant cardiovascular complications. Several studies have reported increased platelet activation and aggregation in patients with OSAS. In this study we aimed to show a correlation between mean platelet volume (MPV and severity of OSAS in patients with OSAS without any overt cardiac disease or diabetes. The polysomnography recordings of 556 consecutive patients admitted to the sleep laboratory between January 2012 and July 2012 were retrospectively evaluated. The relationship between polysomnographic parameters and biochemical parameters was assessed. Polysomnographic results of 200 patients (154 males [77%]; mean age, 44.5 ± 11.4 years were included. No correlation was observed between MPV and the average oxygen saturation index, the minimum desaturation index, or the oxygen desaturation index in the study population as well as in severe OSAS group (AHI > 30. The only correlation was found between MPV and AHI in the severe OSAS group P=0.010. MPV was not correlated with OSAS severity in patients without any overt cardiac disease or diabetes. These findings raise doubts about the suggestion that MPV might be a marker for OSAS severity, as recommended in earlier studies. Thus, further prospective data are needed.

  10. Long-term oral appliance therapy in obstructive sleep apnea syndrome : a controlled study on temporomandibular side effects

    NARCIS (Netherlands)

    Doff, Michiel H. J.; Veldhuis, Steffanie K. B.; Hoekema, Aarnoud; Slater, James J. R. Huddleston; Wijkstra, P. J.; de Bont, Lambert G. M.; Stegenga, Boudewijn

    2012-01-01

    The objective of this study was to assess variations in the occurrence of temporomandibular disorders (TMDs) and the risk of developing pain and function impairment of the temporomandibular complex in obstructive sleep apnea syndrome (OSAS) patients treated with either an oral appliance (mandibular

  11. No evidence for diagnostic value of Mallampati score in patients suspected of having obstructive sleep apnea syndrome.

    NARCIS (Netherlands)

    Bins, S.; Koster, T.D.; Heij, A.H. de; Vries, A.C. de; Pelt, A.B. van; Aarts, M.C.; Rovers, M.M.; Heijden, G.J. van der

    2011-01-01

    OBJECTIVE: To analyze whether the Mallampati score is reliable as a simple diagnostic test for predicting obstructive sleep apnea syndrome (OSAS). DATA SOURCES: A literature search was performed using PubMed, Embase, Scopus, Cochrane, and CINAHL databases. REVIEW METHODS: Studies were ranked by thei

  12. Obstructive Sleep Apnea Syndrome in Company Workers: Development of a Two-Step Screening Strategy with a New Questionnaire

    NARCIS (Netherlands)

    Eijsvogel, Michiel M.; Wiegersma, Sytske; Randerath, Winfried; Verbraecken, Johan; Wegter-Hilbers, Esther; Palen, van der Job

    2016-01-01

    STUDY OBJECTIVES: To develop and evaluate a screening questionnaire and a two-step screening strategy for obstructive sleep apnea syndrome (OSAS) in healthy workers. DESIGN: Cross-sectional study. SETTING AND PARTICIPANTS: A total of 1,861 employees comprising healthy blue- and white-collar wor

  13. Parasomnias: Common sleep disorders in children suffering from obstructive sleep apnea syndrome

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    Alexander Torres Molina

    2010-12-01

    Full Text Available The sleep disorders have a tendency to chronic evolution in approximately the 30% of children and adolescents, what constitute the main parasomnias clinical expressions of these phenomena. The Obstructive Sleep Apnea Syndrome constitute a high prevailment ailment which affects the 2% of the childish population approximately it is considered an entity because of its cognitive and somatic resounding. Parasomnias are part of the complex symptomatic night cortege observed in OSAS, stablishing a direct physiopathology relationship between both of them. The reduction of the apnea episodes after the adenotonsillar hyperplasia surgical treatment is accompanied by diminishing of the sleep disorders modification in this patient.

  14. Parasomnias: Common sleep disorders in children suffering from obstructive sleep apnea syndrome

    OpenAIRE

    Alexander Torres Molina

    2010-01-01

    The sleep disorders have a tendency to chronic evolution in approximately the 30% of children and adolescents, what constitute the main parasomnias clinical expressions of these phenomena. The Obstructive Sleep Apnea Syndrome constitute a high prevailment ailment which affects the 2% of the childish population approximately it is considered an entity because of its cognitive and somatic resounding. Parasomnias are part of the complex symptomatic night cortege observed in OSAS, stablishing a d...

  15. Assessment of the sleep parameters in patients with obstructive sleep apnea syndrome with a

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    Özlem Abakay

    2013-06-01

    Full Text Available Objective: In this study, traffic accident with a history ofobstructive sleep apnea syndrome (OSAS in patientswith polysomnographic parameters was investigated.Methods: A total of 77 OSAS patients were included inthe study. All-night polysomnographic recordings obtainedfrom patients with enuresis parameters and thepresence of traffic accidents recorded in standard form.Results: The mean age of patients was 45.15 ± 11.53years. 53% of the patients were male and 47% female.The mean apnea hypopnea index (AHI in patients was13.54 events/h. History of traffic accidents was found in12% patients. Apnea hypopnea index, supine AHI, arousalindex and oxygen desaturation index were found significantlydifferent parameters between history of trafficaccidents group and non-history of traffic accidents group(p <0.05.Conclusion: In this study, patients with OSAS severity ofthe disease with a history of traffic accidents were associatedthe relationship between the parameters. This relationshipwith the severity of the disease might be due tothe negative effects on attention. J Clin Exp Invest 2013;4 (2: 204-207Key words: OSAS, traffic accident, AHI

  16. Genetic variants in interleukin-6 modified risk of obstructive sleep apnea syndrome.

    Science.gov (United States)

    Zhang, Xiuqin; Liu, Reng-Yun; Lei, Zhe; Zhu, Yehan; Huang, Jian-An; Jiang, Xiefang; Liu, Zeyi; Liu, Xia; Peng, Xiaobei; Hu, Huacheng; Zhang, Hong-Tao

    2009-04-01

    Obesity and inflammation are known to correlate with the pathogenesis of obstructive sleep apnea syndrome (OSAS). Interleukin (IL)-6, an important regulator of obesity and inflammation, was reported to phenotypically increase in patients with OSAS. This study aimed to investigate whether genetic variants in IL-6 confer susceptibility to OSAS. The study population consisted of 151 patients with OSAS and 75 healthy controls from Southeast China. Five haplotype-tagging single nucleotide polymorphisms (tSNPs) were selected across 21 kb of the IL-6 locus using Haploview software V4.1. The tSNPs were amplified by polymerase chain reaction (PCR) and genotyped by restriction enzyme digestion followed by gel electrophoresis. Linkage disequilibrium (LD) and haplotype reconstruction were carried out by means of a SHEsis program. No distribution difference of any of the five tSNPs between OSAS patients and controls was observed. However, in non-obese individuals (n=117), the minor allele G (rs1800796) decreased risk of OSAS compared with the major allele C [odds ratio (OR), 0.48; 95% confidence interval (CI), 0.26-0.86; p=0.014], and the haplotype TG (rs1880242, rs1800796) conferred a significantly decreased risk of OSAS than single allele G (rs1800796) (OR, 0.39; 95% CI, 0.20-0.74; p=0.003). Moreover, the severity of sleep-disordered breathing (measured by apnea hypopnea index) increased linearly in carriers of the C variant of IL-6 -572G/C polymorphism (14.3+/-5.1, 22.0+/-3.6 and 34.8+/-3.5 for GG, CG and CC, respectively; p=0.012). To the best of our knowledge, this is the first study to suggest that genetic variants in IL-6 could modify OSAS susceptibility. SNP genotyping of IL-6 is a potential strategy for detecting the risk of breathing disordered diseases in non-obese individuals.

  17. The Diagnosis Value and Its Implication of Impulse Oscillometry in Obstructive Sleep Apnea Syndrome Patients

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    The change of measurements of impulse oscillometry (IOS) in obstructive sleep apnea syndrome (OSAS) patients and its mechanism were observed. The respiratory impedance was measured by using IOS technique and polysomnography (PSG) was monitored synchronously in 36 OSAS patients,14 patients with chronic obstructive pulmonary disease (COPD) and 12 normal controls. Results showed that R20 in OSAS group was significantly higher than in COPD group and control group (P<0. 01). R5-R20 in OSAS group was lower than that in COPD group, but significantly higher than that in control group(P<0. 01). The levels of R20 and R5-R20 were positively correlated with severity degree of the disease. In addition, apnea-hyponea index (AHI) was positively correlated with R5 and R20 with the correlation index (r)being 0.66 and 0. 86 respectively. The lowest SO2 was negatively correlated with R5 and R5-R20, with r being -0.66 and -0. 79 respectively. The mean SO2 was negatively correlated with R5 and R5-R20 with r being -0.81 and -0. 69 respectively, IOS technique could be used as a valuable tool for assessing the degree of upper airway obstruction in the patients with OSAS, and could help to explore its pathological mechanism.

  18. Effects of Adenotonsillectomy on Neurocognitive Function in Pediatric Obstructive Sleep Apnea Syndrome

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    Fumie Horiuchi

    2014-01-01

    Full Text Available Obstructive sleep apnea syndrome (OSAS in children does not only present with symptoms of sleep disturbances but also with associated symptoms such as growth failure, enuresis, academic learning difficulties, and behavioral problems, including attention deficit/hyperactivity disorder- (ADHD- like symptoms. We evaluated neurocognitive functions before and after adenotonsillectomy in a patient with OSAS. An 11-year-old boy suspected of having ADHD with nocturnal enuresis was referred for evaluation. He was found to have adenotonsillar hypertrophy. Presence of snoring was evident only after detailed medical interview. Polysomnography confirmed the diagnosis of OSAS, which was subsequently treated by adenotonsillectomy. The apnea/hypopnea index decreased from 21.9 at baseline to 1.8 after surgery, and the frequency of enuresis fell from almost nightly to 2-3 times per month. Neurocognitive and behavioral assessment after the treatment of OSAS showed significant improvement in cognitive functions, especially attention capacity and considerable amelioration of behavioral problems including ADHD-like symptoms. As the most common cause of pediatric OSAS is adenotonsillar hypertrophy, medical interview and oropharyngeal examination should always be performed in children suspected of having ADHD. The necessity of sleep evaluation for children with ADHD-like symptoms was also emphasized.

  19. 老年人睡眠呼吸暂停综合征的睡眠质量调查%Sleep quality in elderly patients with obstructive sleep apnea syndrome

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    徐江涛; 宋永斌; 郝舒亮; 叶华; 刘秀梅

    2003-01-01

    AIM: To investigate the sleep quality in elderly patients with obstructivesleep apnea syndrome (OSAS) . METHODS: 54 cases of elderly patientswith OSAS were evaluated by the pittsburgh sleep quality index (PSQI)questionnaire. RESULTS: Among 54 OSAS patients, 35 cases (65%) re-ported poor quality of sleep, only 7(13% ) cases reported good. A signifi-cant negative correlation was found between apnea/hypopnea index (AHI)and PSQI, and part of its components. CONCLUSION: Elderly patientswith OSAS often complain of poor quality of sleep. Daytime dysfunction,poor subjective sleep quality, low habitual sleep efficiency and long sleeplatency constitutes the principal parts of the symptoms about sleep.

  20. High prevalence of obstructive sleep apnea in Marfan's syndrome

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    Mo Li; He Quanying; Wang Yinna; Dong Birong; He Jinhan

    2014-01-01

    Objective To review the current evidence about the prevalence of obstructive sleep apnea in patients with Marfan's syndrome,and discuss some proposed potential mechanisms for this relationship.Data sources The data in this review were mainly from Medline and PubMed articles published in English from 1990 to 2013.The search term was "Marfan's syndrome and sleep apnea".Study selection Clinical evidence about the epidemiology of obstructive sleep apnea in patients with Marfan's syndrome; the mechanism that causes obstructive sleep apnea; interventional therapy for patients with Marfan's syndrome,and coexisting obstructive sleep apnea.Results A high prevalence of obstructive sleep apnea exists in patients with Marfan's syndrome.The potential reasons are craniofacial abnormalities and lax upper airway muscles,which lead to high nasal airway resistance and upper airway collapse.Obstructive sleep apnea mechanically deteriorates aortic dilatation and accelerates progression of aortic aneurysms.The condition is reversible and rapid maxillary expansion and adequate continuous positive airway pressure therapy are possible effective therapies to delay the expansion of aortic diameter in patients with Marfan's syndrome.Conclusions Obstructive sleep apnea is strongly associated with Marfan's syndrome.Craniofacial abnormalities and lax upper airway are the main mechanisms.Untreated obstructive sleep apnea accelerates progression of aortic dissection and rupture.Effective therapies for obstructive sleep apnea could postpone the aortic dilatation in patients with Marfan's syndrome.

  1. Biomarkers to Improve Diagnosis and Monitoring of Obstructive Sleep Apnea Syndrome: Current Status and Future Perspectives

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    Konstantinos Archontogeorgis

    2014-01-01

    Full Text Available Obstructive sleep apnea syndrome (OSAS is characterized by recurrent episodes of upper airway collapse associated with oxygen desaturation and sleep disruption. It is proposed that these periodic changes lead to molecular variations that can be detected by assessing serum biomarkers. Studies have identified inflammatory, oxidative, and metabolic perturbations attributable to sleep-disordered breathing. Given that OSAS is associated with increased cardiovascular and cerebrovascular morbidity, the ideal biomarker should enable timely recognition with the possibility of intervention. There is accumulating data on the utility of serum biomarkers for the evaluation of disease severity, prognosis, and response to treatment. However, current knowledge is limited by data collection techniques, disease complexity, and potential confounding factors. The current paper reviews the literature on the use of serum biomarkers in OSAS. It is concluded that the ideal serum biomarker still needs to be discovered, while caution is needed in the interpretation of hitherto available results.

  2. Upper Airway Resistance Syndrome Patients Have Worse Sleep Quality Compared to Mild Obstructive Sleep Apnea.

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    Luciana Balester Mello de Godoy

    Full Text Available To compare sleep quality and sustained attention of patients with Upper Airway Resistance Syndrome (UARS, mild Obstructive Sleep Apnea (OSA and normal individuals.UARS criteria were presence of excessive daytime sleepiness (Epworth Sleepiness Scale-ESS-≥ 10 and/or fatigue (Modified Fatigue Impact Scale-MFIS-≥ 38 associated to Apnea/hypopnea index (AHI ≤ 5 and Respiratory Disturbance Index (RDI > 5 events/hour of sleep or more than 30% of total sleep time with flow limitation. Mild OSA was considered if the presence of excessive daytime sleepiness (ESS ≥ 10 and/or fatigue (MFIS ≥ 38 associated to AHI ≥ 5 and ≤ 15 events/hour. "Control group" criteria were AHI < 5 events/hour and RDI ≤ 5 events/hour and ESS ≤ 9, without any sleep, clinical, neurological or psychiatric disorder. 115 individuals (34 UARS and 47 mild OSA patients and 34 individuals in "control group", adjusted for age, gender, body mass index (BMI and schooling years, performed sleep questionnaires and sustained attention evaluation. Psychomotor Vigilance Task (PVT was performed five times (each two hours from 8 a.m. to 4 p.m.UARS patients had worse sleep quality (Functional Outcomes of Sleep Questionnaire-FOSQ-and Pittsburgh Sleep Quality Index-PSQI: p < 0.05 and more fatigue than mild OSA patients (p = 0.003 and scored significantly higher in both Beck inventories than "control group" (p < 0.02. UARS patients had more lapses early in the morning (in time 1 compared to the results in the afternoon (time 5 than mild OSA (p = 0.02. Mild OSA patients had more lapses in times 2 than in time 5 compared to "control group" (p = 0.04.UARS patients have a worse sleep quality, more fatigue and a worse early morning sustained attention compared to mild OSA. These last had a worse sustained attention than controls.

  3. Obstructive sleep apnea syndrome in children with 22q11.2 deletion syndrome after operative intervention for velopharyngeal insufficiency

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    David Jeffrey Crockett

    2014-08-01

    Full Text Available Introduction: Surgical treatment of velopharyngeal insufficiency (VPI in 22q11.2 deletion syndrome is often warranted. In this patient population, VPI is characterized by poor palatal elevation and muscular hypotonia with an intact palate. We hypothesize that 22q11.2 deletion patients are at greater risk of obstructive sleep apnea (OSA after surgical correction of VPI, due, in part, to their functional hypotonia, large velopharyngeal gap size, and the need to surgically obstruct the velopharynx. Methods: We performed a retrospective analysis of patients with 22q11.2 deletion syndrome treated at a tertiary pediatric hospital between the years of 2002-2012. The incidence of VPI, need for surgery, post-operative polysomnogram, post-operative VPI assessment, and OSA treatments were evaluated. Results: Forty-three patients (18 males, 25 females, ages 1-14 years fitting the inclusion criteria were identified. Twenty-eight patients were evaluated by speech pathology due to hypernasality. Twenty-one patients had insufficient velopharyngeal function and required surgery. Fifteen underwent pharyngeal flap surgery, three underwent sphincter pharyngoplasty, two underwent Furlow palatoplasty, and one underwent combined sphincter pharyngoplasty with Furlow palatoplasty. Of these, eight had post-operative snoring. Six of these underwent polysomnography. Four patients were found to have OSA based on the results of the polysomnography (average apnea/hypopnea index of 4.9 events/hour, median=5.1, SD=2.1. Two required continuous positive airway pressure (CPAP due to moderate OSA.Conclusion: Surgery is often necessary to correct VPI in patients with 22q11.2 deletion syndrome. Monitoring for OSA should be considered after surgical correction of VPI due to a high occurrence in this population. Furthermore, families should be counseled of the risk of OSA after surgery and the potential need for treatment with CPAP.

  4. Ambulatory treatment of sleep apnea syndrome with CO2 laser: laser-assisted UPPP (LAUP), results on 70 patients

    Science.gov (United States)

    Kamami, Yves-Victor

    1995-05-01

    The pharyngeal airway obstruction during sleep in the Obstructive Sleep Apnea Syndrome (OSAS) can be improved after treatment by LAUP (Laser Assisted Uvulopalatoplasty). This new technique, performed under local anesthesia, permits the snoring treatment without any hospitalization, or general anesthetic; like an ordinary dental visit. This is done by reducing the amount of tissue in the uvula, the velum, and the upper part of the posterior pillars. Our experience with the LAUP in Sleep Apnea Syndrome is described, from December 1988 to May 1994, in 70 patients. Among 62 patients classified as successful `responders', the respiratory disturbance index was reduced more than 50%. Among all the 70 patients: in 51.4 % of cases (36 patients), there's a healing of snoring and Sleep Apnea Syndrome. In 37.2% of cases (26 patients), there's an improvement reduction of length and number of apneas and a significant improvement in nocturnal oxygen saturation. 11.4% (8 patients), are relative failures, with always decrease of snoring, but still Sleep Apnea Syndrome, (with a higher B.M.I.). There were no important complications reported. Patients withstand it well and there's had a better tolerance of the C.P.A.P. in the cases of OSAS LRPP failures. Popularization of LAUP will require serious training of surgeon and further long-term studies.

  5. Obesity and Obstructive Sleep Apnea: Or is it OSA and Obesity?

    Science.gov (United States)

    2008-01-01

    OSA. OSA appears to increase secretion of and/or lter responsiveness to the adipocyte hormone leptin and the rexigenic hormone ghrelin , and these...376. 45] I.A. Harsch, P.C. Konturek, et al., Leptin and ghrelin levels in patients with obstructive sleep apnoea: effect of CPAP treatment, Eur. Respir...J. 22 (2003) 251–257. [ [ ophysiology 15 (2008) 71–77 46] T. Ulukavak Ciftci, O. Kokturk, et al., Leptin and ghrelin levels in patients with

  6. Melatonin secretion and excretion in patients with obstructive sleep apnea syndrome.

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    Wikner, J; Svanborg, E; Wetterberg, L; Röjdmark, S

    1997-11-01

    Melatonin (MT) secretion and excretion were investigated in patients with obstructive sleep apnea syndrome (OSAS). Nine men, mean age 55.1 years, mean body mass index 31.2, with a previously confirmed diagnosis of moderate to severe OSAS, were tested on two occasions: immediately before initiation of continuous positive airway pressure (CPAP) treatment and again after at least 4 weeks of continuous nocturnal use of CPAP. Serum MT concentrations were determined every second hour between 2000 and 0800 hours. Urine was collected between 2200 and 0700 hours for determination of urinary MT excretion. Sleep apnea recordings included ear oximetry, respiration and body movements, body position, and breathing sounds. Nine healthy male controls were tested on one occasion. We found that the MT secretion, as reflected by the area under the curve (AUC), among the OSAS patients did not differ from that found in healthy controls (MT AUC 1.68 vs. 1.92 nmol/l x h). Sleep apnea recordings were normalized during CPAP treatment. Moreover, the excessive daytime sleepiness disappeared in all patients. Neither MT secretion (MT AUC 1.68 vs. 1.56 nmol/l x h) nor urinary excretion of MT (0.122 vs. 0.108 nmol/9 h) changed significantly as a result of the CPAP treatment.

  7. Prevalence of Risk for Obstructive Sleep Apnea Syndrome and Association With Risk Factors in Primary Care

    Science.gov (United States)

    da Silva, Kenia Vieira; Rosa, Maria Luiza Garcia; Jorge, Antônio José Lagoeiro; Leite, Adson Renato; Correia, Dayse Mary Silva; Silva, Davi de Sá; Cetto, Diego Bragatto; Brum, Andreia da Paz; Netto, Pedro Silveira; Rodrigues, Gustavo Domingos

    2016-01-01

    Background Obstructive sleep apnea syndrome (OSAS) is a chronic, progressive disease with high morbidity and mortality. It is underdiagnosed, especially among women. Objective To study the prevalence of high risk for OSAS globally and for the Berlin Questionnaire (BQ) categories, and to evaluate the reliability of the BQ use in the population studied. Methods Observational, cross-sectional study with individuals from the Niterói Family Doctor Program, randomly selected, aged between 45 and 99 years. The visits occurred between August/2011 and December/2012. Variables associated with each BQ category and with high risk for OSAS (global) were included in logistic regression models (p < 0.05). Results Of the total (616), 403 individuals (65.4%) reported snoring. The prevalence of high risk for OSA was 42.4%, being 49.7% for category I, 10.2% for category II and 77.6% for category III. Conclusion BQ showed an acceptable reliability after excluding the questions Has anyone noticed that you stop breathing during your sleep? and Have you ever dozed off or fallen asleep while driving?. This should be tested in further studies with samples mostly comprised of women and low educational level individuals. Given the burden of OSAS-related diseases and risks, studies should be conducted to validate new tools and to adapt BQ to better screen OSAS. PMID:27142651

  8. Obesity and craniofacial variables in subjects with obstructive sleep apnea syndrome: comparisons of cephalometric values

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    Cannavale Rosangela

    2007-12-01

    Full Text Available Abstract Background The aim of this paper was to determine the most common craniofacial changes in patients suffering Obstructive Sleep Apnea Syndrome (OSAS with regards to the degree of obesity. Accordingly, cephalometric data reported in the literature was searched and analyzed. Methods After a careful analysis of the literature from 1990 to 2006, 5 papers with similar procedural criteria were selected. Inclusion criteria were: recruitment of Caucasian patients with an apnea-hypopnea index (AHI >10 as grouped in non-obese (Body Mass Index – [BMI] vs. obese (BMI ≥ 30. Results A low position of the hyoid bone was present in both groups. In non-obese patients, an increased value of the ANB angle and a reduced dimension of the cranial base (S-N were found to be the most common finding, whereas major skeletal divergence (ANS-PNS ^Go-Me was evident among obese patients. No strict association was found between OSAS and length of the soft palate. Conclusion In both non-obese and obese OSAS patients, skeletal changes were often evident; with special emphasis of intermaxillary divergence in obese patients. Unexpectedly, in obese OSAS patients, alterations of oropharyngeal soft tissue were not always present and did not prevail.

  9. Retinal nerve fiber layer thickness changes in obstructive sleep apnea syndrome: one year follow-up results

    Institute of Scientific and Technical Information of China (English)

    Mehmet; Ozgur; Zengin; Ibrahim; Tuncer; Eyyup; Karahan

    2014-01-01

    ·AIM: To investigate the retinal nerve fiber layer(RNFL)thickness changes in patients with obstructive sleep apnea syndrome(OSAS) for one year follow-up. To discuss the possibility of detecting tendency of glaucoma in this population by using spectral domain optical coherence tomography(3D-OCT-2000 Spectral domain).·METHODS: After polysomnographic study, all subjects(64 OSAS patients and 40 controls) underwent detailed ophthalmological examination. After these examinations,patients with glaucoma and patients who had ophthalmological and/or systemic disease were excluded from the study.Totally, 20 patients in OSAS group and five patients in controls were excluded from the study in the first examination and follow-up period. The RNFL thickness was assessed with OCT. Forty-four OSAS patients and 35 control subjects were followed up for12 mo. RNFL thickness change and OSAS patients were evaluated for severity of disease by Apnea-Hypopnea Index(AHI).·RESULTS: Forty-four OSAS patients and 35 controls were enrolled in the study. Statistically significance was found between OSAS patients and controls at the 12 thmo.Average RNFL thickness was found to be significantly lower in last measurements in OSAS patients when compared with first measurements and control subjects(P <0.001, 0.002, respectively). There was a statistically significant correlation among AHI, and RNFL thickness(P <0.05).·CONCLUSION: The results suggest that the patients with OSAS were related with a proportional decrease in the RNFL thickness. These patients should be followed up regularly for glaucomatous changes. Detecting more RNFL thinning in severe OSAS was important.

  10. Obstructive Sleep Apnea Syndrome is Associated with Metabolic Syndrome among Adolescents and Youth in Beijing: Data from Beijing Child and Adolescent Metabolic Syndrome Study

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    Xiao-Xue Qu; Issy C Esangbedo; Xiu-Juan Zhang; Shu-Jun Liu; Lian-Xia Li; Shan Gao; Ming Li

    2015-01-01

    Background:Obstructive sleep apnea (OSA) syndrome has a negative impact on the health of millions of adolescents and youth.The aim of this study was to evaluate the associations of OSA syndrome with obesity and cardiometabolic risk factors among adolescents and youth at risk for metabolic syndrome (MS).Methods:A total of 558 subjects aged 14-28 years were recruited from the Beijing Child and Adolescent Metabolic Syndrome Study.Each underwent a 2-h oral glucose tolerance test (OGTT),echocardiography,and liver ultrasonography.Anthropometric measures,blood levels of glucose,lipids,and liver enzymes were assessed.Subjects with high or low risk for OSA were identified by Berlin Questionnaire (BQ).Results:Among the subjects in obesity,33.7% of whom were likely to have OSA by BQ.Subjects with high risk for OSA had higher neck and waist circumference and fat mass percentage compared to those with low risk for OSA (P < 0.001).Moreover,significant differences in levels of lipids,glucose after OGTT,and liver enzymes,as well as echocardiographic parameters were found between the two groups with high or low risk for OSA (P < 0.05).The rates of nonalcoholic fatty liver disease (71.0% vs.24.2%),MS (38.9% vs.7.0%),and its components in high-risk group were significantly higher than in low-risk group.Conclusions:The prevalence of OSA by BQ was high in obese adolescents and youth.A high risk for OSA indicates a high cardiometabolic risk.Mechanisms mediating the observed associations require further investigation.

  11. Withdrawal of Continuous Positive Airway Pressure Therapy after Malar Advancement and Le Fort II Distraction in a Case of Apert Syndrome with Obstructive Sleep Apnea

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    Nobuto Onda

    2015-01-01

    Full Text Available Apert syndrome is a congenital syndrome characterized by craniosynostosis and craniofacial dysostosis, among other features, and is reported to cause obstructive sleep apnea (OSA because of upper airway narrowing associated with midfacial dysplasia. We recently encountered a case involving a patient with Apert syndrome complicated by OSA who began to receive continuous positive airway pressure (CPAP therapy at the age of 4. OSA resolved after maxillofacial surgery performed at the age of 11, and CPAP was eventually withdrawn. In pediatric patients with maxillofacial dysplasia complicated by OSA, a long-term treatment plan including CPAP in addition to maxillofacial plastic and reconstructive surgery should be considered in view of the effects of OSA on growth.

  12. Genetic polymorphisms variants in interleukin-6 and interleukin-1beta patients with obstructive sleep apnea syndrome in East Northern Turkey

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    Ilhami Gok

    2015-08-01

    Full Text Available Aim To investigate the relationship of IL-1β and IL-6 cytokine gene polymorphisms with obstructive sleep apnea syndrome (OSAS in 61 patients admitted to the neurology clinic in Kafkas University Hospital with insomnia problem who were diagnosed with OSAS in sleeping labs, and 80 healthy subjects not associated with the syndrome. Methods Blood samples were taken to isolate DNA from patients diagnosed with OSAS based on polysomnography results and healthy controls. DNA amplification of the genes was performed with PCR. Amplification products were cut with the restriction enzymes in order to determine IL-1 gene (TaqI and IL-6 gene (Lwel polymorphisms. The cut DNA fragments were carried out in agarose gel electrophoresis, and RFLP analysis was performed by utilizing the images with gel imaging system. PCR products were sequenced with an Applied Biosystems Automated Sequencer. Results Polymorphic changes were observed for IL-1β gene in 26 of 62 patients (41.9%, and 16 of the 80 (25.8% in the control group. The incidence of polymorphic changes in IL-6 gene was in seen in seven (of the 62 patients (11.3%, and in the 16 (20% controls. Conclusion The findings on the genomic level in OSAS may provide an important contribution to diagnosis of obstructive sleep apnea syndrome in clinical practice, as well as it helps to obtain the results easily about environmental and genetic interaction of OSAS patients.

  13. Concurrent presence of inflammation and obstructive sleep apnea exacerbates the risk of metabolic syndrome

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    Kim, Jinkwan; Yoon, Dae Wui; Lee, Seung Ku; Lee, Seunggwan; Choi, Kyung-Mee; Robert, Thomas J.; Shin, Chol

    2017-01-01

    Abstract Obstructive sleep apnea (OSA) leads to multiple end-organ morbidities that are mediated by the cumulative burden of oxidative stress and inflammation. Both OSA and inflammation play key roles in increased risk of cardiovascular disease (CVD). Thus, we hypothesized that the combination of inflammation and OSA could accelerate the development of metabolic syndrome (MetS) in a large cohort study. A total of 1835 participants were randomly selected from the ongoing Korean Genome and Epidemiology Study for the years between 2007 and 2015. Overnight polysomnography was performed on each participant. Blood was drawn for biochemical analyses. Participants with high or low inflammation were divided by high-sensitivity C-reactive protein (hsCRP). MetS was defined using the criteria of the modified National Cholesterol Education Program, Adult Treatment Panel III. The prevalence of MetS was higher among the subjects with OSA and high hsCRP levels than among the other corresponding groups. The incidence of MetS among the 4 groups stratified by OSA and inflammation status at the 6-year follow-up was 11.8%, 19.9%, 25.8%, and 36.0% (HsCRP[−]/OSA[−] vs HsCRP[+]/OSA[−] vs HsCRP[−]/OSA[+] vs HsCRP[+]/OSA[+], P < 0.01). After adjusting for age, sex, smoking, alcohol status, BMI, and change in BMI (ΔBMI) in a multiple logistic regression, the subjects with OSA and high hsCRP levels at follow-up had a 2.22-fold risk of developing MetS, as compared with those with no-OSA and low hsCRP levels (P < 0.01). MetS is more prevalent in the concurrent presence of inflammation and OSA. The combination of these conditions is associated with higher risk of MetS. Additional research is needed to help further define the significance of the combined effect of OSA and subclinical inflammation on the development of MetS in the context of reduction of CVD risk. PMID:28207497

  14. The Change of Interleukin-6 and Tumor Necrosis Factor in Patients with Obstructive Sleep Apnea Syndrome

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    The levels of lipopolysaccharide (LPS)-induced interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) expression in culture of peripheral blood mononuclear cells (PBMC) and the plasma levels of IL-6 and TNF-α in the patients with obstructive sleep apnea syndrome (OSAS) were measured and the relationship between OSAS and IL-6 or TNF-α expression studied. Both IL-6 and TNF-α were detected by using ELISA in 22 patients with OSAS and 16 normal controls. The levels of LPS-induced IL-6 (787.82±151.97 pg/ml) and TNF-α (4165.45±1501.43 pg/ml) expression in the supernatant of the culture of PBMC and plasma level of IL-6 (50.67±4.70 pg/ml) and TNF-α (299.09±43.57 pg/ml) in the patients with OSAS were significantly higher than those in the normal controls (in the supernatant of the culture of PBMC: 562.69±197.54 pg/ml and 1596.25±403.08 pg/ml respectively; in the plasma: 12.69±2.75 pg/ml and 101.88±21.27 pg/ml respectively). There were significantly positive correlation between the levels of IL-6 and TNF-α and the percentage of time of apnea and hyponea, as well as the percentage of time spending at SaO2 below 90 % in the total sleep time. It was concluded that LPS-induced IL-6 and TNF-α levels as well as plasma IL-6 and TNF-α levels in the patients with OSAS were up-regulated, which may be associated with the pathogenesis of OSAS.

  15. Cystatin C Levels in Middle-Aged Patients with Obstructive Sleep Apnea Syndrome

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    Kostas Archontogeorgis

    2016-01-01

    Full Text Available Background. Obstructive sleep apnea syndrome (OSAS is associated with systemic inflammation and increased risk of cardiovascular and chronic kidney disease. Cystatin C (Cyst C is a novel biomarker of both latent renal damage and cardiovascular disease. Aim of the study was to measure serum levels of Cyst C, as well as IL-8 and CRP, in otherwise healthy OSAS patients. Methods. 84 individuals examined with polysomnography for OSAS symptoms without known comorbidities were prospectively recruited. Results. According to apnea hypopnea index (AHI subjects were divided in two groups: OSAS group (AHI > 5/hour, n=64 and controls (AHI < 5/hour, n=20, which were age- and BMI-matched. Cyst C levels were higher in OSAS patients versus controls (1176.13±351.33 versus 938.60±245.83 ng/mL, resp.; p=0.017 while serum IL-8 and CRP levels did not differ significantly. Positive correlation was found between Cyst C levels and respiratory disturbance index (RDI (r=0.240, p=0.039 and percentage of time with oxygen saturation <90% (r=0.290, p=0.02 and negative correlation was found between Cyst C levels and average oxygen saturation during sleep (r=-0.291, p=0.012. After adjustment for age and BMI, RDI was the only independent predictor of Cyst C levels (β = 0.256, p=0.039. Conclusion. Cyst C serum levels are increased in OSAS patients without comorbidities, suggesting an increased renal and cardiovascular disease risk.

  16. The incremental effect of obstructive sleep apnea syndrome on right and left ventricular myocardial performance in newly diagnosed essential hypertensive subjects.

    Science.gov (United States)

    Gao, Jing; Hua, Qi; Li, Jing; Wang, Cai-Rong

    2009-03-01

    Obstructive sleep apnea syndrome (OSAS) may predispose patients to congestive heart failure, suggesting a deleterious effect of OSAS on myocardial contractility. We investigated whether essential hypertensive individuals with OSAS are characterized by decreased right and left ventricular myocardial performance. Our study population consisted of 45 consecutive patients with newly diagnosed untreated stage I-II essential hypertension suffering from OSAS (35 men, aged 49+/-8 years) and 48 hypertensives without OSAS, matched for age, sex, level of blood pressure, heart rate, body mass index and smoking status. All subjects underwent polysomnography and echocardiography. Right and left ventricular functions were evaluated using the myocardial performance index (MPI). Right and left ventricular functions were altered in hypertensives with OSAS. The mean right MPI was 0.26+/-0.11 in hypertensives without OSAS and 0.51+/-0.16 in hypertensives with OSAS (PRight and left MPI correlated positively and significantly with apnea-hypopnea index (rho=0.40, P=0.002).OSAS is associated with impaired right and left ventricular function. These phenomena were independent of hypertension.

  17. What is the most important factor affecting the cognitive function of obstructive sleep apnea syndrome patients: a single center study

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    LI Xiang

    2013-05-01

    Full Text Available Objective Patients with obstructive sleep apnea syndrome (OSAS usually complain of daytime hypersomnia and decrease in cognitive function, which affects the quality of their work and life. The reason why the cognitive function of OSAS patients decreased remains controversial. The aim of this study is to evaluate the impairment and the main influencing factors of cognitive function in OSAS. Methods There were totally 50 OSAS patients (OSAS group and 25 volunteers (control group included in our study. All of them were monitored by polysomnography (PSG and tested by Continuous Performance Test (CPT, n-back test and Stroop Color?Word Test (CWT to evaluate their sleep condition and cognitive function. Results No significant difference was found between the two groups in total sleep time and sleep efficiency (P > 0.05, for all. Compared with control group, OSAS group had significant increased time of non-rapid eye movement (NREM sleep stage Ⅰ and stage Ⅱ, significant decreased time of stage Ⅲ (P 0.05, for all, while had significant connection with AI and NREM Ⅲ (P < 0.05, for all. The rate of OSAS patients who underwent nasal continuous positive airway pressure (nCPAP treatment was very low, only 8% (4/50. Conclusion The abnormality of OSAS patients' sleep structure is characterized with sleep fragmentation and decrease of NREM Ⅲ, which may be the main factors of cognitive impairment. Exploration of treatment methods targeted on regulating the effected hormones and receptors is meaningful.

  18. Clinical manifestations of sleep apnea.

    Science.gov (United States)

    Stansbury, Robert C; Strollo, Patrick J

    2015-09-01

    Obstructive sleep apnea (OSA) may manifest in a number of ways from subtle intrusion into daily life to profound sleepiness, snoring, witnessed apneas and other classic symptoms. Although there is increasing evidence suggesting OSA can adversely affect health in a variety of ways, this disorder remains underdiagnosed. The most well-escribed health consequences of OSA relate to the cardiovascular system. Hypertension and arrhythmias have a strong association with OSA, and evidence suggests that treatment of OSA in patients with refractory hypertension and in patients planning cardioversion for atrial fibrillation may be of particularly importance. Significant associations between heart failure and OSA as well as complex sleep apnea have also been well-described. Cerebrovascular insult, impaired neurocognition, and poorly controlled mood disorder are also associated with in OSA. Therapy for OSA may ameliorate atherosclerotic progression and improve outcomes post-cerebrovascular accident (CVA). OSA should be considered in patients complaining of poor concentration at work, actual or near-miss motor vehicle accidents, and patients with severe sleepiness as a component of their co-morbid mood disorders. The metabolic impact of OSA has also been studied, particularly in relation to glucose homeostasis. Also of interest is the potential impact OSA has on lipid metabolism. The adverse effect untreated OSA has on glucose tolerance and lipid levels has led to the suggestion that OSA is yet another constituent of the metabolic syndrome. Some of these metabolic derangements may be related to the adverse effects untreated OSA has on hepatic health. The cardiovascular, neurocognitive, and metabolic manifestations of OSA can have a significant impact on patient health and quality of life. In many instances, evidence exists that therapy not only improves outcomes in general, but also modifies the severity of co-morbid disease. To mitigate the long-term sequela of this disease

  19. Obstructive sleep apnea predicts risk of metabolic syndrome independently of obesity: a meta-analysis

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    Qian, Yingjun; Xu, Huajun; Wang, Yuyu; Yi, Hongliang; Yin, Shankai

    2016-01-01

    Introduction Obstructive sleep apnea (OSA) has been suggested to be associated with a high risk of metabolic syndrome (MS). However, results on whether the association between OSA and risk of MS is independent of obesity, and the effect of nocturnal intermittent hypoxia (IH) on MS, are conflicting. Our purpose was to estimate the magnitude of the independent association between OSA and risk of MS and further explore whether nocturnal IH in OSA plays a role in MS risk. Material and methods The PubMed and EMBASE databases were systematically searched (until January 21, 2015) for available observational evidence. Unadjusted and body mass index (BMI)-adjusted pooled odds ratios (ORs) for MS in OSA or higher nocturnal IH were calculated using fixed or random models. Tests of homogeneity, publication bias, and robustness of the results were performed. Results A total of 13 independent studies (involving 857 participants in 3 case-control studies and 7077 participants in 10 cross-sectional studies) were included. The OSA was significantly associated with an increased risk of MS in a meta-analysis of 10 studies (pooled OR = 1.72, 95% CI: 1.31–2.26, p < 0.001), with a BMI-adjusted pooled OR of 1.97 (95% CI: 1.34–2.88, p < 0.001). Pooled results from 3 studies on the oxygen desaturation index (ODI) and MS risk (OR = 1.96, 95% CI: 1.73–2.22, p < 0.001) and 3 studies on the cumulative percentage of sleep time with SpO2 below 90% (CT90) and MS risk (OR = 1.05, 95% CI: 1.02–1.07, p < 0.001) were also significant. Conclusions Our findings demonstrated a significant association between OSA and increased MS risk independent of BMI, and further indicated a role of nocturnal IH in this association.

  20. Upper Airway Elasticity Estimation in Pediatric Down Syndrome Sleep Apnea Patients Using Collapsible Tube Theory.

    Science.gov (United States)

    Subramaniam, Dhananjay Radhakrishnan; Mylavarapu, Goutham; McConnell, Keith; Fleck, Robert J; Shott, Sally R; Amin, Raouf S; Gutmark, Ephraim J

    2016-05-01

    Elasticity of the soft tissues surrounding the upper airway lumen is one of the important factors contributing to upper airway disorders such as snoring and obstructive sleep apnea. The objective of this study is to calculate patient specific elasticity of the pharynx from magnetic resonance (MR) images using a 'tube law', i.e., the relationship between airway cross-sectional area and transmural pressure difference. MR imaging was performed under anesthesia in children with Down syndrome (DS) and obstructive sleep apnea (OSA). An airway segmentation algorithm was employed to evaluate changes in airway cross-sectional area dilated by continuous positive airway pressure (CPAP). A pressure-area relation was used to make localized estimates of airway wall stiffness for each patient. Optimized values of patient specific Young's modulus for tissue in the velopharynx and oropharynx, were estimated from finite element simulations of airway collapse. Patient specific deformation of the airway wall under CPAP was found to exhibit either a non-linear 'hardening' or 'softening' behavior. The localized airway and tissue elasticity were found to increase with increasing severity of OSA. Elasticity based patient phenotyping can potentially assist clinicians in decision making on CPAP and airway or tissue elasticity can supplement well-known clinical measures of OSA severity.

  1. Treatment of obstructive sleep apnea syndrome using radiofrequency-assisted uvulopalatoplasty with tonsillectomy.

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    Lim, Dae Jun; Kang, Sung-Ho; Kim, Bo-Hyeng; Hong, Seok-Chan; Yu, Myeong Sang; Kim, Young-Hyun; Choi, Jeong-Seok; Jin, Kwang Ho

    2013-02-01

    Radiofrequency surgery was introduced to minimize thermal damage to the tissue. A radiofrequency electrode can be used to make cuts in the free edge of the soft palate like those done in laser-assisted uvulopalatoplasty [radiofrequency-assisted uvulopalatoplasty (RAUP)]. Tonsillectomy can enlarge the lateral diameter of the pharynx. The aim of our study was to evaluate the efficacy of RAUP with tonsillectomy in treatment of obstructive sleep apnea syndrome (OSAS). Ninety-two patients with obstructive sleep apnea were included in this study. Patients were categorized according to disease severity and Friedman's staging system. Patients were assessed with the preoperative visual analog scale (VAS) for snoring, Epworth Sleepiness Scale (ESS) and apnea-hypopnea index (AHI) at baseline and repeated at 6 months postoperatively. The intensity of postoperative pain, speech deficits and dysphagia were also recorded. There was a significant improvement in the VAS score for snoring, ESS and AHI before and after surgery. Overall, the results of the present study indicated a surgery success rate (a 50 % decrease in AHI and AHI tonsillectomy is an effective treatment for patients with OSAS.

  2. [Treatment of obstructive sleep apnea syndromes].

    Science.gov (United States)

    Poirrier, R

    1993-01-01

    The detection, correction or withdrawal of any cause or associated factor including obesity, drugs or alcohol is essential in the treatment of obstructive sleep apnea syndrome. Treatment is mainly mechanical or surgical, but not medical. Nasal continuous positive airway pressure (NCPAP) has now largely replaced tracheostomy and successful long-term domestic use of this method has been reported on many occasions. Oropharyngeal surgery can solve a large part of social snoring problems. However criteria for procedure selection and evaluation of results are still needed to clarify the indication of this operation in patients with full clinical expression of the syndrome. In this regard, a comprehensive preoperative evaluation and a logical approach to the reconstruction of the upper-airway has recently led to the association of palatopharyngoplasty and maxillo-mandibular surgery, with an excellent long-term success rate.

  3. Obstructive Sleep Apnea Syndrome: Pathogenetic Aspects and Treatment

    NARCIS (Netherlands)

    H. Boot (Hendrik)

    2000-01-01

    textabstractAlmost twenty years ago obstmctive sleep apnea was considered to be a medical curiosity that was of little importance, and snoring was merely the subject of humor than one of serious investigation. Although the clinical manifestations of sleep apnea syndrome have been described as early

  4. The Association between Symptoms of Obstructive Sleep Apnea Syndrome and School Performance

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    Melike Demir

    2016-03-01

    Full Text Available Objective: Obstructive sleep apnea syndrome (OSAS ad­versely affects school performance by causing learning dif­ficulties, attention deficit, and forgetfulness. Aim of this study is to compare two student groups with different school suc­cess levels by symptoms related with OSAS. Methods: First class students from a faculty of our univer­sity with relatively higher university entrance examination scores (Group 1 and the ones from another faculty with low­er scores (Group 2 were included in study. A questionnaire was applied. Demographic features, information related with smoking, driving, and previous traffic accidents were record­ed. Additionally, Epworth Sleepiness Scale and Berlin Ques­tionnaire used in OSAS screening were scored. Findings of two groups were compared. Results: 252 students were included. Group 1 and 2 con­sisted of 136 and 116 students, respectively. No difference was determined by age, sex, weight, and height. Significantly higher prevalence of snoring (87.1% vs.27.2%, sleep apnea (10.3% vs.5.1%, daytime sleepiness (25.8% vs.13.2%, and frequency of smoking (25.3% vs.18.2% were determined in Group 2 than in Group 1 (p<0.001, p=0.021, p=0.002,and p<0.001,respectively. Group 2 also had higher Epworth Sleepiness Scales (5.3±3.5 vs.1.8±3.6,p=0.006 and higher prevalence of OSAS risk (45.7% vs.31.6%,p<0.001. Within Group 2, frequencies of snoring and sleep apnea were high­er in smokers than in non-smokers [(97.8% vs.20%,p<0.001 and (68.9% vs.6.7%,p=0.047,respectively]. Conclusions: The prevalence of smoking and symptoms related with OSAS were found higher in students with lower school performance. Given that one of the factors affecting school success in young adults is sleep breathing disorders including OSAS, more comprehensive studies in this field are warranted.

  5. Maxillomandibular Advancement in Obstructive Sleep Apnea Syndrome Patients: a Restrospective Study on the Sagittal Cephalometric Variables

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    Paolo Ronchi

    2013-06-01

    Full Text Available Objectives: The present retrospective study analyzes sagittal cephalometric changes in patients affected by obstructive sleep apnea syndrome submitted to maxillomandubular advancement. Material and Methods: 15 adult sleep apnea syndrome (OSAS patients diagnosed by polysomnography (PSG and treated with maxillomandubular advancement (MMA were included in this study. Pre- (T1 and postsurgical (T2 PSG studies assessing the apnea/hypopnea index (AHI and the lowest oxygen saturation (LSAT level were compared. Lateral cephalometric radiographs at T1 and T2 measuring sagittal cephalometric variables (SNA, SNB, and ANB were analyzed, as were the amount of maxillary and mandibular advancement (Co-A and Co-Pog, the distance from the mandibular plane to the most anterior point of the hyoid bone (Mp-H, and the posterior airway space (PAS.Results: Postoperatively, the overall mean AHI dropped from 58.7 ± 16 to 8.1 ± 7.8 events per hour (P < 0.001. The mean preoperative LSAT increased from 71% preoperatively to 90% after surgery (P < 0.001. All the patients in our study were successfully treated (AHI < 20 or reduced by 50%. Cephalometric analysis performed after surgery showed a statistically significant correlation between the mean SNA variation and the decrease in the AHI (P = 0.01. The overall mean SNA increase was 6°.Conclusions: Our findings suggest that the improvement observed in the respiratory symptoms, namely the apnea/hypopnea episodes, is correlated with the SNA increase after surgery. This finding may help maxillofacial surgeons to establish selective criteria for the surgical approach to sleep apnea syndrome patients.

  6. HbA1c is associated with severity of obstructive sleep apnea hypopnea syndrome in nondiabetic men

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    Nikolaos Papanas

    2009-09-01

    Full Text Available Nikolaos Papanas1, Paschalis Steiropoulos2, Evangelia Nena2, Argyris Tzouvelekis2, Efstratios Maltezos1, Georgia Trakada2, Demosthenes Bouros21Outpatient Clinic of Obesity, Diabetes and Metabolism at the 2nd Department of Internal Medicine, 2Department of Pneumonology, Democritus University of Thrace, Alexandroupolis, GreeceAbstract: The aim of this study was to examine the potential correlation of sleep characteristics with glucose metabolism in nondiabetic men with obstructive sleep apnea syndrome (OSAS. Included were 31 male patients (mean age 46.7 ± 11 years, recently diagnosed with OSAS by full polysomnography. There was a significant correlation of fasting glucose and glycosylated hemoglobin (HbA1c levels with arousal index (P = 0.047 and P = 0.014, respectively. Moreover, HbA1c levels were correlated with apnea hypopnea index (P = 0.009, a widely accepted marker of the severity of OSAS, and with percentage of sleep time with saturation of hemoglobin with oxygen as measured by pulse oximetry (SpO2 <90% (t < 90% (P = 0.010. Finally, glucose and HbA1c levels showed a significant negative correlation with average SpO2 (P = 0.013 and P = 0.012, respectively and, additionally, glucose levels with minimum SpO2 (P = 0.027 during sleep. In conclusion, severity of OSAS among nondiabetic men is associated with increased HbA1c levels and increased fasting glucose. Thus, severity of OSAS may be an additional marker of cardiovascular risk, as well as of future diabetes, in these subjects. However, further work is needed to confirm the clinical significance of these observations.Keywords: obstructive sleep apnea syndrome, glucose metabolism, glycated hemoglobin, sleep disordered breathing

  7. Risk assessment of obstructive sleep apnea syndrome in pediatric patients with vitamin D deficiency

    Science.gov (United States)

    Ozgurhan, Gamze; Vehapoglu, Aysel; Vermezoglu, Oznur; Temiz, Rabia Nur; Guney, Asuman; Hacihamdioglu, Bulent

    2016-01-01

    Abstract The aim of the following study is to evaluate the risk of obstructive sleep apnea syndrome (OSAS) in subjects with vitamin D deficiency. Prospective and comparative study. We enrolled 240 subjects into the study. The participants were divided into 2 groups based on 25-hydroxyvitamin D (25[OH]D) levels: low level of 25(OH)D (20 ng/mL) group (n = 120). Subjects were classified as being at a high or low risk of developing OSAS by using the Berlin Questionnaire. Risk of developing OSAS, gender, age, and body mass index (BMI) z-score were assessed by comparing the low level of 25(OH)D group and control group. No statistically significant difference was observed between the low level of 25(OH)D group and control group in terms of gender, age, and BMI z-score distributions; P = 0.323, P = 0.387, and P = 0.093, respectively. There were 24 subjects with high risk of developing OSAS in 2 groups (17 subjects in the low level of 25[OH]D group and 7 subjects in the control group). In the low level of 25(OH)D group, the risk of developing OSAS was found to be significantly higher than the control group (P = 0.030). BMI z-score was found significantly higher in high-risk groups than low-risk groups (P = 0.034 for low-level 25[OH]D group and P = 0.023 for control group). The findings revealed that low level of 25(OH)D increases the risk of developing OSAS. PMID:27684795

  8. Upper Airway Resistance Syndrome Patients Have Worse Sleep Quality Compared to Mild Obstructive Sleep Apnea

    Science.gov (United States)

    de Godoy, Luciana Balester Mello; Luz, Gabriela Pontes; Palombini, Luciana Oliveira; e Silva, Luciana Oliveira; Hoshino, Wilson; Guimarães, Thaís Moura; Tufik, Sergio; Bittencourt, Lia; Togeiro, Sonia Maria

    2016-01-01

    Purpose To compare sleep quality and sustained attention of patients with Upper Airway Resistance Syndrome (UARS), mild Obstructive Sleep Apnea (OSA) and normal individuals. Methods UARS criteria were presence of excessive daytime sleepiness (Epworth Sleepiness Scale—ESS—≥ 10) and/or fatigue (Modified Fatigue Impact Scale—MFIS—≥ 38) associated to Apnea/hypopnea index (AHI) ≤ 5 and Respiratory Disturbance Index (RDI) > 5 events/hour of sleep or more than 30% of total sleep time with flow limitation. Mild OSA was considered if the presence of excessive daytime sleepiness (ESS ≥ 10) and/or fatigue (MFIS ≥ 38) associated to AHI ≥ 5 and ≤ 15 events/hour. “Control group” criteria were AHI < 5 events/hour and RDI ≤ 5 events/hour and ESS ≤ 9, without any sleep, clinical, neurological or psychiatric disorder. 115 individuals (34 UARS and 47 mild OSA patients and 34 individuals in “control group”), adjusted for age, gender, body mass index (BMI) and schooling years, performed sleep questionnaires and sustained attention evaluation. Psychomotor Vigilance Task (PVT) was performed five times (each two hours) from 8 a.m. to 4 p.m. Results UARS patients had worse sleep quality (Functional Outcomes of Sleep Questionnaire—FOSQ—and Pittsburgh Sleep Quality Index—PSQI: p < 0.05) and more fatigue than mild OSA patients (p = 0.003) and scored significantly higher in both Beck inventories than “control group” (p < 0.02). UARS patients had more lapses early in the morning (in time 1) compared to the results in the afternoon (time 5) than mild OSA (p = 0.02). Mild OSA patients had more lapses in times 2 than in time 5 compared to “control group” (p = 0.04). Conclusions UARS patients have a worse sleep quality, more fatigue and a worse early morning sustained attention compared to mild OSA. These last had a worse sustained attention than controls. PMID:27228081

  9. Long-term results of tracheostomy for severe obstructive sleep apnea syndrome.

    Science.gov (United States)

    Haapaniemi, J J; Laurikainen, E A; Halme, P; Antila, J

    2001-01-01

    Severe obstructive sleep apnea (OSAS) is most often accompanied by metabolic syndrome, obesity, diabetes and coronary disease. In its most severe form, it is a life-threatening condition, requiring active and immediate help. Nasal continuous positive airway pressure (CPAP) is the most efficient nonsurgical treatment for patients with OSAS. However, for anatomical, disease-related and subjective reasons, many patients cannot accept this treatment. A permanent tracheostomy may be one alternative in such patients who, in addition, often suffer from extreme obesity and severe heart disease. In this paper, we describe the long-term follow-up results of 7 patients suffering from OSAS and treated with permanent tracheostomy. All the patients (5 men, 2 women) were diagnosed using the static charge sensitive bed method and night-time oximetry for sleep analysis. The mean body mass index (BMI) of the patients ranged from 34 to 60 and the age from 41 to 64 years. All the patients had severe OSAS and long periods of low oxygen saturation (SaO2) levels. Six patients had a CPAP trial before tracheostomy. Only 2 patients tolerated the trial but, despite the continuous use of CPAP, they were nonresponders. Permanent tracheostomy was done according to normal routine in each patient. After primary healing of 2 days, they used silver cannulae, which also allowed them to speak. The patients were evaluated every year after the tracheostomy. After some practical difficulties including proper maintenance of the cannula, all the patients quickly learned the correct management. In postoperative sleep studies, nadir SaO2 levels had improved significantly, obstructive apneas had disappeared and the subjective quality of life had improved. No marked changes in BMI were found.

  10. The Predictors of Obesity Hypoventilation Syndrome in Obstructive Sleep Apnea

    Science.gov (United States)

    Pıhtılı, Aylin; Bingöl, Züleyha; Kıyan, Esen

    2017-01-01

    Background: As obesity increases, the frequency of obstructive sleep apnea and obesity hypoventilation syndrome increases also. However, obesity hypoventilation syndrome frequency is not known, as capnography and arterial blood gas analysis are not routinely performed in sleep laboratories. Aims: To investigate the frequency and predictors of obesity hypoventilation syndrome in obese subjects. Study Design: Retrospective clinical study. Methods: Obese subjects who had arterial blood gas analysis admitted to the sleep laboratory and polysomnography were retrospectively analyzed. Subjects with restrictive (except obesity) and obstructive pulmonary pathologies were excluded. Demographics, Epworth-Sleepiness-Scale scores, polysomnographic data, arterial blood gas analysis, and spirometric measurements were recorded. Results: Of the 419 subjects, 45.1% had obesity hypoventilation syndrome. Apnea hypopnea index (p<0.001), oxygen desaturation index (p<0.001) and sleep time with SpO2<90% (p<0.001) were statistically higher in subjects with obesity hypoventilation syndrome compared to subjects with eucapnic obstructive sleep apnea. The nocturnal mean SpO2 (p<0.001) and lowest SpO2 (p<0.001) were also statistically lower in subjects with obesity hypoventilation syndrome. Logistic regression analysis showed that the lowest SpO2, oxygen desaturation index, apnea hypopnea index and sleep time with SpO2 <90% were related factors for obesity hypoventilation syndrome. Conclusion: Obesity hypoventilation syndrome should be considered when oxygen desaturation index, apnea hypopnea index and sleep time with SpO2 <90% are high. PMID:28251022

  11. Obstructive sleep apnea syndrome and hypertension in children%儿童阻塞性睡眠呼吸暂停综合征与高血压

    Institute of Scientific and Technical Information of China (English)

    许志飞; 申昆玲

    2013-01-01

    大量研究显示成人阻塞性睡眠呼吸暂停综合征 (obstructive sleep apnea syndrome,OSAS) 是高血压的危险因素,OSAS可通过多种机制引起血压异常.儿童OSAS的病因以及自然病程不同于成人,但研究表明,儿童OSAS已经出现血压升高和血压调节异常.动态血压监测是早期发现和诊断OSAS相关血压异常的重要方法.该文旨在阐述儿童OSAS与血压关系研究的最新进展.%A large number of studies have shown that adult obstructive sleep apnea syndrome (OSAS) is one of the risk factors of hypertension, can cause abnormal blood pressure by multiple mechanisms. Though the causes and course of childhood OSAS are different from those in adult, hypertension and abnormal blood pressure regulation have been observed in children with OSAS. Ambulatory blood pressure monitoring is a key method for early detection and diagnosis of OSAS-related abnormal blood pressure. This article will review the progress in research on correlation of childhood OSAS and blood pressure.

  12. Undiagnosed obstructive sleep apnea syndrome in children with syndromal craniofacial synostosis.

    NARCIS (Netherlands)

    Pijpers, M.; Poels, P.J.P.; Vaandrager, J.M.; Hoog, M. de; Berg, S.W. van den; Hoeve, H.J.; Joosten, K.F.

    2004-01-01

    Children with syndromal craniofacial synostosis have a high risk for obstructive sleep apnea syndrome. Early diagnosis and treatment can relieve symptoms and morbidity. Little is known about the development and natural history of obstructive sleep apnea syndrome through life. The aim of this study w

  13. Volumetric Brain Morphometry Changes in patients with Obstructive Sleep Apnea Syndrome : effects of CPAP treatment and literature review.

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    Nelly T Huynh

    2014-04-01

    Full Text Available Introduction: Obstructive sleep apnea syndrome (OSAS is a frequent breathing disorder occurring during sleep that is characterized by recurrent hypoxic episodes and sleep fragmentation. It remains unclear whether OSAS leads to structural brain changes, and if so, in which brain regions. Brain region-specific gray and white matter volume (GMV and WMV changes can be measured with voxel-based morphometry (VBM. The aims of this study were to use VBM to analyze GMV and WMV in untreated OSAS patients compared to healthy controls (HC; examine the impact of OSAS-related variables (nocturnal hypoxemia duration and sleep fragmentation index on GMV and WMV; and assess the effects of therapeutic versus sham continuous positive airway pressure (CPAP. We discuss our results in light of previous findings and provide a comprehensive literature review. Methods: Twenty-seven treatment-naïve male patients with moderate to severe OSAS and seven healthy age- and education-matched control subjects (HC were recruited. After a baseline fMRI scan, patients randomly received either active (therapeutic, n=14 or sham (subtherapeutic, n=13 nasal CPAP treatment for 2 months. Results: Significant negative correlations were observed between nocturnal hypoxemia duration and GMV in bilateral lateral temporal regions. No differences in GMV or WMV were found between OSAS patients and HC, and no differences between CPAP versus sham CPAP treatment effects in OSAS patients. Conclusion: It appears that considering VBM GMV changes there is little difference between OSAS patients and HC. The largest VBM study to date indicates structural changes in the lateral aspect of the temporal lobe, which also showed a significant negative correlation with nocturnal hypoxemia duration in our study. This finding suggests an association between the effect of nocturnal hypoxemia and decreased GMV in OSAS patients.

  14. Impact of High Risk for Obstructive Sleep Apnea on Survival after Acute Coronary Syndrome: Insights from the ERICO Registry

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    Flavia C Maia

    Full Text Available Abstract Background: Obstructive sleep apnea (OSA is a very often clinical condition that can be associated with high mortality risk, particularly in coronary heart disease (CHD. The diagnosis of OSA is not always accessible via the gold-standard method polysomnography. Objective: To evaluate long-term influence of the high risk for OSA on fatal and non-fatal outcomes after acute coronary syndrome (ACS in the Acute Coronary Syndrome Registry Strategy (ERICO Study using the Berlin questionnaire as a surrogate. Methods: Berlin questionnaire, a screening questionnaire for OSA, was applied in 639 cases of ACS 30 days after the index event. Cox regression proportional-hazards model was used to calculate the hazard ratio (HR of all-cause, cardiovascular and CHD (myocardial infarction mortality, as well as, the combined endpoint of fatal or recurrent non-fatal CHD. Results: The high-risk group for OSA had higher frequencies of previous personal/family history of CHD and diabetes, in addition to a poorer event-free survival, as compared to the low-risk group (p-log-rank=0.03. The HR for fatal or recurrent non-fatal CHD was 4.26 (95% confidence interval, 1.18 - 15.36 in patients at high risk for OSA compared to those at low risk for OSA after a 2.6-year mean follow-up. Conclusions: Using Berlin questionnaire, we were able to identify high risk for OSA as an independent predictor of non-fatal reinfarction or CHD mortality in post-ACS individuals in a long-term follow-up.

  15. Impact of High Risk for Obstructive Sleep Apnea on Survival after Acute Coronary Syndrome: Insights from the ERICO Registry

    Science.gov (United States)

    Maia, Flavia C; Goulart, Alessandra C.; Drager, Luciano F.; Staniak, Henrique L.; Santos, Itamar de Souza; Lotufo, Paulo Andrade; Bensenor, Isabela M.

    2017-01-01

    Background Obstructive sleep apnea (OSA) is a very often clinical condition that can be associated with high mortality risk, particularly in coronary heart disease (CHD). The diagnosis of OSA is not always accessible via the gold-standard method polysomnography. Objective To evaluate long-term influence of the high risk for OSA on fatal and non-fatal outcomes after acute coronary syndrome (ACS) in the Acute Coronary Syndrome Registry Strategy (ERICO) Study using the Berlin questionnaire as a surrogate. Methods Berlin questionnaire, a screening questionnaire for OSA, was applied in 639 cases of ACS 30 days after the index event. Cox regression proportional-hazards model was used to calculate the hazard ratio (HR) of all-cause, cardiovascular and CHD (myocardial infarction) mortality, as well as, the combined endpoint of fatal or recurrent non-fatal CHD. Results The high-risk group for OSA had higher frequencies of previous personal/family history of CHD and diabetes, in addition to a poorer event-free survival, as compared to the low-risk group (p-log-rank=0.03). The HR for fatal or recurrent non-fatal CHD was 4.26 (95% confidence interval, 1.18 - 15.36) in patients at high risk for OSA compared to those at low risk for OSA after a 2.6-year mean follow-up. Conclusions Using Berlin questionnaire, we were able to identify high risk for OSA as an independent predictor of non-fatal reinfarction or CHD mortality in post-ACS individuals in a long-term follow-up. PMID:28146212

  16. Comparison of Ricketts analysis and Downs-Northwestern analysis for the evaluation of obstructive sleep apnea cephalograms.

    Science.gov (United States)

    Higurashi, N; Kikuchi, M; Miyazaki, S; Itasaka, Y

    2001-06-01

    To determine which analysis is suitable to examine the dentofacial skeletal pattern characteristics of the obstructive sleep apnea syndrome (OSAS), we took lateral cephalograms of 44 Japanese OSAS patients and 34 Japanese non-OSAS controls. By Ricketts analysis, we found significant differences between OSAS patients and non-OSAS controls on facial axis, lower facial height and total facial height, which showed that Japanese OSAS patients have dolico facial patterns. However, by Downs-Northwestern analysis, we did not find any significant difference between OSAS patients and non-OSAS controls using the same cephalograms as the Ricketts analysis.

  17. Clinical Features and Polysomnographic Findings in Greek Male Patients with Obstructive Sleep Apnea Syndrome: Differences Regarding the Age

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    Efremidis George

    2012-01-01

    Full Text Available Background-Aim. Although sleep disturbance is a common complaint among patients of all ages, research suggests that older adults are particularly vulnerable. The aim of this retrospective study was to elucidate the influence of age on clinical characteristics and polysomnographic findings of obstructive sleep apnea syndrome (OSAS between elderly and younger male patients in a Greek population. Methods. 697 male patients with OSAS were examined from December 2001 to August 2011. All subjects underwent an attended overnight polysomnography (PSG. They were divided into two groups: young and middle-aged (<65 years old and elderly (≥65 years old. We evaluated the severity of OSAS, based on apnea-hypopnea index (AHI, and the duration of apnea-hypopnea events, the duration of hypoxemia during total sleep time (TST and during REM and NREM sleep, and the oxygen saturation in REM and in NREM sleep. Results. PSG studies showed that elderly group had significant higher duration of apnea-hypopnea events, longer hypoxemia in TST and in NREM sleep, as well as lower oxygen saturation in REM and NREM sleep than the younger group. Otherwise, significant correlation between BMI and neck circumference with AHI was observed in both groups. Conclusions. The higher percentages of hypoxemia during sleep and longer duration of apnea-hypopnea events that were observed in the elderly group might be explained by increased propensity for pharyngeal collapse and increased deposition of parapharyngeal fat, which are associated with aging. Another factor that could explain these findings might be a decreased partial arterial pressure of oxygen (PaO2 due to age-related changes in the respiratory system.

  18. Consequences of Obstructive Sleep Apnea in Children.

    Science.gov (United States)

    Blechner, Michael; Williamson, Ariel A

    2016-01-01

    Obstructive sleep apnea syndrome (OSAS) has various negative health and behavioral consequences in the pediatric population. As shown in adults, there are metabolic derangements such as obesity, insulin sensitivity, dyslipidemia, and metabolic syndrome, as well as cardiovascular derangements like hypertension, chronic inflammation, endothelial dysfunction, ventricular size/function abnormalities, and even elevated pulmonary arterial pressures, that can be seen in children with OSAS. The first two sections will discuss the metabolic and cardiovascular consequences on OSAS in children. The last section summarizes selected studies and reviews on the behavioral, neurocognitive and academic consequences of OSAS in children.

  19. Functional MRI of the pharynx in obstructive sleep apnea (OSA) with rapid 2-D flash sequences; Funktionelle MRT des Pharynx bei obstruktiver Schlafapnoe (OSA) mit schnellen 2D-FLASH-Sequenzen

    Energy Technology Data Exchange (ETDEWEB)

    Jaeger, L. [Inst. fuer Radiologische Diagnostik, Klinikum Grosshadern der Ludwig-Maximilians-Universitaet, Muenchen (Germany); Guenther, E. [Klinik und Poliklinik fuer Hals-, Nasen- und Ohrenkranke, Klinikum Grosshadern der Ludwig-Maximilians-Universitaet, Muenchen (Germany); Gauger, J. [Inst. fuer Radiologische Diagnostik, Klinikum Grosshadern der Ludwig-Maximilians-Universitaet, Muenchen (Germany); Nitz, W. [Siemens Medizintechnik, Erlangen (Germany); Kastenbauer, E. [Klinik und Poliklinik fuer Hals-, Nasen- und Ohrenkranke, Klinikum Grosshadern der Ludwig-Maximilians-Universitaet, Muenchen (Germany); Reiser, M. [Inst. fuer Radiologische Diagnostik, Klinikum Grosshadern der Ludwig-Maximilians-Universitaet, Muenchen (Germany)

    1996-03-01

    Functional imaging of the pharynx used to be the domain of cineradiography, CT and ultrafast CT. The development of modern MRI techniques led to new access to functional disorders of the pharynx. The aim of this study was to implement a new MRI technique to examine oropharyngeal obstructive mechanisms in patients with obstructive sleep apnea (OSA). Sixteen patients suffering from OSA and 6 healthy volunteers were examined on a 1.5 T whole-body imager (`Vision`, Siemens, Erlangen Medical Engineering, Germany) using a circular polarized head coil. Imaging was performed with 2D flash sequences in midsagittal and axial planes. Patients and volunteers were asked to breathe normally through the nose and to simulate snoring and the Mueller maneuver during magnetic resonance imaging (MRI). Prior to MRI, all patients underwent an ear, nose and throat (ENT) examination, functional fiberoptic nasopharyngoscopy and polysomnography. A temporal resolution of 6 images/s and an in-plane resolution of 2.67x1.8 mm were achieved. The mobility of the tongue, soft palate and pharyngeal surface could be clearly delineated. The MRI findings correlated well with the clinical examinations. We propose ultrafast MRI as a reliable and non-invasive method of evaluating pharyngeal obstruction and their levels. (orig.) [Deutsch] Die funktionelle Bildgebung des Pharynx war bisher eine Domaene der Hochfrequenzroentgenkinematographie, der Computertomographie (CT) und der ultraschnellen Computertomographie. Die Entwicklung moderner Techniken in der Magnetresonanztomographie (MRT) fuehrte zu neuen Ansaetzen in der Diagnostik pharyngealer Dysfunktionen. Ziel der vorliegenden Studie war die Implementierung neuer schneller MR-Sequenzen, um Verschlussmechanismen entlang des Pharnyxschlauches bei Patienten mit obstruktiver Schlafapnoe (OSA) zu untersuchen. 16 Patienten mit OSA und 6 gesunde Probanden wurden an einem 1,5-T-Ganzkoerpermagnetresonanztomographen (`Vision`, Siemens Medizintechnik, Erlangen

  20. Evaluation of Autonomic Dysfunction in Obstructive Sleep Apnea Syndrome

    Directory of Open Access Journals (Sweden)

    Ahmet Turan Evlice

    2012-04-01

    Full Text Available The nervous system, which controls the body's internal organs is called Autonomic Nervous System. Parkinson's disease, vascular diseases, diabetes mellitus and Guilllain-Barre syndrome cause to disotonomia. Recent studies has been shown, obstructive sleep apnea syndrome cause to disotonomia too. To investigate disotonomia in in obstructive sleep apnea syndrome , should be preferred the methods like analysis of heart rate variability and sympathetic skin response which have low cost and easy applicability. Thus, it will be possible to prevent morbidity and mortality due to autonomic dysfuncion. [Archives Medical Review Journal 2012; 21(2.000: 109-121

  1. Cerebral hemodynamics in patients with obstructive sleep apnea syndrome monitored with near-infrared spectroscopy (NIRS) during positive airways pressure (CPAP) therapy: a pilot study

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    Zhang, Zhongxing; Schneider, Maja; Laures, Marco; Fritschi, Ursula; Lehner, Isabella; Qi, Ming; Khatami, Ramin

    2014-03-01

    In obstructive sleep apnea syndrome (OSA) the periodic reduction or cessation of breathing due to narrowing or occlusion of the upper airway during sleep leads to daytime symptoms and increased cardiovascular risk, including stroke. The higher risk of stroke is related to the impairment in cerebral vascular autoregulation. Continuous positive airways pressure (CPAP) therapy at night is the most effective treatment for OSA. However, there is no suitable bedside monitoring method evaluating the treatment efficacy of CPAP therapy, especially to monitor the recovery of cerebral hemodynamics. NIRS is ideally suited for non-invasive monitoring the cerebral hemodynamics during sleep. In this study, we will for first time assess dynamic changes of cerebral hemodynamics during nocturnal CPAP therapy in 3 patients with OSA using NIRS. We found periodic oscillations in HbO2, HHb, tissue oxygenation index (TOI) and blood volume associated with periodic apnea events without CPAP in all OSA patients. These oscillations were gradually attenuated and finally eliminated with the stepwise increments of CPAP pressures. The oscillations were totally eliminated in blood volume earlier than in other hemodynamic parameters. These results suggested that 1) the cerebral hemodynamic oscillations induced by OSA events can effectively be attenuated by CPAP therapy, and 2) blood flow and blood volume recovered first during CPAP therapy, followed by the recovery of oxygen consumption. Our study suggested that NIRS is a useful tool to evaluate the efficacy of CPAP therapy in patients with OSA bedside and in real time.

  2. Effect of Positive Airway Pressure Therapy on Body Mass Index in Obese Patients With Obstructive Sleep Apnea Syndrome: A Prospective Study.

    Science.gov (United States)

    Rishi, Muhammad Adeel; Copur, Ahmet Sinan; Nadeem, Rashid; Fulambarker, Ashok

    2016-01-01

    Because obesity is a common cause of obstructive sleep apnea syndrome (OSAS), weight loss can be an effective treatment. OSAS also may cause weight gain in some patients. Effective treatment of sleep apnea may facilitate weight loss in obese patients. We hypothesize that positive airway pressure (PAP) therapy is associated with weight loss in obese patients with OSAS. This was a single-center observational prospective cohort study. Forty-five patients were diagnosed with OSAS after polysomnographic analysis in sleep laboratory and underwent continuous positive airway pressure titration. Patients were followed for 3 months in terms of change in body mass index (BMI) and compliance with PAP therapy. Of the 45 patients recruited, 3 patients were eliminated because of miss recruitment. Nine patients had incomplete data, and the rest (n = 33) were included for analysis. The mean age was 54.9 ± 16.9 years (mean ± SD), 93.9% were male, and 90.9% were whites. Mean apnea-hypopnea index was 36.3 ± 28.17 events per hour. Mean BMI before treatment was 34.7 ± 3.9 kg/m. Fifteen patients (45.5%) were compliant with therapy of OSAS with PAP. There was no difference in age, gender, neck circumference, BMI, and apnea-hypopnea index of patients compliant to therapy when compared with those who were not. There was a significant decrease in BMI in patients compliant with PAP therapy compared with noncompliant patients (-1.2 ± 0.7 vs. 0.3 ± 0.9 kg/m, P ≤ 0.001). PAP therapy may cause significant loss of weight within 3 months in obese patients with OSAS. Further study is needed to elucidate the physiological basis of this change.

  3. Effects of long-term treatment on brain volume in patients with obstructive sleep apnea syndrome.

    Science.gov (United States)

    Kim, Hosung; Joo, EunYeon; Suh, Sooyeon; Kim, Jae-Hun; Kim, Sung Tae; Hong, Seung Bong

    2016-01-01

    We assessed structural brain damage in obstructive sleep apnea syndrome (OSA) patients (21 males) and the effects of long-term continuous positive airway pressure (CPAP) treatment (18.2 ± 12.4 months; 8-44 months) on brain structures and investigated the relationship between severity of OSA and effects of treatment. Using deformation-based morphometry to measure local volume changes, we identified widespread neocortical and cerebellar atrophy in untreated patients compared to controls (59 males; Cohen's D = 0.6; FDR brain volume following treatment (FDR 64) presented with prefrontal atrophy and displayed an additional volume increase in this area following treatment. Higher impairment of working memory in patients prior to treatment correlated with prefrontal volume increase after treatment. The large overlap between the initial brain damage and the extent of recovery after treatment suggests partial recovery of nonpermanent structural damage. Volume increases in the dentate gyrus and the dentate nucleus possibly likely indicate compensatory neurogenesis in response to diminishing oxidative stress. Such changes in other brain structures may explain gliosis, dendritic volume increase, or inflammation. This study provides neuroimaging evidence that revealed the positive effects of long-term CPAP treatment in patients with OSA.

  4. Role of Oxidative Stress in the Neurocognitive Dysfunction of Obstructive Sleep Apnea Syndrome

    Science.gov (United States)

    Chen, Ping

    2016-01-01

    Obstructive sleep apnea syndrome (OSAS) is characterized by chronic nocturnal intermittent hypoxia and sleep fragmentations. Neurocognitive dysfunction, a significant and extraordinary complication of OSAS, influences patients' career, family, and social life and reduces quality of life to some extent. Previous researches revealed that repetitive hypoxia and reoxygenation caused mitochondria and endoplasmic reticulum dysfunction, overactivated NADPH oxidase, xanthine oxidase, and uncoupling nitric oxide synthase, induced an imbalance between prooxidants and antioxidants, and then got rise to a series of oxidative stress (OS) responses, such as protein oxidation, lipid peroxidation, and DNA oxidation along with inflammatory reaction. OS in brain could trigger neuron injury especially in the hippocampus and cerebral cortex regions. Those two regions are fairly susceptible to hypoxia and oxidative stress production which could consequently result in cognitive dysfunction. Apart from continuous positive airway pressure (CPAP), antioxidant may be a promising therapeutic method to improve partially reversible neurocognitive function. Understanding the role that OS played in the cognitive deficits is crucial for future research and therapeutic strategy development. In this paper, recent important literature concerning the relationship between oxidative stress and cognitive impairment in OSAS will be summarized and the results can provide a rewarding overview for future breakthrough in this field.

  5. Obstructive sleep apnea syndrome and snoring in patients with bilateral vocal cord paralysis.

    Science.gov (United States)

    Misiolek, Maciej; Namyslowski, Grzegorz; Karpe, Jacek; Ziora, Dariusz; Misiolek, Hanna; Czecior, Eugeniusz; Scierski, Wojciech

    2003-04-01

    The analysis of the correlation between bilateral vocal cord paralysis and the occurrence of obstructive sleep apnea syndrome and snoring is presented. The aim of the study was to establish whether the decrease of the air flow in the upper airway in patients with bilateral vocal cord paralysis involves OSAS and/or snoring occurrence and whether arytenoidectomy affects an improvement of breathing parameters measured during sleep. Fourteen patients with bilateral vocal cord paralysis underwent Poly-MESAM examination before and 3 months after arytenoidectomy. They had never complained of snoring before. The Epworth sleepiness scale was used to quantify excessive daytime somnolence. The RDI, DI, mean saturation and percentage of snoring, loud snoring and sleep without snoring were estimated and compared pre- and postoperatively. The results were compared by the Student's t-test for dependent values. No significant differences were shown between the Epworth scores before and after the treatment. The RDI, DI and mean saturation were normal before and after the operation. The percentage of loud snoring decreased and the percentage of sleep without snoring increased significantly after arytenoidectomy in both cases. The mechanism of snoring in patients with vocal cord paralysis seems to be similar to OSAS. The difference consists in the level of flow limitation. On the basis of the results there is no reason to diagnose OSAS and UARS in patients with bilateral vocal cord paralysis. On the other hand, the intensive snoring that occurs after paralysis was significantly reduced as a result of arytenoidectomy.

  6. Elevated nocturnal and morning blood pressure in patients with obstructive sleep apnea syndrome

    Institute of Scientific and Technical Information of China (English)

    HE Quan-ying; WANG Bei; LIN Qi-chang; ZHANG Jin-nong; LIU Hui-guo; LUO Yuan-ming; LIU Jian-hong; WANG Shi; XIAO Gao-hui; LU Gan; ZHANG Jin; FENG Jing; FENG Xue-wei; CHEN Bao-yuan; ZHANG Xi-long; LIANG Zong-an; HUANG Shao-guang; KANG Jian; WANG Guang-fa; ZHANG Li-qiang; MA Li-jun

    2012-01-01

    Background The nocturnal nondipping and elevated morning blood pressure (BP) in patients with obstructive sleep apnea syndrome (OSAS) have not yet been well investigated in Chinese patients.This study aimed to describe the BP profile,and to elucidate the relationships between daytime BP and nighttime BP,and between evening BP and morning BP in patients with OSAS.Methods Twenty teaching hospital sleep centers in China were organized by the Chinese Medical Association to participate in this study and 2297 patients were recruited between January 2004 and April 2006.BP assessments were made at four time points (daytime,evening,nighttime and morning) and polysomnography (PSG) was performed and subjects were classified into four groups by their apnea-hypopnea index (AHI):control,n=213 with AHI<5; mild,n=420 with AHI ≥5 and<15; moderate,n=460 with AHI≥15 and<30; and severe,n=1204 with AHI >30.SPSS 11.5 software package was used for statistical analysis and figure drawing.Results All the average daytime,nighttime,evening and morning BPs were positively correlated with AHI and negatively correlated with nadir nocturnal oxygen saturation.The ralios of nighttime/daytime and morning/evening average BP were positively correlated with AHI.The ratio of nighttime/daytime systolic BP became a “reversed BP dipping” pattern until the classification reached severe,while the ratio of nighttime/daytime diastolic BP became reversed at moderate.Similarly,the ratio of morning/evening diastolic BP becomes reversed even at mild.Conclusions OSAS may result in higher BP levels at all four time points.The ratios of nighttime/daytime and morning/evening BP increase with increased AHI.The increasing of diastolic BP,which is inclined to rise more quickly,is not parallel with increasing systolic BP.

  7. Large eddy simulation of the pharyngeal airflow associated with obstructive sleep apnea syndrome at pre and post-surgical treatment.

    Science.gov (United States)

    Mihaescu, Mihai; Mylavarapu, Goutham; Gutmark, Ephraim J; Powell, Nelson B

    2011-08-11

    Obstructive Sleep Apnea Syndrome (OSAS) is the most common sleep-disordered breathing medical condition and a potentially life-threatening affliction. Not all the surgical or non-surgical OSAS therapies are successful for each patient, also in part because the primary factors involved in the etiology of this disorder are not completely understood. Thus, there is a need for improving both diagnostic and treatment modalities associated with OSAS. A verified and validated (in terms of mean velocity and pressure fields) Large Eddy Simulation approach is used to characterize the abnormal pharyngeal airflow associated with severe OSAS and its interaction with the airway wall in a subject who underwent surgical treatment. The analysis of the unsteady flow at pre- and post-treatment is used to illustrate the airflow dynamics in the airway associated with OSAS and to reveal as well, the changes in the flow variables after the treatment. At pre-treatment, large airflow velocity and wall shear stress values were found at the obstruction site in all cases. Downstream of obstruction, flow separation generated flow recirculation regions and enhanced the turbulence production in the jet-like shear layers. The interaction between the generated vortical structures and the pharyngeal airway wall induced large fluctuations in the pressure forces acting on the pharyngeal wall. After the surgery, the flow field instabilities vanished and both airway resistance and wall shear stress values were significantly reduced.

  8. Endocrine and Metabolic Aspects of OSA

    Directory of Open Access Journals (Sweden)

    Ravinder Goswami

    2014-03-01

    Full Text Available Obstructive sleep apnea (OSA is characterized by repeated spells of apnea.Collapsibility of hypopharynx due to multiple factors involving pharyngeal dilatormuscles and deposition of fat or fluid in the surrounding soft tissues are importantcontributing factors in its pathogenesis. OSA commonly affects obese individuals.Males are more commonly affected than the females probably due to the disturbingeffect of testosterone on sleep.The impact of OSA on human health include disturbances in endocrine and metabolicsystem affecting hypothalamic-pituitary-gonadal axis, adrenocorticotrophic-cortisolaxis, growth hormone, antidiuretic hormones and insulin resistance. There is atendency for predisposition of the metabolic syndrome or its components includingglycemic dysregulation, hypertension, hyperlipidemia and physical parameters relatedto adiposity. On the other hand, several endocrine disorders such as hypothyroidism,growth hormone excess, polycystic ovarian disease and testosterone replacement areassociated with increased prevalence of OSA.There is limited information on the effect of treatment of OSA by continuous positiveairway pressure (CPAP on the endocrine and metabolic disturbances. There is a needto conduct randomized controlled trials using CPAP therapy in patients with OSA andto study its cause and effect relationship with endocrine and metabolic disturbances.

  9. Antioxidant Carbocysteine Treatment in Obstructive Sleep Apnea Syndrome: A Randomized Clinical Trial.

    Directory of Open Access Journals (Sweden)

    Kang Wu

    Full Text Available This study aimed to examine the effects of carbocysteine in OSAS patients.A total of 40 patients with moderate to severe obstructive sleep apnea syndrome (OSAS were randomly divided into two groups. One group was treated with 1500 mg carbocysteine daily, and the other was treated with continuous positive airway pressure (CPAP at night. Before treatment and after 6 weeks of treatment, all patients underwent polysomnography and completed questionnaires. Treatment compliance was compared between the two groups. Plasma was collected for various biochemical analyses. Endothelial function was assessed with ultrasound in the carbocysteine group.The proportion of patients who fulfilled the criteria for good compliance was higher in the carbocysteine group (n = 17 than in the CPAP group (n = 11; 100% vs. 64.7%. Compared with baseline values, the carbocysteine group showed significant improvement in their Epworth Sleepiness Scale score (10.18 ± 4.28 vs. 6.82 ± 3.66; P ≤ 0.01, apnea-hypopnea index (55.34 ± 25.03 vs. 47.56 ± 27.32; P ≤ 0.01, time and percentage of 90% oxygen desaturation (12.66 (2.81; 50.01 vs. 8.9 (1.41; 39.71; P ≤ 0.01, and lowest oxygen saturation level (65.88 ± 14.86 vs. 70.41 ± 14.34; P ≤ 0.01. Similar changes were also observed in the CPAP group. The CPAP group also showed a decreased oxygen desaturation index and a significant increase in the mean oxygen saturation after treatment, but these increases were not observed in the carbocysteine group. Snoring volume parameters, such as the power spectral density, were significantly reduced in both groups after the treatments. The plasma malondialdehyde level decreased and the superoxide dismutase and nitric oxide levels increased in both groups. The endothelin-1 level decreased in the CPAP group but did not significantly change in the carbocysteine group. Ultrasonography showed that the intima-media thickness decreased (0.71 ± 0.15 vs. 0.66 ± 0.15; P ≤ 0.05 but that flow

  10. Concurrent presence of inflammation and obstructive sleep apnea exacerbates the risk of metabolic syndrome: A KoGES 6-year follow-up study.

    Science.gov (United States)

    Kim, Jinkwan; Yoon, Dae Wui; Lee, Seung Ku; Lee, Seunggwan; Choi, Kyung-Mee; Robert, Thomas J; Shin, Chol

    2017-02-01

    Obstructive sleep apnea (OSA) leads to multiple end-organ morbidities that are mediated by the cumulative burden of oxidative stress and inflammation. Both OSA and inflammation play key roles in increased risk of cardiovascular disease (CVD). Thus, we hypothesized that the combination of inflammation and OSA could accelerate the development of metabolic syndrome (MetS) in a large cohort study.A total of 1835 participants were randomly selected from the ongoing Korean Genome and Epidemiology Study for the years between 2007 and 2015. Overnight polysomnography was performed on each participant. Blood was drawn for biochemical analyses. Participants with high or low inflammation were divided by high-sensitivity C-reactive protein (hsCRP). MetS was defined using the criteria of the modified National Cholesterol Education Program, Adult Treatment Panel III.The prevalence of MetS was higher among the subjects with OSA and high hsCRP levels than among the other corresponding groups. The incidence of MetS among the 4 groups stratified by OSA and inflammation status at the 6-year follow-up was 11.8%, 19.9%, 25.8%, and 36.0% (HsCRP[-]/OSA[-] vs HsCRP[+]/OSA[-] vs HsCRP[-]/OSA[+] vs HsCRP[+]/OSA[+], P inflammation and OSA. The combination of these conditions is associated with higher risk of MetS. Additional research is needed to help further define the significance of the combined effect of OSA and subclinical inflammation on the development of MetS in the context of reduction of CVD risk.

  11. Hypoxemia during bilevel positive airway pressure treatment in patients with obstructive sleep apnea syndrome and chronic respiratory insufficiency.

    Science.gov (United States)

    Brzecka, Anna; Piesiak, Pawel; Kosacka, Monika; Jankowska, Renata

    2013-01-01

    In patients with obstructive sleep apnea (OSA) syndrome and chronic respiratory insufficiency one of the options of treatment is bilevel positive airway pressure (BPAP) during sleep. The aim of the study was to find out what are the factors influencing the early results of BPAP treatment in such OSA patients. The study was carried out in 55 adult obese patients (mean body mass index 45 ± 7 kg/m(2)), severe OSA syndrome (mean apnea/hypopnea index 62 ± 19), and chronic respiratory insufficiency (mean PaCO(2) 54 ± 5.7 torr) who underwent polysomnography during BPAP treatment. In 31 patients (56%) the mean SaO(2) during sleep was <88% despite the optimal BPAP and oxygen titration: 83 ± 4% during NREM and 81 ± 7% during REM sleep vs. 91 ± 2% and 90 ± 3%, respectively, in the remaining 24 patients (p < 0.001). The patients with advanced hypoxemia during sleep and BPAP treatment had lower forced vital capacity (2.2 ± 0.9 vs. 2.7 ± 0.8 l, p < 0.05), lower diurnal PaO(2) (49 ± 8 vs. 54 ± 7 torr), higher diurnal PaCO(2) (57 ± 5 vs. 52 ± 5 torr, p < 0.01), and higher PaCO(2) during sleep (75 ± 13 vs. 59.5 ± 7.5 torr). In conclusion, in obese patients with severe OSA syndrome and chronic alveolar hypoventilation there is a risk of sleep hypoxemia during BPAP treatment, despite optimal pressure titration.

  12. Executive dysfunction in children affected by obstructive sleep apnea syndrome: an observational study

    Directory of Open Access Journals (Sweden)

    Esposito M

    2013-08-01

    Full Text Available Maria Esposito,1 Lorenzo Antinolfi,1 Beatrice Gallai,2 Lucia Parisi,3 Michele Roccella,3 Rosa Marotta,4 Serena Marianna Lavano,4 Giovanni Mazzotta,5 Francesco Precenzano,1 Marco Carotenuto1 1Sleep Clinic for Developmental Age, Clinic of Child and Adolescent Neuropsychiatry, Department of Mental and Physical Health and Preventive Medicine, Second University of Naples, Naples, Italy; 2Unit of Child and Adolescent Neuropsychiatry, University of Perugia, Perugia, Italy; 3Child Neuropsychiatry, Department of Psychology, University of Palermo, Palermo, Italy; 4Department of Psychiatry, Magna Graecia University of Catanzaro, Catanzaro, Italy; 5Unit of Child and Adolescent Neuropsychiatry, AUSL Umbria 2, Terni, Italy Introduction: The role of sleep in cognitive processes can be considered clear and well established. Different reports have disclosed the association between sleep and cognition in adults and in children, as well as the impact of disturbed sleep on various aspects of neuropsychological functioning and behavior in children and adolescents. Behavioral and cognitive dysfunctions can also be considered as related to alterations in the executive functions (EF system. In particular, the EF concept refers to self-regulatory cognitive processes that are associated with monitoring and controlling both thought and goal directed behaviors. The aim of the present study is to assess the impact of the obstructive sleep apnea syndrome (OSAS on EF in a large sample of school aged children. Materials and methods: The study population comprised 79 children (51 males and 28 females aged 7–12 years (mean 9.14 ± 2.36 years with OSAS and 92 healthy children (63 males and 29 females, mean age 9.08 ± 2.44 years. To identify the severity of OSAS, an overnight respiratory evaluation was performed. All subjects filled out the Italian version of the Modified Card Sorting Test to screen EFs. Moreover, to check the degree of subjective perceived daytime sleepiness

  13. Clinical symptoms of sleep apnea syndrome and automobile accidents

    DEFF Research Database (Denmark)

    Haraldsson, P O; Carenfelt, C; Diderichsen, Finn

    1990-01-01

    Patients with clinical features of sleep apnea syndrome (SAS) and self-reported sleep spells at the wheel do poorly in simulated monotonous driving. To evaluate whether drivers with defined symptoms of SAS (heavy snoring, sleep disturbances and daytime sleepiness) compensate in real traffic by ca...

  14. Effect of continuous positive airway pressure treatment on serum adiponectin level and mean arterial pressure in male patients with obstructive sleep apnea syndrome

    Institute of Scientific and Technical Information of China (English)

    ZHANG Xi-long; YIN Kai-sheng; LI Chong; JIA En-zhi; LI Yan-qun; GAO Zhao-fang

    2007-01-01

    Background Recent research suggested that obstructive sleep apnea syndrome (OSAS) might be independently associated with hypoadiponectinemia, which was linked to some complications of OSAS, such as hypertension, diabetes,etc. This study was conducted to investigate the effect of continuous positive airway pressure (CPAP) treatment on changes of both serum adiponectin levels and mean arterial pressure and their possible links in male OSAS patients.Methods Twenty-three adult male patients with moderate-to-severe OSAS but without obesity, coronary heart disease and diabetes were recruited. Their blood sampleswere collected and moming mean arterial pressure (MAP) was measured before CPAP treatment and on day 3, 7, 14 of CPAP treatment respectively. The serum adiponectin concentration was tested with radioimmunoassay.Results Compared with the serum adiponectin level before CPAP treatment, no significant change was found in OSAS patients on day 3 and day 7 of CPAP treatment (P>0.05). It was not until day 14 of CPAP treatment did a significant elevation in serum adiponectin level occur (P<0.01). Meanwhile, the MAP showed no statistically significant difference among its levels before CPAP, on day 3 and day 7 of CPAP treatment (P>0.05). However, on day 14 of CPAP treatment,a significantly lower MAP than that obtained before treatment was observed (P<0.05).Conclusions CPAP treatment can gradually reverse hypoadiponectinemia and reduce MAP in OSAS patients.Hypoadiponectinemia might be involved in the pathogenesis of OSAS-mediated hypertension.

  15. A study to investigate the relationship between difficult intubation and prediction criterion of difficult intubation in patients with obstructive sleep apnea syndrome

    Directory of Open Access Journals (Sweden)

    Omer Kurtipek

    2012-01-01

    Full Text Available Background and Aim: Obstructive sleep apnea (OSA syndrome is predisposed to the development of upper airway obstruction during sleep, and it poses considerable problem for anesthetic management. Difficult intubation (DI is an important problem for management of anesthesia. In this clinical research, we aim to investigate the relationship between DI and prediction criteria of DI in cases with OSA. Materials and Methods: We studied 40 [OSA (Group O, n = 20 and non-OSA, (Group C, n = 20] ASA I-II, adult patients scheduled tonsillectomy under general anesthesia. Same anesthetic protocol was used in two groups. Intubation difficulties were assessed by Mallampati grading, Wilson sum score, Laryngoscopic grading (Cormack and Lehane, a line joining the angle of the mouth and tragus of the ear with the horizontal, sternomental distance, and tyromental distance. Demographic properties, time-dependent hemodynamic variables, doses of reversal agent, anesthesia and operation times, and recovery parameters were recorded. Results: Significant difference was detected between groups in terms of BMI, Mallampati grading, Wilson weight scores, Laryngoscopic grading, sternomental distance, tyromental distance, doses of reversal agent, and recovery parameters. Conclusion: OSA patient′s DI ratio is higher than that of non-OSA patients. BMI Mallampati grading, Wilson weight scores, Laryngoscopic grading, sternomental distance, and tyromental distance evaluation might be predictors for DI in patients with OSA.

  16. Effect of continuous positive airway pressure therapy on hypothalamic-pituitary-adrenal axis function and 24-h blood pressure profile in obese men with obstructive sleep apnea syndrome.

    Science.gov (United States)

    Carneiro, Gláucia; Togeiro, Sônia Maria; Hayashi, Lílian F; Ribeiro-Filho, Fernando Flexa; Ribeiro, Artur Beltrame; Tufik, Sérgio; Zanella, Maria Teresa

    2008-08-01

    Obstructive sleep apnea syndrome (OSAS) increases the risk of cardiovascular events. Sympathetic nervous system and hypothalamic-pituitary-adrenal (HPA) axis activation may be the mechanism of this relationship. The aim of this study was to evaluate HPA axis and ambulatory blood pressure monitoring in obese men with and without OSAS and to determine whether nasal continuous positive airway pressure therapy (nCPAP) influenced responses. Twenty-four-hour ambulatory blood pressure monitoring and overnight cortisol suppression test with 0.25 mg of dexamethasone were performed in 16 obese men with OSAS and 13 obese men controls. Nine men with severe apnea were reevaluated 3 mo after nCPAP therapy. Body mass index and blood pressure of OSAS patients and obese controls were similar. In OSAS patients, the percentage of fall in systolic blood pressure at night (P = 0.027) and salivary cortisol suppression postdexamethasone (P = 0.038) were lower, whereas heart rate (P = 0.022) was higher compared with obese controls. After nCPAP therapy, patients showed a reduction in heart rate (P = 0.036) and a greater cortisol suppression after dexamethasone (P = 0.001). No difference in arterial blood pressure (P = 0.183) was observed after 3 mo of nCPAP therapy. Improvement in cortisol suppression was positively correlated with an improvement in apnea-hypopnea index during nCPAP therapy (r = 0.799, P = 0.010). In conclusion, men with OSAS present increased postdexamethasone cortisol levels and heart rate, which were recovered by nCPAP.

  17. Aspectos genéticos da SAOS Genetic aspects of obstructive sleep apnea syndrome

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    Adriane C. Mesquita Petruco

    2010-06-01

    Full Text Available A fisiopatologia da SAOS é resultante da interação entre fatores genéticos e ambientais. Os mais importantes fatores de risco são obesidade e idade. Outros fatores relevantes são anormalidades craniofaciais, hipotireoidismo, menopausa e uso de álcool e de sedativos. A hereditariedade tem sido relacionada a SAOS pela a associação de SAOS a níveis de HLA, obesidade, síndromes genéticas, etnias, sonolência excessiva, alteração do controle ventilatório, expressão de mediadores inflamatórios, entre outros. Este capítulo aborda a variabilidade genética e fenotípica da doença, demonstrando sua relevância no entendimento da fisiopatologia e na avaliação clínica de SAOS.The physiopathology of obstructive sleep apnea syndrome (OSAS results from the interaction between genetic and environmental factors. The principal risk factors are obesity and age. Other relevant risk factors are craniofacial abnormalities, hypothyroidism and menopause, as well as the use of alcohol and sedatives. By virtue of its association with factors such as HLA levels, obesity, genetic syndromes, ethnicity, excessive sleepiness, alterations in ventilatory control and expression of inflammatory mediators, OSAS has been related to heritability. This chapter addresses the genetic and phenotypic variability of the disease, showing its relevance in the understanding of the physiopathology and clinical evaluation of OSAS.

  18. Obstructive sleep apnea syndrome accompanied by diabetes mellitus.

    Science.gov (United States)

    Nagai, Takashi; Imamura, Makoto; Iwasaki, Yasuki; Mori, Masatomo

    2003-01-01

    A 66-year-old man with diabetes mellitus was hospitalized with sleeping and dyspnea. Polysomnography determined an apnea hypopneas index (AHI) of 56/hr and that the events occurred in association with continued diaphragm electromyogram activity and thoraco-abdominal wall movement. Obstructive sleep apnea syndrome was then diagnosed and nasal continuous positive airway pressure (nCPAP) (11cmH2O) was set. AHI subsequently became 21/hr. Six months' later, uvulopalatopharyngoplasty (UPPP) for the narrowing middle pharynx was performed and the AHI became 7/hr. After starting nCPAP and UPPP, body weight and insulin resistance had decreased. Treatment for sleep apnea may improve insulin resistance in diabetes mellitus.

  19. The Influence of a Mandibular Advancement Plate on Polysomnography in Different Grades of Obstructive Sleep Apnea

    Directory of Open Access Journals (Sweden)

    Antti Raunio

    2015-03-01

    Full Text Available Objectives: The purpose of this study was to investigate the effect of a mandibular advancement device on different grades of obstructive sleep apnea using a relatively simple test for the apnea-hypopnea index to determine if a mandibular device will be effective. Material and Methods: A total of 68 patients with obstructive sleep apnea syndrome (OSAS including, 31 with mild, 23 with moderate and 14 with severe OSAS were treated with a mandibular advancement device (MAD and monitored with polysomnography. Results: 25 of the 31 mild, 15 of the 23 moderate and 2 of the 14 severe OSAS patients were cured of their OSAS if a post treatment apnea-hypopnea index of less than 5 is regarded as cured. The odds ratios for success with MAD therapy are 3 for women over men, 14.9 for mild obstructive sleep apnea, 5.42 for moderate obstructive sleep apnea if severe obstructive sleep apnea is assigned an odds ratio of 1. Conclusions: The use of the apnea-hypopnea index alone is useful in mild and moderate disease to predict the effectiveness of mandibular advancement device. Treatment with a mandibular advancement device is very effective in treating mild and moderate obstructive sleep apnea. Conservative treatment with a mandibular advancement device can be successful in less severe grades of sleep apnea and may be an alternative for non-surgical patients with severe obstructive sleep apnea intolerant of Continuous Positive Airway Pressure management.

  20. The role of drug-induced sleep endoscopy in surgical planning for obstructive sleep apnea syndrome.

    Science.gov (United States)

    Aktas, Ozturk; Erdur, Omer; Cirik, Ahmet Adnan; Kayhan, Fatma Tulin

    2015-08-01

    This study investigated the role of drug-induced sleep endoscopy (DISE) in the surgical treatment planning of patients with obstructive sleep apnea syndrome (OSAS). This study was conducted using patients diagnosed with OSAS between January 2007 and March 2009, who were scheduled for surgical treatment. DISE was performed using propofol in patients considered to have upper respiratory tract obstruction as indicated by Muller's maneuver. After completing the sleep endoscopy, the patient was intubated and surgery was performed (tonsillectomy and uvulopalatopharyngoplasty). A successful operation was defined as a decrease in the respiratory disturbance index to below 5 or a decrease of ≥50 % following the operation. The study included 20 patients (4 female and 16 male) aged 19-57 years. No statistically significant correlation between modified Mallampati class and operation success or between the polysomnographic stage of disease and operation success was identified. A significantly high operation success rate was found in the group with obstruction of the upper airway according to DISE (p DISE (p DISE may be used to identify the localization of obstruction for diagnostic purposes, and it can be helpful in selecting the treatment method.

  1. Bilateral and Simultaneous Central Retinal Vein Occlusion in a Patient with Obstructive Sleep Apnea Syndrome

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    Andrea Govetto

    2014-05-01

    Full Text Available Purpose: To describe a case of bilateral and simultaneous central retinal vein occlusion (RVO in a young patient diagnosed with obstructive sleep apnea syndrome (OSAS. Case Report: A 38-year-old man with morbid obesity and daytime sleepiness presented with a history of bilateral vision loss. His visual acuity (VA was hand movements, and fundus examination (FE revealed bilateral central RVO. General medical examination revealed untreated hypertension and type II respiratory failure. Laboratory tests for thrombophilia showed increased hematocrit (59% and high levels of fibrinogen and C-reactive protein. Other causes of congenital and acquired hypercoagulability were ruled out. Pathologic polysomnography led to the diagnosis of OSAS. The patient was treated with antihypertensive drugs and continuous positive air pressure. In addition, he received intravitreal ranibizumab. At 10 months after presentation, his VA was no light perception in the right eye and hand movements in the left eye. FE revealed bilateral retinal and optic nerve atrophy, and the occurrence of a nonarteritic anterior ischemic neuropathy in the right eye was considered.

  2. A device for the treatment of adult Sleep Apnea Syndrome

    OpenAIRE

    Wichmann, Mark William

    1988-01-01

    An electronically-controlled positive-displacement bellows-type air pump has been developed in the Bio-medical Engineering Laboratory for the treatment of adult Sleep Apnea Syndrome (SAS). An electronically-controlled positive-displacement pump has been employed in order to eliminate the pressure regulator and accompanying noise of present therapeutic devices. The positive-displacement pump is found to quietly and effectively provide the required airway pressures for the tre...

  3. Obstructive sleep apnea in chronic obstructive pulmonary disease patients.

    LENUS (Irish Health Repository)

    Lee, Ruth

    2011-03-01

    Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) represent two of the most prevalent chronic respiratory disorders and cardiovascular diseases are major co-morbidities in both. Co-existence of both disorders (overlap syndrome) occurs in 1% of adults and overlap patients have worse nocturnal hypoxemia and hypercapnia than COPD and OSA patients alone. The present review discusses recent data concerning the pathophysiological and clinical significance of the overlap syndrome.

  4. Association between obstructive sleep apnea and health-related quality of life in individuals affected with Treacher Collins syndrome.

    Science.gov (United States)

    Østertun Geirdal, Amy; Øverland, Britt; Heimdal, Ketil; Storhaug, Kari; Asten, Pamela; Akre, Harriet

    2013-11-01

    Although the relationship between Quality of Life (QoL) and obstructive sleep apnea (OSA) has been reported in several studies, little is known about this relationship among individuals affected with Treacher Collins syndrome (TCS). The aim of this study was to examine the associations between obstructive sleep and QoL in TCS patients. Thirty-six individuals with TCS (8-75 years) were invited to participate in expanded medical examinations, including a sleep study, polysomnography, as well as to respond to questionnaires about health related Health-related quality of life (HRQoL). Twenty-three (64 %) responded to the invitation, but four were later excluded due to additional diagnoses or unconfirmed TCS, and four were below 12 years and excluded due to different scoring rules for sleep and respiratory disturbances in young children and adults. The remaining group comprised 15 adults and adolescents with TCS, 5 male (33 %) and 10 female (66 %). The participants were between 12 and 75 years of age (mean 38.6, SD 18.5). Obstructive sleep was found in 87 % of the patients and several sleep apnea parameters, among these wake time after sleep, subjective snoring and mean saturation, were associated with poorer HRQoL. OSA appears to account for reduced HRQoL in adolescents and adults with TCS.

  5. Síndrome de apnea del sueño (SAS Sleep apnea syndrome

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    Camilo José Borrego Abello

    1994-03-01

    Full Text Available Se describe el síndrome de apnea del sueño (SAS abarcando los aspectos históricos, signos y síntomas, las diversas modalidades (apneas obstructiva, central y mixta, complicaciones, principalmente cardiovasculares y cerebrovasculares y formas de tratamiento. Se hace énfasis en la ayuda diagnóstica del polisomnograma que ha permitido definir como SAS síntomas antes considerados inespecíficos y cuantificar su gravedad. Se describen las diversas medidas terapéuticas, locales y generales, recalcando los beneficios que se obtienen con la aplicación de los aparatos de respiración a presión positiva. Estos permiten tratamientos no invasivos que hacen desaparecer la totalidad de los síntomas y evitan los riesgos incrementados de trastornos cardiovasculares y accidentes laborales o de tránsito. Este grave síndrome afecta a un grupo grande de población por lo que su importancia es indudable.

    Different aspects of the sleep apnea síndrome (SAS are described, including history, clinical manifestations, clinical forms (obstructive, central and mixed, cardiovascular, cerebrovascular and other complications and treatment. With the use of the polysomnogram it has been possible to define non-specific symptoms as due to SAS and to quantitate their seriousness. Different therapeutic approaches are described, both local and systemic, with emphasis on the benefits obtained from the use of positive pressure breathing machines which control every manifestation of the syndrome and avoid the increased cardiovascular risks aswell as work and traffic accidents. This syndrome is important in terms of frequency and of increased death risk.

  6. Genetics of obstructive sleep apnea/hypopnea syndrome

    Institute of Scientific and Technical Information of China (English)

    Zhang Dongmei; Xiao Yi; Luo Jinmei

    2014-01-01

    Objective To have a better understanding of genetic contributions to the development of obstructive sleep apnea hypopnea syndrome (OSAHS) by reviewing studies on its genetic basis.Data sources A comprehensive search of the PubMed literature without restriction on the publication date was carried out using terms "obstructive sleep apnea" and "candidate genes" or "genetics".Study selection Articles were selected if they were an original research paper or meta analysis of the genetic factors of OSAHS.Results Four intermediate phenotypes were described and several candidate genes that may determine the expression and severity of OSAHS were reviewed.Conclusion Multiple gene-gene interactions occurring in genes that affect obesity,craniofacial structure,ventilator control and asleep-awake pattern may influence the expression of OSAHS in a suitable environment.

  7. Acoustic-integrated dynamic MR imaging for a patient with obstructive sleep apnea.

    Science.gov (United States)

    Chen, Yunn-Jy; Shih, Tiffany Ting-Fang; Chang, Yi-Chung; Hsu, Ying-Chieh; Huon, Leh-Kiong; Lo, Men-Tzung; Pham, Van-Truong; Lin, Chen; Wang, Pa-Chun

    2015-12-01

    Obstructive sleep apnea syndrome (OSAS) is caused by multi-level upper airway obstruction. Anatomic changes at the sites of obstruction may modify the physical or acoustic properties of snores. The surgical success of OSA depends upon precise localization of obstructed levels. We present a case of OSAS who received simultaneous dynamic MRI and snore acoustic recordings. The synchronized image and acoustic information successfully characterize the sites of temporal obstruction during sleep-disordered breathing events.

  8. Correlation between the oropharyngo-laryngoscopic findings and the severity of obstructive sleep apnea

    OpenAIRE

    Priscila Sequeira Dias; Maria Helena Araujo-Melo; Denise Duprat Neves; Lucas Neves de Andrade Lemes; Manuela Salvador Mosciaro; Sandro Bedoya

    2015-01-01

    Objective: To correlate anatomical and functional changes of the oral cavity, pharynx and larynx to the severity of obstructive sleep apnea syndrome (OSAS). Methods : We conducted a cross-sectional study of 66 patients of both genders, aged between 21 and 59 years old with complaints of snoring and / or apnea. All underwent full clinical evaluation, including physical examination, nasolarybgoscopy and polisonography. We classified individuals into groups by the value of the apnea-hypopnea i...

  9. Childhood Obesity and Obstructive Sleep Apnea

    Directory of Open Access Journals (Sweden)

    Indra Narang

    2012-01-01

    Full Text Available The global epidemic of childhood and adolescent obesity and its immediate as well as long-term consequences for obese individuals and society as a whole cannot be overemphasized. Obesity in childhood and adolescence is associated with an increased risk of adult obesity and clinically significant consequences affecting the cardiovascular and metabolic systems. Importantly, obesity is additionally complicated by obstructive sleep apnea (OSA, occurring in up to 60% of obese children. OSA, which is diagnosed using the gold standard polysomnogram (PSG, is characterised by snoring, recurrent partial (hypopneas or complete (apneas obstruction of the upper airway. OSA is frequently associated with intermittent oxyhemoglobin desaturations, sleep disruption, and sleep fragmentation. There is emerging data that OSA is associated with cardiovascular burden including systemic hypertension, changes in ventricular structure and function, arterial stiffness, and metabolic syndromes. Thus, OSA in the context of obesity may independently or synergistically magnify the underlying cardiovascular and metabolic burden. This is of importance as early recognition and treatment of OSA in obese children are likely to result in the reduction of cardiometabolic burden in obese children. This paper summarizes the current state of understanding of obesity-related OSA. Specifically, this paper will discuss epidemiology, pathophysiology, cardiometabolic burden, and management of obese children and adolescents with OSA.

  10. Study on relationship between obstructive sleep apnea syndrome and obesity,neck circumsfence,neck length%阻塞性睡眠呼吸暂停综合征与肥胖、颈围、颈长的相关性研究

    Institute of Scientific and Technical Information of China (English)

    梁大华; 刘建红; 蔡保芳

    2002-01-01

    Objective Study on relationship between obstructive sleep apnea syndrome(OSAS)and obesity,neck circumsfence(NC),neck length(NL).Methods 89 patients with OSAS were divided into mild group and moderate severe group by apnea hyponea index(AHI).32 non apneic healthy volunteer served as controls.Analysis of correlation and regression were used among AHI and height,weight,body mass index(BMI),NC,NL,NC/NL.Results The weight,BMI,NC,NC/NL in apneic patients were significantly higher than that in the controls.The AHI significant positive correlated with weight,BMI,NC and NC/NL in all patients,and had significant negative correlated with nadir oxygen saturation in sleep .Conclusions The patients with OSAS are more obese and have thicker and shorter necks,it suggests that weight,neck circumference and neck length play an important role in the pathogenic factor of patients with OSAS.

  11. Implications of Renal Denervation Therapy in Patients with Sleep Apnea

    Directory of Open Access Journals (Sweden)

    Fernando Jaén-Águila

    2015-01-01

    Full Text Available Obstructive sleep apnea (OSA syndrome is a prevalent condition characterized by repeated episodes of obstruction of the upper airway, leading to intermittent hypoxemia and important endothelial and anatomical dysfunctions that cause cardiovascular and cerebrovascular disease. The finding of the relationship between OSA and hypertension, especially resistant hypertension (RHT, has increased the interest in therapeutic strategies that affect renal sympathetic activity in these patients. The observational studies published until now demonstrated that renal denervation therapy can reduce the severity of OSA syndrome. Renal sympathetic denervation (RDN could be a future therapeutic possibility for conditions other than RHT, such as atrial fibrillation, heart failure, obesity, and OSA syndrome, where renal sympathetic system plays an important physiological role. The aim of this review was to elucidate the implications of renal sympathetic activity in OSA syndrome.

  12. Obstructive sleep apnea syndrome, continuous positive airway pressure and treatment of hypertension.

    Science.gov (United States)

    Floras, John S

    2015-09-15

    Obstructive sleep apnea (OSA), present in ~15% of the general population, increases the risks of stroke, heart failure, and premature death. Importantly, individuals with cardiovascular disease have a higher prevalence yet they often have few symptoms to alert clinicians to its presence. OSA with an apnea-hypopnea index (AHI) ≥15 events/hour is present in ≥30% of patients with primary hypertension and in up to 80% of those with drug resistant hypertension, suggesting that the neural, hormonal, inflammatory and vascular cascades triggered by OSA may elevate blood pressure chronically. The purpose of this review is to summarize: (1) the epidemiology of OSA and its relation to cardiovascular risk; (2) potential mechanisms by which OSA could promote conditions known to increase the risk of hypertension or contribute to its development and progression; (3) evidence for and against a pro-hypertensive effect of OSA; and, (4) the impact of treatment with continuous positive airway pressure (CPAP) on blood pressure and blood pressure-related morbidities. The prevailing view that the effect of treatment on blood pressure is modest arises from the inability of most contemporary technology to measure accurately the true impact of CPAP on OSA-entrained surges in nocturnal blood pressure. Moreover the exclusive focus on blood pressure, as if this is the principal determinant of cardiovascular event rates in this population, is naïve. The capacity to reduce cardiovascular risk by treating OSA with CPAP likely transcends a simple blood pressure effect; formal testing of this hypothesis will require adequately powered randomized clinical trials.

  13. Effects of plasma ghrelin, obestatin, and ghrelin/obestatin ratio on blood pressure circadian rhythms in patients with obstructive sleep apnea syndrome

    Institute of Scientific and Technical Information of China (English)

    Liu Weiying; Yue Hongmei; Zhang Jiabin; Pu Jiayuan; Yu Qin

    2014-01-01

    Background Obstructive sleep apnea syndrome (OSAS) is strongly associated with obesity and with cardiovascular disease.Ghrelin and obestatin are two peptides from the same source but have opposite roles.Both of them can affect feeding and regulate vascular tune.The aim of this study was to investigate the relationship between plasma ghrelin,obestatin,the ratio of ghrelin and obestatin (G/O) and sleep parameters and blood pressure circadian rhythms in patients with OSAS.Methods This study enrolled 95 newly diagnosed over-weight OSAS patients (OSAS group),30 body mass index (BMI)-match non-OSAS adults (over-weight group) and 30 non-OSAS normal weight adults (control group).Polysomnography (PSG) was performed in the OSAS group and over-weight group.Blood pressure of all subjects was monitored by means of 24-hour ambulatory blood pressure monitoring.The concentration of plasma ghrelin and obestatin was detected by enzyme-linked immunosorbent assay (ELISA).Results Plasma ghrelin levels in the OSAS group and over-weight group were significantly lower than that of the control group (P <0.05).Plasma obestatin levels were lower in the over-weight group and OSAS group,but there was no significant difference among the three groups.The blood pressure in OSAS patients was higher,and there was a significant difference in all blood pressure parameters compared to the control group,and in the daytime average diastolic blood pressure (DBP),nocturnal average systolic blood pressure (SBP) and DBP,DBP variability values as compared to over-weight subjects.Furthermore,there were significantly more non-dipper patterns of blood pressure (including hypertension and normotension) in the OSAS group than in the other two groups (P <0.01).Correlation analysis showed that ghrelin levels had a significant correlation with BMI and nocturnal average DBP but not with PSG parameters.In contrast,the G/O ratio had a negative correlation with apnea-hypopnea index (AHI) (P <0.05),as well as a

  14. Measurement of the square measure of the pharynx and the positional diagnosis of airway obstruction during obstructive sleep apnea syndrome by dynamic MRI

    Energy Technology Data Exchange (ETDEWEB)

    Ozuki, Taizo; Ohkubo, Yasuo; Abe, Kimihiko [Tokyo Medical Coll. (Japan)

    2000-11-01

    The purpose of this study was to apply dynamic MRI for the positional diagnosis of airway obstruction during snoring and sleep apnea and to compare the apnea hypopnea index (AHI) and the square measure of the pharynx obtained before and after laser-assisted uvula-palate-pharyngoplasty (LAUP). From December 1997 to October 1998, dynamic MRI and overnight monitoring were performed at the hospital of Tokyo Medical University on 42 patients who complained of snoring and symptoms related to sleep apnea syndrome (SAS). Of the 42 patients, four exhibited collapse at the position of the soft palate (soft palate type) as diagnosed by dynamic MRI, and four exhibited collapse at the position of the soft palate as well as the tongue (complex type). LAUP was performed on these eight patients with obstructive SAS (OSAS). After LAUP, the AHI of these eight patients with OSAS decreased significantly (p<0.05). The square measure of the pharynx of these eight patients was increased (p<0.01). The AHI of all four patients with soft-palate obstruction decreased, and the square measure of the pharynx of three of these four patients increased. The AHI of three of four patients with the complex type decreased, while the square measure of the pharynx of two of these four patients increased. (author)

  15. Positive airway pressure improves nocturnal beat-to-beat blood pressure surges in obesity hypoventilation syndrome with obstructive sleep apnea.

    Science.gov (United States)

    Carter, Jason R; Fonkoue, Ida T; Grimaldi, Daniela; Emami, Leila; Gozal, David; Sullivan, Colin E; Mokhlesi, Babak

    2016-04-01

    Positive airway pressure (PAP) treatment has been shown to have a modest effect on ambulatory blood pressure (BP) in patients with obstructive sleep apnea (OSA). However, there is a paucity of data on the effect of PAP therapy on rapid, yet significant, BP swings during sleep, particularly in obesity hypoventilation syndrome (OHS). The present study hypothesizes that PAP therapy will improve nocturnal BP on the first treatment night (titration PAP) in OHS patients with underlying OSA, and that these improvements will become more significant with 6 wk of PAP therapy. Seventeen adults (7 men, 10 women; age 50.4 ± 10.7 years, BMI 49.3 ± 2.4 kg/m(2)) with OHS and clinically diagnosed OSA participated in three overnight laboratory visits that included polysomnography and beat-to-beat BP monitoring via finger plethysmography. Six weeks of PAP therapy, but not titration PAP, lowered mean nocturnal BP. In contrast, when nocturnal beat-to-beat BPs were aggregated into bins consisting of at least three consecutive cardiac cycles with a >10 mmHg BP surge (i.e., Δ10-20, Δ20-30, Δ30-40, and Δ>40 mmHg), titration, and 6-wk PAP reduced the number of BP surges per hour (time × bin, P < 0.05). PAP adherence over the 6-wk period was significantly correlated to reductions in nocturnal systolic (r = 0.713, P = 0.001) and diastolic (r = 0.497, P = 0.043) BP surges. Despite these PAP-induced improvements in nocturnal beat-to-beat BP surges, 6 wk of PAP therapy did not alter daytime BP. In conclusion, PAP treatment reduces nocturnal beat-to-beat BP surges in OHS patients with underlying OSA, and this improvement in nocturnal BP regulation was greater in patients with higher PAP adherence.

  16. Obstructive sleep apnea is associated with increased arterial stiffness in severe obesity.

    Science.gov (United States)

    Seetho, Ian W; Parker, Robert J; Craig, Sonya; Duffy, Nick; Hardy, Kevin J; Wilding, John P H

    2014-12-01

    Obstructive sleep apnea is associated with obesity and metabolic syndrome, leading to greater cardiovascular risk. Severely obese patients with obstructive sleep apnea may still be at risk of adverse health outcomes, even without previous cardiovascular disease. Pulse wave analysis non-invasively measures peripheral pulse waveforms and derives measures of haemodynamic status, including arterial stiffness, augmentation pressure and subendocardial viability ratio. We hypothesized that the presence of obstructive sleep apnea in severe obesity, even in the absence of an antecedent history of cardiovascular disease, would affect measurements derived from pulse wave analysis. Seventy-two severely obese adult subjects [obstructive sleep apnea 47 (body mass index 42 ± 7 kg m(-2) ), without obstructive sleep apnea (non-OSA) 25 (body mass index 40 ± 5 kg m(-2) )] were characterised using anthropometric, respiratory and cardio-metabolic parameters. Groups were similar in age, body mass index and gender. More subjects with obstructive sleep apnea had metabolic syndrome [obstructive sleep apnea 60%, without obstructive sleep apnea (non-OSA) 12%]. Those with obstructive sleep apnea had greater arterial stiffness, augmentation pressure and decreased subendocardial viability ratio (all P cardiovascular risk independently of metabolic abnormalities. The presence of obstructive sleep apnea in severe obesity identifies a group at high cardiovascular risk; clinicians should ensure that risk factors are managed appropriately in this group whether or not treatment of obstructive sleep apnea is offered or accepted by patients.

  17. Asthma and Obstructive Sleep Apnea

    Institute of Scientific and Technical Information of China (English)

    Yi-Xian Qiao; Yi Xiao

    2015-01-01

    Objective:To get a comprehensive understanding about the relationship between obstructive sleep apnea (OSA) and asthma by reviewing the epidemiology,pathophysiology,and clinical manifestation and then summarizing the latest progress on diagnosis and treatment.Data Sources:Articles referred in this review were mainly collected from a comprehensive search of the PubMed published in English from 1990 to 2015 with the terms "OSA" and “asthma'" as the main keywords.Highly regarded older publications were also included.Study Selection:Information about the features of the two diseases in common,the pathophysiologic association between them and their current treatments from the literature search were identified,retrieved,and summarized.Results:Both OSA and asthma are very prevalent conditions.The incidences of them have kept on rising in recent years.Asthma is often accompanied by snoring and apnea,and OSA often combines with asthma,as well.They have many predisposing and aggravating factors in common.Possible shared direct mechanistic links between them include mechanical effects,intermittent hypoxia,nerve reflex,inflammation,leptin,etc.Indirect mechanistic links include medication,nose diseases,smoking,obesity,and gastroesophageal reflux disease.Since OSA presents many similar features with nocturnal asthma,some scholars termed them as a sole syndrome "alternative overlap syndrome,"and proved that asthma symptoms in those patients could be improved through the treatment of continuous positive airway pressure.Conclusions:OSA and asthma are closely associated in pathogenesis,symptoms,and therapies.With the growing awareness of the relationship between them,we should raise our vigilance on the coexistence of OSA in those difficult-to-control asthmatic patients.Further studies are still needed to guide the clinical works.

  18. Chiari malformation and central sleep apnea syndrome: efficacy of treatment with adaptive servo-ventilation

    Directory of Open Access Journals (Sweden)

    Jorge Marques do Vale

    2014-10-01

    Full Text Available The Chiari malformation type I (CM-I has been associated with sleep-disordered breathing, especially central sleep apnea syndrome. We report the case of a 44-year-old female with CM-I who was referred to our sleep laboratory for suspected sleep apnea. The patient had undergone decompressive surgery 3 years prior. An arterial blood gas analysis showed hypercapnia. Polysomnography showed a respiratory disturbance index of 108 events/h, and all were central apnea events. Treatment with adaptive servo-ventilation was initiated, and central apnea was resolved. This report demonstrates the efficacy of servo-ventilation in the treatment of central sleep apnea syndrome associated with alveolar hypoventilation in a CM-I patient with a history of decompressive surgery.

  19. Effect of continuous positive airway pressure treatment on serum angiotensin converting enzyme levels in patients with obesity-associated obstructive sleep apnea syndrome%持续气道正压通气对阻塞性睡眠呼吸暂停综合征患者血清血管紧张素转换酶水平的影响

    Institute of Scientific and Technical Information of China (English)

    沈文富; 李红苗; 王强; 王骏; 蒋冬兰; 严锡祥

    2012-01-01

    目的:探讨持续气道正压通气(continuous positive air-way pressure,CPAP)对阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS)患者血清中血管紧张素转换酶(angiotensin converting enzyme,ACE)水平的影响.方法:根据睡眠期多导睡眠监测中的呼吸暂停低通气指数(apnea hypopnea index,AHI) 检查结果,选择43例符合OSAS诊断标准的患者作为研究对象(OSAS组),测定OSAS组实施CPAP治疗1个月前后ACE水平,与AHI正常者(正常组)比较,并分析OSAS组中ACE与睡眠呼吸紊乱指数的相关性.结果:OSAS组治疗前ACE浓度(23.35±15.62) U/L显著低于正常组(38.95±21.83) U/L (P0.05),相关性分析显示OSAS组中ACE浓度与AHI无明显相关性(r=-0.018,P>0.05).结论:OSAS患者血清中ACE水平与睡眠呼吸紊乱指数无明显相关性,与正常人相比,OSAS患者血清ACE显著降低,CPAP治疗不能影响ACE水平变化.%Objective: To investigate the influence of continuous positive airway pressure( CPAP )treatment on the serum angiotensin converting enzyme levels in patients with obstructive sleep apnea syndrome ( OSAS ). Methods: Based on apnea hypopnea index( AHI ) measured by polysomnography, 43 patients were diagnosed as OSAS( OSAS group ) and enrolled in this study. The serum ACE levels of OSAS group were measured and compared with the subjects without OSAS( normal groups ). In patients with OSAS, the relationship between levels of ACE and AHI were analyzed. Results: Compared with normal group[ ( 38. 95 ±21.83 ) U/L], serum ACE levels in OSAS group[ ( 23.35 ±15.62 ) U/L,P 0. 05 ). No relationship was observed in OSAS group between the ACE levels and AHI levels. Conclusion: The serum ACE levels in OSAS group was significantly higher than in normal group. The CPAP treatment cannot change the ACE level in OSAS patients. The serum ACE levels were not correlated with the AHI levels in OSAS patients.

  20. Clinical manifestations of sleep apnea

    OpenAIRE

    Stansbury, Robert C.; Strollo, Patrick J.

    2015-01-01

    Obstructive sleep apnea (OSA) may manifest in a number of ways from subtle intrusion into daily life to profound sleepiness, snoring, witnessed apneas and other classic symptoms. Although there is increasing evidence suggesting OSA can adversely affect health in a variety of ways, this disorder remains underdiagnosed. The most well-escribed health consequences of OSA relate to the cardiovascular system. Hypertension and arrhythmias have a strong association with OSA, and evidence suggests tha...

  1. Investigation of acetone, butanol and carbon dioxide as new breath biomarkers for convenient and noninvasive diagnosis of obstructive sleep apnea syndrome.

    Science.gov (United States)

    Bayrakli, Ismail; Öztürk, Önder; Akman, Hatice

    2016-12-01

    The objective of the present study was to investigate whether analysis of carbon dioxide, acetone and/or butanol present in human breath can be used as a simple and noninvasive diagnosis method for obstructive sleep apnea syndrome (OSAS). For this purpose, overnight changes in the concentrations of these breath molecules were measured before and after sleep in 10 patients who underwent polysomnography and were diagnosed with OSAS, and were compared with the levels of these biomarkers determined after sleep in 10 healthy subjects. The concentrations of exhaled carbon dioxide were measured using external cavity laser-based off-axis cavity enhanced absorption spectroscopy, whereas the levels of exhaled acetone and butanol were determined using thermal desorption gas chromatography mass spectrometry. We observed no significant changes in the levels of exhaled acetone and carbon dioxide in OSAS patients after sleep compared with pre-sleep values and compared with those in healthy control subjects. However, for the first time, to our knowledge, analyses of expired air showed an increased concentration of butanol after sleep compared with that before sleep and compared with that in healthy subjects. These results suggest that butanol can be established as a potential biomarker to enable the convenient and noninvasive diagnosis of OSAS in the future.

  2. Zolpidem Induced Sleep-related Eating and Complex Behaviors in a Patient with Obstructive Sleep Apnea and Restless Legs Syndrome

    Science.gov (United States)

    Park, Young-Min; Shin, Hyun-Woo

    2016-01-01

    Zolpidem-induced sleep-related complex behaviors (SRCB) with anterograde amnesia have been reported. We describe herein a case in which the development of zolpidem-induced sleep-related eating disorder (SRED) and SRCB was strongly suspected. A 71-year-old Korean male was admitted to the Department of Psychiatry due to his repetitive SRED and SRCB with anterograde amnesia, which he reported as having occurred since taking zolpidem. The patient also had restless legs syndrome (RLS) and obstructive sleep apnea (OSA). His baseline serum iron level was low at admission. Zolpidem discontinuation resulted in the immediate disappearance of his SRED, but did not affect his RLS symptoms. These symptoms rapidly improved after adding a single i.v. iron injection once daily, and so he was discharged to day-clinic treatment. These findings indicate that zolpidem can induce SRCB. Although the pathophysiology of zolpidem-induced SRED and other SRCB remains unclear, clinicians should carefully monitor for the potential induction of complex behaviors associated with zolpidem in patients with comorbid RLS or OSA. PMID:27489385

  3. Zolpidem Induced Sleep-related Eating and Complex Behaviors in a Patient with Obstructive Sleep Apnea and Restless Legs Syndrome.

    Science.gov (United States)

    Park, Young-Min; Shin, Hyun-Woo

    2016-08-31

    Zolpidem-induced sleep-related complex behaviors (SRCB) with anterograde amnesia have been reported. We describe herein a case in which the development of zolpidem-induced sleep-related eating disorder (SRED) and SRCB was strongly suspected. A 71-year-old Korean male was admitted to the Department of Psychiatry due to his repetitive SRED and SRCB with anterograde amnesia, which he reported as having occurred since taking zolpidem. The patient also had restless legs syndrome (RLS) and obstructive sleep apnea (OSA). His baseline serum iron level was low at admission. Zolpidem discontinuation resulted in the immediate disappearance of his SRED, but did not affect his RLS symptoms. These symptoms rapidly improved after adding a single i.v. iron injection once daily, and so he was discharged to day-clinic treatment. These findings indicate that zolpidem can induce SRCB. Although the pathophysiology of zolpidem-induced SRED and other SRCB remains unclear, clinicians should carefully monitor for the potential induction of complex behaviors associated with zolpidem in patients with comorbid RLS or OSA.

  4. Pediatric sleep apnea

    Science.gov (United States)

    Sleep apnea - pediatric; Apnea - pediatric sleep apnea syndrome; Sleep-disordered breathing - pediatric ... During sleep, all of the muscles in the body become more relaxed. This includes the muscles that help keep ...

  5. Comprehensive evaluation of functional and anatomical disorders of the patients with distal occlusion and accompanying obstructive sleep apnea syndrome

    Science.gov (United States)

    Nabiev, F. H.; Dobrodeev, A. S.; Libin, P. V.; Kotov, I. I.; Ovsyannikov, A. G.

    2015-11-01

    The paper defines the therapeutic and rehabilitation approach to the patients with Angle's classification Class II dento-facial anomalies, accompanied by obstructive sleep apnea (OSA). The proposed comprehensive approach to the diagnostics and treatment of patients with posterior occlusion, accompanied by OSA, allows for objective evaluation of intensity of a dento-facial anomaly and accompanying respiratory disorders in the nasal and oral pharynx, which allows for the pathophysiological mechanisms of OSA to be identified, and an optimal plan for surgical procedures to be developed. The proposed comprehensive approach to the diagnostics and treatment of patients with Angle's classification Class II dento-facial anomalies provides high functional and aesthetic results.

  6. Obstructive sleep apnea syndrome as an accident risk factor in professional drivers in Yekaterinburg. Dangerous Sleep (DS-1 study

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    A. A. Belkin

    2015-01-01

    Full Text Available About 20% of all road traffic accidents may be associated with falling asleep while driving. This may be caused by sleep disorders leading to daytime sleepiness, the most common of which is obstructive sleep apnea syndrome (OSAS. Objective: to study somatic and mental health, sleep disorders, OSAS in particular, in the population of Russian drivers (Sverdlovsk Region. Patients and methods. The descriptive cohort «Dangerous Sleep» (DS-1 study of 20 professional drivers having more than 5-year driving experience was conducted at the Clinical Institute of the Brain. The mean age of the drivers was 45.8 years. They underwent somatic evaluation for cardiovascular risk factors and a psychological examination involving a risk readiness diagnostic procedure, the Zung Self-Rating Depression Scale, the Beck Depression Inventory, and an electroencephalographic examination. A somnological examination assumed testing using the Epworth sleepiness scale, polysomnography, or overnight pulse metry. Results and discussion. 30% of the drivers were found to have marked attention disorders and an inability to adapt to extreme conditions, which create a risk for professional duties. The predisposing factors were noted to be alcohol addiction, overweight, and OSAS, the rate of the latter proved to be higher than that in the general population of able-bodied men. It was shown that a somnological examination should be obligatorily performed while hiring professional drivers, particularly to long hauliers. The drivers having a long length of experience, in whom a periodic examination detects sleep disorders, should be treated for somatic diseases and should also have individual working schedules to rule out their long night-time driving. 

  7. [Could mouth breathing lead to obstructive sleep apnea syndromes. A preliminary study].

    Science.gov (United States)

    Raskin, S; Limme, M; Poirrier, R

    2000-01-01

    The aim of this preliminary work is to determine an easy method to diagnose "buccal breather" children and "nasal breather" children. Then, to establish a possible connection with the syndrome of obstructive sleep apnea. 22 children agreed to participate. Clinical, orthophonic, orthodontic, postural and polysomnographical exams have been carried out. The proposed clinical exam turns out to be a good means of diagnosing between buccal breathers and nasal breathers. The aerophonoscope reveals velar inadequacies in buccal breathers. The latter also present osseous discrepancies mainly in the mandible. The polysomnography reveals a higher apnea/hypopnea index and more agitated sleep in buccal breathers. Mandibular lowering movements are more frequent and similar to those of adults suffering from apnea. These elements similar to those encountered in adults suffering from apnea make us think that buccal breathing could be the origin of obstructive sleep apnea, several decades later.

  8. Does cognitive dysfunction conform to a distinctive pattern in obstructive sleep apnea syndrome?

    Science.gov (United States)

    Antonelli Incalzi, Raffaele; Marra, Camillo; Salvigni, Bruna Lorena; Petrone, Albino; Gemma, Antonella; Selvaggio, David; Mormile, Flaminio

    2004-03-01

    Obstructive sleep apnea (OSA) is a recognized cause of cognitive dysfunction. By using a cross-sectional comparative study, we aimed to verify whether neuropsychological performance of untreated OSA patients conforms to a distinctive pattern. Forty-nine newly diagnosed, untreated OSA patients, 27 with multi-infarctual dementia (MID), 31 with mild to moderate dementia of Alzheimer type (DAT) and 63 with severe chronic obstructive pulmonary disease (COPD), all free from major comorbid dementing conditions were chosen for the study. The groups were matched for age and education. We found a bimodal distribution of cognitive performance in OSA group, which was therefore divided into two clusters having better (OSAb, n = 35) and worse (OSAw, n = 14) performance on a battery of 10 cognitive indexes. Cognitive performances of OSAb, OSAw, MID, DAT and COPD were compared by discriminant analysis. OSAb performed better than OSAw in all but one test. Deductive thinking and verbal attainment were more severely impaired in OSAw than in COPD patients. Constructive ability, deductive thinking and both verbal attainment and immediate memory were comparably impaired in OSAw and DAT. The mean neuropsychological scores of OSAw and MID were comparable, but 71% of OSAw patients had a distinctive cognitive profile, i.e. a group specific pattern of cognitive dysfunction, according to discriminant analysis. One of four newly diagnosed OSA patients had a severe and distinctive neuropsychological dysfunction mainly involving inductive and deductive thinking, and constructive ability. Some analogy with cognitive pattern of MID suggests that a mainly subcortical damage underlies this dysfunction.

  9. Observational study on efficacy of negative expiratory pressure test proposed as screening for obstructive sleep apnea syndrome among commercial interstate bus drivers - protocol study

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    Hirata Raquel P

    2011-12-01

    enrollment of this study protocol, the expectation is to encounter predictive NEP values for different degrees of OSA in order to contribute toward an early diagnosis of this condition and reduce its impact and complications among commercial interstate bus drivers. Trial registration Registro Brasileiro de Ensaios Clinicos (local acronym RBEC [Internet]: Rio de Janeiro (RJ: Instituto de Informaçao Cientifica e Tecnologica em Saude (Brazil; 2010 - Identifier RBR-7dq5xx. Cross-sectional study on efficacy of negative expiratory pressure test proposed as screening for obstructive sleep apnea syndrome among commercial interstate bus drivers; 2011 May 31 [7 pages]. Available from http://www.ensaiosclinicos.gov.br/rg/RBR-7dq5xx/.

  10. Obstructive sleep apnea treatment with dental appliance.

    Science.gov (United States)

    Reimão, R; De Gouveia, M M; Pestana, M C; Lopes, S R; Papaiz, E G; Papaiz, L F

    1994-12-01

    The case of a 40-year-old male patient with obstructive sleep apnea syndrome (OSAS) is reported, with emphasis on treatment with a dental appliance. This therapeutic approach, which has been focused on recent research, has as its objective, the posturing of the mandibule and, consequently, the tongue more anteriorly, thus in turn leading to an increase in the posterior oropharyngeal airway space (PAS). Cephalometry contributed determining in this case whereby enlargement limits were observed in the PAS with mandibular displacement. Clinical and polysomnographic controls showed subjective reduction of the excessive daytime sleepiness and objective decrease in apneas intensity to normal limits. Eight months follow-up evidenced the steady improvement.

  11. Glucose metabolism in obstructive sleep apnea syndrome%阻塞性睡眠呼吸暂停综合征患者葡萄糖代谢研究

    Institute of Scientific and Technical Information of China (English)

    刘宇; 汪鲁华; 古丽扎尔·买买提明

    2011-01-01

    Objective To observe glucose metabolism changes in patients with obstructive sleep apnea syndrome. Methods A total of 162 patients were diagnosed with polysomnography, and 50 healthy vonlunteers were as controls. Oral glucose tolerance test, fasting insulin and C-reactive protein were measured to observe the impaired fasting glucose and impaired glucose tolerance. Results The incidences of diabetes mellitus, abnormal glucose tolerance and C-reactive protein were higher in patients with obstructive sleep apnea syndrome than those in controls. Conclusion Glucose metabolism is abnormal in obstructive sleep apnea syndrome, and is properly related to inflammation.%目的:观察阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS)患者葡萄糖代谢情况.方法:用多导睡眠图检查确诊的重度OSAS患者162例(OSAS组),行口服糖耐量试验检查、空腹胰岛素及C反应蛋白测定,观察空腹血糖受损及糖耐量异常.并选择同期健康体检者50例作为对照组.结果:OSAS组糖尿病、糖耐量异常发病率及C反应蛋白水平明显高于对照组.结论:OSAS患者存在明显的糖代谢紊乱,可能与炎症有关.

  12. Pulse Oximetry for the Detection of Obstructive Sleep Apnea Syndrome: Can the Memory Capacity of Oxygen Saturation Influence Their Diagnostic Accuracy?

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    Carlos A. Nigro

    2011-01-01

    Full Text Available Objective. To assess the diagnostic ability of WristOx 3100 using its three different recording settings in patients with suspected obstructive sleep apnea syndrome (OSAS. Methods. All participants (135 performed the oximetry (three oximeters WristOx 3100 and polysomnography (PSG simultaneously in the sleep laboratory. Both recordings were interpreted blindly. Each oximeter was set to one of three different recording settings (memory capabilities 0.25, 0.5, and 1 Hz. The software (nVision 5.1 calculated the adjusted O2 desaturation index-mean number of O2 desaturation per hour of analyzed recording ≥2, 3, and 4% (ADI2, 3, and 4. The ADI2, 3, and 4 cutoff points that better discriminated between subjects with or without OSAS arose from the receiver-operator characteristics (ROCs curve analysis. OSAS was defined as a respiratory disturbance index (RDI ≥ 5. Results. 101 patients were included (77 men, mean age 52, median RDI 22.6, median BMI 27.4 kg/m2. The area under the ROCs curves (AUC-ROCs of ADI2, 3, and 4 with different data storage rates were similar (AUC-ROCs with data storage rates of 0.25/0.5/1 Hz: ADI2: 0.958/0.948/0.965, ADI3: 0.961/0.95/0.966, and ADI4: 0.957/0.949/0.963, P NS. Conclusions. The ability of WristOx 3100 to detect patients with OSAS was not affected by the data storage rate of the oxygen saturation signal. Both memory capacity of 0.25, 0.5, or 1 Hz showed a similar performance for the diagnosis of OSAS.

  13. Obstructive sleep apnea-related symptoms in Japanese people with Down syndrome.

    Science.gov (United States)

    Ono, Junji; Chishaki, Akiko; Ohkusa, Tomoko; Sawatari, Hiroyuki; Nishizaka, Mari; Ando, Shin-ichi

    2015-12-01

    This study evaluated the prevalence of obstructive sleep apnea-related symptoms and assessed the relationship with obesity or unusual sleep postures in Down syndrome patients in Japan. We obtained the demographic characteristics, sleep postures, and obstructive sleep apnea-related symptoms experienced by 90 people as reported by their caregivers. Although 71% reported snoring and 59% arousals, obstructive sleep apnea-related symptoms were not significantly different between obese and non-obese participants. The youngest age group had the fewest obstructive sleep apnea-related symptoms, especially symptoms of snoring. The odds for arousal, nocturia, and apnea tended to be higher in the unusual sleep-postures group. Unusual sleep postures were most frequent in the group 6-15 years of age. People with Down syndrome might sleep in unusual postures to avoid upper airway obstruction caused by other anatomical factors. For nurses and other health professionals working in mainstream service, it is important to screen all persons with Down syndrome for symptoms suggestive of obstructive sleep apnea, particularly those six years of age and older, and to refer them for further evaluation for sleep disorders.

  14. Role of sleep endoscopy in obstructive sleep apnea syndrome

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    Suzan Salama

    2013-07-01

    Conclusion: Sleep endoscopy is a useful tool for the assessment of level, degree and shape of the upper airway obstruction during sleep in OSAS and this could be helpful in preoperative evaluation. Presence of obstruction at hypopharyngeal level or tongue base obstruction is an indicator of OSAS severity.

  15. Ictal central apnea and bradycardia in temporal lobe epilepsy complicated by obstructive sleep apnea syndrome

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    Yoko Nishimura

    2015-01-01

    Full Text Available We describe the case of a 12-year-old boy who developed temporal lobe epilepsy (TLE with daily complex partial seizures (CPS and monthly generalized seizures. Moreover, he frequently snored while asleep since early childhood. Polysomnography (PSG revealed severe obstructive sleep apnea with apnea–hypopnea index (AHI of 37.8/h. Video-PSG with simultaneous electroencephalography (EEG recording captured two ictal apneic episodes during sleep, without any motor manifestations. The onset of rhythmic theta activity in the midtemporal area on EEG was preceded by the onset of apnea by several seconds and disappeared soon after cessation of central apnea. One episode was accompanied by ictal bradycardia of <48 beats/min which persisted for 50 s beyond the end of epileptic activity. After treatment with carbamazepine and tonsillectomy/adenoidectomy, the seizures were well controlled and AHI decreased to 2.5/h. Paroxysmal discharges also disappeared during this time. Uncontrolled TLE complicated by sleep apnea should be evaluated for the presence of ictal central apnea/bradycardia.

  16. Impact of Obstructive Sleep Apnea on the Levels of Placental Growth Factor (PlGF and Their Value for Predicting Short-Term Adverse Outcomes in Patients with Acute Coronary Syndrome.

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    Antonia Barcelo

    Full Text Available Placental growth factor (PlGF induces angiogenesis and promotes tissue repair, and plasma PlGF levels change markedly during acute myocardial infarction (AMI. Currently, the impact of obstructive sleep apnea (OSA in patients with AMI is a subject of debate. Our objective was to evaluate the relationships between PlGF levels and both the severity of acute coronary syndrome (ACS and short-term outcomes after ACS in patients with and without OSA.A total of 538 consecutive patients (312 OSA patients and 226 controls admitted for ACS were included in this study. All patients underwent polygraphy in the first 72 hours after hospital admission. The severity of disease and short-term prognoses were evaluated during the hospitalization period. Plasma PlGF levels were measured using an electrochemiluminescence immunoassay.Patients with OSA were significantly older and more frequently hypertensive and had higher BMIs than those without OSA. After adjusting for age, smoking status, BMI and hypertension, PlGF levels were significantly elevated in patients with OSA compared with patients without OSA (19.9 pg/mL, interquartile range: 16.6-24.5 pg/mL; 18.5 pg/mL, interquartile range: 14.7-22.7 pg/mL; p1, even after adjustment.The results of this study show that in patients with ACS, elevated plasma levels of PlGF are associated with the presence of OSA and with adverse outcomes during short-term follow-up.ClinicalTrials.gov NCT01335087.

  17. Consensus and evidence-based Indian initiative on obstructive sleep apnea guidelines 2014 (first edition

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    Surendra K Sharma

    2015-01-01

    Full Text Available Obstructive sleep apnea (OSA and obstructive sleep apnea syndrome (OSAS are subsets of sleep-disordered breathing. Awareness about OSA and its consequences among the general public as well as the majority of primary care physicians across India is poor. This necessitated the development of the Indian initiative on obstructive sleep apnea (INOSA guidelines under the auspices of Department of Health Research, Ministry of Health and Family Welfare, Government of India. OSA is the occurrence of an average five or more episodes of obstructive respiratory events per hour of sleep with either sleep-related symptoms or co-morbidities or ≥15 such episodes without any sleep-related symptoms or co-morbidities. OSAS is defined as OSA associated with daytime symptoms, most often excessive sleepiness. Patients undergoing routine health check-up with snoring, daytime sleepiness, obesity, hypertension, motor vehicular accidents, and high-risk cases should undergo a comprehensive sleep evaluation. Medical examiners evaluating drivers, air pilots, railway drivers, and heavy machinery workers should be educated about OSA and should comprehensively evaluate applicants for OSA. Those suspected to have OSA on comprehensive sleep evaluation should be referred for a sleep study. Supervised overnight polysomnography is the "gold standard" for evaluation of OSA. Positive airway pressure (PAP therapy is the mainstay of treatment of OSA. Oral appliances (OA are indicated for use in patients with mild to moderate OSA who prefer OA to PAP, or who do not respond to PAP or who fail treatment attempts with PAP or behavioral measures. Surgical treatment is recommended in patients who have failed or are intolerant to PAP therapy.

  18. Effects of Continuous Positive Airway Pressure on Cognitive Deficits in Middle-aged Patients with Obstructive Sleep Apnea Syndrome: A Meta-analysis of Randomized Controlled Trials

    Institute of Scientific and Technical Information of China (English)

    Yue-Ying Pan; Yan Deng; Xiu Xu; Ya-Ping Liu; Hui-Guo Liu

    2015-01-01

    Background:Current views on continuous positive airway pressure (CPAP) treatment to improve the cognitive deficits of patients with obstructive sleep apnea syndrome (OSAS) are controversial,so we performed a meta-analysis.Methods:A comprehensive literature search was tmdertaken in PubMed,CINAHL,Medline,PsycInfo,EMBASE,Cochrane Library,CNKI,WanFang,VIP,and CBMdisc for studies published from June 1971 to July 2014.The outcome measures included neuropsychological tests of the 7 cognitive domains detailed below.Results:After screening the titles and abstracts and thoroughly reading the full text,we obtained 13 studies with little risk of bias that incorporated 1744 middle-aged obese participants with mild to severe OSAS.The studies were published from 1994 to 2012.Treatment durations varied from 1 to 24 weeks.The effect sizes of attention,vigilance,processing speed,working memory,memory,verbal fluency,and visuoconstructive skills domains were-0.10 (P =0.24),-0.12 (P =0.04),-0.08 (P =0.16),0.00 (P =0.95),-0.04 (P =0.30),-0.06 (P =0.34),and-0.01 (P =0.92),respectively.Conclusions:Cognition partially improved in patients with OSAS after CPAP treatment.The only domain with significant improvement was vigilance.Rigorous randomized controlled trials need to be performed to obtain clear results.

  19. Sleep apnea syndrome. Examination of pharyngeal obstruction with high-speed MR and polysomnography

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    Suto, Y. [Dept. of Radiology, Tottori Univ. School of Medicine, Yonago (Japan); Inoue, Y. [Dept. of Neuropsychiatry, Tottori Univ. School of Medicine, Yonago (Japan)

    1995-05-01

    We attempted to determine the usefulness of high-speed MR imaging for evaluating the severity of sleep apnea syndrome (SAS) by comparing findings of pharyngeal obstruction obtained with high-speed MR with those of all-night polysomnography (PSG). A total of 33 patients with SAS underwent turbo-FLASH MR examination, while awake and after i.v. injection of hydroxyzine hydrochloride. Serial images were examined by cinemode. Pharyngeal findings on MR were divided into single-site obstruction (SO) at the velopharynx, multiple-site obstruction (MO), and no obstruction (NO). PSG findings were analyzed to determine the predominant type of apnea, severity as evaluated by an apnea index (AI), and the lowest SaO{sub 2} value during sleep. Seventy-five percent of the central apnea group had SO, and 70% of the mixed apneas had MO, while only 15% of the obstructed apneas had MO. The percentage of patients with severe SAS (AI of 20% or higher) was 48% for the SO, and 70% for the MO. The lowest SaO{sub 2} value tended to be low in the mixed apnea in the case of PSG, and tended to be low in the MO at MR examination. Analysis of pharyngeal dynamics using high-speed MR may provide some useful information for evaluating the severity of SAS. (orig.).

  20. Response to Statin Therapy in Obstructive Sleep Apnea Syndrome: A Multicenter Randomized Controlled Trial

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    Marie Joyeux-Faure

    2014-01-01

    Full Text Available Rationale. Accumulated evidence implicates sympathetic activation as inducing oxidative stress and systemic inflammation, which in turn lead to hypertension, endothelial dysfunction, and atherosclerosis in obstructive sleep apnea (OSA. Statins through their pleiotropic properties may modify inflammation, lipid profile, and cardiovascular outcomes in OSA. Methods. This multicenter, randomized, double-blind study compared the effects of atorvastatin 40 mg/day versus placebo over 12 weeks on endothelial function (the primary endpoint measured by peripheral arterial tone (PAT. Secondary endpoints included office blood pressure (BP, early carotid atherosclerosis, arterial stiffness measured by pulse wave velocity (PWV, and metabolic parameters. Results. 51 severe OSA patients were randomized. Key demographics for the study population were age 54 ± 11 years, 21.6% female, and BMI 28.5 ± 4.5 kg/m2. In intention to treat analysis, mean PAT difference between atorvastatin and placebo groups was 0.008 (−0.29; 0.28, P=0.979. Total and LDL cholesterol significantly improved with atorvastatin. Systolic BP significantly decreased with atorvastatin (mean difference: −6.34 mmHg (−12.68; −0.01, P=0.050 whereas carotid atherosclerosis and PWV were unchanged compared to the placebo group. Conclusion. In OSA patients, 3 months of atorvastatin neither improved endothelial function nor reduced early signs of atherosclerosis although it lowered blood pressure and improved lipid profile. This trial is registered with NCT00669695.

  1. Research advance on the relationship between obstructive sleep apnea syndrome and cardiovascular diseases in the elderly%老年阻塞性睡眠呼吸暂停综合征与心血管疾病的研究进展

    Institute of Scientific and Technical Information of China (English)

    黄颖; 张丙芳; 王晓明; 范风云; 黄晨; 张琦

    2008-01-01

    @@ 0 引言 睡眠呼吸暂停综合征(sleep apnea syndrome, SAS)是指每晚7 h睡眠中出现持续10 s以上的呼吸暂停大于30次或睡眠呼吸暂停/低通气指数(AHI,即平均每小时呼吸暂停次数+低通气次数)≥5,60岁以上老年人AHI≥10.SAS分为三型,即阻塞性(obstructive sleep apnea, OSA)、中枢性(central sleep apnea, CSA)和混合性(mixed sleep apnea, MSA).

  2. The importance of neck circumference to thyromental distance ratio (NC/TM as a predictor of difficult intubation in obstructive sleep apnea (OSA patients

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    Hala Ezzat Abdel Naim

    2014-07-01

    Conclusion: Difficult intubation in OSA obese patients was independently associated with a Mallampati score of III or IV, and NC/TM ⩾5.15. Moreover, NC/TM yielded a high sensitivity, specificity and a negative predictive value.

  3. Clinical consequences and economic costs of untreated obstructive sleep apnea syndrome

    Institute of Scientific and Technical Information of China (English)

    Melissa Knauert; Sreelatha Naik; M.Boyd Gillespie; Meir Kryger

    2015-01-01

    Objective: To provide an overview of the healthcare and societal consequences and costs of untreated obstructive sleep apnea syndrome.Data sources: PubMed database for English-language studies with no start date restrictions and with an end date of September 2014.Methods: A comprehensive literature review was performed to identify all studies that discussed the physiologic, clinical and societal consequences of obstructive sleep apnea syndrome as well as the costs associated with these consequences.There were 106 studies that formed the basis of this analysis.Conclusions: Undiagnosed and untreated obstructive sleep apnea syndrome can lead to abnormal physiology that can have serious implications including increased cardiovascular disease, stroke, metabolic disease, excessive daytime sleepiness, work-place errors, traffic accidents and death.These consequences result in significant economic burden.Both, the health and societal consequences and their costs can be decreased with identification and treatment of sleep apnea.Implications for practice: Treatment of obstructive sleep apnea syndrome, despite its consequences, is limited by lack of diagnosis, poor patient acceptance, lack of access to effective therapies, and lack of a variety of effective therapies.Newer modes of therapy that are effective, cost efficient and more accepted by patients need to be developed.

  4. Mean platelet volume is associated with disease severity in patients with obstructive sleep apnea syndrome

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    Selahattin Akyol

    2015-07-01

    Full Text Available OBJECTIVE: Obstructive sleep apnea syndrome is associated with cardiovascular diseases and thromboembolic events. The mean platelet volume (MPV is a predictor of cardiovascular thromboembolic events. The aim of the present study is to investigate the association between the MPV and disease severity in patients with obstructive sleep apnea syndrome. METHODS: We prospectively included 194 obstructive sleep apnea syndrome patients without cardiovascular disease (mean age 56.5±12.5 years who were undergoing sleep tests. An overnight full laboratory polisomnography examination was conducted on each patient. The patients were divided into 3 groups according to the apnea-hypopnea index (AHI: (1 AHIlow group: 5≤AHI30. RESULTS: The highest MPV values were found in the AHIhigh group compared with other groups (p<0.05 for all. Multiple linear regression analysis indicated that the MPV was associated with the AHI (β=0.500, p<0.001 and the high sensitivity C-reactive protein (hs-CRP level (β=0.194, p=0.010. CONCLUSION: The MPV is independently associated with both disease severity and inflammation in patients with obstructive sleep apnea syndrome.

  5. Effects of heated humidification and topical steroids on compliance, nasal symptoms, and quality of life in patients with obstructive sleep apnea syndrome using nasal continuous positive airway pressure.

    LENUS (Irish Health Repository)

    Ryan, Silke

    2012-02-01

    BACKGROUND: Nasal side effects are common in patients with obstructive sleep apnea syndrome (OSAS) starting on nasal continuous positive airway pressure (CPAP) therapy. We tested the hypothesis that heated humidification or nasal topical steroids improve compliance, nasal side effects and quality of life in this patient group. METHODS: 125 patients with the established diagnosis of OSAS (apnea\\/hypopnea index > or = 10\\/h), who tolerated CPAP via a nasal mask, and who had a successful CPAP titration were randomized to 4 weeks of dry CPAP, humidified CPAP or CPAP with additional topical nasal steroid application (fluticasone, GlaxoWellcome). Groups were similar in all demographic variables and in frequency of nasal symptoms at baseline. Outcome measures were objective compliance, quality of life (short form 36), subjective sleepiness (Epworth Sleepiness Scale score) and nasal symptoms such as runny, dry or blocked nose, sneezing and headaches; all variables assessed using a validated questionnaire and by direct interview. RESULTS: There was no difference in compliance between groups after 4 weeks (dry: 5.21 +\\/- 1.66 h\\/night, fluticasone: 5.66 +\\/- 1.68, humidifier: 5.21 +\\/- 1.84; p = 0.444). Quality of life and subjective sleepiness improved in all groups, but there were no differences in the extent of improvement. Nasal Symptoms were less frequently reported in the humidifier group (28%) than in the remaining groups (dry: 70%, fluticasone: 53%, p = 0.002). However, the addition of fluticasone resulted in increased frequency of sneezing. CONCLUSION: The addition of a humidifier, but not nasal steroids decreases the frequency of nasal symptoms in unselected OSAS patients initiating CPAP therapy; however compliance and quality of life remain unaltered.

  6. Cognitive and Emotional Impairments in Obstructive Sleep Apnea Syndrome

    Institute of Scientific and Technical Information of China (English)

    Shun-wei Li; Bin Peng; Hong Kong

    2000-01-01

    Objective: To evaluate the P3 latency in OSAS patients ,snorers and nonsnore subjects and observe the emotional disturbance in OSAS patients. Backround: Neurobehavioral abnormalities are the most common nonrespiratory manifestations in OSAS. Impairment of cognitive functions, as well as emotional disturbances and abnormal P3 latency in OSAS have been documnerted. However, seldom studies were done on comparing the changes the P3 and memory function between OSAS patients and snorers, and the psychological scales of OSAS patients before and after CPAP treatrment Methods: For P3 and memory study, three groups: OSAS group, snorer group, and nosnorer group,21 sub jects each, were administered PSG, ERP and Clinical Memory Test All data were analyzed by General Linear Model; For psychological scales, 16 OSAS patients were tested by SAS,SDS,HRSD and HRSA. Two-tailed students t-test was used for data analysis. A value of p<0.05 was considered statistically significant. Results: The P3 latency in OSAS patients were significant longer than that in snorers and nosnorers. There′s no signficant difference between snorers and norsnorers. No differerces in amplitude were seen among three groups. Scores of MQ and sulbtest FRP was higher than that ofOSAS group and nonsnorers group. Differences in MSO2 and SE among three groups were noticed. Twelve patients′ scores of SDS, SAS, HAMD and HAMA were beyond the normal range. The scores decreased significantly after three months treatment of CPAP. Discussion: Our study revealed the prolonged P3 latency with auditory evoked potential which indicated the impairment of cognitive function in OSAS patients. Deficits of memory were also documented in OSAS patients. As to our knowledge, snoreres were not exclude from controls subjects in many studies when compared with OSAS patient. In our study, data showed significant difference between srorers and nonsnore subjects in merb SO2 value although no difference was seen in the P3 latency. The

  7. Utility of ApneaLinkTM for the diagnosis of sleep apnea-hypopnea syndrome Utilidad del ApneaLinkT para el diagnóstico del síndrome apnea-hipopnea del sueño

    Directory of Open Access Journals (Sweden)

    Carlos A. Nigro

    2010-02-01

    Full Text Available Portable sleep studies may play an important role to take decisions on patients referred for suspicion of Sleep Apnea-Hypopnea Syndrome (SAHS. The aim of this study was to evaluate the diagnostic accuracy of automated analysis of ApneaLinkT in patients with suspicion of SAHS. All participants (75 performed the ApneaLink and polysomnography (PSG simultaneously in the sleep laboratory. The two recordings were interpreted blindly. The ApneaLink software calculated: (1 risk indicator (RI-a combination of apnea/hypopnea index (AHI plus inspiratory flow limitation events and (2 the AHI. ApneaLinkT and SAHS were defined in three ways: AHI or respiratory disturbance index (RDI = 5, 10 and 15 respectively. ROC curves analysis was performed. The sensitivity (S, specificity (E and positive and negative likelihood ratio (LR+, LR- for the different thresholds for RI or AHI were calculated; 66 patients were included (47 men, mean age 51, median RDI 10.6, mean BMI 29.3 kg/m². The best cut off points of RI were: SAHS = RDI = 5: RI > 9 (S 80%, E 100%, LR- 0.20; SAHS = RDI = 10: RI > 13 (S 92%, E 93%, LR+ 13.7 LR- 0.089; SAHS = RDI = 15 =: RI > 16 (S 93.5%, E 91%, LR+ 10.9, LR- 0.071. The AHI had a similar diagnostic accuracy to RI for the different definitions of SAHS. The RI and AHI obtained from automated analysis of ApneaLinkT were highly sensitive and specific to diagnose moderate to severe SAHS.Los equipos portátiles para estudios del sueño pueden tener un rol importante para tomar decisiones en pacientes con sospecha de Síndrome Apneas-Hipopneas del Sueño (SAHS. El objetivo del estudio fue evaluar la exactitud diagnóstica del análisis automático del ApneaLinkT en pacientes con sospecha de SAHS. Setenta y cinco sujetos realizaron simultáneamente el ApneaLinkT y una polisomnografía (PSG en el laboratorio de sueño. Los dos registros fueron interpretados en forma ciega. Un programa calculó: (1 el índice apnea/hipopnea (IAH, (2 el indicador de

  8. Obstructive sleep apnea and inflammation.

    LENUS (Irish Health Repository)

    McNicholas, Walter T

    2012-02-01

    The pathogenesis of cardiovascular complications in obstructive sleep apnea syndrome (OSAS) is not fully understood but is likely multifactorial in origin. Inflammatory processes play an important role in the pathogenesis of atherosclerosis, and circulating levels of several markers of inflammation have been associated with future cardiovascular risk. These include cell adhesion molecules such as intercellular adhesion molecule-1 and selectins, cytokines such as tumour necrosis factor alpha and interleukin 6, chemokines such as interleukin 8, and C-reactive protein. There is also increasing evidence that inflammatory processes play an important role in the cardiovascular pathophysiology of OSAS and many of the inflammatory markers associated with cardiovascular risk have been reported as elevated in patients with OSAS. Furthermore, animal and cell culture studies have demonstrated preferential activation of inflammatory pathways by intermittent hypoxia, which is an integral feature of OSAS. The precise role of inflammation in the development of cardiovascular disease in OSAS requires further study, particularly the relationship with oxidative stress, metabolic dysfunction, and obesity.

  9. Long-term oral appliance therapy in obstructive sleep apnea syndrome: a controlled study on temporomandibular side effects.

    Science.gov (United States)

    Doff, Michiel H J; Veldhuis, Steffanie K B; Hoekema, Aarnoud; Slater, James J R Huddleston; Wijkstra, P J; de Bont, Lambert G M; Stegenga, Boudewijn

    2012-06-01

    The objective of this study was to assess variations in the occurrence of temporomandibular disorders (TMDs) and the risk of developing pain and function impairment of the temporomandibular complex in obstructive sleep apnea syndrome (OSAS) patients treated with either an oral appliance (mandibular advancement device) or continuous positive airway pressure (CPAP) in a 2-year follow-up study. In addition, we assessed the relationship between the mean mandibular protrusion and the frequency of wearing the appliance during follow-up with the occurrence of pain and function impairment of the temporomandibular complex. Fifty-one patients were randomized to oral appliance therapy and 52 patients to CPAP therapy. TMDs (diagnosed according to the Axis I Research Diagnostic Criteria for TMD), pain intensity and disability and mandibular function impairment were recorded at baseline, after 2 months, 1 year and 2 years of therapy. Only in the initial period of treatment the occurrence of pain-related TMDs was considerably higher (24%) in the oral appliance group compared to CPAP (6%). Oral appliance therapy furthermore resulted in more temporomandibular pain compared to CPAP (odds ratio 2.33, 95% confidence interval (1.22-4.43)). However, there were no limitations in mandibular function in both groups during the (entire) follow-up period. Although generally not serious and of transient nature, oral appliance therapy results in more pain-related TMDs in the initial period of use compared with CPAP therapy. Oral appliance therapy is associated with increased pain in the temporomandibular complex in the initial period of use. Because of the transient nature, this pain is not a reason to contra-indicate an oral appliance in OSAS patients. Moreover, TMDs and the risk of developing pain and function impairment of the temporomandibular complex appear limited with long-term oral appliance use.

  10. Positional abnormalities during sleep in children affected by obstructive sleep apnea syndrome: the putative role of kinetic muscular chains.

    Science.gov (United States)

    Carotenuto, Marco; Gimigliano, Francesca; Fiordelisi, Giovanni; Ruberto, Maria; Esposito, Maria

    2013-08-01

    Sleep-related breathing disorders (SRBD) are disorders of breathing during sleep characterized by prolonged partial upper airway obstruction, intermittent complete or partial obstruction (obstructive apnea or hypopnea), or both prolonged and intermittent obstruction that disrupts normal ventilation during sleep, normal sleep patterns, or both. Children with OSAS may sleep in unusual positions, such as seated or with neck hyperextended, even if the neck position is not the only unusual posture or the special sleeping positions that is possible to detect in children with SRBD. We have hypothesized that the assumption of unusual posture during sleep, in particular legs retracting or crossing during sleep, could be a way to enlarge the diaphragmatic excursion and promoting the alveolar gas exchanges avoiding the stress of the antero-lumbar and prevertebral muscular chains in SRBD subjects. We have hypothesized that the assumption of unusual posture during sleep, in particular legs retracting or crossing during sleep, could be a way to enlarge the diaphragmatic excursion and promoting the alveolar gas exchanges avoiding the stress of the antero-lumbar and prevertebral muscular chains in SRBD subjects. We can postulate that the prevertebral and antero-lumbar muscular chains could be oversolicited during the apnoic events, and the assumption of abnormal posture could be interpreted as a way to relax or diminish the strain or muscular stress caused by the apneas. The consequence of this hypothesis could be summarized in the concept that a specific rehabilitation or muscular program to improve the tone of this kinetic chain, could be useful to limit the effect nocturnal or diurnal of this so impacting syndrome.

  11. End-tidal CO2 analysis in sleep apnea syndrome. Conditions for use.

    Science.gov (United States)

    Magnan, A; Philip-Joet, F; Rey, M; Reynaud, M; Porri, F; Arnaud, A

    1993-01-01

    The diagnosis of sleep apnea syndrome (SAS) requires expensive and complex instrumentation. The purpose of the present study was to determine the value of end-tidal CO2 (EtCO2) in screening for sleep apneas. Thirty-nine patients referred to our sleep laboratory because of suspected SAS and ten normal subjects were studied. The EtCO2 was measured using an infrared spectrometer (POET) designed for simultaneous measurement of CO2 and pulse oximetry. In 29 subjects, expired gas was sampled with a nasobuccal mask (Respiron) with lateral orifices. In the other 20 subjects, sampling was done with nasobuccal prongs (Criticare) comprising a four-channel plastic tube to the mouth and the nostrils. Data from an 8-h night were transferred the following day to a microcomputer (Apple Macintosh) for processing. Apnea was defined as an absence of detection of CO2 for more than 10 s. Conventional polysomnography was performed (Respisomnographe). The number of apneas in 8 h and the apnea index (number of apneas in 1 h) were calculated after visual analysis on the screen of the polysomnograph and also with EtCO2 analysis. For recordings made with a nasobuccal mask, the regression curve between the apnea indices computed with EtCO2 and polysomnography was an order 2 polynomial curve (r = 0.76; p < 0.001), with an inflection point at 39 apneas per hour. For recordings with nasobuccal prongs, the correlation was very significant (r = 0.95; p < 0.0001), and the regression curve was linear. The EtCO2 with nasobuccal prongs appears to be a simple and reliable method for screening for SAS.

  12. Obstructive Sleep Apnea

    OpenAIRE

    Brass, Steven D.; Ho, Matthew L.

    2006-01-01

    Obstructive sleep apnea (OSA) affects millions of Americans and is estimated to be as prevalent as asthma and diabetes. Given the fact that obesity is a major risk factor for OSA, and given the current global rise in obesity, the prevalence of OSA will increase in the future. Individuals with sleep apnea are often unaware of their sleep disorder. It is usually first recognized as a problem by family members who witness the apneic episodes or is suspected by their primary care doctor because o...

  13. Sleep apnea syndrome: central sleep apnea and pulmonary hypertension worsened during treatment with auto-CPAP, but improved by adaptive servo-ventilation.

    Science.gov (United States)

    Ono, Hiroshi; Fujimoto, Hiroyuki; Kobayashi, Yoshinori; Kudoh, Shoji; Gemma, Akihiko

    2010-01-01

    In this 71-year-old man diagnosed as obstructive sleep apnea syndrome initially, the apnea-hypopnea index in polysomnography was 31.3/hour. He started auto-adjusted continuous positive airway pressure (auto-CPAP) treatment in July 2005 but developed congestive heart failure in December 2007. Pulmonary arterial pressure (PAP), estimated by echocardiography, was 71 mmHg. In January 2008, during simplified sleep examination with a breath-movement sensor under auto-CPAP, many central-type apneas were recognized. After replacing auto-CPAP with adaptive servo-ventilation (ASV), the apnea-hypopnea index was 5.3/hour and PAP became 36 mmHg after 3 months. It was thought that the increase of PAP was due to long-term inadequate use of auto-CPAP.

  14. Sleep position trainer versus tennis ball technique in positional obstructive sleep apnea syndrome

    NARCIS (Netherlands)

    Eijsvogel, Michiel M.; Ubbink, Rinse; Dekker, Janita; Oppersma, Eline; Jongh, de Frans H.; Palen, van der Job; Brusse-Keizer, Marjolein G.J.

    2015-01-01

    Study Objective Positional therapy (PT) is an effective therapy in positional obstructive sleep apnea syndrome (POSAS) when used, but the compliance of PT is low. The objective of this study was to investigate whether a new kind of PT is effective and can improve compliance. Methods 29 patients wer

  15. Diagnostic accuracy of nocturnal oximetry for detection of sleep apnea syndrome in stroke rehabilitation

    NARCIS (Netherlands)

    J.A. Aaronson; T. van Bezeij; J.G. van den Aardweg; C.A.M. van Bennekom; W.F. Hofman

    2012-01-01

    Background and Purpose—Sleep apnea syndrome (SAS) is a common sleep disorder in stroke patients and is associated with decreased recovery and increased risk of recurrent stroke and mortality. The standard diagnostic test for SAS is poly(somno)graphy, but this is often not feasible in stroke rehabili

  16. Oral-appliance therapy obstructive sleep apnea-hypopnea syndrome : a clinical study on therapeutic outcome

    NARCIS (Netherlands)

    Hoekema, Aarnoud

    2007-01-01

    The obstructive sleep apnea-hypopnea syndrome (OSAHS) is a common sleep-related breathing disorder characterized by disruptive snoring and repetitive upper airway obstructions. Its neurobehavioral consequences include excessive sleepiness, an increased risk of accidents, and an impaired quality of l

  17. Detection of cognitive impairment in patients with obstructive sleep apnea hypopnea syndrome using mismatch negativity

    Institute of Scientific and Technical Information of China (English)

    Xiaohui Wen; Ningyu Wang; Jinfeng Liu; Zhanfeng Yan; Zhonghai Xin

    2012-01-01

    In this experiment, 97 patients with obstructive sleep apnea hypopnea syndrome were divided into three groups (mild, moderate, severe) according to minimum oxygen saturation, and 35 healthy subjects were examined as controls. Cognitive function was determined using the mismatch negativity paradigm and the Montreal Cognitive Assessment. The results revealed that as the disease worsened, the mismatch negativity latency was gradually extended, and the amplitude gradually declined in patients with obstructive sleep apnea hypopnea syndrome. Importantly, mismatch negativity latency in severe patients with a persistent time of minimum oxygen saturation 60 seconds. Correlation analysis revealed a negative correlation between minimum oxygen saturation latency and Montreal Cognitive Assessment scores. These findings indicate that intermittent night-time hypoxemia affects mismatch negativity waveforms and Montreal Cognitive Assessment scores. As indicators for detecting the cognitive functional status of obstructive sleep apnea hypopnea syndrome patients, the sensitivity of mismatch negativity is 82.93%, the specificity is 73.33%, the accuracy rate is 81.52%, the positive predictive value is 85.00%, the negative predictive value is 70.21%, the positive likelihood ratio is 3, and the negative likelihood ratio is 0.23. These results indicate that mismatch negativity can be used as an effective tool for diagnosis of cognitive dysfunction in obstructive sleep apnea hypopnea syndrome patients.

  18. Automated recognition of obstructive sleep apnea syndrome using support vector machine classifier.

    Science.gov (United States)

    Al-Angari, Haitham M; Sahakian, Alan V

    2012-05-01

    Obstructive sleep apnea (OSA) is a common sleep disorder that causes pauses of breathing due to repetitive obstruction of the upper airways of the respiratory system. The effect of this phenomenon can be observed in other physiological signals like the heart rate variability, oxygen saturation, and the respiratory effort signals. In this study, features from these signals were extracted from 50 control and 50 OSA patients from the Sleep Heart Health Study database and implemented for minute and subject classifications. A support vector machine (SVM) classifier was used with linear and second-order polynomial kernels. For the minute classification, the respiratory features had the highest sensitivity while the oxygen saturation gave the highest specificity. The polynomial kernel always had better performance and the highest accuracy of 82.4% (Sen: 69.9%, Spec: 91.4%) was achieved using the combined-feature classifier. For subject classification, the polynomial kernel had a clear improvement in the oxygen saturation accuracy as the highest accuracy of 95% was achieved by both the oxygen saturation (Sen: 100%, Spec: 90.2%) and the combined-feature (Sen: 91.8%, Spec: 98.0%). Further analysis of the SVM with other kernel types might be useful for optimizing the classifier with the appropriate features for an OSA automated detection algorithm.

  19. Inflammation and Growth in Young Children with Obstructive Sleep Apnea Syndrome before and after Adenotonsillectomy

    Directory of Open Access Journals (Sweden)

    Yuval Nachalon

    2014-01-01

    Full Text Available Background. Obstructive sleep apnea (OSA is associated with growth impairment that usually improves following effective treatment. In this study we investigated the mechanisms underlying the growth processes in young children diagnosed with OSA, before and after adenotonsillectomy (T&A. Methods. Young children (6–36 months old were enrolled and evaluated before and several months after T&A surgery for height, weight, circulating high sensitive C-reactive protein (CRP, and insulin-like growth factor 1 (IGF-1 levels. Caloric intake was assessed by a validated Short Food Frequency Questionnaire (SFFQ. Results. Following T&A, children added 4.81 cm and 1.88 kg to their height and weight, respectively (P<0.001 for both and had a significant increase in BMI Z score (P=0.002. Increased caloric intake of 377 kcal/day was noted (P<0.001, with increased protein and decreased fat intake. The decrease in CRP levels correlated with the increase in body weight in boys (P<0.05, adjusted for caloric intake. Conclusions. Adenotonsillectomy results in enhanced somatic growth in young children that correlates with a decrease in systemic inflammation and caloric intake increment. Our findings imply that systemic inflammation may have an important role in this OSA-related morbidity.

  20. Tracking Pulse Oximeter Findings Before, During and After Titration of Mandibular Advancement Devices (MAD) for Patients With Mild to Moderate Obstructive Sleep Apnea (OSA)

    Science.gov (United States)

    2015-06-01

    oral appliance therapy in obstructive sleep apnea patients: part 1. Cephalometric analysis . American Journal of Orthodontics and Dentofacial Orthopedics...M. A., Gotsopoulos, H., Petocz, P. & Cistulli, P. A. (2002). Effect of vertical dimension on efficacy of oral appliance therapy in obstructive... Analysis of nightly pulse oximetty (pulseox) data during home titration of a MAD may indicate when optimal protrusion is achieved. OBJECTIVE: Pulse

  1. [Obstructive sleep apnea-hypopnea syndrome in children: beyond adenotonsillar hypertrophy].

    Science.gov (United States)

    Esteller, Eduard

    2015-01-01

    The prevalence of obstructive sleep apnea-hypopnea syndrome in the general childhood population is 1-2% and the most common cause is adenotonsillar hypertrophy. However, beyond adenotonsillar hypertrophy, there are other highly prevalent causes of this syndrome in children. The causes are often multifactorial and include muscular hypotonia, dentofacial abnormalities, soft tissue hypertrophy of the airway, and neurological disorders). Collaboration between different specialties involved in the care of these children is essential, given the wide variability of conditions and how frequently different factors are involved in their genesis, as well as the different treatments to be applied. We carried out a wide literature review of other causes of obstructive sleep apnea-hypopnea syndrome in children, beyond adenotonsillar hypertrophy. We organised the prevalence of this syndrome in each pathology and the reasons that cause it, as well as their interactions and management, in a consistent manner.

  2. Pierre Robin sequence and obstructive sleep apnea

    Directory of Open Access Journals (Sweden)

    Rubens Reimão

    1994-12-01

    Full Text Available The case of a 12-year-old female patient with Pierre Robin sequence is reported, in which reduction of the pharyngeal airway leads to obstructive sleep apnea syndrome (OSAS and excessive daytime sleepiness. Radiological evaluation, computerized tomography and magnetic resonance image showed bilateral temporomandibular ankylosis. Cephalometric data evidenced marked reduction of the posterior airway space. Three all-night polysomnographic evaluations detected severe OSAS with decrease in oxygen saturation. The Multiple Sleep Latency Test (MSLT perfomed on two separate days objectively quantified the excessive daytime sleepiness with short sleep latencies; stage REM was not present. Polysomnography, MSLT and thorough radiologic studies, in this case, made it possible to determine the severity of OSAS, the site of obstruction, and the associated malformations.

  3. 围手术期阻塞性睡眠呼吸暂停综合征患者的识别及其管理%Perioperative identification and management of patients with obstructive sleep apnea syndrome

    Institute of Scientific and Technical Information of China (English)

    王彦喆; 陈莹; 王镇山

    2013-01-01

    Obstructive sleep apnea syndrome (OSAS) is a common sleep related breathing disorder.Its prevalence is estimated to be between 2% and 25% in the general population.However,the prevalence of sleep apnea is much higher in patients undergoing selective surgery.Sedation and anesthesia have been shown to increase the upper airway collapsibility and therefore increasing the risk of having postoperative complications in these patients.Furthermore,the majority of patients with sleep apnea are undiagnosed and therefore are at risk during the perioperative period.It is important to identify these patients so that appropriate actions can be taken in a timely fashion.In this review article,we will review how to identify these patients preoperatively and the steps that can be taken for their perioperative management.%阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS)是一种常见的与睡眠相关的呼吸功能紊乱,发病率约2%~25%,在择期手术人群中OSAS的患病率更高.一方面,镇静剂和麻醉药会增加上呼吸道的塌陷性,增加了这部分患者发生术后并发症的风险;另一方面,大部分OSAS患者没有被确诊也增加了手术期间的危险.因此,这部分OSAS患者的识别和诊断,对能否在手术期间给予及时合理的处理有重要作用.本文将如何在手术前识别OSAS患者及其围手术期的管理进行综述.

  4. Life-Threatening Obstructive Sleep Apnea Caused by Adenoid Hypertrophy in an Infant with Noonan Syndrome

    Directory of Open Access Journals (Sweden)

    Sonia Khirani

    2012-01-01

    Full Text Available Adenoidectomy is a commonly performed surgery in children, even though its effectiveness is still under investigation. However, in children with risk factors such as age under 3 years old, associated comorbidities, or severe obstructive sleep apneas, a high postoperative respiratory morbidity is possible. We report the case of a 15-month-old boy with Noonan syndrome and a complex clinical history, who presented with a life-threatening obstructive sleep apnea due to hypertrophy of the adenoids which resolved completely after adenoidectomy.

  5. [Study of chemosensitivity in patients believed to have sleep apnea syndrome].

    Science.gov (United States)

    Costes, F; Court-Fortune, I; Fournel, P; Vergnon, J M; Emonot, A; Geyssant, A

    1995-01-01

    We performed polysomnography and measured hypoxic ventilatory (HVR), hypercapnic ventilatory responses (HCVR) in 42 patients (60 +/- 11 years) with obesity and a clinical suspicion of sleep apnea syndrome (SAS) in order to determine whether an altered chemosensitivity was associated with SAS. The apnea/hypopnea index was 38 +/- 20 events per hour of sleep in 28 patients (SAS+ group) and less than 10 in the 14 others (SAS- group). The 2 groups differed only by a lower waking PaO2 in SAS+ as compared to SAS- (71.0 +/- 9 vs 77.4 +/- 8 mmHg, p obesity and SAS there is no difference in chemosensitivity due to the presence of sleep apnea and that CPAP therapy does not alter these measurements. These results suggest no direct effect of SAS on chemosensitivity in the population studied.

  6. Síndrome da apneia obstrutiva do sono em motoristas de caminhão Obstructive sleep apnea syndrome in truck drivers

    Directory of Open Access Journals (Sweden)

    Lucia Castro Lemos

    2009-06-01

    Full Text Available OBJETIVO: Estimar a prevalência da síndrome da apneia obstrutiva do sono (SAOS e verificar os fatores associados à chance de desenvolver SAOS em motoristas de caminhão. MÉTODOS: A população desse estudo constituiu-se de motoristas de caminhão de duas filiais de uma empresa transportadora (n = 209, com idade média de 38,8 anos, sendo 98,5% do sexo masculino. O índice de massa corpórea médio foi de 26,5 ± 4,4 kg/m². Os participantes responderam questionários sobre dados sociodemográficos, atividade física e SAOS. A prevalência de SAOS foi estimada por meio do Questionário de Berlim e sua associação com os fatores estudados foi verificada pela análise de regressão univariada e multivariada. RESULTADOS: A prevalência de SAOS na população foi de 11,5%. Dos 209 motoristas, 72 (34,5% referiram dormir ao volante enquanto dirigiam ao menos uma vez e 81 (38,7% referiram roncar durante o sono. As variáveis estatisticamente significativas associadas à SAOS foram vínculo empregatício informal (OR = 0,27; p = 0,01, índice de massa corpórea > 25 kg/m² (OR = 13,64; p = 0,01 e qualidade do sono ruim (OR = 3,00; p = 0,02. CONCLUSÕES: Apesar de a prevalência de SAOS ter sido inferior à observada em outros estudos com motoristas, essa prevalência é superior à da população em geral. Os resultados ainda sugerem que as características do trabalho, entre as quais o vínculo de trabalho, estão associadas à SAOS. Esses dados evidenciam a relevância de se levar em consideração a atividade de trabalho em estudos que investiguem fatores associados à SAOS.OBJECTIVE: To determine the prevalence of obstructive sleep apnea syndrome (OSAS, as well as to identify factors associated with a greater risk of developing OSAS, among truck drivers. METHODS: The study population comprised 209 truck drivers (mean age, 38.8 years; 98.5% males at two branches of a transportation company. The mean body mass index was 26.5 ± 4.4 kg/m². The

  7. A study on correlation of obstructive sleep apnea-hypopnea syndrome and perihematoma edema of hypertensive cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    高晓刚

    2013-01-01

    Objective To analyse the correlation of obstructive sleep apnea-hypopnea syndrome (OSAHS) and perihematoma edema of hypertensive cerebral hemorrhage.Methods One hundred and forty-four patients with hypertensive cerebral hemorrhage were collected and 78 of

  8. Accurate method for home-based diagnosis of obstructive sleep apnea: a review

    Directory of Open Access Journals (Sweden)

    Hosna Ghandeharioun

    2016-12-01

    Full Text Available Overnight polysomnography is the gold standard for the detection of obstructive sleep apnea-hypopnea syndrome (OSAS. However, it is expensive and needs attending personnel. The study of simplified sleep apnea monitoring is one of the recent trends for sleep medicine research. The proposed clinical prediction rules employ the vital and social statistics, symptoms, craniofacial traits, and obesity-related measures for initial screening of OSAS in an ambulatory setting. However, most of them are partially or completely clinical and not home-based. One disadvantage of this sort of screening methods is their inability to asses OSAS severity. Another approach of initial OSAS screening is a usage of just one or two physiological signals such as electrocardiography (ECG, pulse oximetry, snoring, nasal airflow, or even speech sound. In this study, we aimed to review the different strategies and to compare their performances, reported by means of their sensitivity–specificity and accuracy for OSAS incidence and severity. OSAS severity is determined by apnea-hypopnea index (AHI value. Based on the data obtained from the related articles, the most accurate methods of AHI estimation exploit ECG and pulse oximetry signals.

  9. Correlation between the oropharyngo-laryngoscopic findings and the severity of obstructive sleep apnea

    Directory of Open Access Journals (Sweden)

    Priscila Sequeira Dias

    2015-10-01

    Full Text Available Objective: To correlate anatomical and functional changes of the oral cavity, pharynx and larynx to the severity of obstructive sleep apnea syndrome (OSAS. Methods : We conducted a cross-sectional study of 66 patients of both genders, aged between 21 and 59 years old with complaints of snoring and / or apnea. All underwent full clinical evaluation, including physical examination, nasolarybgoscopy and polisonography. We classified individuals into groups by the value of the apnea-hypopnea index (AHI, calculated measures of association and analyzed differences by the Kruskal-Wallis and chi-square tests. Results : all patients with obesity type 2 had OSAS. We found a relationship between the uvula projection during nasoendoscopy and OSAS (OR: 4.9; p-value: 0.008; CI: 1.25-22.9. In addition, there was a major strength of association between the circular shape of the pharynx and the presence of moderate or severe OSAS (OR: 9.4, p-value: 0.002, although the CI was wide (1.80-53.13. The septal deviation and lower turbinate hypertrophy were the most frequent nasal alterations, however unrelated to gravity. Nasal obstruction was four times more common in patients without daytime sleepiness. The other craniofacial anatomical changes were not predictors for the occurrence of OSAS. Conclusion : oral, pharyngeal and laryngeal disorders participate in the pathophysiology of OSAS. The completion of the endoscopic examination is of great value to the evaluation of these patients.

  10. Maxillomandibular Advancement Surgery as Alternative to Continuous Positive Airway Pressure in Morbidly Severe Obstructive Sleep Apnea : A Case Report

    NARCIS (Netherlands)

    Doff, Michiel H. J.; Jansma, Johan; Schepers, Rutger H.; Hoekema, Aamoud

    2013-01-01

    Obstructive sleep apnea syndrome (OSAS) is a sleep-related breathing disorder, characterized by disrupted snoring and repetitive upper airway obstructions. Oral appliance therapy is an effective alternative to continuous positive airway pressure (CPAP) and is especially effective in mild and moderat

  11. Association of adiponectin genotype polymorphisms at positions 45 and 276 with obstructive sleep apnea hypopnea syndrome

    Institute of Scientific and Technical Information of China (English)

    Mei Su; Xilong Zhang; Shicheng Su

    2009-01-01

    Objective: To investigate the relationship between adiponectin genotype polymorphisms and obstructive sleep apnea hypopnea syndrome (OSAHS). Methods: Using the TaqMan polymerase chain reaction(PCR) method, the single nucleotide polymorphisms(SNP)at positions 45 and 276 in the adiponectin gene were determined in Chinese of the Han nationality in the Nanjing district. The OSAHS group consisted of 78 patients, and the control group contained 40 subjects. The association of adiponectin genotype polymorphisms at positions 45 and 276 with obstructive sleep apnea hypopnea syndrome was analyzed. Results: No evidence of a direct association was found between OSAHS and adiponectin genotype SNP at positions 45 and 276(P> 0.05). However, compared with those OSAHS patients having G/T+T/T genotype at position 276, the OSAHS patients with the G/G genotype showed a greater neck circumference(NC), a prolonged duration of the longest apnea event, and elevated levels of blood cholesterol and low-density lipoprotein cholesterol(P < 0.05). Conclusion: No direct association was detected between OSAHS and adiponectin genotype distribution at positions 45 and 276 in Chinese of Han nationality in the Nanjing district. However, OSAHS patients with the adiponectin GIG genotype at position 276 had a larger NC and the longest apnea event compared to those having the adiponectin SNP276 G/T +T/T genotype. This may have an indirect influence on the development of OSAHS.

  12. Inflammatory Markers and Obstructive Sleep Apnea in Obese Children: The NANOS Study

    Directory of Open Access Journals (Sweden)

    Alex Gileles-Hillel

    2014-01-01

    Full Text Available Introduction. Obesity and obstructive sleep apnea syndrome (OSA are common coexisting conditions associated with a chronic low-grade inflammatory state underlying some of the cognitive, metabolic, and cardiovascular morbidities. Aim. To examine the levels of inflammatory markers in obese community-dwelling children with OSA, as compared to no-OSA, and their association with clinical and polysomnographic (PSG variables. Methods. In this cross-sectional, prospective multicenter study, healthy obese Spanish children (ages 4–15 years were randomly selected and underwent nocturnal PSG followed by a morning fasting blood draw. Plasma samples were assayed for multiple inflammatory markers. Results. 204 children were enrolled in the study; 75 had OSA, defined by an obstructive respiratory disturbance index (RDI of 3 events/hour total sleep time (TST. BMI, gender, and age were similar in OSA and no-OSA children. Monocyte chemoattractant protein-1 (MCP-1 and plasminogen activator inhibitor-1 (PAI-1 levels were significantly higher in OSA children, with interleukin-6 concentrations being higher in moderate-severe OSA (i.e., AHI > 5/hrTST; P<0.01, while MCP-1 levels were associated with more prolonged nocturnal hypercapnia (P<0.001. Conclusion. IL-6, MCP-1, and PAI-1 are altered in the context of OSA among community-based obese children further reinforcing the proinflammatory effects of sleep disorders such as OSA. This trial is registered with ClinicalTrials.gov NCT01322763.

  13. Neurocognitive impairment in obstructive sleep apnea.

    Science.gov (United States)

    Lal, Chitra; Strange, Charlie; Bachman, David

    2012-06-01

    Obstructive sleep apnea syndrome (OSAS) is a common disorder with far-reaching health implications. One of the major consequences of OSAS is an impact on neurocognitive functioning. Several studies have shown that OSAS has an adverse effect on inductive and deductive reasoning, attention, vigilance, learning, and memory. Neurocognitive impairment can be measured objectively with tests such as the Wechsler Adult Intelligence Scale-Revised, the Psychomotor Vigilance Task, the Steer Clear Performance Test, and tests of repetitive finger tapping. In children, OSAS may cause attention-deficit hyperactivity disorder in addition to behavioral problems and learning disabilities. Risk factors for cognitive impairment include increasing age, male sex, apolipoprotein E ε4 allele positivity, current cigarette smoking, obesity, hypertension, diabetes mellitus, metabolic syndrome, Down syndrome, hypothyroidism, significant alcohol consumption, stroke, and the use of psychoactive medications. At a cellular level, OSAS likely causes cognitive impairment through intermittent hypoxia, hormonal imbalance, and/or systemic inflammation, either independently or via the resultant endothelial dysfunction that occurs. Excessive daytime sleepiness should be measured and minimized in all studies of neurocognitive impairment. Recent studies have used functional and structural neuroimaging to delineate the brain areas affected in patients with OSAS with neurocognitive dysfunction. A common finding in several of these studies is decreased hippocampal volume. Other affected brain areas include the frontal and parietal lobes of the brain, which show focal reductions in gray matter. These changes can be reversed at least partially with the use of CPAP, which highlights the importance of early recognition and treatment of OSAS. The currently available data in this field are quite limited, and more research is needed.

  14. CPAP Treats Muscle Cramps in Patients with Obstructive Sleep Apnea

    OpenAIRE

    Westwood, Andrew J.; Spector, Andrew R.; Auerbach, Sanford H.

    2014-01-01

    We describe a case series of 4 patients with varying degrees of obstructive sleep apnea who incidentally had a history of nocturnal leg cramps. None of the patients had periodic limb movements during the study and denied symptoms consistent with restless legs syndrome. In 3 of the 4 patients, nocturnal leg cramps resolved with CPAP treatment for OSA, while the fourth patient noted near-resolution of cramping after starting CPAP. In patients presenting with muscle cramps, obstructive sleep apn...

  15. FRECUENCIA DE PRESENTACIÓN DEL SÍNDROME DE PIERNAS INQUIETAS Y SU ASOCIACIÓN CON APNEA OBSTRUCTIVA DEL SUEÑO Restless legs syndrome, frequency and its association with obstructive sleep apnea syndrome

    Directory of Open Access Journals (Sweden)

    Édgar Osuna Suárez

    2009-01-01

    ón significativa entre las entidades. Conclusiones. La prevalencia en nuestra población de estudio fue similar a la reportada en otros países latinoamericanos. Las mujeres, las personas mayores de 50 años, la obesidad y las mujeres con SAOS leve y moderado, tienen mayor frecuencia de presentación del SPI. La latencia para iniciar el sueño fue significativamente mayor en el grupo del SPI que en el grupo que no presenta SPI.Background. Prevalence of restless legs syndrome (RLS has been reported between 2,5 to 29 percent. To our knowlage there are no studies that show a correlation between restless legs syndrome and obstructive sleep apnea syndrome. Objectives. To determine the frequency of RLS in a group of adult patients who had a polysomnography at the Fundacion Santa Fe of Bogota University Hospital not referred for RLS evaluation, between January 1 to December 31, 2006 and to determine its relationship to OSAS. Materials abd methods. An analytic prevalence study was conducted. Patients filled out a questionnaire in which RLS diagnostic criteria were included and its frequency of presentation. Patients were grouped by gender, age, body mass index and severity of obstructive sleep apnea. Sleep latency was also considered. Results. 302 subjects were included, 72 percent were male, 43 fulfilled RLS clinical criteria. A global prevalence was 14,3 percent, for women it was 18,3 percent and for men 12,8 percent. A higher prevalence was found in patients between 50-59 years old, both in the whole group and in the male group (18,4 % and 16,4% respectively. In the female group prevalence was higher in patients older than 70 years (28,6%. Prevalence was higher in the obese group in both genders (p = 0,003. Sleep latency was significantly increased in the RLS group (p = 0,003. Females with mild to moderate OSAS showed higher RLS frequency whereas there was no correlation between the severity of OSA and RLS frequency in the male group. Conclusions. Prevalence of RLS in our sample was

  16. Sleep apnea in stroke: Diagnosis, consequences & treatment

    NARCIS (Netherlands)

    Aaronson, J.A.

    2016-01-01

    Obstructive sleep apnea (OSA) is the most common sleep disorder in stroke, but is often left unrecognized and untreated. When left untreated, OSA is thought to contribute to decreased recovery from stroke. The main objectives of this thesis were 1) to improve early recognition of sleep apnea in stro

  17. Relationship between obstructive sleep apnea syndrome and asthma and the possible mechanism%睡眠呼吸暂停综合征和支气管哮喘相互促进及其作用机制

    Institute of Scientific and Technical Information of China (English)

    纵单单; 欧阳若芸

    2011-01-01

    Recent research suggests, obstructive sleep apnea syndrome (OSAS) and bronchial asthma (asthma) may influence each other. OSAS is an independent risk factor for asthma. The possible mechanism of OSAS which promotes asthma exacerbations includes the following aspects:gastroesophageal reflux, airway inflammation, neural reflex mechanisms, the indirect effects of cardiovascular harm caused by OSAS, airway vascular proliferation induced by VEGF, airway hyperresponsieness, obesity. The following reasons may be why asthma easily merger OSAS: nasal congestion, the cross-sectional area reductions of the upper respiratory tract, and the increased airway collapse. It is suggested that there is a correlation between the two diseases. Therefore, a clear mechanism of the interaction between OSAS and asthma can provide a valuable therapeutic strategy for the two disease.%近年来的研究提示,睡眠呼吸暂停综合征和支气管哮喘(简称哮喘)之间关系密切,睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS)是哮喘急性发作的独立危险因素。OSAS促进哮喘加重的可能机制包括以下方面:胃食管反流,气道炎症反应,神经反射机制,OSAS相关的心血管损害的间接影响,血管内皮生长因子,气道高反应性,缺氧诱导因子相关的气道重塑,肥胖;哮喘患者易合并OSAS的可能机制:鼻塞,上气道咽部横断面积的减少,以及上气道塌陷性增加;以上均提示这两种疾病存在相关性。明确OSAS和哮喘相互关联的本质对两种疾病的治疗有重要意义。

  18. Oral appliance therapy versus nasal continuous positive airway pressure in obstructive sleep apnea syndrome: a randomized, placebo-controlled trial on self-reported symptoms of common sleep disorders and sleep-related problems.

    Science.gov (United States)

    Nikolopoulou, Maria; Byraki, Anna; Ahlberg, Jari; Heymans, Martijn W; Hamburger, H L; De Lange, Jan; Lobbezoo, Frank; Aarab, Ghizlane

    2017-03-10

    Obstructive sleep apnea syndrome (OSAS) is associated with several sleep disorders and sleep-related problems. Therefore, the aim of this study was to compare the effects of a mandibular advancement device (MAD) with those of nasal continuous positive airway pressure (nCPAP) on self-reported symptoms of common sleep disorders and sleep-related problems in mild and moderate OSAS patients. In this randomized placebo-controlled trial sixty-four OSAS patients (52.0± 9.6 years) were randomly assigned to an MAD, nCPAP or an intra-oral placebo appliance in a parallel design. All participants filled out the validated Dutch Sleep Disorders Questionnaire (SDQ) twice: one before treatment and one after six months of treatment. With 88 questions, thirteen scales were constructed, representing common sleep disorders and sleep-related problems. Linear mixed model analyses were performed to study differences between the groups for the different SDQ scales over time. The MAD group showed significant improvements over time in symptoms corresponding with "insomnia", "excessive daytime sleepiness", "psychiatric sleep disorder", "periodic limb movements", "sleep apnea", "sleep paralysis", "daytime dysfunction", "hypnagogic hallucinations/dreaming", "restless sleep", "negative conditioning", and "automatic behaviour" (range of P values: 0.000-0.014). These improvements in symptoms were, however, not significantly different from the improvements in symptoms observed in the nCPAP and placebo groups (range of P values: 0.090-0.897). It can be concluded that there is no significant difference between MAD and nCPAP in their positive effects on self-reported symptoms of common sleep disorders and sleep-related problems in mild and moderate OSAS patients. These beneficial effects may be a result of placebo effects. This article is protected by copyright. All rights reserved.

  19. Vasoactive peptide and obstruction sleep apnea syndrome%血管活性肽与阻塞性睡眠呼吸暂停综合征

    Institute of Scientific and Technical Information of China (English)

    刘维英

    2011-01-01

    血管活性肽是构成循环系统自稳态调节的物质基础,能够调节血管平滑肌细胞舒缩功能、维持血管张力,多数以自分泌、旁分泌方式发挥作用,并按其血管效应的不同分为缩血管肽和舒血管肽.生理条件下,血管舒-缩活性肽之间存在着复杂的正反馈或负反馈调节,由此构成一个精细、严密的血管张力调控网络.其平衡失调会导致冠状动脉粥样硬化性心脏病、高血压等疾病的发生.阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS)是一种全身性疾病,可对多脏器造成严重损害;内皮素-1、血管紧张索Ⅱ,心钠肽和脑钠肽、降钙素基因相关肽等是目前发现的主要的血管活性肽,研究发现缩血管活性肽与舒血管活件肽的失衡可能是OSAS患者心脑血管疾病的基础,但艿机制目前尚未十分明了并存在争议,作为涉及缺氧、内分泌及神经调节异常、炎症、氧化应激等多种病理过程的OSAS,可能存在着复杂的致病因素.现对上述主要的血管活性肽与OSAS的研究作一综述,以了解其间的关系.%Vasoactive peptide are the material foundation which constitute the circulatory system self-stability adjustment. They are a kind of low molecular weight peptide that regulate the vasodilative and vasoconstrictive function and maintain the vascular tone through the way of autocrine and (or) paracrine. There are dynamic equilibtium in the excretion and activity betwccn vasoconstrictive peptides and vasodilative peptides. The complcx positive feedback or negative feedback exists in different vasoactive peptides, which forms a network of regulation of vascular tone. Their balance disorders can lead to coronary heart disease, hypertension,etc. Obstruction sleep apnea syndrome (OSAS) is a systemic disease, which can cause severe damage to multiple organ. Endothelin-Ⅰ, angiotensin Ⅱ , atrial natriuretic peptide and brain natriuretic peptide

  20. Influence of Auricular Plaster Therapy on Sleeping Structure in OSAS Patients

    Institute of Scientific and Technical Information of China (English)

    WANG Xiao-hong; XIAO Lan-ying; WANG Bao-fa; YUAN Ya-dong; PAN Wen-sen; SHI Yu-zhen

    2009-01-01

    To evaluate the therapeutic effects of auricular plaster therapy for obstructive sleep apnea syndrome (OSAS) and the influence on sleeping structure. Methods: 45 OSAS patients were randomly divided into a treatment group of 30 cases and a control group of 15 cases for comparison of the changes in parameters of respiration and sleep at night. Results: The auricular plaster therapy significantly improved the hypoventilation index, respiratory disturbance index and other respiratory parameters as well as the sleeping parameters such as the time and rate of sleep at stage Ⅰ and Ⅱ, and the waking time and rate.Conclusion: Auricular plaster therapy may show good therapeutic effects for OSAS, and with the advantages of low cost and less side effects.

  1. A Nomogram for Predicting the Likelihood of Obstructive Sleep Apnea to Reduce the Unnecessary Polysomnography Examinations

    Institute of Scientific and Technical Information of China (English)

    Miao Luo; Hai-Yan Zheng; Ying Zhang; Yuan Feng; Dan-Qing Li; Xiao-Lin Li; Jian-Fang Han

    2015-01-01

    Background:The currently available polysomnography (PSG) equipments and operating personnel are facing increasing pressure,such situation may result in the problem that a large number of obstructive sleep apnea (OSA) patients cannot receive timely diagnosis and treatment,we sought to develop a nomogram quantifying the risk of OSA for a better decision of using PSG,based on the clinical syndromes and the demographic and anthropometric characteristics.Methods:The nomogram was constructed through an ordinal logistic regression procedure.Predictive accuracy and performance characteristics were assessed with the area under the curve (AUC) of the receiver operating characteristics and calibration plots,respectively.Decision curve analyses were applied to assess the net benefit of the nomogram.Results:Among the 401 patients,73 (18.2%) were diagnosed and grouped as the none OSA (apnea-hypopnea index [AHI] <5),67 (16.7%) the mild OSA (5 ≤ AHI < 15),82 (20.4%) the moderate OSA (15 ≤ AHI < 30),and 179 (44.6%) the severe OSA (AHI ≥ 30).The multivariable analysis suggested the significant factors were duration of disease,smoking status,difficulty of falling asleep,lack of energy,and waist circumference.A nomogram was created for the prediction of OSA using these clinical parameters and was internally validated using bootstrapping method.The discrimination accuracies of the nomogram for any OSA,moderate-severe OSA,and severe OSA were 83.8%,79.9%,and 80.5%,respectively,which indicated good calibration.Decision curve analysis showed that using nomogram could reduce the unnecessary polysomnography (PSG) by 10% without increasing the false negatives.Conclusions:The established clinical nomogram provides high accuracy in predicting the individual risk of OSA.This tool may help physicians better make decisions on PSG arrangement for the patients referred to sleep centers.

  2. Laser midline glossectomy and lingual tonsillectomy as treatments for sleep apnea syndrome.

    Science.gov (United States)

    Yonekura, Arata; Kawakatsu, Kenji; Suzuki, Kenji; Nishimura, Tadao

    2003-01-01

    Preservation treatments for sleep respiratory disorders, such as the use of a dental device and the technique of nasal continuous positive air pressure, cause discomfort to the patient and are not radical treatments. Therefore, we performed operative therapy instead. Laser midline glossectomy was performed to treat constriction at the root of the tongue in 16 patients diagnosed with sleep apnea syndrome. We also tried lingual tonsil excision using the Harmonic Scalpel in three patients with stenosis at the base of the tongue.

  3. Study of correlation between obstructive sleep apnea syndrome and metabolic syndrome in the male elderly%老年男性阻塞性睡眠呼吸暂停程度与代谢综合征的相关性研究

    Institute of Scientific and Technical Information of China (English)

    王媛媛; 赵庆华

    2013-01-01

    Objective :To study the correlation between the degree of obstructive sleep apnea syndrome and metabolic syndrome in the male elderly .Methods 663 male elderly over 60 years old were enrolled in the study randomly .They were divided into four groups according to apnea -hypopnea index :non -OSAS group and mild ,moderate and severe OSAS group .Data were analyzed ,including neck circumference ,body mass index (BMI) ,waist -to -hip ratio (WHR) , blood pressure ,blood lipids ,fasting blood glucose(FPG) ,and so on .Spearman correlation analysis was used to explore the relationship between severity of OSAS and the incidence of metabolic syndrome and its components .Results OSAS group were significantly higher than non -OSAS group in neck circumference ,BMI , WHR ,systolic blood pressure (SBP) ,diastolic blood pressure (DBP) and FPG .There were significant positive correlation between severity of OSAS and neck circumference ,BMI and TG .Incidence of MS and its components were gradually increasing with the aggravation of OSAS severity .Conclusion There was closely relationship between OSAS severity and incidence of MS in older men ,which may increase the incidence and mortality of cardiovascular disease .%目的:研究老年男性阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome ,OSAS)严重程度与代谢综合征的相关性。方法:随机选择我院收治的663例老年患者,根据呼吸暂停及低通气指数,将其分为非OSAS 组和轻、中、重度OSAS 组。比较各组患者颈围、体质指数(BMI)、腰臀比、血压、血脂、空腹血糖等,分析OSAS严重程度与代谢综合征及其组分发病率之间的相关性。结果 OSAS患者的颈围、BMI、腰臀比、收缩压、舒张压、空腹血糖等显著高于非OSAS组患者。OSAS严重程度与颈围、BMI、甘油三酯等存在显著正相关,且随着OSAS严重程度的增加,代谢综合征及其组分的发生率呈逐渐递增趋势。结论

  4. Consequências metabólicas na SAOS não tratada Metabolic consequences of untreated obstructive sleep apnea syndrome

    Directory of Open Access Journals (Sweden)

    Glaucia Carneiro

    2010-06-01

    /85 mmHg; and fasting glucose > 100 mg/dL. Central obesity is associated with OSAS and metabolic syndrome, and there is evidence that obstructive sleep apnea is an independent risk factor for obesity, glucose intolerance and insulin resistance. The implied mechanisms result from the activation of the sympathetic nervous system and of the hypothalamus-hypophysis-adrenal axis; activation of pro-inflammatory markers, such as IL-6 and TNF-α; and the reduction in adiponectin levels, principally triggered by intermittent hypoxemia related to apnea. Despite such evidence, the results are controversial regarding the benefits of treating sleep apnea with CPAP in the presence of these metabolic alterations. In addition, the few studies that have addressed sleep apnea as a risk factor for dyslipidemia have presented conflicting results. Population-based, longitudinal controlled studies are necessary in order to elucidate the interaction between sleep apnea and metabolic consequences so that these individuals are properly treated.

  5. Orthodontic and Orthognathic Surgical Treatment of a Pediatric OSA Patient

    Science.gov (United States)

    2016-01-01

    A case report is presented which demonstrates the effectiveness of comprehensive orthodontic treatment combined with orthognathic surgery in the correction of malocclusion and reduction in the sequelae of Obstructive Sleep Apnea (OSA). The patient's severe OSA was improved to very mild as evaluated by full overnight polysomnogram. The orthodontic treatment included the expansion of both dental arches and mandibular advancement surgery. There was significant improvement in the patient's sleep continuity and architecture with the elimination of obstructive apneas. PMID:27668098

  6. Sleep Apnea Syndrome in Heart Transplant Patient: One Case Report and Literature Review%心脏移植患者合并睡眠呼吸暂停综合征一例并文献复习

    Institute of Scientific and Technical Information of China (English)

    李兴旺; 谢进生; 钱效森; 王广发; 彭志平; 刘毅

    2011-01-01

    目的 提高对心脏移植患者伴发睡眠呼吸暂停综合征(SAS)的认识.方法 报道1例心脏移植合并睡眠呼吸暂停综合征患者并进行相关文献复习.结果 患者男,44岁,心脏移植术前诊断为中枢性睡眠呼吸暂停综合征(CSAS).心脏移植术后,长期服用环孢菌素A和泼尼松,近两年体质量明显增加并出现类库欣征样体征,经多导睡眠监测图(PSG)检查,为重度阻塞性睡眠呼吸暂停综合征(OSAS),移植前后呼吸暂停的类型发生转变,国外也有类似报道.结论 睡眠呼吸暂停是心脏移植的潜在危险因素,移植前后呼吸暂停的类型会发生转变,可能与移植前后心功能状态改变有关.%Objective To improve our knowledge of heart transplantation with sleep apnea syndrome ( SAS ) . Methods One case of SAS patient underwent heart transplantation was reported and pertinent literatures were reviewed. Results A 44 - year - old male diagnosed as central sleep apnea syndrome ( CSAS ) underwent heart transplantation 4 years ago. The patient was on long - term Cyclosporin A and prednisone therapy, gained significant amount of weight during the past two years and developed Cushingoid features as well. The diagnosis of severe obstructive sleep apnea syndrome ( OSAS ) was confirmed by poly-somnography ( PSG ) . Relevant literatures reported that SAS was common in congestive heart failure patients before heart transplantation and it was the potential danger for cardiac graft patients. Another point was that the apnea types were different before and after the surgery. Conclusion SAS is the potential danger of heart transplantation; the types of apnea may transfer after heart transplantation, which may be related to the improvement of heart function.

  7. Síndrome de apnea hipopnea del sueño e ictus Sleep apnea-hypopnea syndrome and stroke

    Directory of Open Access Journals (Sweden)

    R. Muñoz

    2007-01-01

    Full Text Available Desde hace años se ha llamado la atención sobre la frecuente asociación entre el Síndrome de apnea hipopnea del Sueño (SAHS y el ictus. Disponemos de múltiples y muy diversos estudios epidemiológicos que señalan una posible relación causal. De forma paralela, a lo largo de estos años se ha incrementado el conocimiento de distintos mecanismos fisiopatológicos intermedios por los que teóricamente la apnea podría favorecer la aparición de isquemia cerebral. Entre estos destacaban un incremento de la presión arterial, la aparición de arritmias, cambios hemodinámicos de la circulación cerebral y un estado protrombótico. Asimismo, también se ha comprobado cómo el tratamiento con CPAP era beneficioso para normalizar algunas de estas alteraciones. Sin embargo, no ha sido hasta muy recientemente cuando, gracias a la aparición de diversos estudios prospectivos, se ha demostrado de forma fehaciente que el SAHS es un factor de riesgo que incrementa la posibilidad de padecer un ictus isquémico, de forma independiente a la presencia de otros factores de riesgo clásicos. En espera de nuevos estudios de intervención que confirmen si el tratamiento con CPAP reduce este riesgo, es importante incluir en la anamnesis de pacientes que hayan sufrido un ictus o un accidente isquémico transitorio la búsqueda de datos que nos hagan pensar en un SAHS y remitir a estos pacientes a valoración por el Servicio de Neumología en caso necesario.For many years attention has been drawn to the frequent association between sleep apnea-hypopnea syndrome and stroke. Numerous and very different epidemiological studies are available that point to a possible causal relation. In a parallel way, there has been an increase over these years in the knowledge of the different intermediate physiopathological mechanisms by which apnea could theoretically favour the appearance of cerebral ischemia. An increase in arterial pressure, the appearance of arrhythmias

  8. Management of obstructive sleep apnea: A dental perspective

    Directory of Open Access Journals (Sweden)

    Padma Ariga

    2007-01-01

    Full Text Available Sleep disordered breathing is a term which includes simple snoring, upper airway resistance syndrome, and obstructive sleep apnea (OSA. Simple snoring is a common complaint affecting 45% of adults occasionally and 25% of adults habitually and is a sign of upper airway obstruction. Snoring has also been identified as a possible risk factor for hypertension, ischemic heart disease, and stroke. The role of dentistry in sleep disorders is becoming more significant, especially in co-managing patients with simple snoring and mild to moderate OSA. The practicing dental professional has the opportunity to assist patients at a variety of levels, starting with the recognition of a sleep-related disorder, referring patients to a physician for evaluation, and assisting in the management of sleep disorders. Obesity is the main predisposing factor for OSA. In nonobese patients, craniofacial anomalies like micrognathia and retrognathia may also predispose to OSA. Diagnosis of OSA is made on the basis of the history and physical examination and investigations such as polysomnography, limited channel testing, split-night testing, and oximetry. Nocturnal attended polysomnography, which requires an overnight stay in a sleep facility, is the standard diagnostic modality in determining if a patient has OSA. As far as treatment is concerned, the less invasive procedures are to be preferred to the more invasive options. The first and simplest option would be behavior modification, followed by insertion of oral devices suited to the patient, especially in those with mild to moderate OSA. Continuous positive airway pressure (CPAP and surgical options are chosen for patients with moderate to severe OSA. The American Academy of Sleep Medicine (AAOSM has recommended oral appliances for use in patients with primary snoring and mild to moderate OSA. It can also be used in patients with a lesser degree of oxygen saturation, relatively less day time sleepiness, lower frequency

  9. Sleep Apnea Research in Animals. Past, Present, and Future.

    Science.gov (United States)

    Chopra, Swati; Polotsky, Vsevolod Y; Jun, Jonathan C

    2016-03-01

    Obstructive sleep apnea (OSA) is a common disorder that describes recurrent collapse of the upper airway during sleep. Animal models have been pivotal to the understanding of OSA pathogenesis, consequences, and treatment. In this review, we highlight the history of OSA research in animals and include the discovery of animals with spontaneous OSA, the induction of OSA in animals, and the emulation of OSA using exposures to intermittent hypoxia and sleep fragmentation.

  10. Length of Individual Apnea Events Is Increased by Supine Position and Modulated by Severity of Obstructive Sleep Apnea

    OpenAIRE

    Timo Leppänen; Juha Töyräs; Anu Muraja-Murro; Salla Kupari; Pekka Tiihonen; Esa Mervaala; Antti Kulkas

    2016-01-01

    Positional obstructive sleep apnea (OSA) is common among OSA patients. In severe OSA, the obstruction events are longer in supine compared to nonsupine positions. Corresponding scientific information on mild and moderate OSA is lacking. We studied whether individual obstruction and desaturation event severity is increased in supine position in all OSA severity categories and whether the severity of individual events is linked to OSA severity categories. Polygraphic recordings of 2026 patients...

  11. Incidence of hypothyroidism and its correlation with polysomnography findings in obstructive sleep apnea.

    Science.gov (United States)

    Ozcan, K Murat; Selcuk, Adin; Ozcan, Ibrahim; Ozdas, Talih; Ozdogan, Fatih; Acar, Mustafa; Dere, Huseyin

    2014-11-01

    The aim of this study is to investigate the thyroid functions and its correlation with polysomnography findings in obstructive sleep apnea patients. This study was conducted on 203 patients evaluated with the complaints of snoring, witnessed apnea and daytime sleepiness and established polysomnography (PSG) indication between May 2008 and August 2011. All patients' nocturnal PSG recordings were carried out. The thyroid function was classified as euthyroid, subclinical hypothyroidism and clinical hypothyroidism after analyzing serum TSH and free T4 values. The correlation between the data obtained from PSG records and thyroid function values was statistically compared. Apnea hypopnea index obtained from PSG was in the range of 5.4-132.9/h, and mean value was 32.7/h. The lowest oxygen saturation level was in the range of 20-92 %, and the mean value was 76.4 %. According to PSG results, 55 patients (27.09 %) had mild obstructive sleep apnea syndrome (OSAS), 48 patients (23.65 %) had moderate OSAS and 100 patients (49.26 %) had severe OSAS. On evaluation of the thyroid function test results, 10.8 % (n = 22) of the patients were defined to have subclinical hypothyroidism and 1.97 % (n = 4) clinical hypothyroidism. We found a total of 12.77 % subclinical and clinical hypothyroidism in patients with OSAS. Though the incidence of hypothyroidism was pretty high in patients with OSA, there was no statistically significant correlation between thyroid functions and polysomnography findings. We suggest that evaluation of the thyroid functions is important and necessary in patients with OSAS. Polysomnography findings do not correlate statistically with thyroid function tests, addressing the need for thyroid screening for all OSAS patients.

  12. Association of allergy/immunology and obstructive sleep apnea.

    Science.gov (United States)

    Calais, Charles J; Robertson, Brian D; Beakes, Douglas E

    2016-11-01

    Obstructive sleep apnea (OSA) is characterized by repetitive upper airway collapse that results in nonrefreshing sleep, excessive daytime sleepiness, and, ultimately, adverse consequences on quality of life, the cardiovascular system, and neurocognitive performance. OSA has traditionally been linked to body habitus (obesity and increased neck circumference), racial demographics, alcohol, tobacco, and sedative use. Numerous other conditions are linked to OSA, which may have clinical relevance. Specifically, asthma and nasal obstructive syndromes, e.g., rhinitis, have been shown to be risk factors. This review used the anatomic homogeneity of the upper and lower airways as an explanation for the inflammatory conditions that underlie and interrelate rhinitis, asthma, and OSA. There is strong evidence that both immunoglobulin Emediated and irritant-induced inflammation in either airway location play a significant role in all three (OSA, rhinitis, and asthma). We highlighted pathophysiologic, chemical, and cellular factors that explain the distinct relationship among OSA, asthma, and rhinitis, with emphasis for increased provider vigilance of the other syndromes when a patient is diagnosed with either entity.

  13. Lingua-epiglottis position predicts glossopharyngeal obstruction in patients with obstructive sleep apnea hypopnea syndrome.

    Science.gov (United States)

    Li, Shuhua; Wu, Dahai; Jie, Qin; Bao, Jimin; Shi, Hongjin

    2014-10-01

    The objective of the study was to investigate the relationship between lingua-epiglottis position and glossopharyngeal obstruction in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). One hundred and four patients with OSAHS diagnosed by polysomnography (PSG) were enrolled. Lingua-epiglottis position was visualized using endoscopy and classified into three types. Spiral CT imaging of the upper respiratory tract was performed to measure the cross-sectional area and inner diameter of the glossopharyngeal airway. The PSG was repeated after nasopharyngeal tube insertion (NPT-PSG). The NPT-PSG results, CT-measured data and incidence of stenosis were compared among the different lingua-epiglottis position groups. Obstructive sleep apnea hypopnea syndrome patients with different lingua-epiglottis positions had similar demographics. As lingua-epiglottis position type varied from type I to type III, cross-sectional area and inner diameter of the glossopharyngeal area decreased, glossopharyngeal airway stenosis rate increased, and apnea hypopnea index measured by NPT-PSG increased. The lowest oxygen saturation decreased. Lingua-epiglottis position was significantly related to glossopharyngeal obstruction. Lingua-epiglottis position should be used in clinical practice for the preliminary assessment of glossopharyngeal obstruction.

  14. Serum Level of Vascular Endothelial Growth Factor in Patients with Obstructive Sleep Apnea Hypopnea Syndrome

    Institute of Scientific and Technical Information of China (English)

    MA Jing; XU Yongjian; ZHANG Zhenxiang; LIU Huiguo; XIONG Weining; XU Shuyun

    2007-01-01

    To explore the relationship between the serum vascular endothelial growth factor (VEGF)level and the severity of obstructive sleep apnea hypopnea syndrome (OSAHS), the concentrations of serum VEGF in 40 OSAHS patients and 9 healthy controls were measured by using ELISA method.Meanwhile the correlation between the concentration of VEGF and parameters of polysomnography (PSG) was examined. Our results showed that the concentrations of VEGF were significantly higher in OSAHS patients with severe hypoxia (536.8±334.7 pg/mL) than in those with mild hypoxia (329.2±174.7 pg/mL) and healthy controls (272. 8±211.0 pg/mL) (P<0.05 for both). The concentrations of VEGF were also significantly higher in OSAHS patients with hypertension (484.5±261.4 pg/mL) than in those without hypertension (311.0±158.4 pg/mL) and healthy controls (272. 8±211.0 pg/mL) (P<0.05 for both). There was a positive correlation between the concentration of VEGF and the apnea hypopnea index (AHI) (γ=0.34, P<0.05). It is concluded that the concentration of the serum VEGF is positively related to the severity of OSAHS. The elevated serum VEGF level may be involved in the pathogenesis of the complications of obstructive sleep apnea hypopnea syndrome.

  15. Heart rate responses to autonomic challenges in obstructive sleep apnea.

    Directory of Open Access Journals (Sweden)

    Paul M Macey

    Full Text Available Obstructive sleep apnea (OSA is accompanied by structural alterations and dysfunction in central autonomic regulatory regions, which may impair dynamic and static cardiovascular regulation, and contribute to other syndrome pathologies. Characterizing cardiovascular responses to autonomic challenges may provide insights into central nervous system impairments, including contributions by sex, since structural alterations are enhanced in OSA females over males. The objective was to assess heart rate responses in OSA versus healthy control subjects to autonomic challenges, and, separately, characterize female and male patterns. We studied 94 subjects, including 37 newly-diagnosed, untreated OSA patients (6 female, age mean ± std: 52.1 ± 8.1 years; 31 male aged 54.3 ± 8.4 years, and 57 healthy control subjects (20 female, 50.5 ± 8.1 years; 37 male, 45.6 ± 9.2 years. We measured instantaneous heart rate with pulse oximetry during cold pressor, hand grip, and Valsalva maneuver challenges. All challenges elicited significant heart rate differences between OSA and control groups during and after challenges (repeated measures ANOVA, p<0.05. In post-hoc analyses, OSA females showed greater impairments than OSA males, which included: for cold pressor, lower initial increase (OSA vs. control: 9.5 vs. 7.3 bpm in females, 7.6 vs. 3.7 bpm in males, OSA delay to initial peak (2.5 s females/0.9 s males, slower mid-challenge rate-of-increase (OSA vs. control: -0.11 vs. 0.09 bpm/s in females, 0.03 vs. 0.06 bpm/s in males; for hand grip, lower initial peak (OSA vs. control: 2.6 vs. 4.6 bpm in females, 5.3 vs. 6.0 bpm in males; for Valsalva maneuver, lower Valsalva ratio (OSA vs. control: 1.14 vs. 1.30 in females, 1.29 vs. 1.34 in males, and OSA delay during phase II (0.68 s females/1.31 s males. Heart rate responses showed lower amplitude, delayed onset, and slower rate changes in OSA patients over healthy controls, and impairments may be more pronounced in

  16. Application of lingual tonsillectomy to sleep apnea syndrome involving lingual tonsils.

    Science.gov (United States)

    Suzuki, Kenji; Kawakatsu, Kenji; Hattori, Chikaya; Hattori, Hirokazu; Nishimura, Yoichi; Yonekura, Arata; Yagisawa, Mikio; Nishimura, Tadao

    2003-01-01

    In sleep apnea syndrome, surgical treatment is applied in obstructive-type cases and some mixed-type cases. If the obstructive part is in the root of the tongue, forward transfer of the tongue, lingual tonsillectomy and laser midline glossectomy are applied. In this study, we demonstrate the surgical technique of lingual tonsillectomy using an ultrasonic coagulating dissector (SonoSurg) with a blade tip shape developed in our department. We conclude that lingual tonsillectomy using SonoSurg, which we have frequently used, should be the first choice of treatment for snoring and sleep apnea caused by hypertrophy of the lingual tonsils from the viewpoints of effectiveness, prevention of hemorrhage, safety and handling.

  17. Sex differences in sleep apnea predictors and outcomes from home sleep apnea testing

    Science.gov (United States)

    Cairns, Alyssa; Poulos, Greg; Bogan, Richard

    2016-01-01

    Study objectives To evaluate sex differences in predictors of obstructive sleep apnea (OSA) as per outcomes from home sleep apnea testing. Design This was a retrospective analysis of a large repository of anonymous test results and pretest risk factors for OSA. Setting and patients A total of 272,705 patients were referred for home sleep apnea testing from a variety of clinical practices for suspected sleep disordered breathing across North America from 2009 to 2013. Interventions Not applicable. Measurements and results Predictors of OSA (apnea hypopnea index4%≥5) were evaluated by multiple logistic regression; sex differences were evaluated by interaction effects. Middle age was the single most robust predictor of OSA for both sexes and was particularly foretelling for females (PInsomnia, depression, and use of sleep medication, although more commonly reported in females, did not predict OSA. Hypertension, although equally reported by both sexes, performed better as a predictor in females (Pmenopausal status in OSA screening tools. PMID:27418861

  18. Association of chronic obstructive pulmonary disease and obstructive sleep apnea consequences

    Directory of Open Access Journals (Sweden)

    Carlos Zamarrón

    2009-01-01

    Full Text Available Carlos Zamarrón1, Vanesa García Paz1, Emilio Morete1, Felix del Campo Matías21Servicio de Neumología, Hospital Clínico Universitario de Santiago, Santiago, Spain; 2Servicio de Neumologia, Hospital Universitario Rio Ortega de Vallaclolid, Vallaclolid, SpainAbstract: Obstructive sleep apnea syndrome (OSAS and chronic obstructive pulmonary disease (COPD are two diseases that often coexist within an individual. This coexistence is known as overlap syndrome and is the result of chance rather than a pathophysiological link. Although there are claims of a very high incidence of OSAS in COPD patients, recent studies report that it is similar to the general population. Overlap patients present sleep-disordered breathing associated to upper and lower airway obstruction and a reduction in respiratory drive. These patients present unique characteristics, which set them apart from either COPD or OSAS patients. COPD and OSAS are independent risk factors for cardiovascular events and their coexistence in overlap syndrome probably increases this risk. The mechanisms underlying cardiovascular risk are still unclear, but may involve systemic inflammation, endothelial dysfunction, and tonic elevation of sympathetic neural activity. The treatment of choice for overlap syndrome in stable patients is CPAP with supplemental oxygen for correction of upper airway obstructive episodes and hypoxemia during sleep.Keywords: chronic obstructive pulmonary disease, obstructive sleep apnea syndrome, overlap syndrome, sleep, cardiovascular disease

  19. Relationship between the quality of life and the severity of obstructive sleep apnea syndrome

    Directory of Open Access Journals (Sweden)

    C. Lopes

    2008-10-01

    Full Text Available The effects of sleep disorders on the quality of life (QOL have been documented in the literature. Excessive sleepiness and altered circadian rhythms may negatively affect ability to learn, employment, and interpersonal relations, and directly degrade QOL. The objective of the present study was to evaluate the impact of obstructive sleep apnea syndrome of varying severity on QOL. The study was conducted on 1892 patients aged 18 years or older referred by a physician to the Sleep Institute, São Paulo, with complaints related to apnea (snoring, excessive daytime sleepiness, hyperarousal, and fatigue. They were submitted to overnight polysomnography for the diagnosis of sleep disorders from August 2005 through April 2006. The patients completed the Epworth Sleepiness Scale and QOL SF-36 sleep questionnaires. They were classified as non-physically active and physically active and not-sleepy and sleepy and the results of polysomnography were analyzed on the basis of the apnea hypopnea index (AHI. The apneic subjects showed a reduction in QOL which was proportional to severity. There was a significant decrease in all domains (physical functioning, role physical problems, bodily pain, general health perceptions, vitality, social functioning, emotional problems, general mental health for apneics with AHI >30, who generally were sleepy and did not participate in physical activities (P < 0.05. The present study provides evidence that the impact of sleep disorders on QOL in apneics is not limited to excessive daytime sleepiness and that physical activity can contribute to reducing the symptoms. Thus, exercise should be considered as an adjunct interventional strategy in the management of obstructive sleep apnea syndrome.

  20. 阻塞性睡眠呼吸暂停综合征的潜在遗传易感性因素%Potential genetic susceptibility factors for obstructive sleep apnea syndrome

    Institute of Scientific and Technical Information of China (English)

    张秀琴; 刘仍允; 黄建安; 胡华成

    2008-01-01

    阻塞性睡眠呼吸暂停综合征(OSAS)是一全身多系统性疾病,其病因复杂,很大程度上受遗传因素的影响,且发病率有逐年上升趋势.其发病的主要危险因素包括肥胖、男性、中年和气道狭窄等.新近的研究多集中在心血管疾病和炎症因子与OSAS的关系以及相关基因位点多态性方面.%Obstructive sleep apnea syndrome(OSAS)is a multisystemic complex disease strongly influenced by genetic factors and its prevalence appears to be increasing.The main risk factors for OSAS are obesity,male gender,middle age,and the presence of a narrow airway.Recent researches pay more attention to cardiovascular diseases as well as related factors,inflammatory cytokines and related gene locus polymorphism.

  1. Acute Feasibility of Neuromuscular Electrical Stimulation in Severely Obese Patients with Obstructive Sleep Apnea Syndrome: A Pilot Study

    Science.gov (United States)

    Maffiuletti, Nicola A.; Borel, Anne-Laure; Grangier, Angélique; Wuyam, Bernard; Pépin, Jean-Louis

    2017-01-01

    Objective. Obesity and obstructive sleep apnea (OSA) are closely interconnected conditions both leading to high cardiovascular risk. Inactivity is frequent and physical activity programs remain difficult in these patients. We investigated the acute feasibility of two neuromuscular electrical stimulation (NMES) modalities in extremely inactive obese patients with OSA. Design. A randomized cross-over study, with two experimental sessions (one per condition: multipath NMES versus conventional NMES). Setting. Outpatient research hospital. Subjects. Twelve patients with obesity, already treated for OSA. Interventions. No intervention. Measures. Feasibility outcomes included NMES current intensity, knee extension force evoked by NMES, and self-reported discomfort. Results. We found higher current intensity, a trend to significantly higher evoked force and lower discomfort during multipath NMES versus conventional NMES, suggesting better tolerance to the former NMES modality. However, patients were rapidly limited in the potential of increasing current intensity of multipath NMES. Conclusion. Both NMES modalities were feasible and relatively well tolerated by obese patients with OSA, even if multipath NMES showed a better muscle response/discomfort ratio than conventional NMES. There is an urgent need for a proof-of-concept study and interventional randomized controlled trials comparing NMES therapy versus current care to justify its utilization in obese and apneic patients with low physical activity levels.

  2. Rapid maxillary expansion and obstructive sleep apnea: A review and meta-analysis

    Science.gov (United States)

    Zancanella, Edilson; Crespo, Agrício-Nubiato

    2016-01-01

    Background OSAS during childhood leads to significant physical and neuropsychomotor impairment. Thus, it needs to be recognized and treated early in order to avoid or attenuate the chronic problems associated with OSAS, which are deleterious to a child’s development. Adenotonsillectomy and, in select cases, continuous positive airwaypressure (CPAP) have been the preferred treatments for OSAS in children, and yet they are ineffective at fully ameliorating the disease. Minimally invasive treatments have recently been proposed, comprising intra-oral and extra-oral devices as well as speech therapy. Objetive: to conduct a meta-analysis on studies from around the world that used rapid maxillary expansion (RME) to treat OSAS in children. Material and Methods We performed a meta-analysis of studies using RME for OSA treatment in children. A literature survey was conductedusing PubMed and Medline for English articles published up to December 2014 with the following descriptors: Sleep Apnea, Obstructive, Children, Treatment, Orthodontic, Othopaedic, Maxillaryexpansion. Studies were included in the meta-analysisif they were case-controlled studies, randomized, and involved non-syndromic children aged 0 to 12years old diagnosed with OSA by the polysomnography apnea-hypopnea index (AHI) before and after the intervention, submitted RME only. Results In all, 10 articles conformed to the inclusion criteria and were included in this meta-analysis. The total sample size across all these articles was 215 children, having a mean age of 6.7 years,of whom58.6%were male. The mean AHI during the follow-up was -6.86 (p <0.0001). Conclusions We concluded that rapid maxillary expansion (RME) in children with OSAS appears to be an effective treatment for this syndrome. Further randomized clinical studies are needed to determine the effectiveness of RME in adults. Key words:Rapid maxillary expansión, obstructive sleep apnea, meta-analysis. PMID:27031063

  3. Prevalence and Characteristics of Positional Sleep Apnea Among Patients with Obstructive Sleep Apnea Syndrome%阻塞性睡眠呼吸暂停综合征患者中体位性睡眠呼吸暂停者的发生率及特征观察

    Institute of Scientific and Technical Information of China (English)

    魏永莉; 陈丹丹; 苏梅; 殷敏; 李翀; 刘皓

    2012-01-01

    Objective To investigate the prevalence of positional sleep apnea (PSA) among patients with obstructive sleep apnea syndrom (OSAS) and some clinical characteristics of PSA. Methods The general prevalence of PSA among all OSAS patients and the respective incidences of PSA in mild, moderate and severe OSAS patients were investigated among a total of 7879 OSAS patients undergoing polysomnography (PSC) in sleep centers of author's hospitals from January 2004 to December 2010. 203 PSA patients (PSA group) and 226 AHI - matched non - PSA patients with OSAS (non - PSA group) were selected and compared for their age, body mass index ( BMI), neck and waist circumferences, PSG parameters and possible duration of OSAS history between two groups. Results The general prevalence of PSA in OSAS patients was 16.8% (1326/7879). PSA was seen in 942 of 2574 patients (34.2% ) with mild OSAS (5 ≤AHI<15). 322 of 2821 patients with moderate OSAS (15s≤AHI <30), and 62 of 2214 patients with severe OSAS (AHl≥30). Com- pared with patients in non-PSA, the patients in PSA group showed the following;a lower BMI(24.2 ±2. 8 vs 27.1 ±2.4, P<0.05), smaller neck circumference (37.4 ±1.7cm vs 39.2 ± 1.9cm,P<0.05) , higher percentage of sleep in supine posture (89.4% ±6.3% vs 79.8% ±7.7% , P<0.05), and shorter duration of estimated OSAS history. Conclusion PSA is common particularly in patients with mild OSAS and PSA patients tend to have lower BMI, smaller neck circumference, and possibly a shorter duration of OSAS history than non - PSA patients.%目的 探讨体位性睡眠呼吸暂停(positional sleep apnea,PSA)在阻塞性睡眠呼吸暂停综合征(OSAS)患者中发生率及临床特征.方法 选自2004年1月- 2010年12月在笔者医院睡眠中心经PSG确诊为OSAS的7879例患者中PSA的总体发生率和轻度(5≤AHI<15)、中度(15≤AHI<30)、重度OSAS(AHI≥30)患者中PSA的各自发生率.分别选择AHI相匹配的PSA患者203例(PSA组)和非PSA患者226例(

  4. Obstructive sleep apnea in chronic obstructive pulmonary disease patients.

    LENUS (Irish Health Repository)

    Lee, Ruth

    2012-02-01

    PURPOSE OF REVIEW: Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) represent two of the most prevalent chronic respiratory disorders and cardiovascular diseases are major co-morbidities in both. Co-existence of both disorders (overlap syndrome) occurs in 1% of adults and overlap patients have worse nocturnal hypoxemia and hypercapnia than COPD and OSA patients alone. The present review discusses recent data concerning the pathophysiological and clinical significance of the overlap syndrome. RECENT FINDINGS: The severity of obstructive ventilatory impairment and hyperinflation, especially the inspiratory capacity to total lung capacity (TLC) ratio, correlates with the severity of sleep-related breathing disturbances. Early treatment with continuous positive airway pressure (CPAP) improves survival, reduces hospitalization and pulmonary hypertension, and also reduces hypoxemia. Evidence of systemic inflammation and oxidative stress in COPD and sleep apnea provides insight into potential interactions between both disorders that may predispose to cardiovascular disease. Long-term outcome studies of overlap patients currently underway should provide further evidence of the clinical significance of the overlap syndrome. SUMMARY: Studies of overlap syndrome patients at a clinical, physiological and molecular level should provide insight into disease mechanisms and consequences of COPD and sleep apnea, in addition to identifying potential relationships with cardiovascular disease.

  5. Treatment of obstructive sleep apnea syndrome with a Kampo-formula, San'o-shashin-to: a case report.

    Science.gov (United States)

    Hisanaga, A; Saitoh, O; Fukuda, H; Kurokawa, K; Okabe, A; Tachibana, H; Hagino, H; Mita, T; Yamashita, I; Tsutsumi, M; Kurachi, M; Itoh, T

    1999-04-01

    The following describes a 76-year-old male with obstructive sleep apnea syndrome successfully treated with a Kampo-formula, San'o-shashin-to (Formula medicamentorum tres ad dispellendi cordis). Polysomnography, performed before and after administration of San'o-shashin-to, revealed that the apnea index decreased from 11.1 events/hour to 4.1 events/hour, and that the apnea plus hypopnea index decreased from 18.4 events/hour to 10.7 events/hour. The patient was normo-weight (body mass index: 20.4 kg/m2), and events of sleep apnea and hypopnea were mostly noted during a non-rapid eye movement sleep. It is possible that San'o-shashin-to has some alleviating effects on the upper airway resistance during sleep.

  6. Atrial fibrillation in obstructive sleep apnea

    OpenAIRE

    Goyal, Sandeep K; Sharma, Abhishek

    2013-01-01

    Atrial fibrillation (AF) is a common arrhythmia with rising incidence. Obstructive sleep apnea (OSA) is prevalent among patients with AF. This observation has prompted significant research in understanding the relationship between OSA and AF. Multiple studies support a role of OSA in the initiation and progression of AF. This association has been independent of obesity, body mass index and hypertension. Instability of autonomic tone and wide swings in intrathoracic pressure are seen in OSA. T...

  7. The Clinical Significance of VEGF and carotid intima-media thickness in Obstructive sleep apnea syndrome%VEGF和IMT测定对OSAS的临床意义

    Institute of Scientific and Technical Information of China (English)

    李慧; 钟定; 李莉

    2012-01-01

    Objective To explore the relationship between Vascular endothelial growth factor ( VEGF ), carotid intima-media thickness ( IMT ) and Obstructive sleep apnea syndrome ( OSAS ). Methods 30 male OSAS patients and 25 cases of normal subjects were selected to conduct sleep apnea monitoring by polysomnography. The level of VEGF in plasma was measured and the carotid IMT was evaluated. Their differences and the correlation with sleep monitoring index were analyzed. Results Compared with the control group, the AHI, hypoxia time at night, VEGF and IMT in OSAS increased more obviously, while the Lowest oxygen saturation decreased more obviously, and the differences were statistically significant ( P <0. 05 ). The VEGF positively correlated with AHI, night hypoxia time ( P <0. 05 ), but negatively correlated with lowest oxygen saturation ( P <0. 05 ). Carotid IMT was positively correlated with AHI ( P <0. 05 ), and negatively correlation with lowest oxygen saturation ( P < 0. 05 ). Conclusion VEGF may play an important role in the pathogenesis of patients with OSAS, which provides new ideas for early prevention OSAS patients with cardiovascular complications.%目的 探讨血管内皮生长因子(VEGF)、颈动脉内膜中层厚度(IMT)与OSAS患者的关系.方法 选取男性OSAS患者30例和体检正常者25例进行多导睡眠监测,评估呼吸暂停低通气指数(AHI)、夜间缺氧时间、最低血氧饱和度差异.同时,检测外周血中的VEGF水平和颈动脉内膜中层厚度(IMT),并分析其差异及与睡眠监测指标相关性.结果 与对照组比较,OSAS患者呼吸暂停低通气指数(AHI)、夜间缺氧时间、IMT、VEGF较明显增高,最低血氧饱和度明显降低,差异有统计学意义(P均<0.05);相关性分析显示,血浆VEGF与AHI、夜间缺氧时间正相关(P<0.05),与最低血氧饱和度负相关(P<0.05).颈动脉IMT与AHI正相关(P<0.05),与最低血氧饱和度负相关(P<0.05).结论 VEGF可能在OSAS患者发病

  8. [Perioperative management in children with sleep apnea syndrome (SAS) undergoing adenoidotonsillectomy].

    Science.gov (United States)

    Mizuno, Ju; Nemoto, Mikiko; Sato, Tomoko; Yokoyama, Takeshi; Hanaoka, Kazuo

    2013-02-01

    We should take care of the occurrences of apnea and hypopnea after emergence from general anesthesia in the children with sleep apnea syndrome (SAS) due to an increase in sensitivity to opioid agonists given for previous recurrent hypoxia. Preoperative assessment for SAS with apnea hypopnea index (AHI), oxygen desaturation index (ODI), and minimum artery oxygen saturation by pulse oxymetry (lowest SpO2) obtained from polysomnography (PSG) test could help to predict the postoperative respiratory depression. In perioperative management in the children with SAS who are candidates for adenotonsillectomy, the dose of opioid agonists during anesthesia maintenance for purpose of postoperative analgesia and sedation should be reduced; postoperative respiratory and circulatory management with monitoring of respiratory movement of the thoracoabdominal part, and electrographic (ECG) and SpO2 monitoring should be continued intensively under long-term oxygen administration; and airway management, nasal continuous positive airway pressure (nCPAP), and artificial ventilation should be prepared for the occurrence of postoperative respiratory depression.

  9. Obstructive sleep apnea treatment with dental appliance

    Directory of Open Access Journals (Sweden)

    Rubens Reimão

    1994-12-01

    Full Text Available The case of a 40-year-old male patient with obstructive sleep apnea syndrome (OSAS is reported, with emphasis on treatment with a dental appliance. This therapeutic approach, which has been focused on recent research, has as its objective, the posturing of the mandibule and, consequently, the tongue more anteriorly, thus in turn leading to an increase in the posterior oropharyngeal airway space (PAS. Cephalometry contributed determining in this case whereby enlargement limits were observed in the PAS with mandibular displacement. Clinical and polysomnographic controls showed subjective reduction of the excessive daytime sleepiness and objective decrease in apneas intensity to normal limits. Eight months follow-up evidenced the steady improvement.

  10. Relationship between Obstructive Sleep Apnea Syndrome and Cardiovascular Related Receptors for Research Progress%阻塞性睡眠呼吸暂停综合征与心血管相关受体的研究进展

    Institute of Scientific and Technical Information of China (English)

    隋百萍; 高海波; 孔一慧; 李为民

    2012-01-01

    Obstructive sleep apnea syndrome (OSAS) is importantly involved in respiratory, ENT, dental, neurology department, cardiovascular medicine, and hematology. In cardiovascular disease, OSAS is closely related to some diseases, such as hypertension, coronary heart disease, heart failure, arrhythmia, etc; In the endocrine system disease, OSAS is inseparable with a number of diseases, such as obesity, diabetes, thyroid system diseases, etc. OSAS is very complicated with the interaction mechanism of various diseases. At present the close relationship between OSAS and cardiovascular disease, has become a hot spot OSAS is independent risk factor for cardiovascular disease, so a correct understanding of the relationship between them has great significance in prevention and treatment of cardiovascular disease in the future. Here we mainly summarized. Here is important mention for the relationship between cardiovascular related receptors and OSAS.%阻塞性睡眠呼吸暂停综合征是一种涉及呼吸科、耳鼻喉科、口腔科、神经科、心血管科、血液内科等多学科的疾病.在心血管疾病方面,阻塞性睡眠呼吸暂停综合征主要与高血压、冠心病、心力衰竭、心律失常等疾病的关系密切;在内分泌系统疾病方面,阻塞性睡眠呼吸暂停综合征与肥胖、糖尿病、甲状腺系统疾病等的相互联系.阻塞性睡眠呼吸暂停综合征与各疾病相互作用机制十分复杂,目前阻塞性睡眠呼吸暂停综合征与心血管疾病关系密切,已成为研究热点.阻塞性睡眠呼吸暂停综合征是心血管疾病独立的危险因素,正确认识两者的关系对于今后防御和治疗心血管疾病有重大意义.这里主要关于阻塞性睡眠呼吸暂停综合征与心血管相关受体的相互关系进行综述.

  11. The consolidation of implicit sequence memory in obstructive sleep apnea.

    Directory of Open Access Journals (Sweden)

    Eszter Csabi

    Full Text Available Obstructive Sleep Apnea (OSA Syndrome is a relatively frequent sleep disorder characterized by disrupted sleep patterns. It is a well-established fact that sleep has beneficial effect on memory consolidation by enhancing neural plasticity. Implicit sequence learning is a prominent component of skill learning. However, the formation and consolidation of this fundamental learning mechanism remains poorly understood in OSA. In the present study we examined the consolidation of different aspects of implicit sequence learning in patients with OSA. We used the Alternating Serial Reaction Time task to measure general skill learning and sequence-specific learning. There were two sessions: a learning phase and a testing phase, separated by a 10-hour offline period with sleep. Our data showed differences in offline changes of general skill learning between the OSA and control group. The control group demonstrated offline improvement from evening to morning, while the OSA group did not. In contrast, we did not observe differences between the groups in offline changes in sequence-specific learning. Our findings suggest that disrupted sleep in OSA differently affects neural circuits involved in the consolidation of sequence learning.

  12. Obstructive sleep apnea

    Directory of Open Access Journals (Sweden)

    Steven D. Brass

    2011-11-01

    Full Text Available Obstructive sleep apnea (OSA affects millions of Americans and is estimated to be as prevalent as asthma and diabetes. Given the fact that obesity is a major risk factor for OSA, and given the current global rise in obesity, the prevalence of OSA will increase in the future. Individuals with sleep apnea are often unaware of their sleep disorder. It is usually first recognized as a problem by family members who witness the apneic episodes or is suspected by their primary care doctor because of the individual’s risk factors and symptoms. The vast majority remain undiagnosed and untreated, despite the fact that this serious disorder can have significant consequences. Individuals with untreated OSA can stop breathing hundreds of times a night during their sleep. These apneic events can lead to fragmented sleep that is of poor quality, as the brain arouses briefly in order for the body to resume breathing. Untreated, sleep apnea can have dire health consequences and can increase the risk of hypertension, diabetes, heart disease, and heart failure. OSA management has also become important in a number of comorbid neurological conditions, including epilepsy, stroke, multiple sclerosis, and headache. Diagnosis typically involves use of screening questionnaires, physical exam, and an overnight polysomnography or a portable home study. Treatment options include changes in lifestyle, positive airway pressure, surgery, and dental appliances.

  13. Obstructive sleep apnea.

    Science.gov (United States)

    Ho, Matthew L; Brass, Steven D

    2011-11-29

    Obstructive sleep apnea (OSA) affects millions of Americans and is estimated to be as prevalent as asthma and diabetes. Given the fact that obesity is a major risk factor for OSA, and given the current global rise in obesity, the prevalence of OSA will increase in the future. Individuals with sleep apnea are often unaware of their sleep disorder. It is usually first recognized as a problem by family members who witness the apneic episodes or is suspected by their primary care doctor because of the individual's risk factors and symptoms. The vast majority remain undiagnosed and untreated, despite the fact that this serious disorder can have significant consequences. Individuals with untreated OSA can stop breathing hundreds of times a night during their sleep. These apneic events can lead to fragmented sleep that is of poor quality, as the brain arouses briefly in order for the body to resume breathing. Untreated, sleep apnea can have dire health consequences and can increase the risk of hypertension, diabetes, heart disease, and heart failure. OSA management has also become important in a number of comorbid neurological conditions, including epilepsy, stroke, multiple sclerosis, and headache. Diagnosis typically involves use of screening questionnaires, physical exam, and an overnight polysomnography or a portable home study. Treatment options include changes in lifestyle, positive airway pressure, surgery, and dental appliances.

  14. Correlation between chronic obstructive pulmonary disease and obstructive sleep apnea syndrome in a general population in Iran

    Directory of Open Access Journals (Sweden)

    Babak Amra

    2011-01-01

    Full Text Available Background: The aim of this study was to evaluate epidemiological relationship between chronic obstructive pulmonary disease and sleep apnea syndrome in a sample of Persian population. Methods: As a part of a population-based cross-sectional study, 3900 randomly selected individuals aged 15 years or older were invited to take part in the survey; 3770 individuals (96.6% agreed to fill out the respiratory and sleep questionnaire. Those subjects suspected to have either chronic obstructive pulmonary disease and/or obstructive sleep apnea underwent spirometry and polysomnography test if indicated. Spirometric measurements were performed on 420 invited responders. Polysomnography measurements were performed on 25 of the responders. Results: Prevalence rates for sleep apnea, chronic obstructive pulmonary disease and current asthma were 4.98%, 5.7% and 3.1%, respectively. Logistic regression showed independent associations between sleep apnea and chronic obstructive pulmonary disease. There was no significant independent association between sleep apnea symptoms and current asthma and wheeze ever. Conclusions: These observations indicated relationship between chronic obstructive pulmonary disease and obstructive sleep apnea. These observations indicated the necessity of further studies to explain the possible common pathogenic mechanisms involved in two disease entities.

  15. Resistant Hypertension and Obstructive Sleep Apnea in the Primary-Care Setting

    Directory of Open Access Journals (Sweden)

    M. Demede

    2011-01-01

    Full Text Available We ascertained the prevalence of resistant hypertension (RH among blacks and determined whether RH patients are at greater risk for obstructive sleep apnea (OSA than hypertensives. Method. Data emanated from Metabolic Syndrome Outcome Study (MetSO, a study investigating metabolic syndrome among blacks in the primary-care setting. Sample of 200 patients (mean age = 63 ± 13 years; female = 61% with a diagnosis of hypertension provided subjective and clinical data. RH was defined using the JNC 7and European Society guidelines. We assessed OSA risk using the Apnea Risk Evaluation System ARES, defining high risk as a total ARES score ≥6. Results. Overall, 26% met criteria for RH and 40% were at high OSA risk. Logistic regression analysis, adjusting for effects of age, gender, and medical co morbidities, showed that patients with RH were nearly 2.5 times more likely to be at high OSA risk, relative to those with hypertension (OR = 2.46, 95% CI: 1.03–5.88, P<.05. Conclusion. Our findings show that the prevalence of RH among blacks fell within the range of RH for the general hypertensive population (3–29%. However, patients with RH were at significantly greater risk of OSA compared to patients with hypertension.

  16. Sleep Apnea

    Science.gov (United States)

    ... of other risk factors linked to a higher risk of heart disease. The conditions that make up metabolic syndrome include high blood pressure, abnormal cholesterol, high blood sugar and an increased waist circumference. Complications with medications and surgery. Obstructive sleep apnea ...

  17. Study of patients with OSAS in prethrombotic state

    Institute of Scientific and Technical Information of China (English)

    PAN Lei; XU Wenbing

    2007-01-01

    Objective:To investigate the molecular markers change of prethrombotic state in patients with obstructive sleep apnea syndrome (OSAS) and estimate the effects of nasal continuous positive airway pressure (nCPAP) therapy.Methods:To perform case-controlled study in 30 patients with OSAS and 30 healthy control group. The patients with OSAS were diagnosed by the polysomnography monitor system and treated by Auto-CPAP. Blood samples were taken and measured GMP-140, APTT, AT-Ⅲ ,PAI and t-PA. Results: As compared with the normal controls, the level of GMP-140 which reflects platelet activation was increased in patients with OSAS[(29.67±8.68)% vs (3.07±1.74)%, P<0.05)],the levels of AT-Ⅲ which reflect anticoagulation function decreased [(74.47±5.91)% vs (98.60±3.57)%,P<0.05],and the level of t-PA which reflects the activity of the fibrinolysis system decreased [(4.11±1.36)μg vs (8.65±1.22)μg,P<0.05]. The level of PAI which reflects the inhibition of the fibrinolysis increased [(107.43±8.75)% vs (89.17±4.44)%,P<0.05]. Compared to nCPAP pretherapy, GMP-140 and PAI were decreased [(17.07±7.97)% vs (29.67±8.68)%, and (95.83±5.91)% vs (107.43±8.75)%,respectively, both P<0.05], AT-Ⅲ and t-PA increased [ (95.20±6.67)% vs (74.47±5.91)%, and(5.45±1.61)μg vs (4.11±1.36)μg, respectively, both P<0.05]. The nCPAP theraphy could significantly increase the minimum arterial oxygen saturation(SaO2%) during sleep[(90.37±2.31)% vs (68.3±7.48)%,P<0.05] and significantly deseased AI,AHI and systolic blood pressure (SBP).Conclusion:Prethrombotic state is present in patients with OSAS, nCPAP theraphy can correct nocturnal hypoxaemia, partly or totally reverse prethrombotic state of patients with OSAS, decrease OSAS-related thrombotic complications.

  18. Accelerated Echo Planer J-resolved Spectroscopic Imaging of Putamen and Thalamus in Obstructive Sleep Apnea

    OpenAIRE

    Manoj K. Sarma; Macey, Paul M.; Rajakumar Nagarajan; Ravi Aysola; Ronald M Harper; M. Albert Thomas

    2016-01-01

    Obstructive sleep apnea syndrome (OSAS) leads to neurocognitive and autonomic deficits that are partially mediated by thalamic and putamen pathology. We examined the underlying neurochemistry of those structures using compressed sensing-based 4D echo-planar J-resolved spectroscopic imaging (JRESI), and quantified values with prior knowledge fitting. Bilaterally increased thalamic mI/Cr, putamen Glx/Cr, and Glu/Cr, and bilaterally decreased thalamic and putamen tCho/Cr and GABA/Cr occurred in ...

  19. Long-term oral appliance therapy in obstructive sleep apnea syndrome : a controlled study on dental side effects

    NARCIS (Netherlands)

    Doff, M. H. J.; Finnema, K. J.; Hoekema, A.; Wijkstra, P. J.; de Bont, L. G. M.; Stegenga, B.

    2013-01-01

    This study aimed to assess possible dental side effects associated with long-term use of an adjustable oral appliance compared with continuous positive airway pressure (CPAP) in patients with the obstructive sleep apnea syndrome and to study the relationship between these possible side effects and t

  20. Association between obesity and cognition impairment in patients with moderate-to-severe obstructive sleep apnea-hypopnea syndrome

    Institute of Scientific and Technical Information of China (English)

    王婧

    2014-01-01

    Objective To explore the association between obesity and cognition impairment in patients with moderate-tosevere obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods A total of 425 eligible patients with moderate-to-severe OSAHS were screened for this retrospective study at Sleep Center,Second Affiliated H

  1. The change and its clinical significance of serum cystatin C in elderly patients with obstructive sleep apnea hypopnea syndrome

    Institute of Scientific and Technical Information of China (English)

    张孝斌

    2013-01-01

    Objective To investigate the change of serum cystatin C (CC) level and its clinical significance in elderly patients with obstructive sleep apnea hypopnea syndrome (OSAHS) ,and to evaluate the diagnostic value of serum CC for renal impairment in elderly OSAHS patients.Methods Elderly snoring subjects (age≥60 years) un-

  2. Short-Term Memory Performances during Sustained Wakefulness in Patients with Obstructive Sleep Apnea-Hypopnea Syndrome

    Science.gov (United States)

    Greneche, Jerome; Krieger, Jean; Bertrand, Frederic; Erhardt, Christine; Maumy, Myriam; Tassi, Patricia

    2011-01-01

    Both working and immediate memories were assessed every 4 h by specific short-term memory tasks over sustained wakefulness in 12 patients with obstructive sleep apnea and hypopnea syndrome (OSAHS) and 10 healthy controls. Results indicated that OSAHS patients exhibited lower working memory performances than controls on both backward digit span and…

  3. The relationship between tumor necrosis factor-α gene promoter polymorphism and obstructive sleep apnea-hypopnea syndrome

    Institute of Scientific and Technical Information of China (English)

    刘辉国

    2006-01-01

    Objective To investigate the relationship between tumor necrosis factor-α(TNF-α) gene promoter polymorphism and obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods The plasma TNF-αlevel of OSAHS group and non-OSAHS group was detected by enzyme-linked immunosorbent assay (ELISA). Eighteen patients with severe OSAHS were treated with continuous

  4. Maxillofacial Developmental and Occlusion Disorders in Children with Obstructive Sleep Apnea Syndrome

    Directory of Open Access Journals (Sweden)

    Alexander Torres Molina

    2011-03-01

    Full Text Available The obstructive sleep apnea syndrome is a highly prevalent disease that affects approximately 2% of children and is considered a complex entity due to its somatic and cognitive impact. Occlusion and mouth, skull and facial alterations associated with this syndrome are a matter of concern both for specialists in maxillofacial surgery and orthodontists, who are playing an important role in the diagnosis and final treatment of this disease. Guilleminault scoring system allows to evaluate the severity of the anomalies of the facial skeleton and the dental occlusion in these patients, by relying on the physical examination and the cephalometry. Early diagnosis and appropriate therapy reverse maxillofacial developmental disorders in most of the cases.

  5. Effects of antihypertensives on arterial responses associated with obstructive sleep apneas

    Institute of Scientific and Technical Information of China (English)

    ZHONG Xu; XIAO Yi; Robert C. Basner

    2005-01-01

    Background Many patients with obstructive sleep apnea syndrome (OSAS) have complicated with hypertension and may be prescribed with antihypertension medications to control their blood pressure. But whether antihypertension medications can also decrease arterial stiffness or control the blood pressure increasing following obstructive events is not well described. This study aimed to investigate whether antihypertensive medications can ameliorate the changes in arterial stiffness and blood pressure associated with OSA. Methods Sixty-one OSAS patients [13 women, 48 men, mean age (53.4±12.3) years], 26 normotensive patients (N), 7 hypertensive patients on no antihypertension medications (H), and 28 hypertensive patients on various combination antihypertension therapy (HM), were prospectively diagnosed with standard nocturnal polysomnography. Beat-to-beat blood pressure was continuously recorded from the radial artery by applanation tonometry during baseline sleep. As a measure of arterial stiffness, arterial augmentation index (AAI) was calculated as the ratio of augmented systolic blood pressure (SBP) to pulse pressure and expressed as a percentage for the following conditions: awakening, the first 10 ("early apnea") and last 10 ("late apnea") cardiac cycles of obstructive events (apnea or hypopnea), and the first 15 cardiac cycles following event termination ("post apnea") for all events with nadir O2 saturation ≤89%. Results Systolic blood pressure (SBP) post-apnea [(142.74±13.06) mmHg (N), (137.06±26.56) mmHg (H), (136.94±14.1) mmHg (HM)] was significantly increased from awakening [(135.76±14.76) mmHg (N), (135.58±23.17) mmHg (H), (129.77±14.00) mmHg (HM)], early apnea [(130.53±12.65) mmHg (N),(124.47±24.97) mmHg (H), (126.04±13.12) mmHg (HM)], and late apnea [(129.8±12.68) mmHg(N), (124.78±25.15) mmHg (H),(124.48±13.82) mmHg (HM)] respectively (P<0.001, repeated measures ANOVA). AAI was significantly increased for the N group (P<0.001) from

  6. 复杂型睡眠呼吸暂停综合征%Complex sleep apnea syndromes

    Institute of Scientific and Technical Information of China (English)

    高和; 王莞尔; 刘欣欣

    2010-01-01

    Complex sleep apnea syndromes (CompSAS)is characterized by the frequent central apneas after the removal of obstructive events with continuous positive airway pressure(CPAP).The prevalence of CompSAS among the patients with obstructive sleep apnea is about 15% in American and 5% in Japanese.the American Academy of Sleep Medicine is not defined CopmSAS as a new type of sleep breathing disorder,but it is a challenge for clinic doctors to treat the patients with obstructive sleep apnea with CPAP.%复杂型睡眠呼吸暂停综合征(complex sleep apnea syndromes,CompSAS)是指原有阻塞型睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)患者,在持续气道正压(continuous positive airway pressure,CPAP)滴定治疗期间,阻塞型呼吸事件基本清除后所引诱导出的中枢型呼吸暂停.CompSAS在患有OSAHS患者中的发病率在美国大约为15%,在日本大约为5%.CompSAS还没有被美国睡眠医学会定义为睡眠呼吸紊乱的一种新型综合征,但这种现象的存在的确给临床医师采用CPAP治疗OSAHS提出了挑战.

  7. Length of Individual Apnea Events Is Increased by Supine Position and Modulated by Severity of Obstructive Sleep Apnea

    Directory of Open Access Journals (Sweden)

    Timo Leppänen

    2016-01-01

    Full Text Available Positional obstructive sleep apnea (OSA is common among OSA patients. In severe OSA, the obstruction events are longer in supine compared to nonsupine positions. Corresponding scientific information on mild and moderate OSA is lacking. We studied whether individual obstruction and desaturation event severity is increased in supine position in all OSA severity categories and whether the severity of individual events is linked to OSA severity categories. Polygraphic recordings of 2026 patients were retrospectively analyzed. The individual apnea, and hypopnea durations and desaturation event depth, duration, and area of 526 included patients were compared between supine and nonsupine positions in different OSA severity categories. Apnea events were 6.3%, 12.5%, and 11.1% longer (p<0.001 in supine compared to nonsupine position in mild, moderate, and severe OSA categories, respectively. In moderate and severe OSA categories desaturation areas were 5.7% and 25.5% larger (p<0.001 in supine position. In both positions the individual event severity was elevated along increasing OSA severity category (p<0.05. Supine position elevates apnea duration in all and desaturation area in moderate and severe OSA severity categories. This might be more hazardous for supine OSA patients and therefore, estimation of clinical severity of OSA should incorporate also information about individual event characteristics besides AHI.

  8. 重度睡眠呼吸暂停综合征案%Severe sleep apnea syndrome

    Institute of Scientific and Technical Information of China (English)

    周文新

    2010-01-01

    @@ Patient, male, 47 years old, Norwegian.Date of first visit: October 24, 2007.Main complaints: sleep apnea with daytime dizziness for 3 years.Medical history: epilepsy, which had been treated with cranial surgery in 1996, and the attack ceased since 1997.Due to the domestic problem, he got depressive, followed with severe insomnia.He got fullness and pain of chest and palpitation at night, dizziness, fatigue and drowsiness at daytime, then he visited hospital and was diagnosed with sleep apnea syndrome in 2004.

  9. Weight management of OSAS Patient%阻塞性睡眠呼吸暂停综合征患者的体重管理

    Institute of Scientific and Technical Information of China (English)

    刘艳骄; 闫雪

    2015-01-01

    本文从健康管理学的角度,对阻塞性睡眠呼吸暂停综合征与体重的关系,及 OSAS 患者的体重管理问题,阻塞性睡眠呼吸暂停综合征治疗中的体重控制策略,阻塞性睡眠呼吸暂停综合征患者无创呼吸机治疗中的体重控制,阻塞性睡眠呼吸暂停综合征中药治疗中的体重控制,阻塞性睡眠呼吸暂停综合征治疗中中西医结合治疗进行了论述,可供健康管理者参考。%Based on the point of Health management,this article has given a discussion of weight management issue of obstructive sleep apnea syndrome(OSAS),which includes the points of the relationship between OSAS and weight,weight control strategy during the treatment of OSAS,weight control during the CPAP treatment of OSAS,weight control during the Chinese herbal treatment of OSAS,and integrated traditional and western medicine treatment of OSAS.It could provide reference for Health managers.

  10. Sleep apnea syndrome and stroke%睡眠呼吸暂停综合征与卒中

    Institute of Scientific and Technical Information of China (English)

    董晓峰; 熊康平; 曹勇军; 刘春风

    2011-01-01

    睡眠呼吸暂停综合征(sleep apnea syndrome,SAS)是动脉粥样硬化和卒中的独立危险因素。研究显示,卒中后SAS的发生率显著增高。文章就SAS致动脉粥样硬化的机制以及卒中后睡眠呼吸障碍的特点和研究进展做了综述。%Sleep apnea syndrome (SAS) is an independent risk factor for atherosclerosis and stroke. Studies have shown that the incidence of SAS increases significantly after stroke.This article reviews the mechanism of atherosclerosis caused by SAS and the characteristics and research progress of sleep apnea after stroke.

  11. Correlation between obesity and obstructive sleep apnea syndrome%肥胖症与阻塞性睡眠呼吸暂停综合征的相关性研究

    Institute of Scientific and Technical Information of China (English)

    王倩英

    2016-01-01

    Objective To explore obesity and obstructive sleep apnea syndrome correlation (OSAS) between.Methods January 2015- December period 60 cases of OSAS patients in our hospital as the research object, according to the case of 27 obese patients with BMI (body mass index) ≤28kg / m2 divided into a control group, BMI> 28kg / m2 33 patients were divided into experimental group, two groups of patients for night continued 7h more polysomnography monitoring and statistical groups of monitoring results and OSAS severity, and were analyzed. Results The AHI (apnea-hypopnea index), AD (apnea duration), TRE (total respiratory events) were higher, MSaO2 (average oxygen saturation), LSaO2 (lowest nocturnal oxygen saturation ) were lower than the control group, a significant difference between two groups (P <0.05); the proportion of patients with mild OSAS experimental group was significantly lower than the control group, the proportion of moderate and severe patients was significantly higher than the control group, a significant difference between two groups (P<0.05 ). Conclusion Obesity increases the risk of OSAS, aggravating the patient's condition, is one of the risk factors in the pathogenesis of OSAS.%目的:探究肥胖症与阻塞性睡眠呼吸暂停综合征(OSAS)之间的相关性。方法:选取2015年1月~12月期间我院诊治的60例OSAS患者作为研究对象,根据肥胖情况将BMI(体重指数)≤28kg/m2的27例患者分为对照组,将BMI>28kg/m2的33例分为实验组,对两组患者进行夜间持续7h以上的多导睡眠呼吸监测,统计两组各项监测结果及OSAS严重程度,并进行对比分析。结果:实验组AHI(睡眠呼吸暂停低通气指数)、AD(呼吸暂停持续时间)、TRE(总呼吸事件)均高于对照组,MSaO2(平均血氧饱和度)、LSaO2(夜间最低血氧饱和度)均低于对照组,两组对比差异显著(P<0.05);实验组OSAS轻度患者比例明显小于对照组

  12. Compliance Measurements of the Upper Airway in Pediatric Down Syndrome Sleep Apnea Patients.

    Science.gov (United States)

    Subramaniam, Dhananjay Radhakrishnan; Mylavarapu, Goutham; McConnell, Keith; Fleck, Robert J; Shott, Sally R; Amin, Raouf S; Gutmark, Ephraim J

    2016-04-01

    Compliance of soft tissue and muscle supporting the upper airway are two of several factors contributing to pharyngeal airway collapse. We present a novel, minimally invasive method of estimating regional variations in pharyngeal elasticity. Magnetic resonance images for pediatric sleep apnea patients with Down syndrome [9.5 ± 4.3 years (mean age ± standard deviation)] were analyzed to segment airways corresponding to baseline (no mask pressure) and two positive pressures. A three dimensional map was created to evaluate axial and circumferential variation in radial displacements of the airway, dilated by the positive pressures. The displacements were then normalized with respect to the appropriate transmural pressure and radius of an equivalent circle to obtain a measure of airway compliance. The resulting elasticity maps indicated the least and most compliant regions of the pharynx. Airway stiffness of the most compliant region [403 ± 204 (mean ± standard deviation) Pa] decreased with severity of obstructive sleep apnea. The non-linear response of the airway wall to continuous positive airway pressure was patient specific and varied between anatomical locations. We identified two distinct elasticity phenotypes. Patient phenotyping based on airway elasticity can potentially assist clinical practitioners in decision making on the treatments needed to improve airway patency.

  13. Snoring Sounds Predict Obstruction Sites and Surgical Response in Patients with Obstructive Sleep Apnea Hypopnea Syndrome

    Science.gov (United States)

    Lee, Li-Ang; Lo, Yu-Lun; Yu, Jen-Fang; Lee, Gui-She; Ni, Yung-Lun; Chen, Ning-Hung; Fang, Tuan-Jen; Huang, Chung-Guei; Cheng, Wen-Nuan; Li, Hsueh-Yu

    2016-01-01

    Snoring sounds generated by different vibrators of the upper airway may be useful indicators of obstruction sites in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). This study aimed to investigate associations between snoring sounds, obstruction sites, and surgical responses (≥50% reduction in the apnea-hypopnea index [AHI] and DISE), and relocation pharyngoplasty. All patients received follow-up polysomnography after 6 months. Fifteen (42%) patients with at least two complete obstruction sites defined by DISE were significantly, positively associated with maximal snoring sound intensity (40–300 Hz; odds ratio [OR], 1.25, 95% confidence interval [CI] 1.05–1.49) and body mass index (OR, 1.48, 95% CI 1.02–2.15) after logistic regression analysis. Tonsil obstruction was significantly, inversely correlated with mean snoring sound intensity (301–850 Hz; OR, 0.84, 95% CI 0.74–0.96). Moreover, baseline tonsil obstruction detected by either DISE or mean snoring sound intensity (301–850 Hz), and AHI could significantly predict the surgical response. Our findings suggest that snoring sound detection may be helpful in determining obstruction sites and predict surgical responses. PMID:27471038

  14. A preliminary study on correlation between adiponectin genotype polymorphisms and obstructive sleep apnea hypopnea syndrome

    Institute of Scientific and Technical Information of China (English)

    CAO Juan; SU Shi-cheng; HUANG Han-peng; DING Ning; YIN Min; HUANG Mao; ZHANG Xi-long

    2012-01-01

    Background Obstructive sleep apnea hypopnea syndrome (OSAHS) is regarded as a disease with strong genetic background and associated with hypoadiponectinemia.It is worthwhile to investigate the possible correlation between the single nucleotide polymorphisms (SNPs) in the adiponectin gene and OSAHS.Methods With the TaqMan polymerase chain reaction (PCR) method,the SNPs at positions 45 and 276 in the adiponectin gene were determined in Chinese of Han nationality in Nanjing district consisting of 103 OSAHS patients (OSAHS group) and 67 normal controls (control group).The association of adiponectin genotype polymorphisms at positions 45 and 276 with OSAHS was analyzed.Results No evidence of a direct association was found between OSAHS and adiponectin genotype SNP at positions 45 and 276 (P >0.05).However,compared with those OSAHS patients having G/T+T/T genotype at position 276,the OSAHS patients with G/G genotype showed a longer neck circumference,a prolonged duration of the longest apnea event,and an elevated level of blood cholesterol and low-density lipoprotein cholesterol (P <0.05).Conclusions No direct association was suggested between OSAHS and adiponectin genotype distribution at positions 45 and 276 in Chinese of Han nationality in Nanjing district.However,in OSAHS patients,those with adiponectin G/G genotype at position 276,seemed to have a higher potential risk in development of OSAHS than those having adiponectin SNP276 G/T +T/T genotype.

  15. Serum adiponectin level in patients with obstructive sleep apnea hypopnea syndrome

    Institute of Scientific and Technical Information of China (English)

    张希龙; 殷凯生; 毛辉; 王虹; 杨玉

    2004-01-01

    Background Adiponectin, secreted by adipocytes, has been found to be associated with diabetes, obesity and some cardiovascular diseases. Obstructive sleep apnea hypopnea syndrome (OSAHS) is also closely related to obesity and easily complicated with diabetes and some cardiovascular diseases. This study was carried out to explore the change of serum adiponectin level in patients with OSAHS.Methods Polysomnography was performed in 71 patients with OSAHS (OSAHS group) and 26 simple obese controls (control group). The two groups had no significant difference in age and body mass index (BMI). Radioimmunoassy was used to test serum adiponectin level.Results Serum adiponectin level was significantly lower in OSAHS group [(5.03±1.01) mg/L] than that in the control group [(7.09±1.29) mg/L, P<0.05]. The differences between two groups were independent of gender. In OSAHS groups, serum adiponectin levels were negatively correlated with apnea hypopnea index (AHI) (r=-0.78, P<0.01), BMI (r=-0.13, P<0.05), waist circumsference (r=-0.36, P<0.01), and neck circumference (r=-0.42, P<0.01), but positively correlated with the minimal pulse oxyhemoglobin saturation (r=0.48, P<0.01). Conclusion OSAHS may contribute to the decrease of serum adiponectin level independent of obesity.

  16. Obstructive Sleep Apnea Among Obese Patients With Type 2 Diabetes

    OpenAIRE

    Foster, Gary D.; Sanders, Mark H.; Millman, Richard; Zammit,Gary; Borradaile, Kelley E.; Newman, Anne B.; Thomas A. Wadden; Kelley, David; Wing, Rena R.; Pi Sunyer, F. Xavier; Darcey, Valerie; Kuna, Samuel T.; ,

    2009-01-01

    OBJECTIVE To assess the risk factors for the presence and severity of obstructive sleep apnea (OSA) among obese patients with type 2 diabetes. RESEARCH DESIGN AND METHODS Unattended polysomnography was performed in 306 participants. RESULTS Over 86% of participants had OSA with an apnea-hypopnea index (AHI) ≥5 events/h. The mean AHI was 20.5 ± 16.8 events/h. A total of 30.5% of the participants had moderate OSA (15 ≤ AHI

  17. Obstructive sleep apnea and bone mineral density in obese patients

    Directory of Open Access Journals (Sweden)

    Mariani S

    2012-11-01

    Full Text Available Stefania Mariani,1 Daniela Fiore,1 Laura Varone,2 Sabrina Basciani,1 Agnese Persichetti,1 Mikiko Watanabe,1 Maurizio Saponara,3 Giovanni Spera,1 Costanzo Moretti,4 Lucio Gnessi11Department of Experimental Medicine, Section of Medical Physiopathology and Endocrinology, Sapienza University of Rome, Italy; 2Department of Environmental Biology, Sapienza University of Rome, Italy; 3Department of Otolaryngology, Audiology and Phonation, Sapienza University of Rome, Italy; 4Division of Endocrinology, Department of System Medicine, Section of Reproductive Endocrinology University of TorVergata, Fatebenefratelli Hospital "San Giovanni Calibita" Rome, ItalyContext: Obesity and its co-morbidities may adversely affect bone mineral density (BMD. Obstructive sleep apnea (OSA is a major complication of obesity. To date, the effects of OSA on BMD in obese patients have been poorly studied.Objective: To examine whether the severity of OSA independently correlates with BMD in obese patients.Methods: One hundred and fifteen obese subjects with OSA (Apnea/Hypopnea Index [AHI] ≥5 events per hour were included in the study. BMD was measured at lumbar spine, total hip, and femoral neck by dual energy X-ray absorptiometry. Body mass index, lean mass, and representative measures of metabolic syndrome (waist circumference, fasting plasma glucose, blood pressure, HDL-cholesterol, triglycerides and inflammation (ESR, CRP, fibrinogen were also evaluated.Results: BMD did not differ among obese individuals regardless of OSA severity. Correlation coefficient analysis for all the covariates showed a lack of association between AHI and BMD that was strongly influenced by age and weight.Conclusion: Our study does not support an independent association between AHI and BMD in obese patients. Controlled studies involving a greater number of patients are warranted.Keywords: obesity, polysomnography, metabolic syndrome

  18. 成人阻塞性睡眠呼吸暂停低通气综合征患者临床症状和生活质量的研究%The research on symptoms and quality of life in patients with obstructive sleep apnea syndrome

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

    Objective To evaluate the effect of uvulopalatopharyngoplasty or continuous positive airway pressure on symptoms and quality of life in patients with obstructive sleep apnea syndrome (OSAS). Methods Forty-four patients with OSAS were surveyed before and 3months after,treatment by using ESS and SAQLI. Results The symptoms and quality of life of patients with OSAS treated by UPPP or CPAP were markedly improved(P0.05) Conclusion Adult OSAS had severely influence in quality of life. The treatment of UPPP and CPAP can validly improve symptoms and quality of life for patients. There was significant correlations between SAQLI and the objective data, which can be a valuable measurement in clinical diagnosis and follow-up.%  目的探讨悬雍垂腭咽成形术(uvulopalatopharyngoplasty,UPPP)或经鼻持续正压通气(continuous positive airway pressure,CPAP)治疗方法对成人阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)患者症状和生活质量的影响。方法通过Epworth嗜睡量表(Epworth sleepiness scale,ESS)和睡眠呼吸暂停生活质量指数(the Sleep Apnea Quality of Life Index,SAQLI)量表对44例OSAHS患者治疗前及治疗后3月进行两次问卷调查评估。结果 OSAHS患者经UPPP或CPAP治疗后症状和生活质量较治疗前明显提高(P<0.05);治疗前SAQLI评分与呼吸暂停低通气指数(apnea hypopnea index,AHI)、最低血氧饱和度(LSaO2)存在明显相关性;CPAP改善患者的嗜睡症状较UPPP好,在改善患者生活质量方面两者相似(P>0.05)。结论成人OSAHS严重影响患者的生活质量,UPPP和CPAP这两种治疗方法均能改善患者症状并能提高其生活质量;SAQLI与客观检测之间存在明显的相关性,可作为成人OSAHS患者临床诊断和疗效的评价指标。

  19. Effects of Chronic Obstructive Pulmonary Disease and Obstructive Sleep Apnea on Cognitive Functions: Evidence for a Common Nature

    Directory of Open Access Journals (Sweden)

    Georgia Andreou

    2014-01-01

    Full Text Available Patients with chronic obstructive pulmonary disease (COPD and obstructive sleep apnea syndrome (OSAS show similar neurocognitive impairments. Effects are more apparent in severe cases, whereas in moderate and mild cases the effects are equivocal. The exact mechanism that causes cognitive dysfunctions in both diseases is still unknown and only suggestions have been made for each disease separately. The primary objective of this review is to present COPD and OSAS impact on cognitive functions. Secondly, it aims to examine the potential mechanisms by which COPD and OSAS can be linked and provide evidence for a common nature that affects cognitive functions in both diseases. Patients with COPD and OSAS compared to normal distribution show significant deficits in the cognitive abilities of attention, psychomotor speed, memory and learning, visuospatial and constructional abilities, executive skills, and language. The severity of these deficits in OSAS seems to correlate with the physiological events such as sleep defragmentation, apnea/hypopnea index, and hypoxemia, whereas cognitive impairments in COPD are associated with hypoventilation, hypoxemia, and hypercapnia. These factors as well as vascocerebral diseases and changes in systemic hemodynamic seem to act in an intermingling and synergistic way on the cause of cognitive dysfunctions in both diseases. However, low blood oxygen pressure seems to be the dominant factor that contributes to the presence of cognitive deficits in both COPD and OSAS.

  20. Correlation between the serum level of advanced oxidation protein products and the cognitive function in patients with obstructive sleep apnea hypopnea syndrome

    Institute of Scientific and Technical Information of China (English)

    杨秀红

    2013-01-01

    Objective To observe the change of the cognitive function and the serum level of advanced oxidation protein products(AOPP) in patients with obstructive sleep apnea hypopnea syndrome(OSAHS),and then to investigate

  1. The predictive value of Muller maneuver in REM-dependent obstructive sleep apnea.

    Science.gov (United States)

    Ozcan, Kursat Murat; Ozcan, Muge; Ozdogan, Fatih; Hizli, Omer; Dere, Huseyin; Unal, Adnan

    2013-09-01

    To our knowledge, no studies up to date have investigated the correlation of rapid eye movement (REM) dependent obstructive sleep apnea syndrome (OSAS) and Muller maneuver. The aim of this study is to investigate whether REM-dependent OSAS is predicted by the findings of the Muller maneuver. The study was conducted on 149 patients with witnessed apnea and daytime sleepiness. Muller maneuver was performed to all patients and the obstruction site was determined using a five-point scale. Then, polysomnography of the patient was obtained and the apnea-hypopnea indexes were determined in total sleep time, REM-dependent sleep and non-REM-dependent sleep. The correlations between the Muller maneuver findings and polysomnographic data were analyzed. The ages of the patients included in the study ranged between 25 and 73 years with a mean age of 49.3 ± 10.1 years. Their mean body mass index was 30.8 ± 5.1 kg/m(2) (range 21.9-55.4 kg/m(2)). The patients' mean apnea-hypopnea indexes in total sleep time was 28.1 and ranged between 5.4 and 124.3. REM-dependent OSAS was determined in 49 patients. When the data were analyzed, it was determined that there were no statistically significant correlations between tongue base or lateral pharyngeal band obstruction at the level of hypopharynx and the REM-dependent OSAS. At the level of the soft palate, the obstruction caused by the lateral pharyngeal bands or soft palate and REM dependency did not show any statistically significant correlation (p > 0.05). In conclusion, Muller maneuver does not provide useful data to predict REM dependency of OSAS.

  2. Are we underestimating the lifelong benefits of therapy for obstructive sleep apnea?

    Directory of Open Access Journals (Sweden)

    Berman AM

    2016-03-01

    Full Text Available Alec M Berman, Saurabh S Thosar, Steven A SheaOregon Institute of Occupational Health Sciences, Oregon Health and Science University, Portland, OR, USAObstructive sleep apnea (OSA is a complex disorder involving the cardiovascular (CV, pulmonary, and metabolic systems. Characterized by marked daytime fatigue and reduced quality of life, OSA is independently associated with increased risk of hypertension,1 cardiovascular disease (CVD,2 including myocardial infarction (MI3 and ischemic stroke,4 metabolic syndrome,5 and all-cause mortality.6 Currently, the most common treatment for OSA is continuous positive airway pressure (CPAP during sleep, though its efficacy in reducing daytime fatigue and CVD risk factors depends largely on compliance to therapy, which is poor in the general population.7 Lamberts et al8 performed a large epidemiological study of OSA, using the Danish National Patient Registry (NPR; ∼4.5 million; including 25,389 people diagnosed with OSA, which confirmed associations between OSA and risk of ischemic stroke and MI. Yet, that study failed to show that CPAP reduces the incidence of these adverse CV events.8 On the other hand, a more recent study, which examined the same Danish NPR across a very similar time period, revealed that in people with OSA, CPAP reduces all-cause mortality.9 This editorial evaluates these seemingly conflicting results, whereby CPAP appears to reduce mortality but not two of the largest contributors to mortality: stroke and MI.

  3. Use of Electronic Data and Existing Screening Tools to Identify Clinically Significant Obstructive Sleep Apnea

    Directory of Open Access Journals (Sweden)

    Carl A Severson

    2015-01-01

    Full Text Available OBJECTIVES: To assess the ability of electronic health data and existing screening tools to identify clinically significant obstructive sleep apnea (OSA, as defined by symptomatic or severe OSA.

  4. Low-frequency oscillations and vasoreactivity of cortical vessels in obstructive sleep apnea during wakefulness

    DEFF Research Database (Denmark)

    Schytz, Henrik Winther; Jensen, Benedicte Ersted; Jennum, Poul;

    2013-01-01

    Effective nasal continuous positive airway pressure (CPAP) therapy reduces the cardiovascular outcomes associated with obstructive sleep apnea (OSA), but the mechanism behind this effect is unclear. We investigated if OSA patients during wakefulness showed signs of increased sympathetic activity...

  5. Clinical analysis of adjuvant ventilator treatment of type 2 diabetes with obstructive sleep apnea hypopnea syndrome

    Institute of Scientific and Technical Information of China (English)

    Yu-Xiu Li; Zhu-Feng Wang; Rui Wu; Li Ma; Ying Zhang

    2016-01-01

    Objective:To preliminarily explore the effect of auxiliary ventilator treatment of Type 2 diabetes mellitus with obstructive sleep apnea hypopnea syndrome (OSAHS).Method:A total of 50 OSAHS patients with Type 2 diabetes mellitus treated in Guang’anmen Hospital from September, 2014 to May, 2015 included experimental group (n=25) who received ventilator therapy and control group (n=25), and both groups received 3 months of treatment.Results:Compared with control group, AHI (20.5±9.4(h) vs 57.6±16.1(h)), LSPO (90.8±12.3(%) vs 76.2±14.8(%)) in the experimental group were significantly improved after assisted ventilation therapy.Conclusions: In addition to controlling plasma glucose by conventional drugs, it is also very important for OSAHS patients with type 2 diabetes to actively use assisted ventilation therapy to improve hypoxia.

  6. The Treatment of Mild Pediatric Obstructive Sleep Apnea Syndrome%轻度儿童阻塞性睡眠呼吸暂停低通气综合征的治疗

    Institute of Scientific and Technical Information of China (English)

    范绍翀; 潘永; 张志钢

    2011-01-01

    目的:探讨轻度儿童阻塞性睡眠呼吸暂停低通气综合征(pediatric obstructive sleep apnea hypopnea syndrome,OSAHS)患者的临床治疗方案.方法:对51例轻度儿童OSAHS患儿治疗前及治疗后3月进行鼻内镜、多导睡眠监测(polysomnography,PSG)检查及OSA-18问卷调查,对所得数据进行分析.结果:手术组治疗后30例患者复查PSG结果为正常,P=0.000;药物治疗组治疗后5例患者复查PSG结果为正常,P=0.062.手术组及药物治疗组治疗前后OSA-18量表评分均有显著改善.结论:对于腺样体肥大引起的轻度儿童OSAHS患者,手术治疗是主要的、有效的治疗手段.

  7. Coagulability in Obstructive Sleep Apnea

    Directory of Open Access Journals (Sweden)

    Christina Liak

    2011-01-01

    Full Text Available BACKGROUND: Obstructive sleep apnea (OSA is a common disorder that affects both quality of life and cardiovascular health. The causal link between OSA and cardiovascular morbidity/mortality remains elusive. One possible explanation is that repeated episodes of nocturnal hypoxia lead to a hypercoagulable state that predisposes patients to thrombotic events. There is evidence supporting a wide array of hematological changes that affect hemostasis (eg, increased hematocrit, blood viscosity, platelet activation, clotting factors and decreased fibrinolytic activity.

  8. Innovative treatments for adults with obstructive sleep apnea.

    Science.gov (United States)

    Weaver, Terri E; Calik, Michael W; Farabi, Sarah S; Fink, Anne M; Galang-Boquiren, Maria T; Kapella, Mary C; Prasad, Bharati; Carley, David W

    2014-01-01

    Obstructive sleep apnea (OSA) affects one in five adult males and is associated with significant comorbidity, cognitive impairment, excessive daytime sleepiness, and reduced quality of life. For over 25 years, the primary treatment has been continuous positive airway pressure, which introduces a column of air that serves as a pneumatic splint for the upper airway, preventing the airway collapse that is the physiologic definition of this syndrome. However, issues with patient tolerance and unacceptable levels of treatment adherence motivated the exploration of other potential treatments. With greater understanding of the physiologic mechanisms associated with OSA, novel interventions have emerged in the last 5 years. The purpose of this article is to describe new treatments for OSA and associated complex sleep apnea. New approaches to complex sleep apnea have included adaptive servoventilation. There is increased literature on the contribution of behavioral interventions to improve adherence with continuous positive airway pressure that have proven quite effective. New non-surgical treatments include oral pressure devices, improved mandibular advancement devices, nasal expiratory positive airway pressure, and newer approaches to positional therapy. Recent innovations in surgical interventions have included laser-assisted uvulopalatoplasty, radiofrequency ablation, palatal implants, and electrical stimulation of the upper airway muscles. No drugs have been approved to treat OSA, but potential drug therapies have centered on increasing ventilatory drive, altering the arousal threshold, modifying loop gain (a dimensionless value quantifying the stability of the ventilatory control system), or preventing airway collapse by affecting the surface tension. An emerging approach is the application of cannabinoids to increase upper airway tone.

  9. Reactive Oxygen Species Production in Peripheral Blood Neutrophils of Obstructive Sleep Apnea Patients

    OpenAIRE

    Guoda Pilkauskaite; Skaidrius Miliauskas; Raimundas Sakalauskas

    2013-01-01

    Obstructive sleep apnea (OSA) as well as obesity is associated with increased production of reactive oxygen species (ROS). Neutrophils produce great amounts of ROS. The aim was to evaluate peripheral blood neutrophils ROS production in men with OSA and to establish relations with disease severity and obesity. Methods. Forty-six men with OSA and 10 controls were investigated. OSA was confirmed by polysomnography (PSG), when apnea/hypopnea index was >5/h. Body mass index (BMI) was evaluated. Ne...

  10. Orthodontic and Orthognathic Surgical Treatment of a Pediatric OSA Patient

    Directory of Open Access Journals (Sweden)

    Gregory W. Jackson

    2016-01-01

    Full Text Available A case report is presented which demonstrates the effectiveness of comprehensive orthodontic treatment combined with orthognathic surgery in the correction of malocclusion and reduction in the sequelae of Obstructive Sleep Apnea (OSA. The patient’s severe OSA was improved to very mild as evaluated by full overnight polysomnogram. The orthodontic treatment included the expansion of both dental arches and mandibular advancement surgery. There was significant improvement in the patient’s sleep continuity and architecture with the elimination of obstructive apneas.

  11. Orthodontic and Orthognathic Surgical Treatment of a Pediatric OSA Patient

    OpenAIRE

    Jackson, Gregory W.

    2016-01-01

    A case report is presented which demonstrates the effectiveness of comprehensive orthodontic treatment combined with orthognathic surgery in the correction of malocclusion and reduction in the sequelae of Obstructive Sleep Apnea (OSA). The patient’s severe OSA was improved to very mild as evaluated by full overnight polysomnogram. The orthodontic treatment included the expansion of both dental arches and mandibular advancement surgery. There was significant improvement in the patient’s sleep ...

  12. Evaluation of the related dangerous factors in children with obstructive sleep apnea hypopnea syndrome%儿童阻塞性睡眠呼吸暂停低通气综合征危险因素的评估

    Institute of Scientific and Technical Information of China (English)

    李俊义; 徐华林; 姜彦; 李娜

    2012-01-01

    [Objective] To study the dangerous factors in children with obstructive sleep apnea hypopnea syndrome (OSAHS),and to explore whether obesity and the tonsil and/or adenoid hypertrophy would cause obstructive sleep apnea hypopnea syndrome. [Methods] The body mass index(BMI) and the tonsil and adenoid size were evaluated on 182 OS-AHS and 160 non-OSAHS children. All children were examined by polysomnography(PSG). [Results] Among OSAHS, BMI and the tonsil and adenoid size were significantly higher than the control group of children's. In addition,OSA score and apnea hypopnea index(AHI) ,LSaO2 showed a positive correlation. Obesity, tonsillar hypertrophy, and adenoid hypertrophy were the dangerous factors for OSAHS. [Conclusion] OSAHS had impact on children's quality of life seriously. It indicated that there were certain relations between pathogenetic factors and obesity, tonsillar hypertrophy and adenoid hypertrophy, we can pass from the etiology to control the occurrence of OSAHS in children.%[目的]研究儿童阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)中的危险性因素,并探讨肥胖、扁桃体肥大及腺样体肥大与儿童OSAHS的相关性. [方法]对182例儿童OSAHS患者及160例无OSAHS儿童进行体质指数(body mass index,BMI)、扁桃体大小及腺样体大小进行评价.对全部儿童进行多导睡眠监测(polysomnography,PSG),以无OSAHS儿童作为对照组. [结果] 患有OSAHS儿童的体质指数、扁桃体肿大程度及腺样体肥大显著高于对照组儿童,并且两组患儿的OSA评分、呼吸暂停指数、最低血氧饱和度的差异有统计学意义(P<0.05). [结论]儿童OSAHS严重影响儿童的生活质量,肥胖、扁桃体肥大以及腺样体肥大均是儿童OSAHS的危险因素.可以通过从病因着手控制儿童OSAHS的发生.

  13. Predictors of Success in the Treatment of Obstructive Sleep Apnea Syndrome with Mandibular Repositioning Appliance: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Saffer, Fernanda

    2015-10-01

    Full Text Available See also: Predictors of Success in the Treatment of Obstructive Sleep Apnea Syndrome with Mandibular Repositioning Appliance: A Systematic Review Int Arch Otorhinolaryngol 2015; 19(01: 080-085 DOI: 10.1055/s-0034-1393957 Rio de Janeiro, July 23, 2015 Dear readers, In the article Predictors of Success in the Treatment of Obstructive Sleep Apnea Syndrome with Mandibular Repositioning Appliance: A Systematic Review,[1] published in Int Arch Otorhinolaryngol 2015;19(1:80–85, where it reads: José Faibes Lubianca Lubianca2 2Department of Otorhinolaryngology, UFRGS, Porto Alegre, Brazil It should read José Faibes Lubianca Neto2 2Department of Clinical Surgery, UFSCPA, Porto Alegre, Brazil

  14. Síndrome de apnea-hipopnea del sueño y enfermedad cardiovascular Sleep apnea-hypopnea syndrome and cardiovascular diseases

    Directory of Open Access Journals (Sweden)

    B. Marín

    2007-01-01

    Full Text Available El síndrome de apnea-hipopnea del sueño se caracteriza por un cuadro de somnolencia diurna excesiva, trastornos cognitivos-conductuales, respiratorios, cardíacos, metabólicos o inflamatorios secundarios a episodios repetidos de obstrucción de la vía aérea superior durante el sueño. Numerosos estudios han demostrado que el SAHS se asocia a la presencia de hipertensión arterial y al desarrollo de enfermedades cardiovasculares. Asimismo se acepta un exceso de mortalidad asociado con el SAHS. Como mecanismos mediadores se consideran un aumento de actividad del sistema nervioso simpático, una disfunción endotelial, junto con fenómenos de estrés oxidativo, agregación plaquetaria y trombosis.Sleep apnea-hypopnea syndrome is characterised by daytime sleepiness, cognitive-behavioural, respiratory, cardiac, metabolic or inflammatory disorders, secondary to repeated obstruction of the upper airway during sleep. Numerous studies have shown that SAHS is associated with the presence of arterial hypertension and the development of cardiovascular diseases. Similarly, there is an excess of mortality associated with SAHS. An increase in the activity of the sympathetic nervous system and endothelial dysfunction are considered as mediating mechanisms, together with phenomena of oxidative stress, platelet aggregation and thrombosis.

  15. Body composition in obstructive sleep apneahypopnea syndrome bio-impedance reflects the severity of sleep apnea

    Directory of Open Access Journals (Sweden)

    Lovin Sînziana

    2010-02-01

    Full Text Available Abstract Background Obstructive sleep apnea-hypopnea syndrome (OSAHS is characterized by repeated breathing pauses during sleep and is closely associated with obesity. Body fat is known to be a predictive factor for OSAHS and its severity. Aim To study the correlation between the severity of OSAHS and body composition measurements. Methods 30 patients with OSAHS (21 men, 9 women, mean age 45.1 years, mean apnea-hypopnea index = 29.6/hour were included in the study after full polysomnography. They were divided into 3 groups according to the apnea-hypopnea index (AHI: mild OSAHS (mean AHI 10.9/h, moderate OSAHS (mean AHI 23.9/h and severe OSAHS (mean AHI 53.9/h. Body composition (body fat, body water and dry lean mass was assessed using bioelectric impedance assay (BIA. Other measurements included neck and abdominal circumferences and body mass index (BMI. Pearson's coefficient (r was used to express correlations between AHI and the following parameters: BMI, neck and abdominal circumferences, body fat, dry lean mass, and body water. Wilcoxon Sum-of-Ranks (Mann-Whitney test for comparing unmatched samples was used to compare anthropometric and body composition measurements between groups. Results The correlation between AHI and BMI was weak (r = 0.38. AHI correlated moderately with neck circumference (r = 0.54, with neck circumference corrected by height (r = 0.60, and more strongly with body fat (r = 0.67, with body water (r = 0.69 and with abdominal circumference (r = 0.75. There was a strong negative correlation between AHI and dry lean mass (r = - 0.92. There were significant differences in body fat, body water, neck circumference corrected by height and abdominal circumference (Wilcoxon Sum-of-Ranks, p Conclusions In our study, the severity of OSAHS correlated with body fat and with body water more strongly than with general and cervical obesity. Abdominal adiposity may predict OSAHS severity better than neck circumference.

  16. Relationship between obstructive sleep apnea hypopnea syndrome and cardiovascular disorders in adult snorers

    Institute of Scientific and Technical Information of China (English)

    Rui Wu; Xilong Zhang; Ling Hu; Enzhi Jia

    2009-01-01

    Objective:To investigate the relationship between sleep apnea hypopnea syndrome(OSAHS) and some cardiovascular disorders in adult habitual snorers as well as the effectiveness of nasal continuous positive airway pressure(NCPAP) on those with OSAHS.Methods:With the use of polysomnography,262 adult habitual snorers were examined and divided into the OSAHS group and the Non-OSAHS group (control).Using ambulatory electrocardiogram and blood pressure measurement,daily nocturnal rhythm of blood pressure,hypertension,heart rate variability,some arrythmias and angina pectoris of coronary heart disease were monitored and compared between the two groups,before and after 14 days of treatment with NCPAP in the OSAHS group.Results.This study indicated a higher incidence (39.6%) of OSAHS in adult snorers and demonstrated that there was a significantly higher incidence of hypertension,disappearance of the daily nocturnal rhythm of blood pressure,poor effectiveness of nitrate on angina pcctoris of coronary heart disease,decreased heart rate variability during sleep,increased arrythmias and lower SpO levels in the OSAHS group than in the Non-OSAHS group.After NCPAP treatment during sleep,snoring control,significantly higher SpO and lower apnea hypopnea indices were achieved in the OSAHS group;heart rate variability and dally nocturnal rhythm of blood pressure returned to normal levels.Conclusion:The results of this research suggested that there was a close relationship between the development of OSAHS and some cardiovascular disorders.Furthermore,NCPAP treatment was effective not only on OSAHS but also on coexisting cardiovascular disorders.

  17. Does obstructive sleep apnea associate with atrial fibrillation?

    Institute of Scientific and Technical Information of China (English)

    TAO Hai-long; LONG De-yong; DONG Jian-zeng; MA Chang-sheng

    2008-01-01

    @@ Obstructive sleep apnea(OSA)is a disorder in which transient obstruction fcomplete or partiall of the airway during sleep causes loud snoring,oxyhemoglobin desaturation and frequent arousal.1-4 OSA has been identified to relate to many cardiovascular diseases such as hypertension,coronary heart disease,heart failure,and cardiac arrhythmia.In this article,we attempt to discuss the association between OSA and atrial fibrillation (AF) while reviewing the recent data on OSA and AF.

  18. Obstructive Sleep Apnea, Hypertension, and Their Additive Effects on Atherosclerosis

    OpenAIRE

    Mario Francesco Damiani; Annapaola Zito; Pierluigi Carratù; Vito Antonio Falcone; Elioda Bega; Pietro Scicchitano; Marco Matteo Ciccone; Onofrio Resta

    2015-01-01

    Background and Aims. It is widely accepted that obstructive sleep apnea (OSA) is independently associated with atherosclerosis. Similar to OSA, hypertension (HTN) is a condition associated with atherosclerosis. However, to date, the impact of the simultaneous presence of OSA and HTN on the risk of atherosclerosis has not been extensively studied. The aim of this study was to evaluate the consequences of the coexistence of OSA and HTN on carotid intima-media thickness (IMT) and on inflammatory...

  19. Effects of obstructive sleep apnea syndrome on pilot's sleepiness, mood and subjective quality of life%阻塞性睡眠呼吸暂停综合征对飞行员睡眠、情绪和主观生活质量的影响

    Institute of Scientific and Technical Information of China (English)

    余昳; 谭昌金; 张瞿璐; 武强; 濮捷; 杨长亮

    2011-01-01

    目的 探讨阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS)对飞行员白天过度嗜睡(excessive daytime sleepiness,EDS)、情绪状态和主观生活质量(subjective quality of life,QOF)的影响.方法 对经多导睡眠仪(polysomnography,PSG)监测诊断的54例OSAS飞行员和30例正常飞行员做人体测量、记录Epworth嗜睡量表评分(Epworth sleepiness scale,ESS)、睡眠呼吸暂停生活质量指数(calgary sleep apnea quality of life index,SAQLI)和Zung抑郁自评量表(Zung self-rated depression scale,SDS),将所获资料进行描述和均数比较.结果 OSAS飞行员中76.6%超重,20.3%肥胖;28.1%存有白天嗜睡,对日常工作及生活有明显影响;41.7%的患者抑郁,抑郁症状与白天嗜睡及疲劳有明显关系.比较正常飞行员和不同程度OSAS飞行员的体质指数、颈围、呼吸暂停低通气指数(sleep apnea hypopnea index,AHI)、ESS、SAQLI和SDS评分,差异均有统计学意义(F=6.28~270.29,P<0.01);进一步分析发现,SAQLI和AHI在正常和轻度患者之间差异有统计学意义(P<0.01),ESS在正常和轻度患者之间差异无统计学意义(P>0.05),而在正常和中重度患者之间差异有统计学意义(P<0.01).本研究12例OSAS歼击机飞行员中9例轻度,3例中度,经减轻体重,复测PSG参数和ESS评分正常,均飞行合格;42例OSAS运输机飞行员中13例轻度,飞行合格;15例中度,经减轻体重,PSG参数和ESS评分正常,飞行合格;14例重度,其中8例经减轻体重症状好转飞行合格,6例尚在治疗中.结论 OSAS飞行员常伴有白天过度嗜睡和抑郁情绪,其主观生活质量较正常者明显下降.中度及重度OSAS飞行员应进行干预治疗.%Objective To suggest intervention by investigating the effects of obstructive sleep apnea syndrome(OSAS) on pilot's sleepiness,mood and subjective quality of life.Methods Fiftyfour pilots,who were diagnosed as OSAS by polysomnography (PSG

  20. Avaliação dos níveis séricos de testosterona em pacientes com síndrome da apneia obstrutiva do sono Evaluation of testosterone serum levels in patients with obstructive sleep apnea syndrome

    Directory of Open Access Journals (Sweden)

    Fernando Drimel Molina

    2011-02-01

    Full Text Available Homens com síndrome da apneia obstrutiva do sono (SAOS podem apresentar diminuição dos níveis de testosterona devido à hipóxia. OBJETIVOS: Relacionar os níveis séricos da testosterona, em pacientes com SAOS, com parâmetros clínico-laboratoriais. MATERIAL E MÉTODOS: Foram revisados 103 prontuários de pacientes com SAOS, entre os anos de 2002 e 2009, e coletados os seguintes dados: idade à época da realização da polissonografia, valores do Hematócrito e Hemoglobina, nível sérico da testosterona total, IMC, índice de apneia/hipopneia(IAH e SatO2. FORMA DO ESTUDO: Estudo de casos retrospectivo em corte transversal. RESULTADOS: 79 pacientes (77% não apresentaram alteração hormonal e 24 (23% apresentaram níveis séricos inferiores. Dos pacientes com testosterona normal 70% estavam com sobrepeso, enquanto que 63% com testosterona alterada apresentaram obesidade grau I (pMales with obstructive sleep apnea syndrome (OSAS may present decreased testosterone serum levels because of hypoxemia. AIM: To correlate testosterone levels in OSAS patients with laboratory parameters. MATERIAL AND METHODS: 103 registries of OSAS patients were reviewed from 2002 to 2009. The following data collected: age when polysomnography was done, hematocrit and hemoglobin levels, total testosterone serum levels, BMI, apnea/hypopnea index (AHI, and O2 saturation. STUDY DESIGN: A cross-sectional retrospective case study. RESULTS: 79 patients (77% had no hormonal changes, and 24 patients (23% had decreased serum levels. In patients with normal testosterone levels, 70% were overweight; 63% with altered testosterone levels had obesity grade I (p<0.05. Patients with altered testosterone levels had significantly lower average doses of Ht, Hb and androgen compared to patients without altered androgen levels. The average BMI of patients with altered hormone levels was significantly higher compared to patients with normal hormone levels. CONCLUSIONS: The relationship

  1. Investigation on Association between Obstructive Sleep Apnea Hypopnea and Metabolic Syndromes in Elderly Snorers

    Institute of Scientific and Technical Information of China (English)

    Wang Hong(王虹); Zhang Xilong(张希龙); Yin Kaisheng(殷凯生); Hu Ling(胡玲); Jia Enzhi(贾恩志)

    2004-01-01

    Objective:To investigate the associated pathognesis of higher clinical coexistence of obstructive sleep apnea hypopnea syndrome(OSAHS) and metabolic syndrome (MS) in elderly snorers.Methods:Through polysomnography examination, 69 elderly habitual snorers weredivided into simple snorers (control group) and OSAHS patients who were further divided into mild-to-moderate and severe OSAHS groups basedon their apnea hypopnea index (AHI) and the lowest pulse oxygen saturation (LSpO2) during sleep respectively. The incidences of MS werecompared among different groups. Correlation was analyzed among polysomnography parameters-AHI, LSpO2 and average pulse oxygensaturation (ASpO2),MS-associated parameters-fasting blood glucose (FBG),total cholesterol (TCH),triglyceride(TG),high-densitylipoprotein cholesterol (HDL),low-density lipoprotein cholesterol (LDL),insulin and proinsulin (PI),HOMA index and blood pressure(Bp),as well as some body indexes-body mass index (BMI),waist circumference (WC) and neck circumference (NC).Results:CoexistingMS was found in 28% of all the OSAHS patients. The incidences of MS in severe OSAHS groups were significantly higher than incontrol group(P<0.05).Spearman correlation analysis indicated that HOMA index and PI were negatively correlated with nocturnalLSpO2 and ASpO2 significantly. There were no statistically significant correlation of HOMA index and PI with AHI. LSpO2 and ASpO2were negatively correlated with BMI, WC, NC and diastolic Bp but positively correlated with TCH and HDL significantly. UnivariateLogistic regression analysis suggested that the HOMA index and PI were risk factors of severe OSAHS and the odds ratio (OR) was1.907(1.312~2.796)(P<0.01)and 1.703(1.162~2.497)(P<0.01)respectively. Multivariate stepwise Logistic regression analysis suggestedthat HOMA index and severe OSAHS were independently correlated and the OR was 1.949(1.311~3.181)(P<0.01).Conclusion:It wasconfumedfrom elderly snorers that there was a close

  2. 阻塞性睡眠呼吸暂停综合征患者端粒长度的变化及意义%Alteration of telomere length of the peripheral white blood cells in patients with obstructive sleep apnea syndrome

    Institute of Scientific and Technical Information of China (English)

    林里; 李涛平

    2011-01-01

    目的 探讨阻塞性睡眠呼吸暂停综合征(OSAS)患者外周血白细胞端粒长度的变化及意义.方法 OSAS患者11例,健康对照组10例,提取外周血白细胞DNA,纯度检测合格后,用Q-PCR法检测端粒长度相对T/S比率.结果 OSAS组外周血白细胞端粒长度相对T/S比率较对照组小(P<0.05).结论 OSAS患者外周血白细胞端粒长度的缩短可能与其发病机制有关,低氧血症和高碳酸血症加速r端粒的损耗和细胞的凋亡.%To study the alteration of telomere length of the peripheral white blood cells in patients with obstructive sleep apnea syndrome (OSAS) and explore its significance. Methods The DNA was extracted from the peripheral white blood cells of 11 patients with OSAS and 10 normal subjects matched for age and gender, and the T/S ratio was measured by fluorescence quantitative PCR. Results The T/S ratio in the peripheral white blood cells of patients with OSAS was obviously lower than that of the normal subjects (P<0.05). Conclusion The reduction in the telomere length in the peripheral blood cells suggests a possible relationship between OSAS pathogenesis and telomere length, and hypoxemia and hypercapnia make accelerate telomere shortening and promote cell apoptosis.

  3. Inflammatory cytokines in pediatric obstructive sleep apnea

    Science.gov (United States)

    Huang, Yu-Shu; Guilleminault, Christian; Hwang, Fang-Ming; Cheng, Chuan; Lin, Cheng-Hui; Li, Hsueh-Yu; Lee, Li-Ang

    2016-01-01

    Abstract Pediatric obstructive sleep apnea (OSA) is associated with chronic systemic inflammation and with cognitive impairments. This study aimed to investigate the status of proinflammatory cytokines, particularly interleukin 17 (IL-17) and interleukin 23 (IL-23) and cognition in pediatric OSA. Controls and OSA children participated in the study. Exclusion criteria were adenotonsillectomy, heart, neurological and severe psychiatric diseases, craniofacial syndromes, and obesity. Polysomnogram was followed by serum testing for inflammatory markers and neurocognitive tests such as continuous performance task (CPT) and Wisconsin card sorting test, questionnaires, analyses of plasma high-sensitivity C-reactive protein (HS-CRP), tumor necrosis factor alpha (TNF-α), interleukin 1 (IL-1), interleukin 6 (IL-6), IL-17, and IL-23. Seventy-nine, 4 to 12-year-old subjects in 2 groups ended the study: 47 nonobese OSA children (mean age = 7.84 ± 0.56 years, body mass index [BMI] = 16.95 ± 0.47 kg/m2, BMI z-score = 0.15 ± 0.21, and mean apnea–hypopnea index [AHI] = 9.13 ± 1.67 events/h) and 32 healthy control children (mean age = 7.02 ± 0.65 years, with BMI = 16.55 ± 0.58 kg/m2, BMI z-score = −0.12 ± 0.27, and mean AHI = 0.41 ± 0.07 event/h) were enrolled. Serum cytokine analyses showed significantly higher levels of HS-CRP, IL-17, and IL-23 in OSA children (P = 0.002, P = 0.024, and P = 0.047). Regression test showed significant influence of HS-CRP, TNF-α, IL-6, IL-17, and specifically IL-23, with the continuous performance test and Wisconsin card sorting test. OSA children have abnormal levels of IL-17, an interleukin related to T helper 17 cells, a T helper cell involved in development of autoimmunity and inflammation. This high expression level may contribute to the complications of pediatric OSA; we also found a significant influence of inflammatory cytokines, particularly IL-23, on abnormal neurocognitive testing. PMID

  4. Quality of life impairment in patients of obstructive sleep apnea and its relation with the severity of disease

    OpenAIRE

    Naveen Dutt; Ashok Kumar Janmeja; Prasanta Raghab Mohapatra; Anup Kumar Singh

    2013-01-01

    Background: Several studies have demonstrated considerable impairment of quality of life (QOL) in obstructive sleep apnea (OSA) patients, but its relation with severity of OSA is yet unclear. Study Objectives: To investigate the effects of OSA on the QOL and its association with the disease severity. Design and Setting: Observational, prospective case-control study. Materials and Methods: QOL of 69 OSA patients and 41 healthy controls were assessed using the Calgary sleep apnea quality of lif...

  5. Pharyngeal aerodynamic characteristics of obstructive sleep apnea/hypopnea syndrome patients

    Institute of Scientific and Technical Information of China (English)

    ZANG Hong-rui; LI Li-feng; ZHOU Bing; LI Yun-chuan; WANG Tong; HAN De-min

    2012-01-01

    Background The role of nasal obstruction in the pathogenesis of obstructive sleep apnea/hypopnea syndrome (OSAHS) has been debated for decades.In this prospective study,we compared the pharyngeal aerodynamic characteristics of OSAHS patients and normal people,and investigated the contribution of total nasal airway resistance to the pathophysiology of OSAHS.Methods Computational fluid dynamics (CFD) was used to extract the average pressure and average airflow velocity in three transverse cross-sectional planes of the pharynx for statistical analysis,and the correlation between nasal resistance and the average pressure in the pharyngeal cavity was investigated.Results The negative pressure within the pharyngeal cavity was significantly higher in OSAHS patients than in normal subjects,and total nasal airway resistance correlated well with the average pressure in three consecutive transverse cross-sections of the pharyngeal cavity.Conclusions Greater negative pressure within the pharyngeal cavity contributed to the increased collapsibility of the pharynx in OSAHS patients,and the strong correlation between nasal resistance and pharyngeal pressure suggests that the nose plays a role in the oathogenesis of OSAHS.

  6. Obstructive sleep apnea-hypopnea syndrome and cognitive impairments in the elderly

    Directory of Open Access Journals (Sweden)

    Song Shuling

    2017-01-01

    Full Text Available Obstructive sleep apnea-hypopnea syndrome (OSAHS is a common sleep-related breathing disorder that is associated with significant morbidity and mortality. It has received increasing attention that neurocognitive deficits occur with a high frequency in OSAHS. However, it is rarely known that OSAHS impacts on cognition in the elderly in whom an increased prevalence of OSAHS is present. In this review we consider recent studies in the association between OSAHS and cognitive impairments, with specific interest in the older population. Firstly, we elucidate the characteristics of OSAHS and OSAHS-related cognitive impairments in the older patients. Many studies have showed that the prevalence of OSAHS increases with age and it is higher in the elderly than other population. Moreover, OSAHS is associated with higher incidence of comorbidities and increased risk of clinical deterioration in the elderly, especially the neurocognitive impairments which even can develop dementia. Subsequently, we discuss the possible reasons of cognitive impairments that caused or aggravated by OSAHS in the elderly. The intermittent hypoxia (IH-related disturbances of homeostasis such as oxidative stress, inflammation, and age-related changes such as the changes of sleep architecture, the declined expression level of anti-aging gene, medical comorbidities and polypharmacy, may be both contribute to the increased risk of cognitive impairments in the older patients with OSAHS.

  7. Obstructive sleep apnea syndrome and hypothyroidism - merely concurrence or causal association?

    Science.gov (United States)

    Kuczyński, Wojciech; Gabryelska, Agata; Mokros, Łukasz; Białasiewicz, Piotr

    2016-01-01

    The prevalence of obstructive sleep apnea-hypopnea syndrome (OSAHS) ranges from 4 to 7% in men and from 2 to 5% in women. Its deleterious consequences such as traffic accidents, cardiovascular complications increasing morbidity and mortality, make it a major health problem. Apart from obesity (a major risk factor for OSAHS), hypothyroid patients are prone to reveal this phenotype. Although hypothyroidism seems an acknowledged risk factor for OSAHS, some authors report the lack of clinically relevant association. The argument partly depends on the increased prevalence of hypothyroidism in OSAHS patients, but the epidemiological data is limited and somehow inconsistent; even less is known about sub-clinical hypothyroidism in OSAHS patients. Even if frequency of overt and sub-clinical hypothyroidism in OSAHS patients is comparable to the general population, screening for it seems beneficial, as hormone replacement therapy may improve sleep disordered breathing. Unfortunately, this favorable outcome was found only in a few studies with limited number of patients with hypothyroidism. Yet, despite the lack of international guidelines and no large multicentre studies on the topic available, we think that TSH screening might prove beneficial in vast majority of OSAHS patients.

  8. Physical modelling of the airflow-walls interactions to understand the sleep apnea syndrome

    CERN Document Server

    Payan, Y; Perrier, P; Payan, Yohan; Pelorson, Xavier; Perrier, Pascal

    2003-01-01

    Sleep Apnea Syndrome (SAS) is defined as a partial or total closure of the patient upper airways during sleep. The term "collapsus" (or collapse) is used to describe this closure. From a fluid mechanical point of view, this collapse can be understood as a spectacular example of fluid-walls interaction. Indeed, the upper airways are delimited in their largest part by soft tissues having different geometrical and mechanical properties: velum, tongue and pharyngeal walls. Airway closure during SAS comes from the interaction between these soft tissues and the inspiratory flow. The aim of this work is to understand the physical phenomena at the origin of the collapsus and the metamorphosis in inspiratory flow pattern that has been reported during SAS. Indeed, a full comprehension of the physical conditions allowing this phenomenon is a prerequisite to be able to help in the planning of the surgical gesture that can be prescribed for the patients. The work presented here focuses on a simple model of fluid-walls int...

  9. Multifractal spectra of laser Doppler flowmetry signals in healthy and sleep apnea syndrome subjects

    Science.gov (United States)

    Buard, Benjamin; Trzepizur, Wojciech; Mahe, Guillaume; Chapeau-Blondeau, François; Rousseau, David; Gagnadoux, Frédéric; Abraham, Pierre; Humeau, Anne

    2009-07-01

    Laser Doppler flowmetry (LDF) signals give a peripheral view of the cardiovascular system. To better understand the possible modifications brought by sleep apnea syndrome (SAS) in LDF signals, we herein propose to analyze the complexity of such signals in obstructive SAS subjects, and to compare the results with those obtained in healthy subjects. SAS is a pathology that leads to a drop in the parasympathetic tone associated with an increase in the sympathetic tone in awakens SAS patients. Nine men with obstructive SAS and nine healthy men participated awaken in our study and LDF signals were recorded in the forearm. In our work, complexity of LDF signals is analyzed through the computation and analysis of their multifractal spectra. The multifractal spectra are estimated by first estimating the discrete partition function of the signals, then by determining their Renyi exponents with a linear regression, and finally by computing their Legendre transform. The results show that, at rest, obstructive SAS has no or little impact on the multifractal spectra of LDF signals recorded in the forearm. This study shows that the physiological modifications brought by obstructive SAS do not modify the complexity of LDF signals when recorded in the forearm.

  10. [Sleep apnea-hypopnea syndrome: risk factors in children and adolescents; a systematic review].

    Science.gov (United States)

    Aguilar Cordero, M J; Sánchez López, A M; Mur Villar, N; García García, I; Guisado Barrilao, R

    2013-11-01

    The sleep apnea-hypopnea syndrome (SAHS) is a disorder that currently affects a large number of children and adolescents. The aim of this review is to assess the factors causing this condition and the risk of suffering another disease associated with SAHS. The 50 articles selected for inclusion in this review were identified through GOOGLE SCHOLAR. The validity of the items was established by the degree of evidence obtained, by recommendations made in this respect and by the applicability to the situation observed. The review considers studies of SAHS in children and adolescents, taking into account those relating this disorder with obesity, hypertension, physical activity and other variables. The studies reviewed show that SAHS is associated with childhood obesity and that it increases the risk of cerebro-cardiovascular disease. It is also shown that SAHS decreases children's and adolescents' physical capacity and quality of life. Psychological aspects are also affected, impacting on academic performance, which is poorer than in healthy children. Therefore, early paediatric diagnosis of SAHS is important in order to prevent associated disorders.

  11. Influence of obstructive sleep apnea syndrome in the fluctuation of the submaximal isometric torque of knee extensors in patients with early-grade osteoarthritis

    Science.gov (United States)

    Silva, Andressa; Mello, Marco T.; Serrão, Paula R.; Luz, Roberta P.; Bittencourt, Lia R.; Mattiello, Stela M.

    2015-01-01

    OBJECTIVE: The aim of this study was to investigate whether obstructive sleep apnea (OSA) alters the fluctuation of submaximal isometric torque of the knee extensors in patients with early-grade osteoarthritis (OA). METHOD: The study included 60 male volunteers, aged 40 to 70 years, divided into four groups: Group 1 (G1) - Control (n=15): without OA and without OSA; Group 2 (G2) (n=15): with OA and without OSA; Group 3 (G3) (n=15): without OA and with OSA; and Group 4 (G4) (n=15) with OA and with OSA. Five patients underwent maximal isometric contractions of 10 seconds duration each, with the knee at 60° of flexion to determine peak torque at 60°. To evaluate the fluctuation of torque, 5 submaximal isometric contractions (50% of maximum peak torque) of 10 seconds each, which were calculated from the standard deviation of torque and coefficient of variation, were performed. RESULTS: Significant differences were observed between groups for maximum peak torque, while G4 showed a lower value compared with G1 (p=0.005). Additionally, for the average torque exerted, G4 showed a lower value compared to the G1 (p=0.036). However, no differences were found between the groups for the standard deviation (p=0.844) and the coefficient of variation (p=0.143). CONCLUSION: The authors concluded that OSA did not change the parameters of the fluctuation of isometric submaximal torque of knee extensors in patients with early-grade OA. PMID:26443974

  12. Influence of obstructive sleep apnea syndrome in the fluctuation of the submaximal isometric torque of knee extensors in patients with early-grade osteoarthritis

    Directory of Open Access Journals (Sweden)

    Andressa Silva

    2015-08-01

    Full Text Available OBJECTIVE: The aim of this study was to investigate whether obstructive sleep apnea (OSA alters the fluctuation of submaximal isometric torque of the knee extensors in patients with early-grade osteoarthritis (OA.METHOD: The study included 60 male volunteers, aged 40 to 70 years, divided into four groups: Group 1 (G1 - Control (n=15: without OA and without OSA; Group 2 (G2 (n=15: with OA and without OSA; Group 3 (G3 (n=15: without OA and with OSA; and Group 4 (G4 (n=15 with OA and with OSA. Five patients underwent maximal isometric contractions of 10 seconds duration each, with the knee at 60° of flexion to determine peak torque at 60°. To evaluate the fluctuation of torque, 5 submaximal isometric contractions (50% of maximum peak torque of 10 seconds each, which were calculated from the standard deviation of torque and coefficient of variation, were performed.RESULTS: Significant differences were observed between groups for maximum peak torque, while G4 showed a lower value compared with G1 (p=0.005. Additionally, for the average torque exerted, G4 showed a lower value compared to the G1 (p=0.036. However, no differences were found between the groups for the standard deviation (p=0.844 and the coefficient of variation (p=0.143.CONCLUSION: The authors concluded that OSA did not change the parameters of the fluctuation of isometric submaximal torque of knee extensors in patients with early-grade OA.

  13. Sleep apnea and occupational accidents: Are oral appliances the solution?

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    Maria De Lourdes Rabelo Guimarães

    2014-01-01

    Full Text Available Background: Dental practitioners have a key role in the quality of life and prevention of occupational accidents of workers with Obstructive Sleep Apnea Syndrome (OSAS. Aim: The aim of this study was to review the impact of OSAS, the Continuous Positive Airway Pressure (CPAP therapy, and the evidence regarding the use of oral appliances (OA on the health and safety of workers. Materials and Methods: Searches were conducted in MEDLINE (PubMed, Lilacs and Sci ELO. Articles published from January 1980 to June 2014 were included. Results: The research retrieved 2188 articles and 99 met the inclusion criteria. An increase in occupational accidents due to reduced vigilance and attention in snorers and patients with OSAS was observed. Such involvements were related to excessive daytime sleepiness and neurocognitive function impairments. The use of OA are less effective when compared with CPAP, but the results related to excessive sleepiness and cognitive performance showed improvements similar to CPAP. Treatments with OA showed greater patient compliance than the CPAP therapy. Conclusion: OSAS is a prevalent disorder among workers, leads to increased risk of occupational accidents, and has a significant impact on the economy. The CPAP therapy reduces the risk of occupational accidents. The OA can improve the work performance; but there is no scientific evidence associating its use with occupational accidents reduction. Future research should focus on determining the cost-effectiveness of OA as well as its influence and efficacy in preventing occupational accidents.

  14. [Role and mechanism of Th17/Treg in obstructive sleep apnea hypopnea syndrome].

    Science.gov (United States)

    Liu, Y; Gu, Y C; Tang, Y; Lü, X L; Chen, H; Wu, Q Z

    2016-11-29

    Objective: To explore the role and the mechanism of Th17/Treg in obstructive sleep apnea hypopnea syndrome (OSAHS). Methods: A total of 100 patients who completed polysomnography (PSG) in the sleep lab of Affiliated Wujiang Hospital of Nantong University from Mar. 2015 to Apr. 2016 were enrolled and divided into four groups (primary snoring as the control group, mild OSAHS, moderate OSAHS and severe OSAHS) according apnea hypopnea index (AHI). The proportion of Th17, Treg (of CD4(+) T cells) and the expression of interleukin (IL)-17A, IL-6 were detected and the relevant data were analyzed by the correlation analysis and the multiple stepwise regression analysis. Results: Compared with the control group, the OSAHS patients had higher Th17% [(1.36±0.46)%, (1.68±0.30)%, (2.23±0.03)% vs (1.02±0.22)%], Th17/Treg [(0.22±0.07), (0.28±0.10), (0.29±0.00) vs (0.13±0.03)], IL-17A [(2.53±0.89), (2.99±1.96), (7.77±1.63) vs (1.45±0.78) ng/L], IL-6 [(6.14±4.37), (9.41±4.66), (12.58±6.65) vs (5.44±3.13) ng/L] and lower Treg% [(7.57±0.16)%, (6.46±1.57)%, (6.10±1.19)% vs (8.02±1.45)%] (all PTreg, IL-17A, IL-6 and AHI, oxygen desaturation index (ODI) respectively, there was a negative correlation between Th17%, Th17/Treg, IL-17A, IL-6 and the lowest oxygen saturation (SpO2) (all PTreg had a negative correlation with AHI or ODI and a positive correlation with the lowest SpO2 (all PTreg% and the radio of Th17/Treg. Conclusions: There is an imbalance of Th17/Treg in OSAHS. Therefore, Th17 and the relevant inflammatory cytokines may be involved in the occurrence and development of OSAHS.

  15. Obstructive Sleep Apnea in MPS

    Directory of Open Access Journals (Sweden)

    Abhijit Ricky Pal MBBChir, MA, MD, FRCS(ORL-HNS

    2015-11-01

    Full Text Available The mucopolysaccharidoses (MPSs are a group of inherited, metabolic disorders characterized by progressive multisystem accumulation of partially degraded glycosaminoglycans. This manifests with multilevel airway obstruction, presenting with obstructive sleep apnea (OSA. We systematically reviewed the literature to determine the severity and prevalence of OSA in MPS based on polysomnography analysis. Fifteen studies with 294 participants met the inclusion criteria for review. The pretreatment prevalence of OSA in MPS was 81% with a mean apnea–hypopnea index (AHI of 10.4. Patients with MPS I are most significantly affected, with 75% suffering with moderate to severe OSA (mean AHI, 16.6. Enzyme replacement therapy (ERT results in an almost significant reduction in OSA in MPS I (P = .06, while adenotonsillar surgery significantly improves AHI (P = .002. Obstructive sleep apnea least affects MPS III. There is a lack of long-term post-ERT and hematopoietic stem cell transplant data relating to OSA outcomes in this population, with further prospective studies required to determine the ongoing response to treatment.

  16. Nursing advance on sleep apnea hypopena syndrome%睡眠呼吸暂停低通气综合征的护理进展

    Institute of Scientific and Technical Information of China (English)

    范树腾

    2011-01-01

    @@ 睡眠呼吸暂停低通气综合征(sleep apnea hypopnea syndrome,SAHS)是指各种原因导致睡眠状态下反复出现呼吸暂停和(或)低通气,引起低氧血症、高碳酸血症、睡眠呼吸中段,从而使机体发生一系列病理生理改变的临床综合征.临床表现为睡眠打鼾、白天嗜睡、呼吸暂停.分为中枢型睡眠呼吸暂停低通气综合征(central sleep apnea hypopnea syndrome,CSAHS)和阻塞型睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome, OSAHS),其中OSAHS占大多数.

  17. Changes of growth hormone secretion in children with obstructive sleep apnea syndrome%阻塞性睡眠呼吸暂停综合征患儿体内生长激素水平的变化

    Institute of Scientific and Technical Information of China (English)

    谢利生; 黄群

    2011-01-01

    Objective To observe changes of growth hormone (GH) secretion levels in children with obstructive sleep apnea syndrome (OSAS). Methods 60 in-patients in the Nanjing Children's Hospital had polysomnography (PSG) performed. 45 OSAS cases served as the experimental group, and IS non-OSAS cases as the control group. Growth hormone secretion levels in both groups were examined by enzyme-linked immunosorbent assay (ELISA). Results GH secretion level in the OSAS group was (8.% ±1.74) ng/mL, significantly lower than that in the control group (10.09 ±1.54)ng/ mL. And in the experimental group, there was no significant difference between mild and moderate cases, while they were obviously reduced in severe cases. Further correlation and regression analysis showed that GH secretion levels were negatively correlated with the oxygen de-saturation index (r = -0.507). Conclusion Growth hormone secretion in OSAS patients was inhibited, especially in severe OSAS cases with a decrease of the oxygen de-saturation index.%目的 探讨阻塞性睡眠呼吸暂停综合征(OSAS)对儿童体内生长激素(GH)分泌水平的影响.方法 经患儿家长知情同意,选取南京市儿童医院经多导睡眠监测仪(PSG)确诊为OSAS的患儿45例为实验组,非OSAS患儿15例为对照组,应用酶联免疫吸附测定法(ELISA)测定晨起生长激素(GH).结果 OSAS组患儿GH值为(8.96±1.74)ng/mL,明显低于对照组(10.09±1.54)ng/mL,差异有统计学意义.进一步分析显示轻中度OSAS组患儿体内的GH分泌水平与正常组差异无统计学意义,而重度OSAS体内的GH分泌水平与轻中度OSAS及对照组差异明显.进一步相关回归分析显示,GH的分泌量与OSAS患儿的氧减指数呈负相关(r=-0.507).结论 OSAS患儿体内生长激素水平受到一定的抑制,尤其伴氧减指数增加的量度OSAS患儿下降明显,应早期治疗,以防影响患儿生长发育.

  18. Nasal and oral snoring endoscopy: novel and promising diagnostic tools in OSAS patients.

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    Lovato, Andrea; Kotecha, Bhik; Vianello, Andrea; Giacomelli, Luciano; Staffieri, Alberto; Marchese-Ragona, Rosario

    2015-07-01

    The aim of the present study was to investigate if any of the three awake procedures [fiberoptic nasopharyngoscopy with modified Müller Maneuver (FNMM), nasal snoring endoscopy (NSE), or oral snoring endoscopy (OSE)] could efficiently predict the grade or pattern of upper airway (UA) collapse found with drug-induced sleep endoscopy (DISE), which is considered by many authors as the current gold standard in optimizing obstructive sleep apnea syndrome (OSAS) patient selection for UA surgery. Twenty consecutive patients (simple snorers and OSAS patients) were studied with FNMM, NSE, OSE, and DISE. The inter-test agreement was evaluated with Cohen's kappa coefficient (κ). In the current series, we found that NSE and OSE were better than FNMM in predicting the pattern of collapse found with DISE. A significant pattern agreement between NSE and DISE was present in all sub-sites, and the agreement was measured with a scale proposed by Landis and Koch as: moderate in velo- and oropharynx (κ = 0.52, p = 0.001, and κ = 0.47, p = 0.003, respectively), and substantial in hypopharynx (κ = 0.63, p DISE, the pattern agreement was almost perfect at oropharyngeal level (κ = 0.82, p DISE only at oropharyngeal level (κ = 0.31, p = 0.009); while in the other sub-sites, no significant agreement was found. NSE and OSE are new promising diagnostic tools in OSAS patients. Further investigations are needed to see if they could predict the effectiveness of UA surgery.

  19. Drug induced sleep endoscopy in the decision-making process of children with obstructive sleep apnea.

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    Galluzzi, Francesca; Pignataro, Lorenzo; Gaini, Renato Maria; Garavello, Werner

    2015-03-01

    Tonsillectomy and adenoidectomy (T&A) is currently recommended in children with Obstructive Sleep Apnea (OSA). However, the condition persists after surgery in about one third of cases. It has been suggested that Drug Induced Sleep Endoscopy (DISE) may be of help for planning a more targeted and effective surgical treatment but evidence is yet weak. The aim of this review is to draw recommendation on the use of DISE in children with OSA. More specifically, we aimed at determine the proportion of cases whose treatment may be influenced by DISE findings. A comprehensive search of articles published from February 1983 to January 2014 listed in the PubMed/MEDLINE databases was performed. The search terms used were: "endoscopy" or "nasoendoscopy" or "DISE" and "obstructive sleep apnea" and "children" or "child" or "pediatric." The main outcome was the rate of naive children with hypertrophic tonsils and/or adenoids. The assumptions are that clinical diagnosis of hypertrophic tonsils and/or adenoids is reliable and does not require DISE, and that exclusive T&A may solve OSA in the vast majority of cases even in the presence of other concomitant sites of obstruction. Five studies were ultimately selected and all were case series. The median (range) number of studied children was 39 (15-82). Mean age varied from 3.2 to 7.8 years. The combined estimate rate of OSA consequent to hypertrophic tonsils and/or adenoids was 71% (95%CI: 64-77%). In children with Down Syndrome, the combined estimated rate of hypertrophic tonsils and/or adenoids was 62% (95%CI: 44-79%). Our findings show that DISE may be of benefit in a minority of children with OSA since up to two thirds of naive cases presents with hypertrophic tonsils and/or adenoids. Its use should be limited to those whose clinical evaluation is unremarkable or when OSA persists after T&A.

  20. Global brain blood-oxygen level responses to autonomic challenges in obstructive sleep apnea.

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    Paul M Macey

    Full Text Available Obstructive sleep apnea (OSA is accompanied by brain injury, perhaps resulting from apnea-related hypoxia or periods of impaired cerebral perfusion. Perfusion changes can be determined indirectly by evaluation of cerebral blood volume and oxygenation alterations, which can be measured rapidly and non-invasively with the global blood oxygen level dependent (BOLD signal, a magnetic resonance imaging procedure. We assessed acute BOLD responses in OSA subjects to pressor challenges that elicit cerebral blood flow changes, using a two-group comparative design with healthy subjects as a reference. We separately assessed female and male patterns, since OSA characteristics and brain injury differ between sexes. We studied 94 subjects, 37 with newly-diagnosed, untreated OSA (6 female (age mean ± std: 52.1±8.1 yrs; apnea/hypopnea index [AHI]: 27.7±15.6 events/hr and 31 male 54.3±8.4 yrs; AHI: 37.4±19.6 events/hr, and 20 female (age 50.5±8.1 yrs and 37 male (age 45.6±9.2 yrs healthy control subjects. We measured brain BOLD responses every 2 s while subjects underwent cold pressor, hand grip, and Valsalva maneuver challenges. The global BOLD signal rapidly changed after the first 2 s of each challenge, and differed in magnitude between groups to two challenges (cold pressor, hand grip, but not to the Valsalva maneuver (repeated measures ANOVA, p<0.05. OSA females showed greater differences from males in response magnitude and pattern, relative to healthy counterparts. Cold pressor BOLD signal increases (mean ± adjusted standard error at the 8 s peak were: OSA 0.14±0.08% vs. Control 0.31±0.06%, and hand grip at 6 s were: OSA 0.08±0.03% vs. Control at 0.30±0.02%. These findings, indicative of reduced cerebral blood flow changes to autonomic challenges in OSA, complement earlier reports of altered resting blood flow and reduced cerebral artery responsiveness. Females are more affected than males, an outcome which may contribute to the sex

  1. Cost-Effectiveness of a Community Pharmacist-Led Sleep Apnea Screening Program - A Markov Model.

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    Clémence Perraudin

    Full Text Available Despite the high prevalence and major public health ramifications, obstructive sleep apnea syndrome (OSAS remains underdiagnosed. In many developed countries, because community pharmacists (CP are easily accessible, they have been developing additional clinical services that integrate the services of and collaborate with other healthcare providers (general practitioners (GPs, nurses, etc.. Alternative strategies for primary care screening programs for OSAS involving the CP are discussed.To estimate the quality of life, costs, and cost-effectiveness of three screening strategies among patients who are at risk of having moderate to severe OSAS in primary care.Markov decision model.Published data.Hypothetical cohort of 50-year-old male patients with symptoms highly evocative of OSAS.The 5 years after initial evaluation for OSAS.Societal.Screening strategy with CP (CP-GP collaboration, screening strategy without CP (GP alone and no screening.Quality of life, survival and costs for each screening strategy.Under almost all modeled conditions, the involvement of CPs in OSAS screening was cost effective. The maximal incremental cost for "screening strategy with CP" was about 455€ per QALY gained.Our results were robust but primarily sensitive to the treatment costs by continuous positive airway pressure, and the costs of untreated OSAS. The probabilistic sensitivity analysis showed that the "screening strategy with CP" was dominant in 80% of cases. It was more effective and less costly in 47% of cases, and within the cost-effective range (maximum incremental cost effectiveness ratio at €6186.67/QALY in 33% of cases.CP involvement in OSAS screening is a cost-effective strategy. This proposal is consistent with the trend in Europe and the United States to extend the practices and responsibilities of the pharmacist in primary care.

  2. Sleep overlap syndrome

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    Fariba Rezaeetalab

    2016-12-01

    Full Text Available Overlap syndrome, which is known as the coexistence of chronic obstructive pulmonary disease (COPD and obstructive sleep apnea (OSA, was first defined by Flenley. Although it can refer to concomitant occurrence of any of the pulmonary diseases and OSA, overlap syndrome is commonly considered as the coexistence of OSA and COPD. This disease has unique adverse health consequences distinct from either condition alone. Given the high prevalence of each solitary disease, overlap syndrome is also likely to be common and clinically relevant. Despite the fact that overlap syndrome has been described in the literature for nearly 30 years, paucity of evaluations and studies limited the discussion on diagnosis, prevalence, pathophysiology, treatment, and outcomes of this disease. This review article addresses these issues by reviewing several recent studies conducted in Iran or other countries. This review suggests that overlap syndrome has worse outcomes than either disease alone. Our findings accentuated the urgent need for further studies on overlap syndrome and all overlaps between OSA and chronic pulmonary disease to provide a deeper insight into diagnosis and non-invasive treatments of this disease.

  3. Quality of life of patients with obstructive sleep apnea syndrome treated with an intraoral mandibular repositioner Qualidade de vida em pacientes com síndrome de apnéia obstrutiva do sono tratados com reposicionador mandibular intra-oral

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    Marco Antonio Cardoso Machado

    2004-06-01

    Full Text Available BACKGROUND: Obstructive sleep apnea syndrome (OSAS is a very important and prevalent disease, which is associated with a poor quality of life in many patients. Treatments for OSAS include surgery, Continuos Positive Air way Pressure, and an intraoral mandibular repositioner (IOMR, but the tendency of sleep centers is to emphasize the apnea index, neglecting quality of life as treatment outcome. OBJECTIVE: To verify to what extent treatment with an IOMR improves the OSAS patient's quality of life. METHOD: Eleven male patients aged 34 to 63 years (mean=49 with mild to moderate OSAS were evaluated using the Calgary SAQLI questionnaire applied before and four weeks after treatment with an IOMR. The mandibular repositioners were manufactured individually for each patient with acrylic polymer and equipped with a retentive device to maintain the mandible in a forward position during sleep. RESULTS: Excellent improvement in the quality of life was observed in five patients (45.5% and excellent improvement in symptoms in 10 (90.9%. CONCLUSION: The systematic use of the IOMR indicates a clear improvement in the global quality of life as well as in the symptoms of patients with OSAS.CONTEXTO:A síndrome da apnéia obstrutiva do sono (SAOS é importante e prevalente doença associada à má qualidade de vida em muitos pacientes. Os tratamentos disponíveis incluem cirurgias, CPAP e o aparelho reposicionador mandibular intra-oral (ARMIO. Muitos centros de distúrbios de sono valorizam apenas a redução do número de apnéias no tratamento da SAOS, dando pouca atenção à qualidade de vida como desfecho do tratamento. OBJETIVO: Graduar melhora da qualidade de vida dos pacientes com SAOS usando ARMIO. MÉTODO: O questionário Calgary SAQLI foi aplicado, antes e após, 4 semanas de tratamento com ARMIO, a 11 pacientes masculinos, entre 34 e 63 anos de idade (média de 49 anos, com SAOS leve a moderada. ARMIOs foram manufaturados com polímero acrílico e

  4. 阻塞性睡眠呼吸暂停综合征患者术前心理干预的效果%Effects of Preoperative Nursing Intervention in Patients with Obstructive Sleep Apnea Syndrome

    Institute of Scientific and Technical Information of China (English)

    严喆; 陈蓓敏; 徐琼; 傅珺; 张家雄

    2011-01-01

    目的 探讨术前心理干预在阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS)手术患者中的效果.方法 将2009-2010年行手术治疗的164例OSAS患者按入院时间分为对照组和观察组,对照组进行常规护理,观察组在此基础上进行针对性的心理干预(包括心理疏导、行为干预、睡眠卫生教育及建立良好的社会支持系统等).比较两组患者入院时及术日晨的焦虑水平和血压、心率的变化,以及术中的疼痛程度.结果 两组患者入院时焦虑水平及血压、心率差异无统计学意义(P>0.05);观察组术日晨焦虑水平及血压、心率明显低于对照组,术中疼痛程度比对照组明显减轻,差异均有统计学意义(P<0.05).结论 术前心理干预可改善OSAS患者的焦虑状态,稳定血压和心率,减轻术中疼痛,促进患者平稳度过手术期,有利于患者早日康复.%Objective To explore the effects of preoperative nursing intervention in patients with the surgery of obstructive sleep apnea syndrome(OSAS). Methods From 2009 to 2010,164 OSAS patients with surgery were classified into control group and observation group according to the admission sequence. The patients in the control group underwent the routine nursing. Based on the routine nursing the patients in the observation group underwent specific psychological intervention including psychological counseling,behavioral interventions, sleep hygiene education and good social support systems. Comparisons were conducted on the extent of anxiety on admission and in the morning before the surgery and the changes in blood pressure, heart rate and pain in the surgery between the two groups. Results There wasno statistical significance in the extent of anxiety on admission and the changes in blood pressure and heart rate between the two groups(P>0.05). The anxiety,blood pressure and heart rate in the morning before the surgery were significantly lower and the pain in the

  5. [Chronic snoring and obstructive sleep apnea-hypopnea syndrome in children].

    Science.gov (United States)

    de Carlos Villafranca, F; Cobo Plana, J; Díaz-Esnal, B; Fernández-Mondragón, P; Macías Escalada, E; Puente Rodríguez, M

    2003-09-01

    The problems children have in sleeping are manifold; the gamut of disorders that have been described ranges from simple, occasional snoring with no accompanying complications, through the syndrome of increased blockage of the upper airways to the obstructive sleep apnea-hypopnea syndrome (OSAHS) where respiratory difficulties accompanied by hypoxemia, hypercapnia and structural sleep difficulties. Mouth breathing and chronic snoring occur frequently in children, with the incidence of snoring, identical for both sexes, varying between 3.2 and 27%. Difficulties in sleeping begin between the ages of the 3 and 9, peaking between 3 and 6. These results demonstrate, in a general way, the disparity between growth of the adenoids and tonsils, and upper airway growth. A differential diagnosis between the various pathological possibilities is based on the observed clinical signs and symptoms, analysis of cephalometric radiographs, polysomnography, a nocturnal cardio-respiratory polygraph and a video film taken during sleep. Snoring is the most characteristic sign of OSAHS in children. We do not yet have available any synthetic study that would sum up results of studies of sleep disorders in children. Nevertheless, we can define obstructive sleep apnea in children as the partial or total cessation of nose and mouth breathing for a period double that of the normal respiratory cycle. Classical treatment of children who suffer from severe respiratory difficulties during sleep, after identification of the etiology of the problem, consists of surgical removal of the adenoids or tonsils and, in certain, continuous positive pressure to assist breathing. The authors of this article have worked with 137 patients between the ages of 6 and 9, 77 of whom were chronic snorers with an average age of 7 years 6 months. The average age of the control group of 60 children was 7 years 2 months. We collected clinical data, medical histories, and distributed a questionnaire to determine

  6. Innovative treatments for adults with obstructive sleep apnea

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    Weaver TE

    2014-11-01

    Full Text Available Terri E Weaver,1,2 Michael W Calik,1,2 Sarah S Farabi,1,2 Anne M Fink,1,2 Maria T Galang-Boquiren,2,3 Mary C Kapella,1,2 Bharati Prasad,2,4 David W Carley1,21Biobehavioral Health Science Department, College of Nursing, University of Illinois at Chicago; 2Center for Narcolepsy, Sleep and Health, University of Illinois at Chicago College of Nursing, 3Department of Orthodontics, University of Illinois at Chicago College of Dentistry, 4Sleep Center, Department of Medicine, University of Illinois at Chicago College of Medicine, Chicago, IL, USAAbstract: Obstructive sleep apnea (OSA affects one in five adult males and is associated with significant comorbidity, cognitive impairment, excessive daytime sleepiness, and reduced quality of life. For over 25 years, the primary treatment has been continuous positive airway pressure, which introduces a column of air that serves as a pneumatic splint for the upper airway, preventing the airway collapse that is the physiologic definition of this syndrome. However, issues with patient tolerance and unacceptable levels of treatment adherence motivated the exploration of other potential treatments. With greater understanding of the physiologic mechanisms associated with OSA, novel interventions have emerged in the last 5 years. The purpose of this article is to describe new treatments for OSA and associated complex sleep apnea. New approaches to complex sleep apnea have included adaptive servoventilation. There is increased literature on the contribution of behavioral interventions to improve adherence with continuous positive airway pressure that have proven quite effective. New non-surgical treatments include oral pressure devices, improved mandibular advancement devices, nasal expiratory positive airway pressure, and newer approaches to positional therapy. Recent innovations in surgical interventions have included laser-assisted uvulopalatoplasty, radiofrequency ablation, palatal implants, and electrical

  7. Obstructive Sleep Apnea Hypopnea Syndrome as a Reason for Active Management of Pulmonary Embolism

    Institute of Scientific and Technical Information of China (English)

    Jiang Xie; Yong-Xiang Wei; Shuang Liu; Wei Zhang; Xiang-Feng Zhang; Jie Li

    2015-01-01

    Background:Obstructive sleep apnea hypopnea syndrome (OSAHS) constitutes an independent factor for high warfarin dose for patients with pulmonary embolism (PE).The aim of this study was to investigate whether the 6-month anticoagulation treatment by warfarin is enough for patients with PE complicated by OSAHS.Methods:We investigated 97 PE patients,32 of them had OSAHS and 65 non-OSAHS.Warfarin was administered for 6-month if no abnormal circumstances occurred.All patients were followed up for 18 months.Adverse events (AE) included death,major bleeding,hospitalization due to heart failure or pulmonary hypertension,and recurrence or aggravation of PE (including deep vein thrombosis).Recurrence rate of PE after warfarin cessation was compared between the two groups.Results:OSAHS patients required a significantly higher dose of warfarin than their non-OSAHS counterparts (4.73 mg vs.3.61 mg,P < 0.001).During warfarin treatment,no major bleeding and aggravation of PE occurred among OSAHS patients,and the rates of various AE were not significantly different between the OSAHS and non-OSAHS groups.PE recurrence was higher in OSAHS than non-OSAHS groups after withdrawal of warfarin (21.43% vs.6.78%,P =0.047).Compared with non-OSAHS patients,OSAHS group had lower international normalized ratio (INR) value but higher plasminogen on baseline and INR resumed to a relatively low level after warfarin discontinuation.Conclusions:OSAHS patients may present with hypercoagulation and relatively high-risk of recurrence of PE after cessation of 6-month warfarin treatment.

  8. Comparação da área da faringe na vigília e durante o sono induzido em pacientes com Síndrome da Apneia Obstrutiva do Sono (SAOS Comparison of the area of the pharynx during wakefulness and induced sleep in patients with Obstructive Sleep Apnea (OSA

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    Ana Célia Faria

    2012-02-01

    Full Text Available O estudo da Síndrome da Apneia Obstrutiva do Sono (SAOS tem merecido atenção crescente nos últimos anos, uma vez que vários aspectos não foram ainda suficientemente esclarecidos. OBJETIVO: Avaliar, com o uso da Ressonância Magnética (RM, as modificações da área da faringe durante vigília e sono induzido em pacientes portadores de SAOS. MATERIAL E MÉTODOS: Estudo prospectivo de 32 pacientes com diagnóstico polissonográfico de SAOS. Todos foram submetidos à aquisição das Imagens por RM, com sequências sagitais de alta definição anatômica, realizadas inicialmente com o paciente em vigília e durante o sono induzido por Propofol. Uma área foi definida no plano sagital na linha média da faringe. Essa região passou a ser denominada como área do plano mediano da faringe (PMF. RESULTADOS: As medidas (mm² da área do PMF de cada paciente, na vigília e durante o sono induzido, apresentaram diferença estatisticamente significante pThe study of obstructive sleep apnea (OSA has received growing attention over the past years since various aspects have not been sufficiently established. AIM: To evaluate, with the use of magnetic resonance imaging (MRI, changes in the area of the pharynx during wakefulness and induced sleep in patients with OSA. MATERIALS AND METHODS: A prospective study of thirty-two patients with a polysomnographic diagnosis of OSA. All patients were submitted to MR imaging in order to obtain high-definition anatomical sagittal sequences during wakefulness and during sleep induced with Propofol. An area was defined on the sagittal plane in the midline of the pharynx. This region was called pharyngeal midplane (PMP area. RESULTS: A significant difference in PMP area (mm² was observed between wakefulness and induced sleep in each patient (p < 0.000001. CONCLUSION: The patients with OSA suffer a significant reduction of 75,5 % in the area of the pharynx during induced sleep compared to wakefulness.

  9. 阻塞性睡眠呼吸暂停综合征大鼠皮质海马损害及机制研究%Injury of cortex and hippocampus in rats with obstructive sleep apnea syndrome and its mechanisms

    Institute of Scientific and Technical Information of China (English)

    宋凯英; 徐平; 史艳红

    2013-01-01

    Objective To study the correlation between obstructive sleep apnea syndrome (OSAS ) and ischemic stroke by establishing a rat OSAS model .Methods Twenty clear Wistar rats were randomly divided into control group and OSAS group (10 in each group) .An OSAS model was established by injectiing sodium hyaluronate gel into the rats of OSAS group .Nose and mouth airflow ,and dynamic oxygen in the rats were monitored by EEG .Their serum levels of C-reactive protein(CRP) ,fibrinogen (Fib ) and homocysteine (Hey ) were measured .Structure of cortex and hippocampus was observed with HE staining .Results The serum CRP and Fib levels were significantly higher in OSAS group than in control group ( P0 .05).The serum CRP and Fib levels were negatively correlated with the mean blood oxygen saturation and positively correlated with the sleep apnea index .Brain tissue HE staining showed loss and disarrangement of neurons and proliferation of brain small blood vessels in OSAS group .Conclusion The high serum CRP and Fib levels and morphological change of neurons in cortex and hippocampus are the pathogensis of ischemic stroke in OSAS rats .%目的 通过建立大鼠阻塞性睡眠呼吸暂停综合征(OSAS)模型,探讨OSAS与缺血性脑卒中的相关性.方法 清洁级Wistar大鼠20只,随机分为正常对照组和OSAS组,各10只.OSAS组大鼠咽腔多点注射透明质酸钠凝胶建立OSAS模型,并监测脑电、口鼻气流及血氧;检测2组血C反应蛋白(CRP)、纤维蛋白原(Fib)、同型半胱氨酸(Hcy)水平;HE染色法观察大鼠皮质及海马结构.结果 OSAS组大鼠CRP、Fib较正常对照组明显升高(P0.05);CRP和Fib与平均血氧饱和度呈负相关(r=-0.802,-0.867,P<0.05),与睡眠呼吸暂停指数呈正相关(r=0.874,0.941,P<0.05).OSAS组大鼠脑组织HE染色皮质及海马区有神经元缺失、排列紊乱及脑小血管增生.结论 OSAS大鼠CRP、Fib水平升高,皮质海马区神经元形态学发生变化,可能是OSAS发生缺血性脑卒中的发病机制.

  10. Obstructive sleep apnea decreases central nervous system-derived proteins in the cerebrospinal fluid.

    Science.gov (United States)

    Ju, Yo-El S; Finn, Mary Beth; Sutphen, Courtney L; Herries, Elizabeth M; Jerome, Gina M; Ladenson, Jack H; Crimmins, Daniel L; Fagan, Anne M; Holtzman, David M

    2016-07-01

    We hypothesized that one mechanism underlying the association between obstructive sleep apnea (OSA) and Alzheimer's disease is OSA leading to decreased slow wave activity (SWA), increased synaptic activity, decreased glymphatic clearance, and increased amyloid-β. Polysomnography and lumbar puncture were performed in OSA and control groups. SWA negatively correlated with cerebrospinal fluid (CSF) amyloid-β-40 among controls and was decreased in the OSA group. Unexpectedly, amyloid-β-40 was decreased in the OSA group. Other neuronally derived proteins, but not total protein, were also decreased in the OSA group, suggesting that OSA may affect the interaction between interstitial and cerebrospinal fluid. Ann Neurol 2016;80:154-159.

  11. Sleep Endoscopy in the Evaluation of Pediatric Obstructive Sleep Apnea

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    Aaron C. Lin

    2012-01-01

    Full Text Available Pediatric obstructive sleep apnea (OSA is not always resolved or improved with adenotonsillectomy. Persistent or complex cases of pediatric OSA may be due to sites of obstruction in the airway other than the tonsils and adenoids. Identifying these areas in the past has been problematic, and therefore, therapy for OSA in children who have failed adenotonsillectomy has often been unsatisfactory. Sleep endoscopy is a technique that can enable the surgeon to determine the level of obstruction in a sleeping child with OSA. With this knowledge, site-specific surgical therapy for persistent and complex pediatric OSA may be possible.

  12. A Robust Apnea Period Detection Method in Changing Sleep Posture by Average Mutual Information of Heartbeat and Respiration

    Science.gov (United States)

    Kurihara, Yosuke; Watanabe, Kajiro; Kobayashi, Kazuyuki; Tanaka, Tanaka

    Sleep disorders disturb the recovery from mental and physical fatigues, one of the functions of the sleep. The majority of those who with the disorders are suffering from Sleep Apnea Syndrome (SAS). Continuous Hypoxia during sleep due to SAS cause Circulatory Disturbances, such as hypertension and ischemic heart disease, and Malfunction of Autonomic Nervous System, and other severe complications, often times bringing the suffers to death. In order to prevent these from happening, it is important to detect the SAS in its early stage by monitoring the daily respirations during sleep, and to provide appropriate treatments at medical institutions. In this paper, the Pneumatic Method to detect the Apnea period during sleep is proposed. Pneumatic method can measure heartbeat and respiration signal. Respiration signal can be considered as noise against heartbeat signal, and the decrease in the respiration signal due to Apnea increases the Average Mutual Information of heartbeat. The result of scaling analysis of the average mutual information is defined as threshold to detect the apnea period. The root mean square error between the lengths of Apnea measured by Strain Gauge using for reference and those measured by using the proposed method was 3.1 seconds. And, error of the number of apnea times judged by doctor and proposal method in OSAS patients was 3.3 times.

  13. Utility of portable monitoring in the diagnosis of obstructive sleep apnea

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    U Krishnaswamy

    2015-01-01

    Full Text Available Obstructive sleep apnea (OSA is a common but underdiagnosed sleep disorder, which is associated with systemic consequences such as hypertension, stroke, metabolic syndrome, and ischemic heart disease. Nocturnal laboratory-based polysomnography (PSG is the gold standard test for diagnosis of OSA. PSG consists of a simultaneous recording of multiple physiologic parameters related to sleep and wakefulness including electroencephalography (EEG, electrooculography (EOG, surface electromyography (EMG, airflow measurement using thermistor and nasal pressure transducer, pulse oximetry and respiratory effort (thoracic and abdominal. Multiple alternative and simpler methods that record respiratory parameters alone for diagnosing OSA have been developed in the past two decades. These devices are called portable monitors (PMs and enable performing sleep studies at a lower cost with shorter waiting times. It has been observed and reported that comprehensive sleep evaluation coupled with the use of PMs can fulfill the unmet need for diagnostic testing in various out-of-hospital settings in patients with suspected OSA. This article reviews the available medical literature on PMs in order to justify the utility of PMs in the diagnosis of OSA, especially in resource-poor, high-disease burden settings. The published practice parameters for the use of these devices have also been reviewed with respect to their relevance in the Indian setting.

  14. Impact of acetazolamide and CPAP on cortical activity in obstructive sleep apnea patients.

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    Katrin Stadelmann

    Full Text Available STUDY OBJECTIVES: 1 To investigate the impact of acetazolamide, a drug commonly prescribed for altitude sickness, on cortical oscillations in patients with obstructive sleep apnea syndrome (OSAS. 2 To examine alterations in the sleep EEG after short-term discontinuation of continuous positive airway pressure (CPAP therapy. DESIGN: Data from two double-blind, placebo-controlled randomized cross-over design studies were analyzed. SETTING: Polysomnographic recordings in sleep laboratory at 490 m and at moderate altitudes in the Swiss Alps: 1630 or 1860 m and 2590 m. PATIENTS: Study 1: 39 OSAS patients. Study 2: 41 OSAS patients. INTERVENTIONS: Study 1: OSAS patients withdrawn from treatment with CPAP. Study 2: OSAS patients treated with autoCPAP. Treatment with acetazolamide (500-750 mg or placebo at moderate altitudes. MEASUREMENTS AND RESULTS: An evening dose of 500 mg acetazolamide reduced slow-wave activity (SWA; approximately 10% and increased spindle activity (approximately 10% during non-REM sleep. In addition, alpha activity during wake after lights out was increased. An evening dose of 250 mg did not affect these cortical oscillations. Discontinuation of CPAP therapy revealed a reduction in SWA (5-10% and increase in beta activity (approximately 25%. CONCLUSIONS: The higher evening dose of 500 mg acetazolamide showed the "spectral fingerprint" of Benzodiazepines, while 250 mg acetazolamide had no impact on cortical oscillations. However, both doses had beneficial effects on oxygen saturation and sleep quality.

  15. Increased level of vascular endothelial growth factor in obstructive sleep apnea syndrome with severe nocturnal hypoxia%阻塞性睡眠呼吸暂停综合征患者血浆血管内皮生长因子浓度测定

    Institute of Scientific and Technical Information of China (English)

    王艳姣; 杨宇; 张湘瑜; 傅柳英

    2004-01-01

    目的探讨伴有不同程度夜间缺氧血症的阻塞性睡眠呼吸暂停综合征(Obstructive sleep apnea syndrome,OSAS)患者血浆血管内皮生因子(Vascular endothelial growth factor,VEGF)浓度的变化.方法40例经多导睡眠图(polysomnography,PSG)检查诊断为OSAS的患者,根据夜间缺氧程度分为2组(重度夜间缺氧组和非重度夜间缺氧组),每组各20例.清晨空腹采用检测血浆VEGF浓度.结果重度夜间缺氧组血浆VEGF浓度为(125.96±99.04)pg/ml,而非重度夜间缺氧组血浆VEGF浓度为(49.83±17.16)pg/mi,二者之间有显著差异.血浆VEGF浓度与夜间缺氧程度呈正相关(r=0.743,P<0.01).结论重度夜间缺氧的OSAS患者血浆VEGF浓度明显升高,OSAS患者夜间缺氧的严重程度呈血浆VEGF浓度正相关.%Objective: To investigate the relationship between the level of plasma vascular endothelial growth factor (VEGF) and the severity degree of obstructive sleep apnea syndrome (OSAS). Methods: Forty patients with OSASwere evaluated by polysomnography during sleep. The concentration of plasma VEGF was measured by ELISA in samples obtained from the antecubital vein at 7 a.m. Results: Patients with severe nighttime hypoxia had significantly higher plasma VEGF levels compared with mild to moderate nighttime hypoxia ones [(154.96+99.04)pg/ml versus (49.83+17.16)pg/ml]. The degree of nocturnal oxygen desaturation in OSAS was significantly correlated with plasma VEGF level (r=0.743,P<0.01). Conclusion: The plasma level of VEGF is elevated in OSAS patients with severe hypoxia and related to the severity degree of nocturnal oxygen desaturation.

  16. Sexual dysfunction in patients with obstructive sleep apnea hypopnea syndrome:a review of literat ure%阻塞性睡眠呼吸暂停低通气综合征对性功能影响的研究进展

    Institute of Scientific and Technical Information of China (English)

    杨婷婷; 余勤

    2015-01-01

    OSA HS是一种发病率较高而诊断率低,并具有一定潜在危险的疾患,其特征性的慢性间歇低氧方式及睡眠片段化,是累积多系统、多器官损害的病理生理基础。近年来研究证实,OSA HS与性功能障碍的发生有密切的关系。正确认识OSA HS与性功能障碍的关系有助于疾病的早期诊治,提高患者的生活质量。现对OSA HS和性功能障碍的流行病学,病理生理机制及相关的治疗进行综述。%Obstructive sleep apnea hypopnea syndrome (OSAHS) is a potentially life‐threatening disease ,featured with chronic intermittent hypoxia (CIH ) and microarousal leading to multisystem and multi‐organ injury ,with a high incidence but a low diagnosis rate .In recent years ,extensive studies have confirmed that OSAHS is closely associated with the sexual dysfunction .Correct understanding of the association of OSAHS with sexual dysfunction can contribute to the early diagnosis and treatment of such diseases and to improve the quality of life of patients .In this article ,the relevant epidemiology , pathophysiological mechanisms and treatmeat between OSAHS and sexual dysfunction were reviewed .

  17. The comparison of current and previous (2002) editions of American clinical practice guideline: diagnosis and management of childhood obstructive sleep apnea syndrome%美国新版《儿童睡眠呼吸暂停综合征诊治指南》与2002版指南的比较

    Institute of Scientific and Technical Information of China (English)

    邓力; 印根权

    2013-01-01

    2012年8月27日,美国儿科学会杂志在线发布了新版,意在指导初级保健医师对儿童青少年OSAS的诊断与治疗.自从前一版 (2002版) 指南发表后,有关OSAS研究的文献质量有明显提高.新版指南是在参考1999至2010年间发表的3 166篇文献中的350篇文献相关数据基础上所制定的.本文主要比较新版指南与2002版的不同,以及十年间对儿童OSAS认识的变化.%The current clinical practice guideline, diagnosis and management of childhood obstructive sleep apnea syndrome (OSAS), was issued in Pediatrics on line by American academy of pediatrics on August 27th, 2012. This revised guideline, intended for use by primary earc clinicians, provides recommesdations for the diagnosis and management of OSAS in children and adolescents. Since the previous guideline (version 2002) was published, studies of OSAS have bees improved significantly. The current guideline was formulated according to the relevant data from 350 of 3166 articles published from 1999 to 2010. What are the differences between the two guidelines? What are the greatest changes in cbildhood OSAS in the past 10 years? This article will focus on the comparison between these two guidelines.

  18. Mechanisms of endothelial dysfunction in obstructive sleep apnea

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    Amy Atkeson

    2008-12-01

    Full Text Available Amy Atkeson, Sanja JelicDivision of Pulmonary, Allergy, and Critical Care Medicine, Columbia University College of Physicians and Surgeons, New York, NYAbstract: Endothelial activation and inflammation are important mediators of accelerated atherogenesis and consequent increased cardiovascular morbidity in obstructive sleep apnea (OSA. Repetitive episodes of hypoxia/reoxygenation associated with transient cessation of breathing during sleep in OSA resemble ischemia/reperfusion injury and may be the main culprit underlying endothelial dysfunction in OSA. Additional factors such as repetitive arousals resulting in sleep fragmentation and deprivation and individual genetic suseptibility to vascular manifestations of OSA contribute to impaired endothelial function in OSA. The present review focuses on possible mechanisms that underlie endothelial activation and inflammation in OSA.Keywords: endothelial, obstructive sleep apnea, inflammation, dysfunction

  19. Treatment of snoring and sleep apnea syndrome with a removable mandibular advancement device in patients without TMD

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    Eduardo Rollo Duarte

    2012-04-01

    Full Text Available INTRODUCTION: Among the sleep disorders reported by the American Academy of Sleep, the most common is obstructive sleep apnea-hypopnea syndrome (OSAHS, which is caused by difficulties in air passage and complete interruption of air flow in the airway. This syndrome is associated with increased morbidity and mortality in apneic individuals. OBJECTIVE: It was the objective of this paper to evaluate a removable mandibular advancement device as it provides a noninvasive, straightforward treatment readily accepted by patients. METHODS: In this study, 15 patients without temporomandibular disorders (TMD and with excessive daytime sleepiness or snoring were evaluated. Data were collected by means of: Polysomnography before and after placement of an intraoral appliance, analysis of TMD signs and symptoms using a patient history questionnaire, muscle and TMJ palpation. RESULTS: After treatment, the statistical analysis (t-test, and the "before and after" test showed a mean reduction of 77.6% (p=0.001 in the apnea-hypopnea index, an increase in lowest oxyhemoglobin saturation (p=0.05, decrease in desaturation (p=0.05, decrease in micro-awakenings or EEG arousals (p=0.05 and highly significant improvement in daytime sleepiness (p=0.005, measured by the Epworth Sleepiness Scale. No TMD appeared during the monitoring period. CONCLUSION: The oral device developed in this study was considered effective for mild to moderate OSAHS.

  20. ISH...? ISH! / Eve Osa

    Index Scriptorium Estoniae

    Osa, Eve

    1999-01-01

    23.-27. märtsini 1999. a. Frankfurdis Maini ääres toimunud 20. ehitustehnoloogia messist ISH, seal eksponeeritud vannitoa ja tualettruumi sisustusest. Osa võttis 2243 firmat 42 riigist. 22 illustratsiooni

  1. Management of Obstructive Sleep Apnea

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    V K Vijayan

    2014-03-01

    Full Text Available Obstructive Sleep Apnea (OSA is an important public health problem and is associatedwith considerable morbidity and mortality. Therefore, treatment of this condition is ofparamount importance. The treatment of OSA includes general and behaviouralmeasures, mechanical measures including continuous positive airway pressure(CPAP, Bilevel positive airway pressure (BiPAP and Oral Appliances (OA,pharmacological treatment and surgical procedures. Continuous positive airwaypressure (CPAP treatment reverses the repetitive upper airway obstruction of sleepapnea and associated daytime sleepiness and is the most effective treatment for OSA.However maintaining patient adherence to CPAP therapy is a challenge. Weight lossshould be recommended to overweight patients with OSA, as it has been shown thatweight reduction has additional health benefits. Treatment of underlying medicalconditions such as hypothyroidism or acromegaly has profound effect onapnea/hypopnea index. A subset of patients with OSA may benefit from supplementaloxygen and positional therapy. Presently, there are no effective pharmacotherapeuticagents for treatment of patients with OSA and the role of surgical treatment in OSA iscontroversial. However, pharmacological treatment of persisting residual sleepiness,despite adequate positive airway pressure therapy delivery and adherence, is indicatedand may improve daytime sleepiness.Key words : CPAP, Oral appliances, Modafinil, CPAP complianceUvulopalatopharyngoplasty, positional therapy

  2. Changes of vasoactive substance in obstructive sleep apnea syndrome patients with type 2 diabetes%合并2型糖尿病的阻塞性睡眠呼吸暂停综合征患者血管活性物质的变化

    Institute of Scientific and Technical Information of China (English)

    陈列; 王玮

    2011-01-01

    substance in obstructive sleep apnea syndrome (OSAS) patients with type 2 diabetes and type 2 diabetes mellitus (T2DM) and OSAS patients.Methods 50 cases of OSAS confirmed by polysomnography (PSG) were selected, which included 24 patients with type 2 diabetes and 26 without type 2 diabetes. 18 patients with type 2 diabetes were selected and 24 normal controls selected as the control group. Serum levels of nitric oxide (NO),endothelin 1 (ET-1), thromboxane A2 (TXA2), and high-sensitive C-creative protein (hs-CRP) in patients were detected by enzyme-linked immunosorbent assay (ELISA). Then we analysed the relativity between the changed above index and apnea-hypopnea index (AHI). Results ①AHI significantly elevated hs-CRP in patients with OSAS and the lowest oxygen saturation declined and the OSAS with T2DM more evident. ②Compared vasoactive substances between OSAS group and T2DM group with control group,serum levels of ET-1, hs-CRP, TXA2 were higher in patients with OSAS patients and T2DM patients than those in control group, and the level of NO and NO/ET-1 decreased in OSAS patients and T2DM patients. Then we found the changes more significant in OSAS with T2DM patients except for hs-CRP. ③In OSAS patients, the level of ET-1,TXA2 and hs-CRP has positive correlation with AHI and the level of NO and NO/ET-1 has negative correlation with AHI. Conclusions The results indicate that the patients with OSAS have obvious endothelial dysfunction, and the changes in OSAS with T2DM patients more severe.

  3. Relationship between Obstructive Sleep Apnea Severity and Sleep, Depression and Anxiety Symptoms in Newly-Diagnosed Patients

    OpenAIRE

    Macey, Paul M.; Woo, Mary A; Rajesh Kumar; Cross, Rebecca L.; Ronald M Harper

    2010-01-01

    Obstructive sleep apnea (OSA) occurs in at least 10% of the population, and leads to higher morbidity and mortality; however, relationships between OSA severity and sleep or psychological symptoms are unclear. Existing studies include samples with wide-ranging comorbidities, so we assessed relationships between severity of OSA and common sleep and psychological disturbances in recently diagnosed OSA patients with minimal co-morbidities. We studied 49 newly diagnosed, untreated OSA patients wi...

  4. Drug-induced sedation endoscopy in children <2 years with obstructive sleep apnea syndrome: upper airway findings and treatment outcomes.

    Science.gov (United States)

    Boudewyns, A; Van de Heyning, P; Verhulst, S

    2017-02-20

    Few data are available about the pattern of upper airway (UA) obstruction in children DISE) in young OSAS children to investigate the pattern of UA obstruction and the value of DISE in therapeutic decision making. Retrospective analysis of ≤2-year-old children undergoing DISE-directed UA surgery. OSAS severity and the treatment outcomes were documented by polysomnography. Data are available for 28 patients, age 1.5 years (1.3-1.8), BMI-z score 0.5 (-0.7 to 1.3) with severe OSAS, obstructive apnea/hypopnea index (oAHI) 13.8/hr (7.5-28.3). All but 3 had (>50%) obstruction at the level of the adenoids, and all but 5 had (>50%) tonsillar obstruction. DISE-directed treatment consisted of adenoidectomy (n = 4), tonsillectomy (n = 1), and AT (n = 23). There was a significant improvement in respiratory parameters. Twenty children (71.4%) had a postoperative oAHI DISE showed a collapse of the epiglottis in 6 and late-onset laryngomalacia in 4. These findings did not affect surgical outcome. Adenotonsillar hypertrophy is the major cause of UA obstruction, and DISE-directed UA surgery was curative in 71,4% of children ≤2 years. We suggest that DISE may be helpful in surgical decision making. Circumferential UA narrowing may result in less favorable surgical outcomes.

  5. Assessment of anatomic parameters on lateral cephalogram and body mass index in patients with obstructive sleep apnea symptoms

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    Nemat Mokhtari Amir Majdi

    2009-01-01

    Full Text Available Introduction: Obstructive sleep apnea syndrome (OSAS is a serious and life threatening disorder caused by various anatomic and physio-pathologic factors. This study was conducted to clarify some anatomic etiologic factors of OSAS and the role of body mass index (BMI in expression of its symptoms. Materials and Methods: In this case-control study 127 patients were included. Sixty patients had OSAS symptoms and 67 patients were considered as controls. Cephalometric parameters from lateral skull view of CT scan and BMI of patients were statistically analyzed and compared between two groups. Results: The position of hyoid bone was significantly lower and soft palate was significantly larger in patients with OSAS symptoms than control group. Moreover, mean BMI measurement was significantly higher in the patient group. Conclusion: Our results suggest that in addition to apparent role of BMI in OSAS symptoms, increased soft tissue compartment of pharyngeal area and position of hyoid bone are significant etiologic factors in this syndrome.    

  6. 睡眠阶段对阻塞性睡眠呼吸暂停期间RR间期的影响%The influence of sleep stage to RR intervals of patients with obstructive sleep apnea syndrome

    Institute of Scientific and Technical Information of China (English)

    魏先梅; 张娜娜; 殷敏; 程雷; Miyazaki S

    2013-01-01

    Objective:To investigate the changes of the autonomic nervous system (ANS) activity induced by obstructive sleep apnea (OA) during different sleep stages.Methods:Thirty male patients who were diagnosed with obstructive sleep apnea syndrome (OSAS) by polysomnography(PSG) were enrolled in the study.The RR intervals,sleep stages and relative data were extracted during the OA (Event),as well as a 15-second period before and after the OA(Pre-,Post-).Heart rate variability (HRV) parameters were calculated and classified in light sleep stage (S1~2) and REM.Then the influence of sleep stages on HRV was analyzed and compared.Results:RR-Mean and RR-SD shifted to the lowest and △RR-Mean turned to the highest with in both stage 1~2 and REM with OA,while the trends shifted back again after OA.However,RR-Mean in REM was lower than that in S1 ~2 during the whole process.Conclusion:Sleep stages and respiratory events lead to repeated changes of autonomic nervous system activity in patients with OSAS during sleep.The sympathetic activity dominates during REM and OA.These might be associated with the development of cardiovascular diseases in patients with OSAS.%目的:探讨不同睡眠阶段下阻塞性睡眠呼吸暂停(OA)进程中自主神经功能活动的特点.方法:选择30例经标准多导睡眠图(PSG)监测诊断为阻塞性睡眠呼吸暂停综合征(OSAS)的男性患者.在PSG上选取OA发生期间(Event)及其前后各15 s(Pre-,Post-)的3个连续区间,提取各区间相应的RR间期变化的时间序列资料及相关睡眠背景等资料.计算并整理出浅睡眠期(S1~2)及快动眼期(REM)OA进程中3个连续区间的心率变异性(HRV)分析指标,分析不同睡眠阶段下RR间隔变动趋势,探讨睡眠阶段对OSAS患者自主神经功能活性的影响.结果:随着OA的发生,RR-平均值、标准差随着呼吸暂停逐步降低,相邻RR则逐步增大,而这一变化随着呼吸暂停的结束而回复.无论在S1~2期还是REM期该

  7. Cognitive profile and brain morphological changes in obstructive sleep apnea

    OpenAIRE

    Torelli, Federico; Moscufo, Nicola; Garreffa, Girolamo; Placidi, Fabio; Romigi, Andrea; Zannino, Silvana; Bozzali, Marco; Fasano, Fabrizio; Giulietti, Giovanni; Djonlagic, Ina; Malhotra, Atul; Marciani, Maria Grazia; Guttmann, Charles RG

    2010-01-01

    Obstructive sleep apnea (OSA) is accompanied by neurocognitive impairment, likely mediated by injury to various brain regions. We evaluated brain morphological changes in patients with OSA and their relationship to neuropsychological and oximetric data. Sixteen patients affected by moderate-severe OSA (age: 55.8±6.7 years, 13 males) and fourteen control subjects (age: 57.6±5.1 years, 9 males) underwent 3.0 Tesla brain magnetic resonance imaging (MRI) and neuropsychological testing evaluating ...

  8. Childhood Obstructive Sleep Apnea

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    R Dayal

    2014-03-01

    Full Text Available Obstructive sleep apnea (OSA is a common condition in childhood and can result insevere complications if left untreated. It is showing a rising trend in India. A significantassociation with obesity has been observed; however, some children with enlargedtonsils and/or adenoids may even be underweight. The patient usually presents withsnoring and other respiratory problems like mouth breathing, choking and gaspingepisodes in night. Poor school performance and neurocognitive deficits have beenreported. Pulmonary hypertension and cor pulmonale are seen in severe cases. Besidesthe history and clinical examination, for definitive diagnosis an overnightpolysomnographic evaluation is the gold standard. In all cases, the specific treatmentranges from simple lifestyle modifications and medications to surgeries likeadenotonsillectomy. Early diagnosis is vital.Key words: Childhood OSA, Obesity, adenotonsillar hypertrophy

  9. Study of Blood Pressure Variability in Acute Cerebral Infarction with Obstructive Sleep Apnea Syndrome%合并阻塞性睡眠呼吸暂停综合征的急性脑梗死患者血压变异性研究

    Institute of Scientific and Technical Information of China (English)

    于逢春; 刘永珍; 唐晓梅; 陈新平; 孟晓梅; 尹静; 冯研; 刘淑琴

    2011-01-01

    Objective To assess the blood pressure variability(BPV) in acute infarction with obstructive sleep apnea syndrome(OSAS), and to explore the relationship between BPV and stroke. Methods We studied patients with acute cerebral infarction. All of the patients were admitted to the department of neurology, Beijing Haidian Hospital, from Jan. 2009 to Jun. 2010. Overnight polysomnography(PSG) and 24-hour ambulatory blood pressure monitoring recordings were performed on all patients within the first week from the onset of the ischemic stroke. According to the PSG, patients were divided into OSAS group(n=126) and non-OSAS group(n=51) except the patients with central and mixed sleep apnea syndrome and taking anti-hypertension drugs. BPV was expressed as the standard deviation of blood pressure(BP) during a 24 period. The aim of study is to determine the relationships in BP, BPV, the National Institutes of Health Stroke Scale(NIHSS), and so on between groups. Data was analyzed by spssl1.5. We used for nominal variables the x2 test or t test. Significance was set at P<0.05. The correlations between the baseline data, clinical complications and recurrent stroke were studied.Results There were significantly higher daytime systolic(138.9±17.8 mmHg vs 131.4±15.8 mmH g, and P-value is less than 0.01), nighttime BPV(12.1±4.7 mmHg vs 8.8±3.7 mmHg, and P-value is less than 0.01) in the OSAS group as compared to the non-OSAS group. There were significantly differences in NIHSS and the number of recurrence stroke between two groups. Hypertention, diabetes mellitus, OSAS, apnea hypopnea index(AHI) and nighttime BPV were related to recurrent stroke(P<0.05). After adjustment for the other factors, nighttime BPV(OR 0.910, 95%CI 0.855-0.969, P=0.003) was a independent risk factor of recurrent stroke.Conclusion The nighttime-BPV was higher in the OSAS group as compared to the non-OSAS group.The BPV was one of the reasons of recurrence of stroke in patients with OSAS.%目的 探讨合并

  10. Relative rather than absolute macroglossia in patients with Down syndrome: implications for treatment of obstructive sleep apnea

    Energy Technology Data Exchange (ETDEWEB)

    Guimaraes, Carolina V.A. [Medical Center, Department of Radiology, Cincinnati, OH (United States); Cincinnati Children' s Hospital, OH (United States); Donnelly, Lane F. [Medical Center, Department of Radiology, Cincinnati, OH (United States); Medical Center, Department of Pediatrics, Cincinnati, OH (United States); Cincinnati Children' s Hospital, OH (United States); Shott, Sally R. [Medical Center, Division of Otolaryngology, Cincinnati, OH (United States); Cincinnati Children' s Hospital, OH (United States); Amin, Raouf S.; Kalra, Maninder [Medical Center, Department of Pediatrics, Cincinnati, OH (United States); Cincinnati Children' s Hospital, OH (United States)

    2008-10-15

    Children with Down syndrome are described as having macroglossia as well as midface hypoplasia. We reviewed anatomic parameters on MRI to determine whether adolescents with Down syndrome have true macroglossia or relatively large tongues compared to the small size of their oral cavity. This has implications for the treatment of obstructive sleep apnea, which occurs at a relatively high rate among patients with Down syndrome. To determine whether adolescents with Down syndrome have relative rather than true macroglossia. On sagittal and axial MR images, parameters for tongue size (area in sagittal midline), the bony craniofacial confines of the retroglossal pharynx (distance between the mandibular rami and distance between the posterior aspect of the mental mandible and the anterior aspect of the spine), and the size of the tongue relative to the craniofacial bony parameters [tongue area/(transverse diameter x anterior-to-posterior diameter)] were compared between 16 patients with Down syndrome and 16 age- and gender-matched controls. The tongue area was significantly smaller in patients with Down syndrome (2,432 mm{sup 2}) than in the control patients (2,767 mm{sup 2}; P=0.02). The craniofacial bony parameters were also smaller in patients with Down syndrome than in the controls (left-right 69.8 vs. 80.1 mm, P<0.001; anterior-posterior 64.2 vs. 74.9 mm, P<0.001). However, the size of the tongue relative to the craniofacial parameters was larger in the patients with Down syndrome (0.54) than in the controls (0.46; P<0.001). Children with Down syndrome do not have true macroglossia but have relatively large tongues compared to the bony confines of the oral cavity. (orig.)

  11. Association Between Apnea of Prematurity and Respiratory Distress Syndrome in Late Preterm Infants: An Observational Study

    Directory of Open Access Journals (Sweden)

    François Olivier

    2016-09-01

    Full Text Available AbstractLate preterm infants (34 to 36 weeks’ gestation remain a population at risk for apnea of prematurity (AOP. As infants affected by respiratory distress syndrome (RDS have immature lungs, they might also have immature control of breathing. Our hypothesis is that an association exists between RDS and AOP in late preterm infants.ObjectiveThe primary objective of this study was to assess the association between RDS and AOP in late preterm infants. The secondary objective was to evaluate if an association exists between apparent RDS severity and AOP.MethodsThis retrospective observational study was realized in a tertiary care center between January 2009 and December 2011. Data from late preterm infants who presented an uncomplicated perinatal evolution, excepted for RDS, were reviewed. Information related to AOP and RDS were collected using the medical record. Odds ratios were calculated using a binary logistic regression adjusted for GA and sex.ResultsAmong the 982 included infants 85 (8,6% had an RDS diagnosis, 281 (28,6% had AOP diagnosis and 107 (10,9% were treated with caffeine for AOP. There was a significant association between AOP treated with caffeine and RDS for all infants (OR = 3.3, 95% CI : 2.0 – 5.7. There was no association between AOP and RDS in 34 weeks infants [AOR : 1.6 (95% CI: 0.7 – 3.8] but an association remains for 35 [AOR : 5.7 (95% CI: 2.5 – 13.4] and 36 [OR: 7.8 (95% CI: 3.2 – 19.4] weeks infants. No association was found between apparent RDS severity and AOP regarding mean oxygen administration duration or complications associated with RDS.ConclusionThe association between RDS and AOP in late preterm infants reflects that patients affected by RDS are not only presenting lung immaturity, but also respiratory control immaturity. Special consideration should be given before discontinuing monitoring after RDS resolution in those patients.

  12. Obstructive Sleep Apnea and Lipid Abnormalities

    Science.gov (United States)

    Karkinski, Dimitar; Georgievski, Oliver; Dzekova-Vidimliski, Pavlina; Milenkovic, Tatjana; Dokic, Dejan

    2017-01-01

    BACKGROUND: There has been a great interest in the interaction between obstructive sleep apnea (OSA) and metabolic dysfunction, but there is no consistent data suggesting that OSA is a risk factor for dyslipidemia. AIM: The aim of this cross-sectional study was to evaluate the prevalence of lipid abnormalities in patients suspected of OSA, referred to our sleep laboratory for polysomnography. MATERIAL AND METHODS: Two hundred patients referred to our hospital with suspected OSA, and all of them underwent for standard polysomnography. All patients with respiratory disturbance index (RDI) above 15 were diagnosed with OSA. In the morning after 12 hours fasting, the blood sample was collected from all patients. Blood levels of triglycerides, total cholesterol, high-density lipoprotein cholesterol (HDL) and low-density lipoprotein cholesterol (LDL), were determined in all study patients. In the study, both OSA positive and OSA negative patients were divided according to the body mass index (BMI) in two groups. The first group with BMI ≤ 30 kg/m^2 and the second group with BMI > 30 kg/m^2. RESULTS: OSA positive patients with BMI ≤ 30 kg/m^2 had statistically significant higher levels of triglycerides and total cholesterol, and statistically significant lower level of HDL compared to OSA negative patients with BMI ≤ 30. There were no statistically significant differences in age and LDL levels between these groups. OSA positive patients with BMI > 30 kg/m^2 had higher levels of triglycerides, total cholesterol and LDL and lower levels of HDL versus OSA negative patients with BMI > 30 kg/m^2, but without statistically significant differences. CONCLUSION: OSA and obesity are potent risk factors for dyslipidemias. OSA could play a significant role in worsening of lipid metabolism in non-obese patients. But in obese patients, the extra weight makes the metabolic changes of lipid metabolism, and the role of OSA is not that very important like in non-obese patients. PMID

  13. Apnea of Prematurity (For Parents)

    Science.gov (United States)

    ... other babies. The apnea of prematurity does not cause brain damage. A healthy baby who is apnea free for a week will probably never have AOP again. Although sudden infant death syndrome (SIDS) does happen more often in premature infants, no relationship between AOP and SIDS has ...

  14. Evaluations of autonomic nervous system function in children with obstructive sleep apnea syndrome by heart rate variability analysis%阻塞性睡眠呼吸暂停综合征患儿心率变异性与自主神经功能

    Institute of Scientific and Technical Information of China (English)

    许志飞; 吴云肖; 张励兵; 申昆玲

    2013-01-01

    Objectives To evaluate the autonomic nervous system function in children with obstructive sleep apnea syndrome (OSAS) by heart rate variability (HRV) analysis. Methods A total of 93 snoring children (≥5 years old) were enrolled. All subjects underwent polysonmography and spectrum analysis of heart rate variability using 24-hour Holter electrocardiograms. Time domain indices, SDNN, RMSSD, SDANN, and PNN50, and frequency domain indices, low fire-qnency (LF) and high frequency (HF), as well as LF/HF were included in HRY analysis. Results Forty-ssven of 93 children met the criteria for OSAS and 46 did not. HRV analysis showed that OSAS children had significantly decreased SDNN and SDANN than those of non-GSAS children (all P<0.01). Nocturnal PNN50 in OSAS children was significanlty decreased while LF/HF was significantly elevated compared to those of non-OSAS children (P=0.025 and 0,026 respectively). Multiple regression analysis showed that SDNN was significantly related to apnea-hypopnea index and age (P=0.03 and 0.006, re-spectively). Conclusions Autooomic nervous system dysfunctions are found in OSAS children with sympathetic overflow* weaker parasympathetic modulation and dysfunction of equilibrium between sympathetic and parasympathetie nerves as main manifestations.%目的 分析心率变异性 (HRV) 评估阻塞性睡眠呼吸暂停综合征 (OSAS) 儿童的自主神经功能.方法 对93名≥5岁的打鼾儿童,在睡眠监测同时进行24 h动态心电图监测.HRV分析包括时域指标和频域指标,即SDNN、RMSSD、SDANN、PNN50、低频功率谱 (LF)、高频功率谱 (HF) 以及LF/HF.结果 93名儿童中,47名儿童符合OSAS诊断,46名为非OSAS.OSAS组的SDNN、SDANN较非OSAS组降低,差异有统计学意义 (P 均<0.01);不同严重程度OSAS患儿间,其SDNN的差异也有统计学意义 (P <0.01).OSAS组较非OSAS组夜间PNN50降低,LF/HF增高,差异均有统计学意义 (P =0.025,0.026).多元逐步回归分析显示,SDNN

  15. [Obstructive sleep apnea features and occupational fitness of railway workers].

    Science.gov (United States)

    Buniatyan, M S; Belozerova, N V; At'kov, O Yu

    2016-01-01

    The article covers prevalence of obstructive sleep apnea syndrome, its role in health disorders of workers engaged into railway safety. The authors analyzed present standards of occupational fitness in workers performing critically important operating activities and methods of occupational selection with possible obstructive sleep apnea syndrome. I stage recommendations are suggested in diagnosis of obstructive sleep apnea syndrome in workers engaged into railway safety. Obstructive sleep apnea syndrome appeared to threaten operators' activity, to cause accidents, to early disablement due to life-threatening complications, to unsuitability for the occupation due to diseases connected with obstructive sleep apnea syndrome (arterial hypertension, diabetes mellitus, metabolic syndrome, cardiac rhythm and conductivity disorders, obesity).

  16. Association of Duration of Sleep and Cardiovascular and Metabolic Comorbidities in Sleep Apnea Syndrome

    Directory of Open Access Journals (Sweden)

    Zeynep Zeren Ucar

    2012-01-01

    Full Text Available Background/Aim. Previous population-based studies found association between duration of sleep and cardiovascular and metabolic comorbidities. Our aim was to investigate the association between the duration of sleep and cardiovascular and metabolic comorbidities in OSAS. Patients and Methods. The study enrolled 312 patients, who had polysomnography (PSG during 2006-2007 and responded to a telephone-administered questionnaire providing information on characteristics of sleep on average 12 months after PSG. Results. Of the patients, 90 were female (28.8%, 173 (58.5 received the diagnosis of OSAS, 150 (45% had no comorbidities, 122 had hypertension (HT, 44 had diabetes mellitus (DM, and 38 had coronary heart disease (CHD. Mean ± SD of age in years was 47.2±10.6, 56.5±9.3, 53.2±8.9, and 59.9±9.0 for the no comorbidity, HT, DM, and CHD groups, respectively. Reported duration of sleep was not associated with any of the comorbidities in the overall group. In the analysis restricted to OSAS patients, sleep duration ≤6 hours was significantly associated with CHD after the adjustment for age, gender, and other associated factors (OR: 5.8, 95% CI: 1.0–32.6. Conclusions. Confirmation of the association between shorter duration of sleep and CHD will provide prognostic information and help for the management of OSAS.

  17. Effect of sedative-hypnotics, anesthetics and analgesics on sleep architecture in obstructive sleep apnea.

    Science.gov (United States)

    McEntire, Dan M; Kirkpatrick, Daniel R; Kerfeld, Mitchell J; Hambsch, Zakary J; Reisbig, Mark D; Agrawal, Devendra K; Youngblood, Charles F

    2014-11-01

    The perioperative care of obstructive sleep apnea (OSA) patients is currently receiving much attention due to an increased risk for complications. It is established that postoperative changes in sleep architecture occur and this may have pathophysiological implications for OSA patients. Upper airway muscle activity decreases during rapid eye movement sleep (REMS). Severe OSA patients exhibit exaggerated chemoreceptor-driven ventilation during non-rapid eye movement sleep (NREMS), which leads to central and obstructive apnea. This article critically reviewed the literature relevant to preoperative screening for OSA, prevalence of OSA in surgical populations and changes in postoperative sleep architecture relevant to OSA patients. In particular, we addressed three questions in regard to the effects of sedative-hypnotics, anesthetics and analgesics on sleep architecture, the underlying mechanisms and the relevance to OSA. Indeed, these classes of drugs alter sleep architecture, which likely significantly contributes to abnormal postoperative sleep architecture, exacerbation of OSA and postoperative complications.

  18. Perioperative sleep apnea: a real problem or did we invent a new disease? [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Sebastian Zaremba

    2016-01-01

    Full Text Available Depending on the subpopulation, obstructive sleep apnea (OSA can affect more than 75% of surgical patients. An increasing body of evidence supports the association between OSA  and perioperative complications, but some data indicate important perioperative outcomes do not differ between patients with and without OSA. In this review we will provide an overview of the pathophysiology of sleep apnea and the risk factors for perioperative complications related to sleep apnea. We also discuss a clinical algorithm for the identification and management of OSA patients facing surgery.

  19. Cervical computed tomography in patients with obstructive sleep apnea: influence of head elevation on the assessment of upper airway volume

    Energy Technology Data Exchange (ETDEWEB)

    Souza, Fabio Jose Fabricio de Barros; Evangelista, Anne Rosso; Silva, Juliana Veiga; Madeira, Kristian, E-mail: fsouzapneumo@hotmail.com [Universidade do Extremo Sul Catarinense (UNESC), Criciuma, SC (Brazil). Curso de Medicina; Perico, Gregory Vinicius [Unidade Radiologica Criciuma, SC (Brazil)

    2016-01-15

    Objective: Obstructive sleep apnea syndrome (OSAS) has a high prevalence and carries significant cardiovascular risks. It is important to study new therapeutic approaches to this disease. Positional therapy might be beneficial in reducing the apnea-hypopnea index (AHI). Imaging methods have been employed in order to facilitate the evaluation of the airways of OSAS patients and can be used in order to determine the effectiveness of certain treatments. This study was aimed at determining the influence that upper airway volume, as measured by cervical CT, has in patients diagnosed with OSAS. Methods: This was a quantitative, observational, cross-sectional study. We evaluated 10 patients who had been diagnosed with OSAS by polysomnography and on the basis of the clinical evaluation. All of the patients underwent conventional cervical CT in the supine position. Scans were obtained with the head of the patient in two positions (neutral and at a 44° upward inclination), and the upper airway volume was compared between the two. Results: The mean age, BMI, and neck circumference were 48.9 ± 14.4 years, 30.5 ± 3.5 kg/m{sup 2} , and 40.3 ± 3.4 cm, respectively. The mean AHI was 13.7 ± 10.6 events/h (range, 6.0-41.6 events/h). The OSAS was classified as mild, moderate, and severe in 70%, 20%, and 10% of the patients, respectively. The mean upper airway volume was 7.9 cm{sup 3} greater when the head was at a 44° upward inclination than when it was in the neutral position, and that difference (17.5 ± 11.0%) was statistically significant (p = 0.002). Conclusions: Elevating the head appears to result in a significant increase in the caliber of the upper airways in OSAS patients. (author)

  20. Cervical computed tomography in patients with obstructive sleep apnea: influence of head elevation on the assessment of upper airway volume

    Science.gov (United States)

    Souza, Fábio José Fabrício de Barros; Evangelista, Anne Rosso; Silva, Juliana Veiga; Périco, Grégory Vinícius; Madeira, Kristian

    2016-01-01

    Objective : Obstructive sleep apnea syndrome (OSAS) has a high prevalence and carries significant cardiovascular risks. It is important to study new therapeutic approaches to this disease. Positional therapy might be beneficial in reducing the apnea-hypopnea index (AHI). Imaging methods have been employed in order to facilitate the evaluation of the airways of OSAS patients and can be used in order to determine the effectiveness of certain treatments. This study was aimed at determining the influence that upper airway volume, as measured by cervical CT, has in patients diagnosed with OSAS. Methods : This was a quantitative, observational, cross-sectional study. We evaluated 10 patients who had been diagnosed with OSAS by polysomnography and on the basis of the clinical evaluation. All of the patients underwent conventional cervical CT in the supine position. Scans were obtained with the head of the patient in two positions (neutral and at a 44° upward inclination), and the upper airway volume was compared between the two. Results : The mean age, BMI, and neck circumference were 48.9 ± 14.4 years, 30.5 ± 3.5 kg/m2, and 40.3 ± 3.4 cm, respectively. The mean AHI was 13.7 ± 10.6 events/h (range, 6.0-41.6 events/h). The OSAS was classified as mild, moderate, and severe in 70%, 20%, and 10% of the patients, respectively. The mean upper airway volume was 7.9 cm3 greater when the head was at a 44° upward inclination than when it was in the neutral position, and that difference (17.5 ± 11.0%) was statistically significant (p = 0.002). Conclusions : Elevating the head appears to result in a significant increase in the caliber of the upper airways in OSAS patients. PMID:26982042

  1. Sleep Apnea

    Science.gov (United States)

    Sleep apnea is a common disorder that causes your breathing to stop or get very shallow. Breathing ... an hour. The most common type is obstructive sleep apnea. It causes your airway to collapse or ...

  2. [Sleep-apnea syndrome, mechanical ventilation and critical care in Archivos de Bronconeumología (December 2009-December 2010)].

    Science.gov (United States)

    Abad Fernández, Araceli; Pumarega, Irene Cano; Hernández, Concepción; Sampol, Gabriel; Terán-Santos, Joaquín

    2011-01-01

    The present study aims to review all the major articles on respiratory sleep disorders, mechanical ventilation, and respiratory critical care published in the last year in Archivos de bronconeumología. Between December 2009 and November 2010, 15 studies on these topics were published in Archivos de bronconeumología. Ten of these studies dealt with respiratory sleep disorders, consisting of six original articles, one special article, one review article, one letter to the editor and one supplement on chronic obstructive pulmonary disease and its association with sleep apneas. Five articles were published on non-invasive mechanical ventilation: one editorial, one special article, one article in a supplement and two original articles. As in previous years, there was a marked difference in the number of articles published on non-invasive mechanical ventilation and sleep-apnea syndrome, with a greater number of articles being published on the latter. Although some articles highlight the importance of the place where ventilation is commenced, no study specifically dealing with intermediate care units was published in Archivos de bronconeumología in 2010. This absence could be interpreted as a result of the low implantation of this type of unit in Spain, contrasting with the high activity undertaken in this field by pneumology services.

  3. Outcomes of upper airway reconstructive surgery for obstructive sleep apnea syndrome based on polysomnography after nasopharyngeal tube insertion

    Institute of Scientific and Technical Information of China (English)

    LI Shu-hua; WU Da-hai; BAO Ji-min; SHI Hong-jin

    2013-01-01

    Background The most common obstruction sites for obstructive sleep apnea hypopnea syndrome (OSAHS) are the oropharynx and the glossopharyx.The diagnosis of glossopharyngeal airway obstruction is difficult.The study aimed to assess the effect of upper airway reconstructive surgery for OSAHS based on polysomnography (PSG) after nasopharyngeal tube insertion (NPT-PSG),and to evaluate the clinical value of NPT-PSG in localizing the obstructive sites.Methods Seventy-nine OSAHS patients diagnosed with PSG were included in the study.PSG was repeated with a nasopharyngeal tube in place (NPT-PSG).Results of the two PSGs were compared.A NPT-PSG apnea hypopnea index (AHI) greater than 15 times per hour was used as a threshold for glossopharyngeal surgery.The cause of glossopharyngeal airway obstruction was taken into consideration in planning glossopharyngeal surgery.Assessment of efficacy was followed-up.Results After NPT-PSG,patients' AHI significantly decreased and lowest oxygen saturation (LaSO2) significantly increased.Of the 79 patients,47 were treated with uvulopalatopharyngoplasty (UPPP) alone and 32 with UPPP + glossopharyngeal surgery.Thirty-two patients were considered cured,33 markedly improved,and 14 failed.The overall surgery success rate was 82.3%.Conclusions NPT-PSG can be used as a diagnosis tool for localizing airway obstruction in OSAHS patients.Surgical treatment based on NPT-PSG results in good treatment efficacy.

  4. Obstructive Sleep Apnea and the Subsequent Risk of Chronic Rhinosinusitis: A Population-Based Study

    OpenAIRE

    Li-Ting Kao; Shih-Han Hung; Herng-Ching Lin; Chih-Kuang Liu; Hung-Meng Huang; Chuan-Song Wu

    2016-01-01

    The relationship between obstructive sleep apnea (OSA) and chronic rhinosinusitis (CRS) still remains unclear. This retrospective cohort study aimed to investigate the relationship between OSA and subsequent CRS using a population-based dataset. The study used data from the Taiwan Longitudinal Health Insurance Database 2005. We selected 971 patients with OSA for the study cohort and 4855 patients without OSA for the comparison cohort. Each patient was tracked for 5 years to determine those wh...

  5. [Upper airway's 3D analysis of patients with obstructive sleep apnea using tomographic cone beam].

    Science.gov (United States)

    Bruwier, A; Poirrier, A L; Limme, M; Poirrier, R

    2014-12-01

    The progress of medical imaging over the last decades has led to a better understanding of the upper airway structure in sleep-disordered patients. The Obstructive Sleep Apnea Syndrome (OSA) is attributed to a functional narrowing of the upper airway, particularly of the oropharynx, during sleep. This narrowing is multifactorial. We have shown that in 60% cases, the maxilla (nasal pyramid) seems too narrow. A mandible retroposition may also play a dominant role in 30% of the cases. Both scenarios can be combined. Cone Beam Computed Tomography (CBCT) is a new medical imaging technique that permits to visualize the upper airway with less ionizing radiation than the conventional scanner. To date, only five authors have performed an upper airway's 3D analysis of sleep apnea patients with cone beam. A better understanding of the affected segment of the upper airway should help refine treatment options.

  6. 呼出气冷凝液生物标记物在OSAS中的研究进展%Research advances in the exhaled breath condensate detection for OSAS

    Institute of Scientific and Technical Information of China (English)

    许静; 黄礼年

    2015-01-01

    呼出气冷凝液(exhaled breath condensate,EBC)检测是近年来发展的研究呼吸道疾病的一种无创方法,具有简便易行、实时监测、重复性好、患者易耐受等优点.对阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS)患者EBC中反映气道炎症、氧化应激状态的生物标记物进行研究将有助于OSAS的诊断、严重程度的评估及治疗效果的评价.这些异常分子的研究可能为OSAS发病机制和诊治提供新的思路和治疗方法.%Exhaled breath condensate (EBC) detection,as a new way of non-invasive studying pulmonary diseases,has advantages of being easily carried out,real-time monitoring,repeatability and better patients acceptance.Analying biomarkers in EBC which reflect airway inflammation and oxidative stress could assist in the diagnosis of obstructive sleep apnea syndrome (OSAS),the severity of this disease,and the evaluation of treatment.Identification of abnormal markers in EBC may provide new opinion on the pathogenesis of OSAS and new therapeutic.

  7. Obstructive Sleep Apnea, Hypertension, and Their Additive Effects on Atherosclerosis

    Directory of Open Access Journals (Sweden)

    Mario Francesco Damiani

    2015-01-01

    Full Text Available Background and Aims. It is widely accepted that obstructive sleep apnea (OSA is independently associated with atherosclerosis. Similar to OSA, hypertension (HTN is a condition associated with atherosclerosis. However, to date, the impact of the simultaneous presence of OSA and HTN on the risk of atherosclerosis has not been extensively studied. The aim of this study was to evaluate the consequences of the coexistence of OSA and HTN on carotid intima-media thickness (IMT and on inflammatory markers of atherosclerosis (such as interleukin- [IL-] 6 and pentraxin- [PTX-] 3. Methods. The study design allowed us to define 4 groups: (1 controls (n=30; (2 OSA patients without HTN (n=30; (3 HTN patients without OSA (n=30; (4 patients with OSA and HTN (n=30. In the morning after portable monitoring (between 7 am and 8 am, blood samples were collected, and carotid IMT was measured. Results. Carotid IMT, IL-6, and PTX-3 in OSA normotensive patients and in non-OSA HTN subjects were significantly higher compared to control subjects; in addition, in OSA hypertensive patients they were significantly increased compared to OSA normotensive, non-OSA HTN, or control subjects. Conclusions. OSA and HTN have an additive role in the progression of carotid atherosclerosis and in blood levels of inflammatory markers for atherosclerosis, such as interleukin-6 and pentraxin-3.

  8. Recognition of upper airway and surrounding structures at MRI in pediatric PCOS and OSAS

    Science.gov (United States)

    Tong, Yubing; Udupa, J. K.; Odhner, D.; Sin, Sanghun; Arens, Raanan

    2013-03-01

    Obstructive Sleep Apnea Syndrome (OSAS) is common in obese children with risk being 4.5 fold compared to normal control subjects. Polycystic Ovary Syndrome (PCOS) has recently been shown to be associated with OSAS that may further lead to significant cardiovascular and neuro-cognitive deficits. We are investigating image-based biomarkers to understand the architectural and dynamic changes in the upper airway and the surrounding hard and soft tissue structures via MRI in obese teenage children to study OSAS. At the previous SPIE conferences, we presented methods underlying Fuzzy Object Models (FOMs) for Automatic Anatomy Recognition (AAR) based on CT images of the thorax and the abdomen. The purpose of this paper is to demonstrate that the AAR approach is applicable to a different body region and image modality combination, namely in the study of upper airway structures via MRI. FOMs were built hierarchically, the smaller sub-objects forming the offspring of larger parent objects. FOMs encode the uncertainty and variability present in the form and relationships among the objects over a study population. Totally 11 basic objects (17 including composite) were modeled. Automatic recognition for the best pose of FOMs in a given image was implemented by using four methods - a one-shot method that does not require search, another three searching methods that include Fisher Linear Discriminate (FLD), a b-scale energy optimization strategy, and optimum threshold recognition method. In all, 30 multi-fold cross validation experiments based on 15 patient MRI data sets were carried out to assess the accuracy of recognition. The results indicate that the objects can be recognized with an average location error of less than 5 mm or 2-3 voxels. Then the iterative relative fuzzy connectedness (IRFC) algorithm was adopted for delineation of the target organs based on the recognized results. The delineation results showed an overall FP and TP volume fraction of 0.02 and 0.93.

  9. Bimaxillary Advancement as the Initial Treatment of Obstructive Sleep Apnea: Five Years Follow-Up of the Pori Experience

    Directory of Open Access Journals (Sweden)

    Antti Raunio

    2012-03-01

    Full Text Available Objectives: Bimaxillary advancement surgery has proven to be effective treatment of obstructive sleep apnea syndrome. According to the Stanford protocol upper airway soft tissue surgery or advancement of tongue by chin plastic surgery is first carried out and if obstructive sleep apnea persists, then bimaxillary advancement is done. This study describes the 5 year outcome of 13 obstructive sleep apnea patients in whom the Stanford protocol was omitted and bimaxillary advancement was carried out as initial surgical treatment. Material and Methods: Patients were divided in two groups. Group A comprised patients with obstructive sleep apnea (OSAS confirmed by polysomnography in whom ODI-4 (oxygen desaturation index was 5 or more. Group B consisted of patients with occlusal problems needing orthognathic surgery and with OSAS symptoms but no clear disease on polysomnography, where the ODI-4 index was less than 5. Both groups were treated with bimaxillary advancement surgery (BAS as initial therapy. Results: In the group A mean ODI-4 was 17.8 (SD 12 before treatment and 3.5 (SD 3.4 at 5-year follow-up (P = 0.018 in paired differences t-test. In group B the ODI-4 remained below 5. In group A mean saturation improved from 94.3% (SD 1.6 to 96.3% (SD 2, P = 0.115 and in group B from 96.3% (SD 1.2 to 97.8% (SD 1.7, P = 0.056 (in paired differences t-test. The static charge sensitive bed evaluation showed improvement in all patients except one. Conclusions: Bimaxillary advancement surgery is safe and reliable as an initial surgical treatment of obstructive sleep apnea syndrome.

  10. 阻塞性睡眠呼吸暂停低通气综合征患者血清铁蛋白、铁调素的变化及其临床意义%The changes and clinical significance of serum ferritin and hepcidin in patients with obstructive sleep apnea hypopnea syndrome

    Institute of Scientific and Technical Information of China (English)

    董世荣; 张兰兰; 王蓓

    2013-01-01

    目的 探讨阻塞性睡眠呼吸暂停低通气综合征(OSAS)患者血清铁蛋白(SF)、铁调素的变化及其临床意义.方法 选取经多导睡眠监测确诊为OSAS的男性患者51例,其中单纯OSAS组36例(轻度OSAS组13例,中重度OSAS组23例),OSAS合并糖尿病组15例;另选取单纯2型糖尿病(T2DM)患者14例作为T2DM组;设立单纯肥胖男性18例为对照组.分别检测各组受试者空腹血糖、HbA1c及空腹胰岛素水平,并用ELISA法检测SF、铁调素水平,观察OSAS患者SF、铁调素对糖代谢的影响.结果 (1)轻度OSAS组、中重度OSAS组、OSAS合并糖尿病组和T2DM组的SF水平升高,分别为(268.24±47.94),(316.45 ±49.36),(377.66±49.95),(286.01 ±45.53) μg/L,均高于对照组(203.28±32.83) μg/L,差异有统计学意义(F =39.38,P <0.01);铁调素水平下降,分别为(66.41 ±12.00),(47.34 ±13.35),(34.52±8.49),(54.45±8.25) μg/L,均低于对照组(88.26±12.34)μg/L,差异有统计学意义(F=67.80,P<0.01).(2)SF、铁调素与睡眠呼吸紊乱指数、最长呼吸暂停时间、夜间血氧饱和度低于90%的时间占总睡眠时间的百分比、最低血氧饱和度存在相关性(r=-0.65 ~0.34,P均<0.01),且SF与铁调素之间存在线性相关(F=22.40,P<0.01).结论 OSAS患者存在SF及铁调素水平的异常,可能在T2DM的发生中发挥一定的作用.%Objective To explore the changes and clinical significance of serum ferritin (SF)and hepcidin in patients with obstructive sleep apnea hypopnea syndrome (OSAS).Methods 51 cases of male patients with OSAS,diagnosed by polysomnography were selected,which included simple OSAS group 36 cases (mild OSAS group 13 cases,moderate and severe OSAS group 23 cases),OSAS with diabetes group 15 cases.14 patients with simple type 2 diabetes mellitus(T2DM)were selected as T2DM group.And selected 18 obese men as control group.Measured the levels of fasting plasma glucose(FPG),HbA1c and fasting insulin of each group.SF and hepcidin

  11. Obstructive sleep apnea: management considerations in psychiatric patients

    Directory of Open Access Journals (Sweden)

    Heck T

    2015-10-01

    Full Text Available Taryn Heck,1 Monica Zolezzi21Pharmacy Department, University of Alberta Hospital, Alberta Health Services, Edmonton, AB, Canada; 2Clinical Pharmacy and Practice, College of Pharmacy, Qatar University, Doha, QatarAbstract: Psychiatric disorders and obstructive sleep apnea (OSA are often comorbid. However, there is limited information on the impact of psychotropic medications on OSA symptoms, on how to manage psychiatric pharmacotherapy in patients presenting with OSA, or on the effectiveness and challenges of OSA treatments in patients with comorbid mental illness. As such, the objective of this article is to provide an overview of some epidemiological aspects of OSA and treatment considerations in the management of OSA in individuals with comorbid psychiatric disorders. Predefined keywords were used to search for relevant literature in electronic databases. Data show that OSA is particularly prevalent in patients with psychiatric disorders. The medical care that patients with these comorbidities require can be challenging, as some of the psychiatric medications used by these patients may exacerbate OSA symptoms. As such, continuous positive airway pressure continues to be the first-line treatment, even in patients with psychiatric comorbidity. However, more controlled studies are required, particularly to determine continuous positive airway pressure compliance in patients with mental illness, the impact of treating OSA on psychiatric symptoms, and the impact of the use of psychotropic medications on OSA symptoms.Keywords: obstructive sleep apnea, psychiatric disorders, comorbidity, psychotropic medications

  12. Portable Prescreening System for Sleep Apnea

    DEFF Research Database (Denmark)

    Guul, Martin Kjær; Jennum, Poul; Sørensen, Helge Bjarup Dissing

    2016-01-01

    for sleep apnea is at high risk or low risk of having OSA. A new test setup was developed containing an Android based smartphone, the built in accelerometer, and a microphone. To ease the clinical analysis of the data a MATLAB based graphical user interface has been developed visualizing the data allowing...

  13. Portable prescreening system for sleep apnea

    DEFF Research Database (Denmark)

    Guul, Martin Kjaer; Jennum, Poul; Sorensen, Helge B D

    2016-01-01

    for sleep apnea is at high risk or low risk of having OSA. A new test setup was developed containing an Android based smartphone, the built in accelerometer, and a microphone. To ease the clinical analysis of the data a MATLAB based graphical user interface has been developed visualizing the data allowing...

  14. Is the severity of obstructive sleep apnea or the magnitude of respiratory effort associated with gastroesophageal reflux?

    Institute of Scientific and Technical Information of China (English)

    Levent Ozturk; Zerrin Pelin

    2005-01-01

    @@ TO THE EDITOR In a tecent issue of World Journal of Gastroenterology,Demeter et al.[1],reported that in patients having both gastro-esophageal reflux disease(GERD)and obstructive sleep apnea(OSA),there was a positive correlation between endoscopic findings of GERD and the number of apneas and hypopneas per hour,namely apnea hypopnea index.

  15. Association of inflammation and vascular active factors with hypertension in obstructive sleep apnea syndrome patients%睡眠呼吸暂停综合征患者炎症和血管活性因子水平与合并高血压的关系

    Institute of Scientific and Technical Information of China (English)

    钱小顺; 李天志; 康春燕; 孙宝君; 刘长庭

    2011-01-01

    Objective To observe the association of inflammation and vascular active factors with hypertension in obstructive sleep apnea syndrome (OSAS)patients. Methods Diagnosis of OSAS was confirmed with polysomnography (PSG) in 70 patients,among them, 40 patients were complicated with hypertension. Another 30 age-matched healthy males were taken as normal controls.The serum levels of high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), C-reactive protein (CRP), noradrenalin (NA), angiotensin Ⅱ (Ang Ⅱ ), endothelin (ET) and nitric oxide (NO) were measured with ELISA,radioimmuno-assay, and auto biochemical assay respectively. Results Hypertension-complicated OSAS patients had a family history of hypertension. There were more patients complicated with diabetes in OSAS patients with hypertension than in those without hypertension. Serum HDL-C was lower(P<0.05), but LDL-C was higher in patients with hypertension than those without hypertension(P<0.05). Age, body mass index, Epworth sleepiness scale score, respiratory disturbance index, apnea time and oxygen saturation were not different significantly between patients with and without hypertension. Serum levels of CRP, NA, Ang Ⅱ and ET were higher in patients with hypertension than those without hypertension(P<0.05), but NO level was lower in OSAS patients with hypertension(P<0.01). Conclusion Endothelial impairment and chronic inflammation may play a role in the development of hypertension in OSAS patients.%目的 观察阻塞性睡眠呼吸暂停综合征(OSAS)患者炎症、血管活性因子水平变化与合并高血压的关系.方法 用多导睡眠仪检查确诊重度OSAS患者70例,其中30例为单纯OSAS患者,40例合并高血压病.同时以30例年龄相近无OSAS和高血压的健康男性做为对照组.用ELISA、放射免疫法和全自动生化仪检测所有纳入对象血清高密度脂蛋白胆固醇(HDL-C)、血清低密度脂蛋白胆固醇(LDL-C)、C

  16. 肥胖与非肥胖患者患睡眠呼吸暂停综合征的危险因素分析%Analysis on the Risk Factors of Sleep Apnea Syndrome in the Patients with/ without Obesity

    Institute of Scientific and Technical Information of China (English)

    荣毅; 李磊; 亢秀红; 刘志国; 王师菡

    2016-01-01

    Objective To explore the relevant risk factors of obstructive sleep apnea syndrome(OS-AS)in the patients of either gender with/ without obesity. Methods The multi - conductive sleep monitoring was adopted to collect the relevant data among 229 male patients and 127 female patients,including body mass index(BMI),neck circumference(NC),arm circumference(AC),waist circumference(WC),hip circ-umference(HC),waist - hip ratio(WC/ HC),age,apnea hypopnea index(AHI)etc. According to the gender and BMI,the obesity group(BMI≥28)and the non - obesity group(BMI < 28)were divided. The correlative statistical analysis was done on all of the data and the condition of OSAS(AHI≥5)and the risk factors of OS-AS were explored in the patients of either gender with/ without obesity. Results Among the male patients, the risk factors of obese males were HC,WC/ HC and WC/ height. It was found after multiple regression anal-ysis that WC/ height ratio was relevant with OSAS. The risk factors of non - obese males were NC and age. A-mong the female patients,the risk factors of obese females were NC,WC and age. The risk factors in the non- obese females were not found. Conclusion The risk factors of OSAS are different among the patients of either gender with/ without obesity. Obesity is the major factor of OSAS,but it cannot represent all of the pa-tients. The patients without obesity should be considered greatly in OSAS.%目的 探索分析不同性别肥胖与非肥胖人群患阻塞性睡眠呼吸暂停综合征(OSA)的相关危险因素.方法 对行多导睡眠检测的229位男性患者和127位女性患者采集相关数据,包括体质指数(BMI)、颈围、臂围、腰围、臀围、腰臀比、年龄、睡眠呼吸暂停低通气指数(AHI)等.根据性别和BMI分组,按BMI分为肥胖组(BMI≥28),非肥胖组(BMI<28).对所收集数据与是否患睡眠呼吸暂停(AHI≥5)进行相关性统计分析,寻找不同性别肥胖与非肥胖组患者患睡眠呼

  17. História clínica e exame físico em SAOS: clinical history and physical examination Obstructive sleep apnea syndrome

    Directory of Open Access Journals (Sweden)

    Gleison Marinho Guimarães

    2010-06-01

    Full Text Available Embora SAOS seja uma patologia comum, é frequentemente subdiagnosticada. Seus sinais e sintomas são, na sua maioria, subjetivos e, portanto, deve haver suspeição diagnóstica quando existir roncos, sonolência diurna, cansaço, desânimo e alteração de humor. Escalas e tabelas com boa sensibilidade, que incluem os sintomas clínicos mais relevantes e dados do exame físico, podem indicar o diagnóstico de SAOS. A confirmação diagnóstica é realizada através de polissonografia, considerada o método padrão ouro.Although obstructive sleep apnea syndrome is a common disease, it often goes undiagnosed. The signs and symptoms of the syndrome are mostly subjective. Therefore, snoring, daytime sleepiness, fatigue, dejection and mood changes should raise the suspicion of obstructive sleep apnea syndrome. Scales and tables that have good sensitivity and include the most relevant clinical symptoms and physical examination results can suggest a diagnosis of obstructive sleep apnea syndrome. The diagnosis is confirmed by polysomnography, which is considered the gold standard method.

  18. Síndrome metabólico y sus componentes en pacientes con síndrome de apnea-hipoapnea del sueño Metabolic syndrome and its components in patients with sleep apnea syndrome

    Directory of Open Access Journals (Sweden)

    M. Tumbeiro

    2011-12-01

    Full Text Available Fundamento. El síndrome de apnea-hipoapnea del sueño (SAHS es un factor de riesgo reconocido de patología cardiovascular y la evidencia reciente sugiere que está relacionado con el síndrome metabólico (SM. El objetivo del estudio fue conocer la prevalencia de los componentes individuales del SM y del SM como entidad, en pacientes con sospecha clínica de SAHS, y ver si ambas entidades están en relación con la obesidad central. Material y métodos. Se estudiaron prospectivamente a 486 pacientes consecutivos, 359 hombres (73,9%, con una edad media de 57,3 ± 13,5 años y un índice de masa corporal (IMC de 32,1 ± 6,5 kg/m² con sospecha clínica de SAHS. El SAHS se diagnosticó por registro nocturno. Un Indice de Apnea-Hipoapnea (IAH > 5 era considerado diagnóstico de SAHS. El SM era diagnosticado siguiendo los criterios de la International Diabetes Federation. Resultados. De los pacientes estudiados 325 (66,9% eran SAHS de grado moderado-grave. El IAH medio fue de 30,2 ± 23,8. De 456 pacientes (93,8% teníamos datos para el diagnóstico de SM y su prevalencia fue del 64,7% (295 pacientes. En el análisis multivariante, tanto la edad como el perímetro abdominal se comportaron como predictores de SAHS y de SM (pBackground. Sleep Apnea Syndrome (SAHS represents a significant risk factor for the development of cardiovascular disease and evidence suggests a relation with Metabolic Syndrome (MS. The aim of this study was to determine the prevalence of individual components of MS and of MS as an entity, in patients with clinical suspicion of SAHS, and their relation to central obesity. Methods. We examined the records of 486 consecutive patients, 359 (73.9% men, with a mean age of 57.3 ± 13.5 years and a mean body mass index (BMI of 32.1 ± 6.5 kg/m², with clinical suspicion of SAHS. SAHS was diagnosed from the nocturnal register. An Apnea-Hipopnea Index (AHI > 5 was considered SAHS. MS was evaluated according to the diagnostic criteria of

  19. Effects of nasal-continuous positive airway pressure on patients with obstructive sleep apnea apnea-hypopnea syndrome combined with depression and anxiety emotions%经鼻持续正压通气治疗对合并抑郁焦虑情绪的阻塞性呼吸睡眠暂停综合征患者的影响

    Institute of Scientific and Technical Information of China (English)

    牛丹丹; 王亮

    2014-01-01

    Objective:To explore effects of nasal-continuous positive airway pressure ( CPAP ) on patients with obstructive sleep apnea apnea-hypopnea syndrome ( OSAHS) combined with depression and anxiety emotions. Methods:56 patients with moder-ate and severe OSAHS with mood disorders were randomly divided into CPAP treatment group and conventional treatment group. The patients were evaluated with HAD test three and six months after the treatment, and the two groups were compared. Results:For CPAP treatment group, the mood disorders were not improved three months after the treatment for the patients with OSAHS (P>0. 05);how-ever, they were significantly improved six months after the treatment (P0. 05). Conclusions:The state of mood could be improved by effective long-term CPAP therapy for OSAS patients with mood disorders.%目的::探讨经鼻持续正压通气( CPAP)治疗对合并情绪障碍的阻塞性呼吸睡眠暂停综合征( OSAHS)患者的影响。方法:选取中重度OSAHS合并情绪障碍患者56例,随机分为CPAP治疗组及常规治疗组,在治疗3月及6月后进行医院焦虑抑郁情绪测量表( HAD量表)评测,比较两组患者之间HAD评分情况。结果:使用CPAP治疗3月后OSAHS患者情绪障碍无明显改善(P>0.05),6月后有明显改善(P0.05)。结论:对临床上OSAHS合并情绪障碍的患者,经过较长时间CAPA治疗后,其情绪障碍可以得到有效改善。

  20. Treatment outcomes of mandibular advancement devices in positional and non-positional OSA patients

    Science.gov (United States)

    Chung, Jin Woo; Enciso, Reyes; Levendowski, Daniel J.; Morgan, Todd D.; Westbrook, Philip R.; Clark, Glenn T.

    2011-01-01

    Objective The aim of the study was to investigate treatment outcome of mandibular advancement devices (MADs) for positional and non-positional obstructive sleep apnea (OSA). Study design Forty-two positional (supine apnea-hypopnea index [AHI] ≥ 2x’s lateral AHI) and 30 non-positional (supine AHI < 2x’s lateral AHI) OSA patients performed two-nights of sleep study before and after insertion of MADs. Results The decreases in apnea severity based on a reduction in the overall and supine AHI values after MADs therapy were significantly greater for the positional OSA than non-positional OSA group. A multiple linear regression analysis showed that decrease in overall AHI was significantly associated with being in the positional group (standardized coefficient=0.505). Age, body mass index, gender, and time in supine position during sleep did not show significant associations with decrease in overall AHI after MAD therapy. Conclusion Our data suggest that MADs are more effective in positional OSA than non-positional OSA patients. PMID:20299246

  1. Apneia obstrutiva do sono em portadores da anemia falciforme Obstructive sleep apnea in sickle cell disease carriers

    Directory of Open Access Journals (Sweden)

    Cristina Salles

    2010-02-01

    Full Text Available A Síndrome da Apneia Obstrutiva do Sono (SAOS é definida como episódios recorrentes de obstrução completa ou parcial das vias aéreas superiores que ocorrem durante o sono. O fluxo aéreo pode estar diminuído ou completamente interrompido, a despeito do esforço inspiratório, resultando em episódios intermitentes de hipoxemia, hipercapnia. A presença de SAOS poderá ser um fator de piora da hipoxemia noturna, da doença de base, concorrendo para ocorrência de síndrome torácica aguda. Com o objetivo de revisar dados sobre a fisiopatologia da SAOS em crianças e adolescentes portadores de anemia falciforme, foi realizada busca eletrônica de artigos no Medline e Lilacs nos últimos dez anos, bem como referências cruzadas dos artigos encontrados. Palavras-chaves: "sleep apnea, sickle cell anemia, sickle cell disease, pathophysiology ". Estudos sugerem que a SAOS pode potencializar o quadro clínico, ou seja, as crises álgicas, déficit de estatura, de peso, cognitivo e de inteligência, dessaturação arterial noturna, e acidente vascular cerebral das crianças portadoras de anemia falciforme. Rev. Bras. Hematol. Hemoter.Obstructive Sleep Apnea Syndrome (OSAS is defined as recurrent episodes of complete or partial obstruction of the upper airway during sleep. The airflow can be reduced or completely stopped despite of inspiratory effort, resulting in intermittent episodes of hypoxemia and hypercapnia. OSAS may be a factor in the worsening of nocturnal hypoxemia, of the underlying disease, leading to acute chest syndrome. The aim of this work was to review data on the pathophysiology of OSAS in children and adolescents with sickle cell anemia. We revisited articles published over the last ten years linked to the Medline and Lilacs databases, as well as cross-referencing using these articles. The following keywords were used: sleep apnea, obstructive sleep apnea, sickle cell anemia, sickle cell disease. Studies suggest that OSAS may

  2. 机关工作人员阻塞性睡眠呼吸暂停综合征状况分析%Analysis for the obstructive sleep apnea syndrome in government employees

    Institute of Scientific and Technical Information of China (English)

    刘剑南; 陆甘; 沈久成; 陈丽萍; 刘俊衡; 梅永才; 傅坤发; 张希龙

    2011-01-01

    Objective To investigate the relationship between obstructive sleep apnea syndrome (OSAS) and metabolic syndrome (MS) in snoring people in government employees.Methods A total of 546 snoring official participants received physical examination in Jiangsu Province Geriatrics Hospital from October 2007 to April 2009,were brought into the research with cluster sampling.Questionnaire survey was performed firstly.All participants were divided into 2 groups according to Epworth sleepiness scale (ESS):normal group(group Ⅰ ): ESS <9 and abnormal group (group Ⅱ ): ESS≥9.The first 175 participants received polysomnography (PSG) test. Linear regression analysis and multivariate Logistic regression analysis were used for statistics.Results ( 1 ) The median of ESS was 5 (0-20).Of all 546 participants,398 (72.9%) were in group Ⅰ and 148 (27.1%) were in group Ⅱ. (2) Linear regression analysis showed: constituent ratio of MS = 0.1433 + 0.0337 × ESS ( r2 = 0.7414,P = 0.000),the constituent ratio of MS increased 3.37% when ESS scores increased 1. There was statistical significance difference in constituent ratio of MS between the two groups( x2 =4.605 ,P =0.032).(3)175 participants received PSG test and the apnea hypopnea index ( AHI ) was 0.3 - 90.0/h.The median of AHI was 34.2/h.Pearson correlation analysis showed ESS was linearly correlated with AHI ( r = 0.721,P = 0.000 ).In all of the participants,there were 50 definite OSAS patients (AHI ≥ 5/h + ESS ≥ 9 ),118 high risk of OSAS participants ( AHI ≥5/h + ESS < 9),and 7 exclusion OSAS participants ( AHI < 5/h).Correlation analysis between AHI and HOMA-IR showed that the mean value of HOMA-IR in definite OSAS group was significantly higher than that of in the other two groups ( P < 0.01 and P < 0.05,respectively ).( 4 )Multivariate Logistic regression analysis showed that the major factors affecting MS were body mass index ( OR = 2.303,P = 0.000 ),AHI ( OR = 1.083,P = 0.004 ) and mean SpO2 ( OR = 0.443,P

  3. 儿童睡眠呼吸暂停的诊断及治疗进展%Diagnosis and treatment of children with sleep apnea

    Institute of Scientific and Technical Information of China (English)

    李淼(综述); 尚云晓(审校)

    2016-01-01

    Sleep apnea includes obstructive sleep apnea,central sleep apnea and mixed sleep apnea.Ob-structive sleep apnoea syndrome(OSAS)is affecting up to 5.7% of children,which hss adverse impact on growth,development cognitive and behavioral outcomes,and untreated OSAS increases cardiovascular risk,so paying closer attention to childhood OSAS early diagnosis and treatment seems more important.First-line treat-ment in OSAS children is adenotonsillectomy,although other treatment options available include continuous posi-tive airways pressure,anti-inflammatory therapies,airway adjuncts and orthodontic appliances.Central sleep ap-nea may be related to respiratory regulation center immaturity or dysplasia.Central sleep apnea may be hereditary or acquired.Therefore,the treatment of central sleep apnea should be focused on primariy etiology.%睡眠呼吸暂停包括阻塞性、中枢性及混合性睡眠呼吸暂停。目前有5.7%的儿童患有阻塞性睡眠呼吸暂停综合征,其危害包括影响生长、发育、认知及行为等方面,同时会增加心脏血管疾病的风险。因此关注阻塞性睡眠呼吸暂停综合征儿童早期的诊断及治疗更有意义。阻塞性睡眠呼吸暂停首选的治疗是扁桃体切除术,其他治疗包括连续的正压通气、抗炎治疗、气道调节器及咽腔矫正器等。中枢性睡眠呼吸紊乱与呼吸中枢不成熟及发育异常有关。中枢性呼吸暂停可能是遗传性的,或者是后天获得性的,因此中枢性呼吸暂停的治疗主要是病因学治疗。

  4. Nocturnal mouthpiece ventilation and medical hypnosis to treat severe obstructive sleep apnea in a child with cherubism.

    Science.gov (United States)

    Khirani, Sonia; Kadlub, Natacha; Delord, Vincent; Picard, Arnaud; Fauroux, Brigitte

    2013-09-01

    A 4-year old boy presented severe obstructive sleep apnoea due to complete nasal obstruction secondary to cherubism. Because of anticipatory anxiety due to numerous surgical interventions, medical hypnosis was proposed to facilitate non-invasive continuous positive pressure ventilation (CPAP) acceptance. CPAP by means of an oral interface was completely accepted after three hypnosis sessions and resulted in the correction of his obstructive sleep apnea (OSA) syndrome. This report highlights the benefit of medical hypnosis in facilitating CPAP acceptance as well as the efficacy of mouthpiece ventilation in a severe form of cherubism with complete nasal obstruction.

  5. High Adherence to CPAP Treatment Does Not Prevent the Continuation of Weight Gain among Severely Obese OSAS Patients

    Science.gov (United States)

    Myllylä, Minna; Kurki, Samu; Anttalainen, Ulla; Saaresranta, Tarja; Laitinen, Tarja

    2016-01-01

    Study Objectives: Obstructive sleep apnea syndrome (OSAS) patients benefit from continuous positive airway pressure (CPAP) treatment in a dose-response manner. We determined adherence and weight control, as well as their predictors, among long-term CPAP users. Methods: Cohort of 1,023 OSAS patients had used CPAP on average of 6.6 ± 1.2 years. BMI was determined at baseline and at follow-up visits. There were 7.4 ± 1.7 BMI and 6.5 ± 1.8 CPAP usage measurements per patient on average. Using the Bayesian hierarchical model, we determined the patients' individual trends of BMI and adherence development. Patients with significantly increasing or decreasing trends were identified at the posterior probability level of > 90%. Results: The mean age in the cohort was 55.6 ± 9.8 years, BMI 33.5 ± 6.4 kg/m2, apnea-hypopnea index 33.7 ± 23.1, and CPAP usage 6.0 ± 1.8 h/day. The majority of patients had no significant change in BMI (mean annual weight gain 0.04 ± 0.29 kg/m2) or CPAP adherence (mean annual increase 11.4 ± 7.0 min/day). However, at the individual level, 10% of the patients showed significant annual weight gain (0.63 ± 0.35 kg/m2) during the 5-year follow-up period. At baseline these patients were already more severely obese (mean BMI 40.0 ± 5.9 kg/m2) despite being younger (mean 50.9 ± 9.5 years) than the rest of the cohort. Conclusions: In the majority of CPAP-treated OSAS patients, weight did not significantly change but gained slightly slower than in age-matched population in general. However, in 10% of patients, high adherence to CPAP treatment did not prevent the continuation of weight gain. These patients present a high-risk group for OSAS-related multimorbidity later in life. Citation: Myllylä M, Kurki S, Anttalainen U, Saaresranta T, Laitinen T. High adherence to CPAP treatment does not prevent the continuation of weight gain among severely obese OSAS patients. J Clin Sleep Med 2016;12(4):519–528. PMID:26888588

  6. Relationship between brain-derived neurotrophic factor and cognitive function of obstructive sleep apnea/hypopnea syndrome patients

    Institute of Scientific and Technical Information of China (English)

    Wei-Hong Wang; Guo-Ping He; Xu-Ping Xiao; Can Gu; Hua-Ying Chen

    2012-01-01

    Objective:To determine the relationship between the blood serum brain-derived neurotrophic factor (BDNF) level and cognitive function deterioration in patients with obstructive sleep apnea/hypopnea syndrome (OSAHS), and to explore the possible mechanism of cognitive impairment. Methods: Twenty-eight male OSAHS patients and 14 normal males (as controls) were enrolled in the study. Polysomnography and the Montreal cognitive assessment (MoCA) were conducted. The blood serum BDNF levels were measured using ELISA. Results: The OSAHS group had significantly decreased blood serum BDNF levels compared with the control group (t=-10.912, P= 0.000). The blood serum BDNF level of the subjects was significantly positively associated with the MoCA score (r= 0.544, P= 0.000), significantly negatively associated with the apnea-hypopnea index (AHI) and shallow sleep (S1+S2) (AHI:r=-0.607, P=0.000;S1+S2:r=-0.768, P=0.000), and significantly positively associated with the lowest SaO2 (LSO), slow wave sleep (S3+S4), and rapid eye movement sleep (REM) (LSO:r=0.566, P=0.000;S3+S4:r=0.778, P=0.000;REM:r= 0.575, P= 0.000). Conclusions: OSAHS patients have significantly decreased blood serum BDNF levels compared with the control. Nocturnal hypoxia as well as the deprivation of slow wave sleep and REM may lead to the decreased serum BDNF level of OSAHS patients. This decreased blood serum BDNF level may contribute to the cognitive impairment in OSAHS.

  7. CHANGES AND SIGNIFICANCE OF BLOOD LIPID IN MS COMBINED OSAS PATIENTS%MS合并OSAS时血脂的变化和意义

    Institute of Scientific and Technical Information of China (English)

    张楠; 金凤表; 史亦男; 张爱文; 侯瑞田

    2015-01-01

    目的::探讨代谢综合征(MS)合并阻塞性睡眠呼吸暂停低通气综合征(OSAS)时血脂的改变和意义。方法:以就诊于承德医学院附属医院的MS患者为研究对象,均行睡眠监测,其中单纯MS患者200例,MS合并OSAS患者265例。分别检测两组患者的体重指数(BMI)、颈围、腰围、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)和Epworth睡眠评价量表(ESS)评分。结果:MS+OSAS组患者的BMI、颈围、腰围、TG、TC、LDL-C明显高于MS组,HDL-C明显低于MS组(P<0.05)。MS+OSAS组患者,随着阻塞程度的加重,ESS评分逐渐升高(P<0.05)。结论:MS合并OSAS时可进一步加重血脂的改变;ESS评分可反映OSAS严重程度,积极治疗OSAS亦是预防心血管疾病的重要环节。%Objective: To investigate the changes and significance of blood lipid in metabolic syndromes (MS) combined obstructive sleep apnea hypopnea syndrome (OSAS) patients.Methods: The body weight index (BMI), neck circumference, waist circumference, triglyceride (TG), total cholesterol (TC), high-density lipoprotein (HDL-C), low density lipoprotein (LDL-C) and ESS score of 200 MS patients and 265 MS+OSAS patients that were treated in the Afifliated Hospital of Chengde Medical College and monitored by polysomnography were measured and recorded respectively. Results:The BMI, neck circumference, waist circumference, TG, TC and LDL-C of MS+OSAS patients were obviously higher than MS patients (P<0.05); but HDL-C was obviously lower (P<0.05). For MS+OSAS patients, the ESS score gradually increased as the degree of obstruction.Conclusions: MS combined OSAS can increase the changes of blood lipid;ESS score may relfect the severity of OSAS, active treatment of OSAS is also an important part for preventing cardiovascular disease.

  8. Evaluation of Cross-section Airway Configuration of Obstructive Sleep Apnea

    Science.gov (United States)

    Ogawa, Takumi; Enciso, Reyes; Shintaku, Werner H.; Clark, Glenn T.

    2007-01-01

    Upper airway imaging techniques can be useful to identify the exact location and nature of the obstruction in obstructive sleep apnea (OSA) patients. Methods Ten OSA patients and ten non-OSA control subjects were imaged using cone-beam computed tomography (Newtom QR-DVT9000) to compare their upper airway structure. Results The OSA subjects presented higher BMI (OSA: 29.5 ± 9.05 kg/m2; Non-OSA: 23.1 ± 3.05 kg/m2 [p=0.034]), lower total volume (mm3) of the airway (OSA: 4868.4 ± 1863.9; Non-OSA: 6051.7 ± 1756.4 [p =0.054]), statistically significantly smaller anterior-posterior dimension (mm) of the minimum cross-section segment (OSA: 4.6 ± 1.2; Non-OSA: 7.8 ± 3.31 [p =0.009]), and smaller minimum cross-section area (OSA: 45.8±17.5 mm2; Non-OSA: 146.9±111.7 mm2 [p=0.011]) positioned below the occlusal plane in 70% of the cases (OSA:7 out of 10; Non-OSA: 5 out of 10 [p=0.030]). The OSA group presented a concave or elliptic shaped airway and the non-OSA group presented a concave, round or square shaped airway. (156 words) PMID:17178502

  9. [Prevalence of silent cerebrovascular lesions in patients with obstructive sleep apnea syndrome].

    Science.gov (United States)

    Colla-Machado, Pedro E; Luzzi, Ariel A; Balian, Natalia R; Pigretti, Santiago G; Zurrú-Ganen, M Cristina; Cristiano, Edgardo; Valiensi, Stella M

    2016-02-01

    Introduccion. El sindrome de apnea/hipopnea obstructiva del sueño (SAHOS) confiere mayor riesgo de enfermedad cardiovascular, dada su asociacion con otros factores de riesgo vascular. Tanto el SAHOS como otros factores de riesgo vascular se asocian con lesiones cerebrales silentes. Objetivo. Evaluar la prevalencia de lesiones cerebrales silentes en pacientes con SAHOS. Pacientes y metodos. Se evaluo retrospectivamente una cohorte de 137 pacientes con SAHOS, con una edad media de 65 ± 12 años, el 45% mujeres. Las lesiones cerebrales silentes en resonancia magnetica se evaluaron con la escala visual de Fazekas, y se consigno la presencia de infartos corticales, lacunares y microsangrados. Resultados. La prevalencia de factores de riesgo vascular fue: hipertension, 64%; dislipidemia, 58%; diabetes, 18%; tabaquismo, 34%; ateromatosis carotidea, 26%; enfermedad coronaria, 13%; y fibrilacion auricular, 4%. El SAHOS fue leve en el 47%, moderado en el 31% y grave en el 22% de los casos. El 91% de los pacientes tenia hiperintensidades periventriculares y el 66% presentaba lesiones en la sustancia blanca subcortical. El valor medio del indice de apnea/hipopnea fue mayor en los pacientes con mayor carga de lesiones, aunque sin significacion estadistica. Conclusiones. Los pacientes con SAHOS presentan una elevada prevalencia de lesiones cerebrales silentes, fundamentalmente con un patron microangiopatico. Posiblemente esto se explique por la asociacion entre el SAHOS, la hipertension arterial y otros factores de riesgo vascular.

  10. Comorbidities Associated with Obstructive Sleep Apnea: a Retrospective Study

    Science.gov (United States)

    Pinto, José Antonio; Ribeiro, Davi Knoll; Cavallini, Andre Freitas da Silva; Duarte, Caue; Freitas, Gabriel Santos

    2016-01-01

    Introduction Obstructive sleep apnea (OSA) is characterized by partial or complete recurrent upper airway obstruction during sleep. OSA brings many adverse consequences, such as hypertension, obesity, diabetes mellitus, cardiac and encephalic alterations, behavioral, among others, resulting in a significant source of public health care by generating a high financial and social impact. The importance of this assessment proves to be useful, because the incidence of patients with comorbidities associated with AOS has been increasing consistently and presents significant influence in natural disease history. Objective The objective of this study is to assess major comorbidities associated with obstructive sleep apnea (OSA) and prevalence in a group of patients diagnosed clinically and polysomnographically with OSA. Methods This is a retrospective study of 100 charts from patients previously diagnosed with OSA in our service between October 2010 and January 2013. Results We evaluated 100 patients with OSA (84 men and 16 women) with a mean age of 50.05 years (range 19–75 years). The prevalence of comorbidities were hypertension (39%), obesity (34%), depression (19%), gastroesophageal reflux disease (GERD) (18%), diabetes mellitus (15%), hypercholesterolemia (10%), asthma (4%), and no comorbidities (33%). Comorbidities occurred in 56.2% patients diagnosed with mild OSA, 67.6% with moderate OSA, and 70% of patients with severe OSA. Conclusion According to the current literature data and the values obtained in our paper, we can correlate through expressive values obesity with OSA and their apnea hypopnea index (AHI) values. However, despite significant prevalence of OSA with other comorbidities, our study could not render expressive significance values able to justify their correlations. PMID:27096019

  11. Comorbidities Associated with Obstructive Sleep Apnea: a Retrospective Study

    Directory of Open Access Journals (Sweden)

    Pinto, José Antonio

    2016-03-01

    Full Text Available Introduction Obstructive sleep apnea (OSA is characterized by partial or complete recurrent upper airway obstruction during sleep. OSA brings many adverse consequences, such as hypertension, obesity, diabetes mellitus, cardiac and encephalic alterations, behavioral, among others, resulting in a significant source of public health care by generating a high financial and social impact. The importance of this assessment proves to be useful, because the incidence of patients with comorbidities associated with AOS has been increasing consistently and presents significant influence in natural disease history. Objective The objective of this study is to assess major comorbidities associated with obstructive sleep apnea (OSA and prevalence in a group of patients diagnosed clinically and polysomnographically with OSA. Methods This is a retrospective study of 100 charts from patients previously diagnosed with OSA in our service between October 2010 and January 2013. Results We evaluated 100 patients with OSA (84 men and 16 women with a mean age of 50.05 years (range 19–75 years. The prevalence of comorbidities were hypertension (39%, obesity (34%, depression (19%, gastroesophageal reflux disease (GERD (18%, diabetes mellitus (15%, hypercholesterolemia (10%, asthma (4%, and no comorbidities (33%. Comorbidities occurred in 56.2% patients diagnosed with mild OSA, 67.6% with moderate OSA, and 70% of patients with severe OSA. Conclusion According to the current literature data and the values obtained in our paper, we can correlate through expressive values obesity with OSA and their apnea hypopnea index (AHI values. However, despite significant prevalence of OSA with other comorbidities, our study could not render expressive significance values able to justify their correlations.

  12. Comparison of Polysomnographic and Portable Home Monitoring Assessments of Obstructive Sleep Apnea in Saskatchewan Women

    Directory of Open Access Journals (Sweden)

    JA Gjevre

    2011-01-01

    Full Text Available OBJECTIVES: To compare a commercially available, level III in-home diagnostic sleep test (Embletta, Embletta USA and in-laboratory polysomnography (PSG in women with suspected obstructive sleep apnea (OSA.

  13. 老年男性阻塞性睡眠呼吸暂停与心血管疾病危险因素的相关性%Relationship Between Obstructive Sleep Apnea Syndrome and Cardiovascular Risk Factors in the Male Elderly

    Institute of Scientific and Technical Information of China (English)

    李忠; 张湘瑜; 王艳姣; 缪琴

    2011-01-01

    目的 观察老年男性阻塞性睡眠呼吸暂停综合征与心血管疾病危险因素的相关性.方法 采用多导睡眠仪对老年男性582例进行监测并明确有无阻塞性睡眠呼吸暂停,同时测定受试者体质指数、颈围、腰围、臀围、血压、血脂、空腹血糖和高敏C反应蛋白水平.根据多导睡眠仪监测得出的呼吸暂停低通气指数,将研究对象分为阻塞性睡眠呼吸暂停综合征组和对照组,阻塞性睡眠呼吸哲停综合征组又根据呼吸哲停低通气指数的高低分为重度、中度及轻度阻塞性睡眠呼吸暂停综合征组,观察阻塞性睡眠呼吸暂停综合征对上迷冠心病危险因素的影响.结果 阻塞性睡眠呼吸暂停综合征组体重指数、颈围、臀围、腰围、收缩压、空腹血糖、高敏C反应蛋白、甘油三酯较对照组明显升高(P<0.05);高密度脂蛋白胆固醇、最低脉搏容积血氧饱和度、平均脉搏容积血氧饱和度较对照组明显降低(P<0.05);阻塞性睡眠呼吸暂停综合征组合并代谢综合征人数较时照组明显增多;重度阻塞性睡眠呼吸暂停综合征组体重指数、颈围、腰围、臀围较轻、中度组明显增高(均P<0.001);重度组高密度脂蛋白胆固醇、最低脉搏容积血氧饱和度、平均脉搏容积血氧饱和度较中度组明显降低(P<0.05); Spearman's相关分析显示,阻塞性睡眠呼吸暂停综合征呼吸暂停低通气指数与体重指数、颈围、臀围、腰围、收缩压、空腹血糖、高敏C反应蛋白成明显正相关,与高密度脂蛋白胆固醇成明显负相关;Stepwise回归分析显示,颈围与阻塞性睡眠呼吸暂停综合征独立相关.结论 在老年男性,阻塞性睡眠呼吸暂停综合征与心血管疾病危险因素密切相关,这可能是阻塞性睡眠呼吸暂停综合征增加心血管疾病发生率和死亡率的主要原因.%im To study the association between obstructive sleep apnea syndrome (OSAS

  14. Low ventilate syndrome in obstructive sleep apnea and diseases%阻塞性睡眠呼吸暂停低通气综合征与全身疾病

    Institute of Scientific and Technical Information of China (English)

    王明辉

    2010-01-01

    @@ 冠状动脉疾病;糖尿病;胃食管反流;勃起功能障碍睡眠呼吸暂停综合征包括阻塞型睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OS-AHS)、中枢性睡眠呼吸暂停综合征(central sleep apnea syndrome)、睡眠低通气综合征(sleep hypoventilation syndrome)等[1].

  15. Relationship between aldosterone and the metabolic syndrome in patients with obstructive sleep apnea hypopnea syndrome: effect of continuous positive airway pressure treatment.

    Directory of Open Access Journals (Sweden)

    Antonia Barceló

    Full Text Available BACKGROUND: Metabolic syndrome (MS occurs frequently in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS. We hypothesized that aldosterone levels are elevated in OSAHS and associated with the presence of MS. METHODS: We studied 66 patients with OSAHS (33 with MS and 33 without MS and 35 controls. The occurrence of the MS was analyzed according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III clinical criteria. Measurements of plasma renin activity (PRA, aldosterone, aldosterone:PRA ratio, creatinine, glucose, triglycerides, cholesterol and HDL cholesterol were obtained at baseline and after CPAP treatment. RESULTS: Aldosterone levels were associated with the severity of OSAHS and higher than controls (p = 0.046. Significant differences in aldosterone levels were detected between OSAHS patients with and without MS (p = 0.041. A significant reduction was observed in the aldosterone levels in patients under CPAP treatment (p = 0.012. CONCLUSION: This study shows that aldosterone levels are elevated in OSAHS in comparison to controls, and that CPAP therapy reduces aldosterone levels. It also shows that aldosterone levels are associated with the presence of metabolic syndrome, suggesting that aldosterone excess might predispose or aggravate the metabolic and cardiovascular complications of OSAHS. TRIAL REGISTRATION: The study is not a randomized controlled trial and was not registered.

  16. Prediagnosis of Obstructive Sleep Apnea via Multiclass MTS

    Directory of Open Access Journals (Sweden)

    Chao-Ton Su

    2012-01-01

    Full Text Available Obstructive sleep apnea (OSA has become an important public health concern. Polysomnography (PSG is traditionally considered an established and effective diagnostic tool providing information on the severity of OSA and the degree of sleep fragmentation. However, the numerous steps in the PSG test to diagnose OSA are costly and time consuming. This study aimed to apply the multiclass Mahalanobis-Taguchi system (MMTS based on anthropometric information and questionnaire data to predict OSA. Implementation results showed that MMTS had an accuracy of 84.38% on the OSA prediction and achieved better performance compared to other approaches such as logistic regression, neural networks, support vector machine, C4.5 decision tree, and rough set. Therefore, MMTS can assist doctors in prediagnosis of OSA before running the PSG test, thereby enabling the more effective use of medical resources.

  17. Obstructive sleep apnea is associated with higher healthcare utilization in elderly patients

    Directory of Open Access Journals (Sweden)

    Karla Diaz

    2014-01-01

    Full Text Available Background: Obstructive sleep apnea (OSA is an important cause of morbidity in the elderly population. Limited data are available regarding the healthcare utilization and predisposing conditions related to OSA in the elderly. Our aim was to evaluate the healthcare utilization and the conditions associated with new and chronic diagnosis of OSA in a large cohort of elderly patients in the Veterans Health Administration (VHA. Materials and Methods: This retrospective cohort study used inpatient and outpatient VHA data to identify the individuals diagnosed with OSA using ICD-9 codes during the fiscal years 2003-2005. Primary outcomes were emergency department (ED visits and hospitalizations. Multivariable logistic regression analysis was performed to identify the demographic and clinical characteristics associated with new and chronic diagnosis of OSA. Results: Of 1,867,876 elderly veterans having 2 years of care, 82,178 (4.4% were diagnosed with OSA. Individuals with OSA were younger and more likely to have chronic diseases than those without OSA. Individuals with chronic OSA were more likely to have diagnoses of congestive heart failure (CHF, pulmonary circulation disorders, COPD, and obesity and less likely to have diagnoses of hypertension, osteoarthritis, and stroke than individuals with newly diagnosed OSA. The proportion of patients with new OSA diagnosis who required at least one ED visit was higher than the proportion of chronic OSA and no OSA patients (37%, 32%, and 15%, respectively; P-value <0.05. The proportion of new OSA patients who required at least one hospitalization was also higher than the proportion of chronic OSA and no OSA patients (24%, 17%, and 7%, respectively; P-value <0.05. Conclusion: Patients with OSA had a higher incidence of healthcare utilization compared to patients without OSA. New OSA patients had a higher rate of healthcare utilization in the year of diagnosis compared to chronic patients and patients without OSA

  18. Dynamic imaging assessment on the upper airway in patients with obstructive sleep apnea hypopnea syndrome%OSAHS的上气道动态影像学评估

    Institute of Scientific and Technical Information of China (English)

    闫智强; 孙建军

    2012-01-01

    Dynamic imaging assessment on the upper airway in patients with obstructive sleep apnea hypopnea syndrome Summary It is vital to make an individual plan for each patient with obstructive sleep apnea-hypopnea syn-drome(OSAHS) according to the obstruction sites. The high resolution anatomical information of upper airway and soft tissue can be obtained, especially by MRI and CT scans. Dynamic and state-dependent imaging techniques are beneficial to study stereo changes of anatomy and morphology of upper airway in quiet breathing, sleeping or airway closure. Although dynamic imaging examination has value in diagnosis and treatment of OSAHS, there has no uniform position diagnosis standard. This article reviews the history of dynamic imaging study on OSAHS, the advantages and disadvantages of various imaging technologies and prospects of imaging position diagnosis.

  19. Quantitative Effects of Trunk and Head Position on the Apnea Hypopnea Index in Obstructive Sleep Apnea

    Science.gov (United States)

    van Kesteren, Ellen R.; van Maanen, J. Peter; Hilgevoord, Anthony A.J.; Laman, D. Martin; de Vries, Nico

    2011-01-01

    Study Objectives: To test the hypothesis that head position, separately from trunk position, is an additionally important factor for the occurrence of apnea in obstructive sleep apnea (OSA) patients. Design: Prospective cohort study. Setting: St. Lucas Andreas Hospital, Amsterdam, the Netherlands. Patients and Participants: Three hundred patients referred to our department because of clinically suspected OSA. Interventions: N/A Measurements and Results: Patients underwent overnight polysomnography with 2 position sensors: one on the trunk, and one in the mid-forehead. Of the 300 subjects, 241 were diagnosed with OSA, based on an AHI > 5. Of these patients, 199 could be analyzed for position-dependent OSA based on head and trunk position sensors (AHI in supine position twice as high as AHI in non-supine positions): 41.2% of the cases were not position dependent, 52.3% were supine position dependent based on the trunk sensor, 6.5% were supine position dependent based on the head sensor alone. In 46.2% of the trunk supine position-dependent group, head position was of considerable influence on the AHI (AHI was > 5 higher when the head was also in supine position compared to when the head was turned to the side). Conclusions: The results of this study confirm our hypothesis that the occurrence of OSA may also be dependent on the position of the head. Therefore in patients with a suspicion of position-dependent OSA, sleep recording with dual position sensors placed on both trunk and head should be considered. Citation: van Kesteren ER; van Maanen JP; Hilgevoord AAJ; Laman DM; de Vries N. Quantitative effects of trunk and head position on the apnea hypopnea index in obstructive sleep apnea. SLEEP 2011;34(8):1075-1081. PMID:21804669

  20. Comparison of MRI fast SPGR single slice scan and continuous dynamic scan in patients with obstructive sleep apnea-hypopnea syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Zhang Xinyu [Department of Radiology, Medical School Hospital of Qingdao University, 16 Jiangsu Road, Qingdao 266003 (China)], E-mail: myginny2@sina.com; Yang Xue [Department of Radiology, Medical School Hospital of Qingdao University, 16 Jiangsu Road, Qingdao 266003 (China)], E-mail: yangxueqyfy@126.com; Hua Hui [Department of Otorhinolaryngology-Head and Neck Surgery, Medical School Hospital of Qingdao University, Qingdao (China)], E-mail: huahuisky@163.com; Chen Jingjing [Department of Radiology, Medical School Hospital of Qingdao University, 16 Jiangsu Road, Qingdao 266003 (China)], E-mail: chenjingjingsky@126.com

    2009-07-15

    Objective: To evaluate the application value of MRI fast SPGR single slice scan in patients with obstructive sleep apnea-hypopnea syndrome when comparing the images between fast SPGR single slice scan and continuous dynamic scan. Methods: Eighteen patients with obstructive sleep apnea-hypopnea syndrome were examined by fast SPGR single slice scan and continuous dynamic scan in turn. Fast SPGR single slice scans were conducted when the phases of apnea, inspiration and expiration appeared on the respiratory wave of the subjects. Fast SPGR continuous dynamic scans were conducted when the patients were awake and apneic. The scan planes were median sagittal plane and axial planes (the slice of middle part of palate, the slice of inferior part of palate, the slice of middle part of lingual root and the slice of 0.5 cm beneath the free margin of epiglottis). The obstructed sites and the cross-sectional areas of upper airway were compared between the two scan methods. Results: Seven cases showed complete obstruction at the narrowest sites of upper airway when apnea appeared; eleven cases showed marked decrease in cross-sectional areas at the narrowest sites compared with the areas when the patients were awake; two cases manifested multiple narrowness. The obstructed sites showed by the two scan methods were same. The difference of the cross-sectional areas of upper airway between the two scan methods was insignificant (P > 0.05). Conclusion: Fast SPGR single slice scan can accurately reflect the obstructed sites of upper airway when the breath breaks off and is the complementary method of continuous dynamic scan. Sometimes, single slice scan can replace continuous dynamic scan.

  1. Impact of obstructive sleep apnea treatment by continuous positive airway pressure on cardiometabolic biomarkers: a systematic review from sham CPAP randomized controlled trials.

    Science.gov (United States)

    Jullian-Desayes, Ingrid; Joyeux-Faure, Marie; Tamisier, Renaud; Launois, Sandrine; Borel, Anne-Laure; Levy, Patrick; Pepin, Jean-Louis

    2015-06-01

    Reducing cardiometabolic risk may represent an important target for effective obstructive sleep apnea (OSA) treatment. The impact of continuous positive airway pressure (CPAP), the first line therapy of OSA, on metabolic or inflammatory markers is still debated. A systematic literature search using several databases was performed. We provide a systematic analysis of randomized studies comparing therapeutic versus sham CPAP intervention and also include studies using a CPAP withdrawal design. We addressed the impact of CPAP on the following cardiometabolic biomarkers: 1) plasma and urine catecholamines and their metabolites that reflect sympathetic activity; 2) insulin resistance and lipid metabolism biomarkers; 3) oxidative stress, systemic and vascular inflammation biomarkers; 4) liver enzymes highlighting the association between OSA and nonalcoholic fatty liver disease (NAFLD); 5) coagulation biomarkers. The impact of CPAP on sympathetic activity is robust across studies and occurs rapidly. In contrast to sympathetic activity, the well-designed studies included in this review failed to demonstrate that CPAP alters metabolic or inflammatory markers in OSA. CPAP did not change glucose, lipids, insulin resistance levels or the ratio of patients with metabolic syndrome. In unselected OSA patients, it is not realistic to expect a clinically relevant decrease in cardiometabolic biomarkers with CPAP therapy.

  2. Risk of obstructive sleep apnea with daytime sleepiness is associated with liver damage in non-morbidly obese patients with nonalcoholic fatty liver disease.

    Directory of Open Access Journals (Sweden)

    Edoardo Alessandro Pulixi

    Full Text Available BACKGROUND: A high prevalence of obstructive sleep apnea syndrome (OSAS has been reported in severely obese patients with nonalcoholic fatty liver disease (NAFLD, but few studies have evaluated OSAS in non-morbidly obese NAFLD patients. AIMS: To determine the prevalence of risk for OSAS with or without daytime sleepiness in non-morbidly obese patients with NAFLD and evaluate the association with the severity of liver damage. METHODS: We considered 159 consecutive patients with histological NAFLD and body mass index (BMI 1; 9/13, 69% vs. 39/146, 27%; p = 0.003. At multivariate logistic regression analysis, OSAS with sleepiness was strongly associated with NASH and fibrosis>1 independently of known clinical risk factors such as age, gender, BMI, diabetes, and ALT levels (OR 7.1, 95% c.i. 1.7-51, p = 0.005 and OR 14.0, 95% c.i. 3.5-70, p = 0.0002, respectively. CONCLUSIONS: A proportion of NAFLD patients without severe obesity is at risk for OSAS with daytime sleepiness, which is associated with the severity of liver damage independently of body mass and other cofactors.

  3. [Effect of positive pressure respiration on diurnal catecholamine excretion by patients with obstructive sleep apnea].

    Science.gov (United States)

    Cieślicki, J; Wocial, B; Koziej, M; Pałasiewicz, G; Zieliński, J

    1996-02-01

    The aim of the study was to investigate effects of CPAP treatment on diurnal catecholamine excretion in urine in patients with obstructive sleep apnea (OSA). 12 males with severe OSA (mean AHI = 63) were measured in 3 separate 8 hour samples by fluorimetric method. NA levels were higher in OSA patients in all urine samples than in obese, mildly hypertensive males (control group = C). In C group patients NA levels were significantly lower at night than during the day contrary to OSA patients in whom NA levels dropped insignificantly during sleep. In OSA patients NA levels during sleep correlated with severity of apneas (r = 0.42) and night hypoxaemia (r = -0.46). CPAP treatment resulted in significant fall in NA levels during sleep (p sleep in OSA patients may be related to sleep fragmentation and hypoxia. CPAP treatment restores normal circadian rhythm of NA excretion.

  4. COMPARISON OF CBCT PARAMETERS AND SLEEP QUESTIONNAIRES IN SLEEP APNEA PATIENTS AND CONTROLS

    Science.gov (United States)

    Enciso, Reyes; Nguyen, Manuel; Shigeta, Yuko; Ogawa, Takumi; Clark, Glenn T.

    2009-01-01

    Objective To compare the Cone-Beam Computerized Tomography (CBCT) scan measurements between patients with Obstructive Sleep Apnea (OSA) and snorers to develop a prediction model for OSA based on CBCT imaging and the Berlin Questionnaire. Materials and methods 80 subjects (46 OSA patients with Apnea-Hypoapnea Index [AHI]≥ 10 and 34 snorers AHI57 years, male gender, a “high risk” Berlin Questionnaire and narrow upper airway lateral dimension (<17mm) were identified as significant risk factors for OSA. The results of this study indicate that 3-dimensional CBCT airway analysis could be used as a tool to assess the presence and severity of OSA. The presence and severity (as measured by the RDI) of OSA is associated with a narrow lateral dimension of the airway, increasing age, male gender, and the Berlin questionnaire. PMID:20123412

  5. Comparison of Anthropometric Data Between Asian and Caucasian Patients With Obstructive Sleep Apnea: A Meta-Analysis

    OpenAIRE

    Cho, Jae Hoon; Choi, Ji Ho; Suh, Jeffrey D.; Ryu, Seungho; Cho, Seok Hyun

    2016-01-01

    Objectives Obesity is considered to be one of the most important risk factors for obstructive sleep apnea (OSA) but less is known about the role of ethnicity in OSA. The purpose of this study was to investigate the interethnic difference of obesity-related phenotypes in OSA and to reveal the role of ethnicity in OSA. Methods We searched MEDLINE, LILACS, Scopus, and the Cochrane Library using the key words “sleep apnea,” “body mass index,” “neck circumference,” “waist circumference,” “waist to...

  6. Increased neck soft tissue mass and worsening of obstructive sleep apnea after growth hormone treatment in men with abdominal obesity

    DEFF Research Database (Denmark)

    Karimi, Mahssa; Koranyi, Josef; Franco, Celina

    2010-01-01

    Risk factors for obstructive sleep apnea (OSA) are male gender, obesity and abnormalities in neck soft tissue mass. OSA is associated with both growth hormone (GH) excess and severe GH deficiency in adults. Adults with abdominal obesity have markedly suppressed GH secretion.......Risk factors for obstructive sleep apnea (OSA) are male gender, obesity and abnormalities in neck soft tissue mass. OSA is associated with both growth hormone (GH) excess and severe GH deficiency in adults. Adults with abdominal obesity have markedly suppressed GH secretion....

  7. Associations between craniofacial morphology, head posture, and cervical vertebral body fusions in men with sleep apnea

    DEFF Research Database (Denmark)

    Svanholt, Palle; Petri, Niels; Wildschiødtz, Gordon;

    2009-01-01

    INTRODUCTION: The aim of this study was to analyze craniofacial profiles and head posture in patients with obstructive sleep apnea (OSA) subgrouped according to cervical column morphology. METHODS: Seventy-four white men aged 27 to 65 years (mean, 49.0 years) diagnosed with OSA in sleep studies b...

  8. An Empirical Continuous Positive Airway Pressure Trial for Suspected Obstructive Sleep Apnea

    Directory of Open Access Journals (Sweden)

    Robert P Skomro

    2007-01-01

    Full Text Available BACKGROUND: Standard practice in obstructive sleep apnea (OSA management requires that a positive diagnostic, overnight polysomnography (PSG test be obtained before initiating treatment. However, long waiting times due to lack of access to PSG testing facilities may delay the initiation of definitive treatment for OSA.

  9. Progress of Imaging Study on Obstructive Sleep Apnea Syndrome%阻塞性睡眠呼吸暂停综合征影像学研究进展

    Institute of Scientific and Technical Information of China (English)

    栾承鹏; 范丽; 刘士远

    2005-01-01

    阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS)指7h的夜间睡眠时间里,至少有30次呼吸暂停,每次发作时,口鼻气流停止流通至少10s以上或呼吸暂停指数(apnea index,AI)(即每小时呼吸暂停的平均指数)>5。中年人的发病率为2%-4%,常导致患者血压升高,心率失常或脑损害,严重影响患者的生活质量和身体健康。

  10. Genioglossus fatigue in obstructive sleep apnea.

    LENUS (Irish Health Repository)

    McSharry, David

    2012-08-15

    Obstructive sleep apnea (OSA) is a prevalent disorder that may cause cardiovascular disease and fatal traffic accidents but the pathophysiology remains incompletely understood. Increased fatigability of the genioglossus (the principal upper airway dilator muscle) might be important in OSA pathophysiology but the existing literature is uncertain. We hypothesized that the genioglossus in OSA subjects would fatigue more than in controls. In 9 OSA subjects and 9 controls during wakefulness we measured maximum voluntary tongue protrusion force (Tpmax). Using surface electromyography arrays we measured the rate of decline in muscle fiber conduction velocity (MFCV) during an isometric fatiguing contraction at 30% Tpmax. The rate of decline in MFCV provides an objective means of quantifying localized muscle fatigue. Linear regression analysis of individual subject data demonstrated a significantly greater decrease in MFCV in OSA subjects compared to control subjects (29.2 ± 20.8% [mean ± SD] versus 11.2 ± 20.8%; p=0.04). These data support increased fatigability of the genioglossus muscle in OSA subjects which may be important in the pathophysiology of OSA.

  11. Sleep Apnea (For Parents)

    Science.gov (United States)

    ... Feeding Your 1- to 2-Year-Old Obstructive Sleep Apnea KidsHealth > For Parents > Obstructive Sleep Apnea Print ... kids and teens can develop it, too. About Sleep Apnea Sleep apnea happens when a person stops ...

  12. Value of STOP-Bang questionnaire in screening patients with obstructive sleep apnea hypopnea syndrome in sleep disordered breathing clinic

    Institute of Scientific and Technical Information of China (English)

    Luo Jinmei; Huang Rong; Zhong Xu; Xiao Yi; Zhou Jiong

    2014-01-01

    Background Obstructive sleep apnea hypopnea syndrome (OSAHS) is the most common sleep-disordered breathing and is still underdiagnosed.This study was designed to evaluate the value of the STOP-Bang questionnaire (SBQ) in screening OSAHS in sleep-disordered breathing clinics in order to extend it into the general Chinese population.Methods Two hundred and twelve patients undergoing overnight polysomnography (PSG) in the sleep-disordered breathing clinic of Pecking Union Medical College Hospital between May 2011 and January 2012 were prospectively included and were asked to fill in the SBQ.A score of 3 or more of the SBQ indicated a high risk of OSAHS.We analyzed the sensitivities and specificities of SBQ in screening OSAHS.Logistic regression analysis was used to evaluate the probabilities of the severity of OSAHS based upon the apnea hypopnea index (AHI).Results The patients at high risk of OSAHS had higher AHI,higher oxygen desaturation index (ODI),lower pulse oxygen saturation (LSpO2) during sleep time and less sleep time in stage N3.SBQ scores were positively correlated with AHI,ODI and the ratio of SpO2 lower than 90%,and negatively correlated with LSpO2 during sleep.The sensitivities of the SBQ with AHI ≥5/h,AHI ≥15/h,AHI ≥30/h as cut-offs were 94.9%,96.5%,and 97.7%,respectively,and the specificities were 50.0%,28.6%,and 17.9%,respectively.The Logistic regression analysis showed the probability of severe OSAHS increased and the probability of normal subjects decreased with increasing SBQ score.Conclusions The STOP-Bang questionnaire has excellent sensitivity in screening OSAHS patients and can predict the severity of OSAHS.More studies will be required to determine the value of SBQ in the general Chinese population.

  13. CDE估测阻塞性睡眠呼吸暂停对左心室整体功能的影响%Influence of Obstructive Sleep Apnea Syndrome on Left Ventricular Global Function by Color Doppler Echocardiography

    Institute of Scientific and Technical Information of China (English)

    王超; 张芬; 王雷; 宫坤; 郭艳杰

    2015-01-01

    Objective:Obstructive sleep apnea (OSA) may predispose patients to and heart failure.The aim of this study was to determine the index of myocardial performance ( IMP) reflecting left ventricular global function in uncomplicated OSA pa-tients.Methods:Fifty-eight subjects without hypertension,diabetes mellitus, and any cardiac or pulmonary disease referred for evaluation of OSA underwent overnight polysomnography and complete echocardiographic assessment.According to the apnea hy-popnea index ( AHI) , subjects were divided into three groups: group 1, control subjects with nonapneic snorers ( AHI30, n=19) . Basic echocardiographic measurements LVM index were measured. Left ventricular IMP was calculated as ( isovolumic contraction time+isovolumic relaxation time) /aortic ejection time by Doppler echocardiography. Results:There were no significant differ-ences in age, sex, body mass index, heart rate, and systolic and diastolic blood pressure among the three groups. Left ventricular IMP was significantly higher in severe OSA patients than in controls ( P30,N=19)。应用超声心动图测量基本数据,计算IMP指标。左室IMP=(等容收缩时间+等容舒张时间)/主动脉射血时间。结果:三组受试者在年龄、性别、身体质量指数,心率,收缩压和舒张压无显著差异。左室IMP在重度OSA患者比对照组(P<0.01)显著增高。对照组和轻中度OSA、轻中度OSA和重度OSA受试者之间无显著差异。结论:本研究表明,重度OSA可导致左心室整体功能不全。

  14. Mild obstructive sleep apnea: beyond the AHI

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    Lee-Iannotti J

    2014-07-01

    Full Text Available No abstract available. Article truncated at 150 words. A common conundrum faced by sleep medicine practitioners is how to manage the large group of patients with mild sleep apnea. Many patients are referred for sleep evaluation, with symptoms thought to be due to obstructive sleep apnea (OSA. Often polysomnography demonstrates only mild sleep apnea, and the clinician and patient are faced with the dilemma of whether to use continuous positive airway pressure (CPAP therapy or an oral appliance. In making this important decision the clinician incorporates the commonly used definition of mild sleep apnea as an apnea-hypopnea index of between 5 and 14 apneas or hypopneas per hour of sleep. Moderate sleep apnea is defined as 15-29 events per hour, and severe is 30 and above events per hour. These arbitrary thresholds originated in the early 1980s when knowledge of this condition was in its infancy and little was known about the long term health effects. The definition ...

  15. Clinical observation of low-temperature coblation tonsillectomy and/or adenoidectomy in 146 children with obstructive sleep apnea syndrome%低温等离子治疗146例儿童阻塞性睡眠呼吸暂停综合征临床观察

    Institute of Scientific and Technical Information of China (English)

    顾建华; 宋柏龙; 李艳芬

    2012-01-01

    目的 对比传统方法,探讨低温等离子射频扁桃体、腺样体切除术对于治疗儿童阻塞性睡眠呼吸暂停综合征(OSAS)的可行性并观察疗效.方法 回顾性分析2010年3月~2011年7月在我院手术治疗的262例OSAHS患儿的临床资料.其中,实验组146例,应用低温等离子射频行扁桃体切除术、腺样体消融术治疗;对照组116例,采用扁桃体电刀切除术、经鼻内镜下腺样体电动吸切术.随访2~16个月.结果 相对于对照组,采用低温等离子射频治疗的实验组在出血量、手术时间长短、术后疼痛评分和住院时间方面的改善都有统计学意义.结论 对比与传统的手术方法,低温等离子射频治疗儿童OSAS具有微创、安全、有效等优势,是一种较好的儿童OSAS治疗方法.%Objective To investigate the feasibility and therapeutic effect of low-temperature coblation tonsillectomy and/or adenoidectomy for obstructive sleep apnea syndrome (OSAS) in children. Method Retrospective studies were carried out in 262 clinical records of OSAS children who were cured in our department between March 2010 and July 2011. All of these 262 cases were divided into two groups. 146 cases of the experimental group were treated with low-temperature coblation tonsillectomy and/or adenoidectomy; while the other 116 cases of the control group were treated with tonsillectomy and/or adenoidectomy with electrotome. The follow up time of all cases varied from 2 to 16 months. Result Comparing to the control group, the experimental group had statistical advantages in intraoperative bleeding, operation time, postoperative pain and hospitalization time. Conclusion Low-temperature coblation tonsillectomy and/or adenoidectomy was better than the traditional method in curing children's OSAS with much more minimal invasiveness, safety and efficacy.

  16. Meta analysis of nasal corticosteroid treatment in the children with obstructive sleep apnea hypopnea syndrome%鼻用激素治疗儿童阻塞性睡眠呼吸暂停低通气综合征疗效的 Meta 分析

    Institute of Scientific and Technical Information of China (English)

    陈曦; 李进让

    2015-01-01

    目的:通过 Meta 分析探讨鼻用激素治疗儿童阻塞性睡眠呼吸暂停低通气综合征(OSA HS)的疗效。方法依照既定的纳入和排除标准,通过计算机对 Pubmed 数据库、中国生物医学文献光盘数据库(CBMdisc)、中国知网全文数据库(CNKI)中英文数据库的相关文献进行检索,并结合文献追溯、网上查询(www.metstr.com;www. cnki.net)的方法获取全文。结果共纳入3篇英文文献,涉及88例患者,Meta 分析结果显示,鼻用激素可明显减轻患者加权平均呼吸暂停低通气指数(A HI)[WM D=4.07,95% CI(0.00,8.14),P <0.00001]。结论应用鼻用激素可能有助于减轻儿童 OSA HS 患者病情程度。%Objective To investigate the effectiveness of nasal corticosteroids to treat the children with obstructive sleep apnea hypopnea syndrome (OSA HS)using meta-analysis.Methods The published articles were searched from PubMed,Chinese Biomedical Literature C D-ROM databases,and China Academic Journals Full -text database bases on the inclusion and exclusion criteria.The results of the found studies were analyzed.Results 3 English articles and 88 cases were finally included.The results of Meta analysis showed that application of nasal corticosteroids significantly reduced the weighted mean A HI[weighted mean difference (WM D)=4.07,95% CI(0.00,8.14),P <0.000 01]. Conclusion Nasal corticosteroids may be helpful in ameliorating children with OSA HS.

  17. Caffeine intake is independently associated with neuropsychological performance in patients with obstructive sleep apnea

    OpenAIRE

    Norman, Daniel; Bardwell, Wayne A; Loredo, Jose S.; Ancoli-Israel, Sonia; Heaton, Robert K; Dimsdale, Joel E.

    2008-01-01

    In healthy individuals, caffeine intake may improve performance on cognitive tests. Obstructive sleep apnea (OSA) is a disorder that has been associated with impaired cognitive function. In this study, we investigated whether increased caffeine intake in untreated patients with OSA is linked to better cognitive performance. Forty-five untreated OSA patients underwent baseline polysomnography after completing a survey of 24-h caffeine intake. Participants completed a battery of neuropsychologi...

  18. Piecing Together Phenotypes of Brain Injury and DysfunctionIn Obstructive Sleep Apnea

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    Sigrid eVeasey

    2012-10-01

    Full Text Available Obstructive sleep apnea (OSA is a highly prevalent condition that is associated with significant neurobehavioral impairments. Cognitive abnormalities identified in individuals with OSA include impaired verbal memory, planning, reasoning, vigilance and mood. Therapy for OSA improves some but not all neurobehavioral outcomes, supporting a direct role for OSA in brain dysfunction and raising the question of irreversible injury form OSA. Recent clinical studies have refined the neurobehavioral, brain imaging and electrophysiological characteristics of obstructive sleep apnea, highlighting findings shared with aging and some unique to OSA. This review summarizes the cognitive, brain metabolic and structural, and peripheral nerve conduction changes observed in OSA that collectively provide a distinct phenotype of OSA brain injury and dysfunction. Findings in animal models of OSA provide insight into molecular mechanisms underlying OSA neuronal injury that can be related back to human neural injury and dysfunction. A comprehensive phenotype of brain function and injury in OSA is essential for advancing diagnosis, prevention and treatment of this common disorder.

  19. Clinical Treatment of Patients With Obstructive Sleep Apnea Syndrome%阻塞性呼吸睡眠暂停综合征临床治疗体会

    Institute of Scientific and Technical Information of China (English)

    才旭

    2016-01-01

    Objective To analyze the clinical effect of microwave in treatment of obstructive sleep apnea syndrome.Methods40 patients with obstructive sleep apnea syndrome who were treated with microwave in our hospital from February 2015 to February 2016 were selected as the study subjects,and the therapeutic effect was analyzed.Results After treatment, patients with postoperative respiratory suspended index reduced by 50%, and blood oxygen saturation had more than 90%to 95%. The total effective rate was 85%.Conclusion Microwave in treatment of obstructive sleep apnea syndrome has a good therapeutic effect.%目的:分析采用微波治疗阻塞性睡眠呼吸暂停综合征的临床效果。方法选择2015年2月~2016年2月在我院使用微波进行治疗阻塞性睡眠呼吸暂停综合征患者40例作为研究对象,分析其治疗效果。结果经治疗后,患者术后的呼吸暂停指数较手术前降低50%,且血氧饱和度超过90%~95%,总有效率为85%。结论微波治疗阻塞性睡眠呼吸暂停综合征有良好的治疗效果。

  20. Role of continuous positive airway pressure in patients with combined sleep apnea syndrome without congestive heart failure

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    Shereen Farghaly

    2016-07-01

    Conclusion: CPAP can be effective in combined obstructive and central apnea patients without heart failure with consideration of individual variability. A trial of CPAP titration should be done in those patients.

  1. 老年2型糖尿病并阻塞性睡眠呼吸暂停低通气综合征患者的免疫与临床相关性%Correlation of immune status with clinical features of obstructive sleep apnea syndrome in elderly type 2 diabetes mellitus patients

    Institute of Scientific and Technical Information of China (English)

    夏瑾玮; 张省亮; 张莉; 易红良; 钟远

    2013-01-01

    目的 探讨2型糖尿病(T2DM)并阻塞性睡眠呼吸暂停低通气综合征(OSAS)患者T淋巴细胞亚群(CD3+、CD4+、CD8+、CD19+)和自然杀伤细胞(NK)百分率变化的意义及其临床相关性.方法 2011年6月至2012年6月在上海交通大学附属第六人民医院老年科住院患者符合1999年WHO关于2型糖尿病诊断标准的患者50例,按照2002年公布的阻塞性睡眠呼吸暂停低通气综合征诊治指南(草案),根据患者是否存在OSAS分为T2DM组(30例)、T2DM+OSAS组(20例),同期选择单纯OSAS患者为OSAS组(25例),正常对照组(NC组25例).采用稳态模型计算胰岛素抵抗指数(HOMA-IR);应用流式细胞仪单克隆免疫荧光法和放射免疫法检测外周血T淋巴细胞、NK细胞和胰岛素水平,并分别对T细胞亚群和NK细胞百分率的变化与睡眠呼吸紊乱主要参数(AHI)、体质量指数(BMI)、空腹血糖(FBG)、空腹胰岛素(FINS)及胰岛素抵抗指数(HOMA-IR)指数进行了多元回归分析.结果 (1)本研究中,T2DM+OSAS组的BMI、血氧饱和度(SpO2)及心脑血管并发症的差异有显著性(P0.05).(4)直线相关性分析提示,AHI变化与FINS及HOMA-IR呈正相关.(5)多元回归分析提示,外周血CD4+T细胞亚群及NK细胞的变化与AHI、BMI、FBG、HOMA-IR具有明显相关性.结论 免疫调节异常参与了T2DM和OSAS的发生发展,合理使用免疫调节治疗可能是治疗糖尿病并睡眠呼吸暂停综合征的另一新途径.%Objective To explore the changes and significance of lymphocyte subsets (CD3+, CD4+, CD8+ and CD19+ cells) and natural killer (NK) cells in type 2 diabetes mellitus (T2DM) patients with obstructive sleep apnea syndrome (OSAS). Methods Fifty patients with identified T2DM according to the WHO criteria for diagnosis of T2DM admitted to our hospital from June 2011 to June 2012 was enrolled in this study. Then, they were divided into T2DM group (n = 30) and T2DM+OSAS group (n = 20) according to the diagnosis and

  2. Relationship between Obstructive Sleep Apnea Syndrome Accompanied by Hypertension and Red Blood Cell Distribution Width%阻塞性睡眠呼吸暂停综合征合并高血压与红细胞分布宽度的关系

    Institute of Scientific and Technical Information of China (English)

    徐劲松; 程亚慧; 夏国际

    2014-01-01

    目的:探讨阻塞性睡眠呼吸暂停综合征(OSAS)合并高血压与红细胞分布宽度(RDW)的关系。方法选择2011年1月至2013年8月在中国人民解放军第九四医院呼吸内科门诊及住院的 OSAS 合并高血压患者(OSAS合并高血压组)44例和体检中心体检的原发性高血压患者(高血压组)57例、健康体检者(正常对照组)52例。各组清晨空腹抽取肘静脉血2 mL,用全自动五分类血细胞分析仪检测红细胞(RBC)计数、血红蛋白(Hb)、RDW 及白细胞(WBC)计数,比较各组 RDW 的差异,并进行相关性分析。结果高血压组 RBC 计数、Hb、RDW 和 WBC 计数与正常对照组比较差异均无统计学意义(均 P >0.05);OSAS 合并高血压组 BMI、DBP、RBC 计数、Hb 和 RDW 均明显高于正常对照组、高血压组,SBP 明显高于正常对照组、明显低于高血压组(均 P <0.05);高血压组 SBP、DBP均明显高于正常对照组(均 P <0.05)。相关性分析结果显示,OSAS 合并高血压组 RDW 与睡眠呼吸暂停低通气指数(AHI)呈正相关(r=0.426,P <0.05),与最低氧饱和度呈负相关(r=-0.509,P <0.05)。结论高血压患者RDW 无明显改变,RDW 增高可能是 OSAS 合并高血压患者心脑血管事件的标志物。%Objective To explore the relationship between obstructive sleep apnea syndrome (OSAS)accompanied by hypertension and red blood cell distribution width(RDW).Methods Forty-four patients with OSAS accompanied by hypertension who were treated in the department of respiratory medicine in the 94th Hospital of the Chinese People’s Liberation Army from January 2011 to August 2013(OSAS accompanied by hypertension group)and 57 patients with primary hypertension(hypertension group)and 52 healthy physical examinees(normal control group)who were examined at physical examination center during the same period were selected in this

  3. Validation of the MediByte® Type 3 Portable Monitor Compared with Polysomnography for Screening of Obstructive Sleep Apnea

    Directory of Open Access Journals (Sweden)

    Helen S Driver

    2011-01-01

    Full Text Available BACKGROUND: Portable monitors are increasingly being used as a diagnostic screening tool for obstructive sleep apnea (OSA, and in-laboratory validation of these devices with polysomnography (PSG is required.

  4. Radiological findings in patients with obstructive sleep apnea

    Energy Technology Data Exchange (ETDEWEB)

    Mello Junior, Carlos Fernando de; Guimaraes Filho, Helio Antonio; Gomes, Camila Albuquerque de Brito; Paiva, Camila Caroline de Amorim, E-mail: carlosfmello@hotmail.com [Universidade Federal da Paraiba UFPB, Joao Pessoa (Brazil)

    2013-01-15

    Obstructive sleep apnea (OSA) is characterized by recurrent upper airway obstruction occurring at the level of the pharynx during sleep. Although cephalometric analysis is an important method in the diagnosis of craniofacial deformities, CT and magnetic resonance imaging have been highlighted as the major imaging methods to investigate the possible causes of OSA, which, in most cases, is multifactorial. Magnetic resonance and CT both allow an excellent evaluation of the various anatomical planes of the site of obstruction, which enables better clinical assessment and surgical approach. This pictorial essay aims to describe the aspects that must be evaluated in the diagnostic imaging of patients presenting with the major predisposing factors for OSA. (author)

  5. Obstructive sleep apnea prevents the expected difference in craniofacial growth of boys and girls

    Directory of Open Access Journals (Sweden)

    Maria Ligia Juliano

    2013-01-01

    Full Text Available OBJECTIVES: It was to compare cephalometric measures of mouth-breather boys and girls and with the cephalometric pattern observed in obstructive sleep apnea syndrome (OSAS patients. METHODS: Craniofacial measurements of lateral cephalometric radiographs obtained from 144 children aged 7-14 years were compared between boys and girls, and both were compared to cephalometric pattern of OSAS patients. RESULTS: Mouth-breather boys and girls had no gender differences regarding to craniofacial morphology while nose-breather boys and girls showed those expected differences. Nose-breather boys presented a more retruded mandible and proinclined upper incisor when compared to nose-breather girls, but mouth-breather boys and girls had no differences. The measure NS.GoGn was the only variable with an interaction with gender and breathing. CONCLUSIONS: There were no cephalometric difference in mouth breather-boys and girls related to normal growth, suggesting that oral breathing make the same craniofacial morphology and both have craniofacial morphology close to that of OSAS patients.

  6. Clinical Characteristics, Comorbidities, and Response to Treatment of Veterans With Obstructive Sleep Apnea, Cincinnati Veterans Affairs Medical Center, 2005-2007

    OpenAIRE

    Samson, Pamela; Casey, Kenneth R.; Knepler, James; Panos, Ralph J.

    2012-01-01

    Introduction Obstructive sleep apnea (OSA) is a common disorder that is associated with significant morbidity. Veterans may be at an elevated risk for OSA because of increased prevalence of factors associated with the development and progression of OSA. The objective of this study was to determine the clinical characteristics, comorbidities, polysomnographic findings, and response to treatment of veterans with OSA. Methods We performed a retrospective chart review of 596 patients undergoing p...

  7. Suspeita de Apneia Obstrutiva do Sono definida pelo Questionário de Berlim prediz eventos em pacientes com Síndrome Coronariana Aguda Sospecha de apnea obstructiva del sueño definida por el cuestionario de Berlín predice eventos en pacientes con síndrome coronario agudo Suspicion of Obstructive Sleep Apnea by Berlin Questionnaire predicts events in patients with Acute Coronary Syndrome

    Directory of Open Access Journals (Sweden)

    Eryca Vanessa S. de Jesus

    2010-09-01

    extras a la homeostasis cardiovascular en la presencia del síndrome coronario aguda (SCA OBJETIVO: Investigar si un diagnóstico clínico estandarizado de SAOS, en pacientes con SCA, predice el riesgo de eventos cardiovasculares durante la hospitalización. MÉTODOS: En un estudio de cohorte prospectivo, un grupo de 200 pacientes con diagnóstico de SCA elecido entre Septiembre de 2005 y Noviembre de 2007, fueron estratificados por el Cuestionario de Berlín (CB para el riesgo de SAOS (alto o bajo riesgo. Se probó si el subgrupo de alto riesgo para SAOS presenta mayor tendencia a eventos cardiovasculares. El endpoint primario evaluado fue un desenlace conformado por muerte cardiovascular, eventos cardíacos isquémicos recurrentes, edema pulmonar agudo y accidente vascular cerebral durante la hospitalización. RESULTADOS: Noventa y cuatro (47% de los pacientes identificados por el CB presentaban sospecha de SAOS. Alto riesgo para SAOS estaba asociado con una mortalidad más elevada, aunque sin diferencia estadística (4,25% vs 0,94%; p=0,189, pero con una estadísticamente significativa mayor incidencia de desenlace conformada por eventos cardiovasculares (18,08% vs 6,6%; p=0,016. En el modelo de regresión logística, los predictores multivariados de desenlace conformado por eventos cardiovasculares fueron edad (OR= 1,048; IC95%: 1,008 a 1,090; p=0,019, fracción de eyección del VI (OR= 0,954; IC95%: 0,920 a 0,989; p=0,010, y riesgo más elevado de SAOS (OR= 3,657; IC95%: 1,216 a 10,996; p=0,021. CONCLUSIÓN: El uso de un cuestionario sencillo y validado (CB para identificar a pacientes con riesgo más elevado de SAOS puede ayudar a prever el desenlace cardiovascular durante la hospitalización. Además de ello, nuestros datos sugieren que SAOS es mucho común en pacientes con SCA.BACKGROUND: From a mechanistic standpoint, obstructive sleep apnea (OSA may further disturb cardiovascular homeostasis in the setting of acute coronary syndrome (ACS. OBJECTIVE: We sought

  8. Cirugía como tratamiento de la apnea obstructiva del sueño Surgery for obstructive sleep apnea

    Directory of Open Access Journals (Sweden)

    P. M. Baptista

    2007-01-01

    Full Text Available El presión continua positiva en la vía aérea (CPAP nasal se considera como el tratamiento ideal para el tratamiento de Síndrome Apnea Obstructiva del Sueño (SAOS, debido a que es conservador y reversible, sin embargo, existe una pobre tasa de adherencia en su utilización a largo plazo, La cirugía podrá complementar de una manera importante aquellos casos en las cuales el CPAP no es tolerado. La cirugía para el SAOS se deberá realizar tomando en cuenta el grado de apnea obstructiva, el lugar de mayor obstrucción y la experiencia del equipo médico. Mientras más severo sea el SAOS se podrá ser más agresivo con la terapia quirúrgica. El lugar de obstrucción no deberá ser considerado de una manera simplista en la que se define un solo lugar de obstrucción, sino como una alteración general de la vía aérea donde el cirujano deberá actuar para remodelarlo de una manera efectiva. Se describen en el trabajo diversos tipos de cirugía y su eficacia en el SAOS de acuerdo al área anatómica comprometido (nariz, cirugía de adenoides, amígdalas, paladar blando, base de lengua, hipofaringe y el avance bimaxilar. La evidencia científica demuestra en los actuales momentos que la cirugía de reconstrucción de la vía aérea compite de una manera efectiva con el tratamiento médico.Nasal continuous positive airway pressure (CPAP is considered an ideal treatment for treating Obstructive Sleep Apnea Syndrome (OSAS, due to its being conservative and reversible; however, there is a poor rate of adherence in its long-term use. Surgery can significantly complement those cases where CPAP is not tolerated. Surgery for OSAS must be carried out taking into account the degree of obstructive apnea, the place of greatest obstruction and the experience of the medical team. The more severe the OSAS, the more aggressive the surgical therapy can be. The place of obstruction must not be considered in a simplistic way, in which only one place of

  9. Excessive daytime sleepiness of the Brazilian emperor Dom Pedro II probably due to sleep apnea syndrome Sonolência diurna excessiva de Dom Pedro II do Brasil devida provavelmente à síndrome de apnéia do sono

    Directory of Open Access Journals (Sweden)

    Rubens Reimão

    2008-01-01

    Full Text Available OBJECTIVE: To show that the obstructive sleep apnea syndrome (OSAS was the probable cause of D. Pedro II's excessive daytime sleepiness. METHOD: Research of historical documents and bibliographical. RESULTS: The excessive daytime sleepiness of D. Pedro II (1825-1891 was well known and bitterly criticized behavior by oppositionist magazines; it was also recognized by his peers. He would fall asleep in public places such as the theater and while attending lectures. As a youth, he was of normal complexion, putting on weight (obesity at middle years. CONCLUSION: The possibility of this diagnosis is particularly relevant in this case because it points to an organic cause for D. Pedro II daytime naps and excessive daytime sleepiness. It could be the result of OSAS and not "disinterest" as erroneously assumed at that time.OBJETIVO: Evidenciar a síndrome de apnéia do sono tipo obstrutivo (SASO como provável causa da sonolência diurna excessiva de D. Pedro II. MÉTODO: Pesquisa de documentos históricos e bibliográfica. RESULTADOS: A sonolência diurna excessiva de D. Pedro II (1825-1891 era bem conhecida e criticada enfaticamente pelas revistas oposicionistas, era também reconhecida pelos seus pares. Ele adormecia em lugares públicos como no teatro e ao assistir aulas. Como jovem ele tinha compleição normal, ganhando peso (obesidade na meia idade. CONCLUSÃO: A possibilidade deste diagnóstico é particularmente relevante neste caso porque aponta para uma causa orgânica para os cochilos diurnos e a sonolência diurna excessiva. Pode se dever à SASO e não ao "desinteresse" como erroneamente admitido naquela época.

  10. Cardiac function and hypertension in patients with obstructive sleep apnea

    Directory of Open Access Journals (Sweden)

    Bertolami A

    2014-08-01

    Full Text Available Adriana Bertolami, Carolina Gonzaga, Celso AmodeoSleep Laboratory of Dante Pazzanese Institute of Cardiology, Sao Paulo, BrazilAbstract: Cardiovascular disease is one of the major causes of death worldwide. Among its risk factors, obstructive sleep apnea (OSA is a common but still underestimated condition. OSA often coexists and interacts with obesity, sharing multiple pathophysiological mechanisms and subsequent cardiovascular risk factors, such as type 2 diabetes, dyslipidemia, systemic inflammation, and in particular hypertension. There is also evidence suggesting an increased risk of arrhythmia, heart failure, renal failure, acute myocardial infarction, stroke, and death. OSA is characterized by recurrent episodes of partial (hypopnea or complete interruption (apnea of breathing during sleep due to airway collapse in the pharyngeal region. The main mechanisms linking OSA to impaired cardiovascular function are secondary to hypoxemia and reoxygenation, arousals, and negative intrathoracic pressure. Consequently, the sympathetic nervous and the renin-angiotensin-aldosterone systems may be overestimulated, and blood pressure increased. Resistance to treatment for hypertension represents a growing issue, and given that OSA has been recognized as the major secondary cause of resistant hypertension, clinical investigation for apnea is mandatory in this population. Standard diagnosis includes polysomnography, and treatment for OSA should include control of risk factors for cardiovascular disease, including obesity. So far, continuous positive airway pressure is the treatment of choice for OSA, impacting positively on blood pressure goals; however, the impact on long-term follow-up and on cardiovascular disease should be better assessed.Keywords: obstructive sleep apnea, hypertension, cardiac function

  11. Impact of obstructive sleep apnea on cognitive performance

    Directory of Open Access Journals (Sweden)

    Felipe Cunha Bawden

    2011-08-01

    Full Text Available OBJECTIVE: To evaluate the impact of obstructive sleep apnea (OSA on cognition. METHOD: We compared the performance of 17 patients with polysomnographic diagnosis of OSA in brief cognitive tests to that of 20 healthy controls, matched for age and education. The testing battery included the Mini-Mental State Examination (MMSE, Brief Cognitive Screening Battery (BCSB, Digit-Symbol (DS and Phonemic Verbal Fluency (FAS. Anthropometric measures and scores from the Epworth Sleepiness Scale were also recorded. RESULTS: OSA patients performed significantly worse than controls in the MMSE, in memory items from the BCSB, in DS and also in FAS. OSA patients also exhibited higher body mass index, increased neck circumference and higher scores in Epworth Sleepiness Scale than controls. CONCLUSION: OSA significantly impairs cognitive performance, especially within the domains of attention, memory and executive functioning. These deficits may be detected by brief and easy-to-administer cognitive tests.

  12. Maxillofacial Developmental and Occlusion Disorders in Children with Obstructive Sleep Apnea Syndrome Alteraciones del desarrollo maxilofacial y de la oclusión en el niño con síndrome de apnea obstructiva del sueño

    OpenAIRE

    Alexander Torres Molina

    2011-01-01

    The obstructive sleep apnea syndrome is a highly prevalent disease that affects approximately 2% of children and is considered a complex entity due to its somatic and cognitive impact. Occlusion and mouth, skull and facial alterations associated with this syndrome are a matter of concern both for specialists in maxillofacial surgery and orthodontists, who are playing an important role in the diagnosis and final treatment of this disease. Guilleminault scoring system allows to evaluate the sev...

  13. Interaction between smoking and obstructive sleep apnea:not just participants

    Institute of Scientific and Technical Information of China (English)

    LIN Ying-ni; LI Qing-yun; ZHANG Xiu-juan

    2012-01-01

    Objective To review the current evidence that links smoking to obstructive sleep apnea (OSA) and to discuss some potential mechanisms proposed for these links.Data sources We searched PubMed and Medline to identify studies investigating the interaction between smoking and OSA.Study selection Articles regarding the relationship between smoking and OSA were selected.Studies considered smoking as a confounding factor were excluded.Results The association of smoking and OSA has been confirmed in several studies.The effects of smoking on the pathophysiology of OSA may include smoking-induced upper airway inflammation,stimulant effects of nicotine on upper airway muscles,and a "rebound effect" due to nightly short-term nicotine withdrawal,or all of the above.In addition,the coexistence of OSA and smoking may have more widespread implications for cardiovascular dysfunction in patients with OSA.Finally,OSA might be responsible for the addiction to nicotine.Conclusions Smoking may act as a risk factor for OSA and join with OSA in a common pathway to increase the risk of systematic injury.OSA,in turn,may be a predisposing factor for smoking.Thus,smoking cessation is recommended when considering treatment for OSA,and treating OSA may be a necessary precondition for successful smoking cessation.

  14. Revisión bibliográfica exploratoria sobre síndrome de apnea obstructiva del sueño y conducción profesional An exploratory literature review on obstructive sleep apnea syndrome and professional drivers

    Directory of Open Access Journals (Sweden)

    Mariholy Carolina Hernández García

    2012-06-01

    Full Text Available El síndrome de apnea-hipopnea del sueño es el más frecuente de los trastornos respiratorios que se producen durante el sueño, afectando alrededor del 4% de los adultos, y a casi 2 millones de personas en España. Se presenta con episodios repetidos de obstrucción de la vía aérea superior provocando un colapso del flujo de aire hacia los pulmones y síntomas como somnolencia diurna, trastornos respiratorios, cardiovasculares, psicológicos e intelectuales. La somnolencia al conducir es común entre conductores profesionales, afectando su rendimiento y la seguridad de la población. Se llevó a cabo una revisión bibliográfica exploratoria, para conocer la prevalencia de la patología en conductores profesionales, los factores del riesgo implicados, los métodos utilizados en su diagnóstico y su relación con los accidentes de tránsito. Se seleccionaron nueve bases de datos, PUBMED, IBECS, LILACS, COCHRANE LIBRARY, EMBASE, SCOPUS, SCIELO, WOS y WOK, para llevar a cabo la búsqueda entre Octubre 2011 y Enero 2012. Luego de aplicados los criterios de inclusión/exclusión se analizaron 12 artículos. La prevalencia del síndrome es similar en la mayoría de los estudios pero superior a la población general. Los factores de riesgo de mayor estudio e impacto fueron la obesidad, la somnolencia excesiva, los ronquidos. No existe consenso entre los test diagnósticos utilizados y su eficacia. Sin embargo el más utilizado ha sido la escala de Epworth (ESE. La relación siniestralidad y apnea del sueño ha sido poco estudiada en conductores profesionales.The sleep apnea-hypopnea syndrome is the most common respiratory disorders that occur during sleep, affecting about 4% of adults, and nearly 2 million people in Spain. It occurs with repeated episodes of upper airway obstruction causing a flow of air collapse into the lungs and symptoms such as daytime sleepiness, respiratory, cardiovascular, psychological and intellectual disorders. Sleepiness

  15. [Effect of the obstructive sleep apnea hypopnea syndrome treatment on blood pressure in patients with resistant hypertension].

    Science.gov (United States)

    Wang, H W; Liu, H M; Zheng, Z Y; Jia, Y Z; Li, H R

    2017-01-07

    Objective: To investigate the effect of the treatments for obstructive sleep apnea hypopnea syndrome (OSAHS) on the resistant hypertension (RH) of patients. Methods: Eighty patients with OSAHS and RH (blood pressure could not be controlled under 140/90 mmHg (1 mmHg=0.133 kPa) even with more than three kinds of antihypertensive drugs including diuretics) received surgery or continuous positive airway pressure (CPAP) treatment. The results of polysomnography monitoring, ambulatory blood pressure monitoring, and the dosage of antihypertensive medication were recorded before and six months after the treatment. Results: Apnea hypopnea index (AHI) decreased from (32.9±10.8) before treatment to (9.4±6.5) after treatment, while the lowest oxygen saturation (SaO(2)) increased from (0.682±0.062) to (0.884±0.056), with significant differences (t value was 18.863 and 26.614, respectively; both PSBP)/diastolic blood pressure (DBP) decreased respectively from ((150.5±9.8)/(97.8±7.3)) mmHg to ((140.7±6.8)/(88.6±6.3)) mmHg, daytime SBP/DBP decreased from ((154.3±8.9)/(100.6±7.4)) mmHg to ((144.8±5.8)/(91.3±5.5)) mmHg, and nighttime SBP/DBP decreased from ((145.5±8.8)/(93.8±6.4)) mmHg to ((135.8±5.7)/(84.6±5.9)) mmHg, with significant differences (t value was 7.832, 6.903, 7.005, 6.848, 8.025, 7.554, respectively; all PSBP /DBP was ((11.5±2.2)/(10.2±3.1)) mmHg, and the reduction of daytime SBP/DBP was ((9.0±2.8)/(7.9±3.5)) mmHg. The reduction of nighttime SBP/DBP was more obvious than daytime SBP/DBP, with significant differences (t value was 9.732 and 6.936, respectively; both P<0.001). Before treatment, nighttime blood pressure decrease rate below 10% was showed in 75 percent of patients, and after treatment, this rate only in 37.5 percent of patients (χ(2)=22.857, P<0.01). The numbers of required antihypertensive drugs decreased in 45 (56.3%) cases, the average numbers of antihypertensive drugs decreased from (3.2±0.4) before treatment to (2.6±0.5) after

  16. BMI in patients with obstructive sleep apnea

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    Dobrowolska-Zarzycka Magdalena

    2015-12-01

    Full Text Available Obstructive sleep apnea (OSA is a disease of multicasual etiology. The risk factors include obesity, among other issues. Hence, it is extremely important to determine the effect of body weight on the severity of OSA. The aim of the study was to evaluate the influence of the body weight expressed as body mass index (BMI, on the value of upper airways diameter and on the AHI (Apnea-Hypopnea Index value. The study was comprised of 41 patients diagnosed with OSA by way of polysomnography. Each patient was first examine via a lateral cephalometric image of the skull, which served to measure the upper and lower diameter of the upper airways. BMI was also calculated for each patient. Statistical analysis was carried out in accordance with Pearson’s correlation coefficient test. Our work demonstrated a negative correlation between BMI and the diameter of the upper airways, and a positive correlation between BMI and AHI value. We thus put forward that the increase in body weight in patients with OSA can contribute to the severity of the disease, regardless of the fact that it may not lead to a reduction of the lumen of the upper airways.

  17. High levels of inflammation and insulin resistance in obstructive sleep apnea patients with hypertension.

    Science.gov (United States)

    Qian, Xiaoshun; Yin, Tong; Li, Tianzhi; Kang, Chunyan; Guo, Ruibiao; Sun, Baojun; Liu, Changting

    2012-08-01

    Hypertension induced by obstructive sleep apnea (OSA) may be multifactorial in origin, and systemic inflammation is one of the major factors. However, OSA patients do not always have the identical probability with hypertension even in patients with the same history and degree of OSA. The aim of this study was to compare the levels of inflammation and insulin resistance in two groups of patients who had the same degree as well as the same long history of OSA, but with/without hypertension. OSA patients (Apnea Hyponea Index, AHI ≥ 40/h, n = 70) were examined by polysomnography and blood analysis for the measurements of fasting plasma glucose, serum insulin (FINS), high-sensitivity C-reactive protein (CRP), peptide C,TNF-α, IL-6, and IL-10. Patients with hypertension (n = 40) had higher level of LDL-C and lower HDL-C levels than patients without hypertension. Almost half (16/40) of OSA patients with hypertension had family history of hypertension. Moreover in OSA patients with hypertension, the levels of TNF-α, IL-6, and CRP were higher, but IL-10 was lower than those without hypertension. FINS, peptide C, HOMA-IR, and HOMA-islet were also higher in OSA patients with hypertension. OSA patients with hypertension have higher level of inflammation and insulin resistance. Systemic inflammation and insulin resistance are both important factors for the development of hypertension in OSA patients.

  18. A clinical approach to obstructive sleep apnea as a risk factor for cardiovascular disease

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    Maeder MT

    2016-03-01

    Full Text Available Micha T Maeder,1 Otto D Schoch,2 Hans Rickli1 1Department of Cardiology, 2Department of Respiratory Medicine, Kantonsspital St Gallen, St Gallen, Switzerland Abstract: Obstructive sleep apnea (OSA is associated with cardiovascular risk factors, cardiovascular diseases, and increased mortality. Epidemiological studies have established these associations, and there are now numerous experimental and clinical studies which have provided information on the possible underlying mechanisms. Mechanistic proof-of-concept studies with surrogate endpoints have been performed to demonstrate that treatment of OSA by continuous positive airway pressure (CPAP has the potential to reverse or at least to attenuate not only OSA but also the adverse cardiovascular effects associated with OSA. However, no randomized studies have been performed to demonstrate that treatment of OSA by CPAP improves clinical outcomes in patients with cardiovascular risk factors and/or established cardiovascular disease and concomitant OSA. In the present review, we summarize the current knowledge on the role of OSA as a potential cardiovascular risk factor, the impact of OSA on cardiac function, the role of OSA as a modifier of the course of cardiovascular diseases such as coronary artery disease, atrial fibrillation, and heart failure, and the insights from studies evaluating the impact of CPAP therapy on the cardiovascular features associated with OSA. Keywords: obstructive sleep apnea, cardiovascular, risk, heart failure, atrial fibrillation, hypertension

  19. 77 FR 25226 - Proposed Recommendations on Obstructive Sleep Apnea

    Science.gov (United States)

    2012-04-27

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF TRANSPORTATION... withdrawing its proposed regulatory guidance for obstructive sleep apnea (OSA) and request for comment as published on April 20, 2012. The Agency is still in the process of carefully reviewing the...

  20. Compensatory Head Posture Changes in Patients with Obstructive Sleep Apnea

    Institute of Scientific and Technical Information of China (English)

    TONG Maorong; XIA Xirong; Hiroki SAKAKIBARA; Susumu SUETSUGU

    2000-01-01

    The upper airway narrowing and changes in head posture and their relationship with apnea severity in patients with obstructive sleep apnea (OSA) were investigated. In 86 male OSA patients and 37 healthy men, one-night polysomnographic examination was performed and a lateral cephalogram by digital image processing system was taken in each subject. Fifteen variables concerning the upper airway dimensions, area and head postures were measured by using a computer software (NIH Image). The results showed that upper airway dimensions in the OSA group at all levels were significantly smaller than those in the control group and the results hold true when the age and body mass index were well controlled in these two groups. Significant forward inclination of the cervical column was found in the patients with an apnea index (AI) greater than 35episodes/h. And changes in the head posture variables in the whole study group were significantly correlated with AI and airway dimensions at various levels. It was suggested that there exist significant and extensive upper airway narrowing in OSA patients even in upright position and awake state; And as the apnea severity progresses, patients may assume certain compensatory head postures in an attempt to maintain an adequate airway patency.

  1. Evaluation of Anthropometric and Metabolic Parameters in Obstructive Sleep Apnea

    Directory of Open Access Journals (Sweden)

    Yaşar Yildirim

    2015-01-01

    Full Text Available Aims. Sleep disorders have recently become a significant public health problem worldwide and have deleterious health consequences. Obstructive sleep apnea (OSA is the most common type of sleep-related breathing disorders. We aimed to evaluate anthropometric measurements, glucose metabolism, and cortisol levels in patients with obstructive sleep apnea (OSA. Materials and Methods. A total of 50 patients with a body mass index ≥30 and major OSA symptoms were included in this study. Anthropometric measurements of the patients were recorded and blood samples were drawn for laboratory analysis. A 24-hour urine sample was also collected from each subject for measurement of 24-hour cortisol excretion. Patients were divided equally into 2 groups according to polysomnography results: control group with an apnea-hypopnea index (AHI <5 (n=25 and OSA group with an AHI ≥5 (n=25. Results. Neck and waist circumference, fasting plasma glucose, HbA1c, late-night serum cortisol, morning serum cortisol after 1 mg dexamethasone suppression test, and 24-hour urinary cortisol levels were significantly higher in OSA patients compared to control subjects. Newly diagnosed DM was more frequent in patients with OSA than control subjects (32% versus 8%, p=0.034. There was a significant positive correlation between AHI and neck circumference, glucose, and late-night serum cortisol. Conclusions. Our study indicates that increased waist and neck circumferences constitute a risk for OSA regardless of obesity status. In addition, OSA has adverse effects on endocrine function and glucose metabolism.

  2. The Influence of Obesity on Different Genders in Patients with Obstructive Sleep Apnea

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    Kuo-Tung Huang

    2014-01-01

    Full Text Available Obesity is considered to be a major contributing factor to obstructive sleep apnea (OSA; however, there is limited evidence with regard to gender predominance. We analyzed 2345 patients (339 females in correlation with body mass index (BMI and OSA severity. Male AHIs were significantly higher than female AHIs in each BMI group. As the BMI increased, the AHI increased in both males and females, and this trend was more obvious in males. For BMI-matched male and female patients with OSA, the severity of OSA was higher in males. As BMI increased, the severity of OSA increased more obviously in males. Our findings suggest that increased body fat contributes to the pathogenesis of OSA more in males than in females and that obesity plays a more significant role in contributing to OSA in male patients.

  3. Obstructive Sleep Apnea and Coronary Artery Disease: From Pathophysiology to Clinical Implications

    Directory of Open Access Journals (Sweden)

    Fernando De Torres-Alba

    2013-01-01

    Full Text Available Coronary artery disease (CAD and obstructive sleep apnea (OSA are both complex and significant clinical problems. The pathophysiological mechanisms that link OSA with CAD are complex and can influence the broad spectrum of conditions caused by CAD, from subclinical atherosclerosis to myocardial infarction. OSA remains a significant clinical problem among patients with CAD, and evidence suggesting its role as a risk factor for CAD is growing. Furthermore, increasing data support that CAD prognosis may be influenced by OSA and its treatment by continuous positive airway pressure (CPAP therapy. However, stronger evidence is needed to definitely answer these questions. This paper focuses on the relationship between OSA and CAD from the pathophysiological effects of OSA in CAD, to the clinical implications of OSA and its treatment in CAD patients.

  4. 男性高血压并阻塞性睡眠呼吸暂停综合征患者综合干预效果分析%The comprehensive intervention effect of male hypertensive patients with obstructive sleep apnea syndrome

    Institute of Scientific and Technical Information of China (English)

    莫剑梅; 黄江南; 刘唐威; 黄荣杰

    2012-01-01

    OBJECTIVE To analyze the comprehensive intervention effect of 36 cases of male hypertensive patients with obstructive sleep apnea syndrome (OSAS). METHODS We recruited 36 male patients with hypertension and OSAS, 16 cases received pharmacotherapy were as control group, 20 cases combined with life—style were as observation group. Compared their data of living habits, blood biochemical, ambulatory blood pressure and echocardiography before comprehensive intervention and after 6 months of follow-up. RESULTS ① After the intervention, the rates of smoking, obesity and high salt/fat diet, drinking in patients were decreased (P< 0.05). The rates to reach the effective movement in a week in patients were increased (P< 0.01). ② After the intervention, the rates of blood pressure levels of two groups were decreased (P< 0.05). ③ After the intervention, the rates of BMI, and blood of the TC, TG, LDL, Cr and 24-hour urine total protein and albumin in the observation patients decreased significantly (P < 0.05) , and IVST, SBPVand DBPV were smaller (P< 0.01). ④ Apnea hyponea index AHI in the observation decreased (P< 0.05). CONCLUSION The comprehensive intervention can effectively reduce the cardiovascular risk factors in male hypertension with OSAS and reduce the damage of cardiac and renal target organ.%目的 对男性高血压并阻塞性睡眠呼吸暂停综合征(OSAS)患者进行综合干预的效果分析.方法 36例男性高血压并OSAS患者,药物治疗16例,为对照组;结合生活方式干预20例,为观察组.随访6个月前后比较生活习惯,血液生化资料及动态血压,超声心动图,睡眠呼吸多导图参数变化.结果 ①干预后观察组患者吸烟、肥胖及高盐高脂饮食、饮酒率均降低,P< 0.05.每周到达有效运动的患者增加,P<0.01.②干预后两组患者血压水平下降,P<0.05.③干预后观察组患者BMI及血TC、TG、LDL、Cr浓度明显下降,P< 0.01.24 h尿总蛋白及微量白蛋白

  5. Effects of the Treatment with Continuous Positive Airway Pressure for One Night on the Sleep Architecture of the Patients with Obstructive Sleep Apnea Syndrome%一夜持续正压呼吸道通气治疗对阻塞性睡眠呼吸暂停低通气综合征患者睡眠结构的影响

    Institute of Scientific and Technical Information of China (English)

    张立芳; 李博; 刘煜; 宿长军

    2013-01-01

    Objective To investigate the effects of the treatment with continuous positive airway pres-sure( CPAP ) for one night on sleep architecture of the patients with obstructive sleep apnea syndrome ( OSAS ). Methods 113 patients with slight, moderate or serious OSAS diagnosed by polysomnogram ( PSG )were treated by CPAP for at least 7 hours during one night. In the mean time, PSG was used to monitor the changes of sleep of the patients and some parameters related to the severity of the disease. Results After treatment with CPAP for one night, the ratio of the patients' sleep durations at stage 1 and stage 2 to total sleep time( TST ) decreased significantly ( P<0.05),4.5% and 10. 1% respectively. And the ratio of the deep sleep time( stage 3 and stage 4 )to total sleep time increased by 6. 5%( P < 0. 05 ). The ratio of the time of rapid eye movement( REM ) sleep to TST increased by 8 % ( P < 0. 05 ). Apnea hyponea index( AHI) decreased by 59. 6% ( P < 0. 05 ). Minimum SaO2 and average SaO2 increased by 18.0% and 5% respectively (P <0. 05 ). Conclusion CPAP treatment for one night can significantly improve the sleep architecture of OSAS patients , increasing the duration of deep sleep , decreasing AHI and increasing SaO2.%目的 了解一夜持续正压呼吸道通气(CPAP)治疗对阻塞性睡眠呼吸暂停低通气综合征(OSAS)患者睡眠结构的影响.方法 经多导睡眠图(PSG)确诊的OSAS患者113例,经CPAP治疗一夜(≥7 h),同时行PSG监测,观察患者治疗前后睡眠结构以及病情严重程度的参数变化.结果 经一夜CPAP治疗后,1、2期睡眠占睡眠总时间的比率显著降低,分别为4.5%、10.1%(P<0.05);3、4期睡眠(深睡眠)占睡眠总时间比率增加6.5%(P<0.05),快速眼动睡眠比率增加8.0%(P<0.05).呼吸紊乱指数(AHI)下降59.6%(P<0.05);最低血氧饱和度、平均血氧饱和度分别增加18.0%、5.0%(P<0.05).结论 一夜CPAP治疗能显著改善睡眠结构,增加患者的深睡眠,降低AHI,增高血氧饱和度.

  6. Risk of New-Onset Atrial Fibrillation in Elderly Patients with the Overlap Syndrome: A Retrospective Cohort Study

    Institute of Scientific and Technical Information of China (English)

    Harsha V. Ganga; Sanjeev U. Nair; Venkata K. Puppala; Wayne L. Miller

    2013-01-01

    Objective Co-existence of obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) is referred to as overlap syndrome. Overlap patients have greater degree of hypoxia and pulmonary hypertension than patients with OSA or COPD alone. Studies showed that elderly patients with OSA alone do not have increased risk of atrial fibrillation (AF) but it is not known if overlap patients have higher risk of AF. Objective To determine whether elderly patients with overlap syndrome have an increased risk of AF. Methods In this single center, community-based retrospective cohort analysis, data were collected on 2,873 patients > 65 years of age without AF, presenting in the year 2006. Patients were divided into OSA group (n = 60), COPD group (n = 416), overlap syndrome group (n = 28) and group with no OSA or COPD (n = 2369). The primary endpoint was incidence of new-onset AF over the following two years. Logistic regression was performed to adjust for heart failure (HF), coronary artery disease, hypertension (HTN), cerebrovascular disease, cardiac valve disorders, diabetes mellitus, hyperlipidemia, chronic kidney disease (CKD) and obesity. Results The incidence of AF was 10% in COPD group, 6% in OSA group and 21% in overlap syndrome group (P < 0.05). After adjusting for age, sex, HF, CKD, and HTN, patients with overlap syndrome demonstrated a significant association with new-onset AF (OR = 3.66, P = 0.007). HF, CKD and HTN were also significantly associated with new-onset AF (P < 0.05). Conclusion Among elderly patients, the presence of overlap syndrome is associated with a marked increase in risk of new-onset AF as compared to the presence of OSA or COPD alone.

  7. Effects of an oral appliance with different mandibular protrusion positions at a constant vertical dimension on obstructive sleep apnea

    NARCIS (Netherlands)

    Aarab, G.; Lobbezoo, F.; Hamburger, H.L.; Naeije, M.

    2010-01-01

    The aim of the study was to assess the influence of four mandibular protrusion positions, at a constant vertical dimension, on obstructive sleep apnea (OSA). Seventeen OSA patients (49.2 ± 8.5 years) received an adjustable mandibular advancement device (MAD). The patients underwent four polysomnogra

  8. Obstructive Sleep Apnea and Postoperative Complications in Patients Undergoing Coronary Artery Bypass Graft Surgery: A Need for Preventive Strategies

    Directory of Open Access Journals (Sweden)

    Babak Amra

    2014-01-01

    Conclusions: Obstructive sleep apnea is frequent, but unrecognized among patients undergoing CABG. In these patients, OSA is associated with prolonged intubation duration. Preventing these problems may be possible by early diagnosis and management of OSA in cardiac surgery patients. Further studies with larger sample of patients and longer follow-ups are required in this regard.

  9. The Effect of Treatment of Obstructive Sleep Apnea on Quality of Life in Children with Cerebral Palsy

    Science.gov (United States)

    Hsiao, Kai Hsun; Nixon, Gillian M.

    2008-01-01

    Benefits of treatment for obstructive sleep apnea (OSA) in children with cerebral palsy could differ from those in otherwise healthy children. We examined the effects of OSA treatment by comparing a group of children with cerebral palsy treated with adenotonsillectomy or continuous positive airway pressure (CPAP) by nasal mask with controls who…

  10. Role of Sensory Stimulation in Amelioration of Obstructive Sleep Apnea

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    Mak Adam Daulatzai

    2011-01-01

    Full Text Available Obstructive sleep apnea (OSA, characterized by recurrent upper airway (UA collapse during sleep, is associated with significant morbidity and disorders. Polysomnogram is employed in the evaluation of OSA and apnea-hypopnea number per hour reflects severity. For normal breathing, it is essential that the collapsible UA is patent. However, obstruction of the UA is quite common in adults and infants. Normally, important reflex mechanisms defend against the UA collapse. The muscle activity of UA dilators, including the genioglossus, tensor palatini (TP, and pharyngeal constrictors, is due to the integrated mechanism of afferent sensory input → to motor function. Snoring is harsh breathing to prevent UA obstruction. Unfortunately, snoring vibrations, pharyngeal suction collapse, negative pressure, and hypoxia cause pathological perturbations including dysfunctional UA afferent sensory activity. The current paper posits that peripheral sensory stimulation paradigm, which has been shown to be efficacious in improving several neurological conditions, could be an important therapeutic strategy in OSA also.

  11. Cardiovascular Complications of Sleep Apnea: Role of Oxidative Stress

    Directory of Open Access Journals (Sweden)

    Mohammad Badran

    2014-01-01

    Full Text Available Obstructive sleep apnea (OSA occurs in 2% of middle-aged women and 4% of middle-aged men with a higher prevalence among obese subjects. This condition is considered as an independent risk factor for cerebrovascular and cardiovascular diseases. One of the major pathophysiological characteristics of OSA is intermittent hypoxia. Hypoxia can lead to oxidative stress and overproduction of reactive oxygen species, which can lead to endothelial dysfunction, a hallmark of atherosclerosis. Many animal models, such as the rodent model of intermittent hypoxia, mimic obstructive sleep apnea in human patients and allow more in-depth investigation of biological and cellular mechanisms of this condition. This review discusses the role of oxidative stress in cardiovascular disease resulting from OSA in humans and animal models.

  12. Obstructive Sleep Apnea and Driving: A Canadian Thoracic Society and Canadian Sleep Society Position Paper

    Directory of Open Access Journals (Sweden)

    Najib Ayas

    2014-01-01

    Full Text Available Individuals with obstructive sleep apnea (OSA experience sleep fragmentation and poor sleep quality that results in daytime sleepiness, which impairs performance during driving and leads to an increased risk for collisions. Not surprisingly, observational studies have shown that patients with OSA experience a two- to 10-fold higher risk for collision compared with healthy controls. Although treatment would clearly mitigate these risks, there is no current Canadian position on driving and OSA. This article, the first Canadian position statement addressing the issue, provides an overview of provincial regulations and proposes recommendations with regard to driving in patients with OSA.

  13. Síndrome de apnea-hipopnea del sueño: Concepto, diagnóstico y tratamiento médico Sleep apnea-hypopnea syndrome: Concept, diagnosis and medical treatment

    Directory of Open Access Journals (Sweden)

    V. M. Eguía

    2007-01-01

    Full Text Available El Síndrome de apneas-hipopneas del sueño (SAHS se caracteriza por somnolencia diurna excesiva, trastornos cardiorrespiratorios y cognitivos, secundarios a episodios repetidos de obstrucción de la vía aérea superior durante el sueño. Esta enfermedad es muy prevalente en la población general y tiene efectos deletéreos sobre el sistema cardiovascular; aumenta la incidencia de accidentes de tráfico a causa de la excesiva somnolencia, deteriora la calidad de vida y se asocia a un exceso de mortalidad. Suele afectar a pacientes obesos y los síntomas más importantes son los ronquidos y las pausas respiratorias repetidas. Cada apnea y/o hipopnea condiciona una puntual caída en la saturación que altera la media nocturna y termina ocasionando serios problemas cardiovasculares a medio-largo plazo. La desestructuración de la arquitectura del sueño conduce a la excesiva somnolencia diurna capaz de interferir en la vida socio-laboral. El diagnóstico se realiza mediante polisomnografía o poligrafía respiratoria, método abreviado válido para el 75% de casos. El tratamiento médico más eficaz es la aplicación de presión positiva en la vía aérea (CPAP que tiene escasos y leves efectos secundarios y es, en general, bien tolerado. Una vez adaptado el paciente debe realizarse un ajuste de la presión mediante polisomnografía o con las autoCPAP, capaces de variar la presión hasta la corrección de los eventos respiratorios. El papel de la atención primaria es fundamental en la sospecha del cuadro, la utilización correcta de los criterios de derivación y el control de los pacientes en tratamiento una vez adaptados.The sleep apnea-hypopnea syndrome (SAHS is characterised by daytime sleepiness, cardiorespiratory and cognitive disorders, secondary to repeated episodes of obstruction of the upper airway during sleep. This disease is highly prevalent in the general population and has damaging effects on the cardiovascular system; it increases

  14. Manejo del SAHS mediante dispositivos de avance mandibular: Estudio preliminar Sleep apnea-hypopnea syndrome management using a mandibular advancement device: Preliminary study

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    Manuel Sánchez-Moliní

    2010-12-01

    Full Text Available El tratamiento que ha demostrado mayor eficacia en los pacientes con síndrome de apneas-hipopneas del sueño (SAHS es la presión positiva continua de la vía aérea (CPAP. Los mayores inconvenientes son la incomodidad y la sensación de claustrofobia, que en algunos pacientes provoca rechazo o intolerancia. Una alternativa son los dispositivos de avance mandibular (DAM, que insertados en las arcadas dentarias producen el avance de la mandíbula y de la lengua, aumentando el volumen de la vía aérea. Objetivo: Presentar nuestra experiencia en el tratamiento del SAHS mediante dispositivos de avance mandibular tipo Herbst. Metodología: Estudio de seguimiento prospectivo desde junio de 2006 hasta enero de 2009 de 7 pacientes del Área Hospitalaria Virgen Macarena con SAHS que rechazan el tratamiento con CPAP y a los que se ofrece tratamiento con DAM. Las variables analizadas son: índice de apneas-hipopneas por hora, índice de desaturaciones por hora, intensidad subjetiva del ronquido y el test de somnolencia de Epworth, antes del tratamiento y al menos 6 meses después desde el inicio de su uso. Utilizamos el test de Wilcoxon para detectar diferencias estadísticas significativas (pThe most effective treatment in patients with sleep apnea-hypopnea syndrome (SAHS is CPAP (continuous positive airway pressure. The main drawback of CPAP is the discomfort and claustrophobic sensation that it causes, which elicits rejection or intolerance by some patients. A non-surgical alternative to CPAP is the mandibular advancement device (MAD, which consists of a plastic splint inserted between the dental arches to shift the jaw and tongue forward and thus increase airway volume. Objective: Report our experience with the treatment of SAHS using the Herbst mandibular advancement device. Material and method: A prospective follow-up study was carried out from June 2006 until January 2009 at the Virgen Macarena University Hospital with 7 patients with SAHS who

  15. Numerical analysis for the efficacy of nasal surgery in obstructive sleep apnea hypopnea syndrome

    Science.gov (United States)

    Yu, Shen; Liu, Ying-Xi; Sun, Xiu-Zhen; Su, Ying-Feng; Wang, Ying; Gai, Yin-Zhe

    2014-04-01

    In the present study, we reconstructed upper airway and soft palate models of 3 obstructive sleep apnea—hypopnea syndrome (OSAHS) patients with nasal obstruction. The airflow distribution and movement of the soft palate before and after surgery were described by a numerical simulation method. The curative effect of nasal surgery was evaluated for the three patients with OSAHS. The degree of nasal obstruction in the 3 patients was improved after surgery. For 2 patients with mild OSAHS, the upper airway resistance and soft palate displacement were reduced after surgery. These changes contributed to the mitigation of respiratory airflow limitation. For the patient with severe OSAHS, the upper airway resistance and soft palate displacement increased after surgery, which aggravated the airway obstruction. The efficacy of nasal surgery for patients with OSAHS is determined by the degree of improvement in nasal obstruction and whether the effects on the pharynx are beneficial. Numerical simulation results are consistent with the polysomnogram (PSG) test results, chief complaints, and clinical findings, and can indirectly reflect the degree of nasal patency and improvement of snoring symptoms, and further, provide a theoretical basis to solve relevant clinical problems. [Figure not available: see fulltext.

  16. Apnea of prematurity

    Science.gov (United States)

    Apnea - newborns; AOP; As and Bs; A/B/D; Blue spell - newborns; Dusky spell - newborns; Spell - newborns; Apnea - neonatal ... particular those who were born early, may have apnea, including: If their brain is not fully developed ...

  17. Sleep Apnea Information Page

    Science.gov (United States)

    ... Page You are here Home » Disorders » All Disorders Sleep Apnea Information Page Sleep Apnea Information Page Search Disorders Search NINDS SEARCH ... Institutes of Health (NIH) conduct research related to sleep apnea in laboratories at the NIH, and also ...

  18. Orthodontics treatments for managing obstructive sleep apnea syndrome in children: A systematic review and meta-analysis.

    Science.gov (United States)

    Huynh, Nelly T; Desplats, Eve; Almeida, Fernanda R

    2016-02-01

    A small maxilla and/or mandible may predispose children to sleep-disordered breathing, which is a continuum of severity from snoring to obstructive sleep apnea. Preliminary studies have suggested that orthodontic treatments, such as orthopedic mandibular advancement or rapid maxillary expansion, may be effective treatments. The aim is to investigate the efficacy of orthopedic mandibular advancement and/or rapid maxillary expansion in the treatment of pediatric obstructive sleep apnea. Pubmed, Medline, Embase, and Internet were searched for eligible studies published until April 2014. Articles with adequate data were selected for the meta-analysis; other articles were reported in the qualitative assessment. Data extraction was conducted by two independent authors. A total of 58 studies were identified. Only eight studies were included in the review; of these, six were included in the meta-analysis. The research yielded only a small number of studies. Consequently, any conclusions from the pooled diagnostic parameters and their interpretation should be treated carefully. Although the included studies were limited, these orthodontic treatments may be effective in managing pediatric snoring and obstructive sleep apnea. Other related health outcomes, such as neurocognitive and cardiovascular functions have not yet been systematically addressed. More studies are needed with larger sample size, specific inclusion and exclusion criteria and standardized data reporting to help establish guidelines for the orthodontic treatment of pediatric obstructive sleep apnea.

  19. Psychomotor development in infants with Prader-Willi syndrome and associations with sleep-related breathing disorders.

    Science.gov (United States)

    Festen, Dederieke A M; Wevers, Maaike; de Weerd, Al W; van den Bossche, Renilde A S; Duivenvoorden, Hugo J; Otten, Barto J; Wit, Jan Maarten; Hokken-Koelega, Anita C S

    2007-08-01

    Prader-Willi syndrome (PWS) is a neurogenetic disorder with hypotonia, psychomotor delay, obesity, short stature, and sleep-related breathing disorders. The aim of this study was to evaluate the association between psychomotor development and sleep-related breathing disorders in PWS infants. Bayley Scales of Infant Development were performed in 22 PWS infants, with a median (interquartile range, IQR) age of 1.8 (1.1-3.4) y, and a body mass index SD score (BMISDS) of -0.5 (-1.3 to 1.6). We evaluated psychomotor development in relation to results of polysomnography. Median (IQR) mental and motor development was 73.1% (64.3-79.6%) and 55.2% (46.5-63.1%) of normal children, respectively. All infants had sleep-related breathing disorders, mostly of central origin. The apnea hypopnea index was not associated with psychomotor development. Only four infants had obstructive sleep apnea syndrome (OSAS). They had a significantly delayed mental development of 65.5% (60.0-70.3%) of normal. They had a median BMISDS of 1.4 (0.1-1.6), which tended to be higher than in those without OSAS. Our data indicate that psychomotor development in PWS infants is not related to central sleep-related breathing disorders, but infants with OSAS have more severely delayed mental development, suggesting that PWS infants should be screened for OSAS.

  20. Atualização em síndrome da apnéia obstrutiva do sono na infância Update in obstructive sleep apnea syndrome in children

    Directory of Open Access Journals (Sweden)

    Aracy P. S. Balbani

    2005-02-01

    polysomnography are useful tools for screening suspected cases of OSAS in children, and the gold-standard for diagnosis is overnight polysomnography in the sleep laboratory. On the contrary of SAOS adults, children usually present: less arousals associated to apnea events, more numerous apneas/hypopneas during REM sleep, and more significant oxihemoglobin dessaturation even in short apneas. The treatment of OSAS may be surgical (adenotonsillectomy, craniofacial abnormalities correction, tracheostomy or clinical (sleep hygiene, continuous positive airway pressure - CPAP.

  1. Circulating adhesion molecules in obstructive sleep apnea and cardiovascular disease.

    Science.gov (United States)

    Pak, Victoria M; Grandner, Michael A; Pack, Allan I

    2014-02-01

    Over 20 years of evidence indicates a strong association between obstructive sleep apnea (OSA) and cardiovascular disease. Although inflammatory processes have been heavily implicated as an important link between the two, the mechanism for this has not been conclusively established. Atherosclerosis may be one of the mechanisms linking OSA to cardiovascular morbidity. This review addresses the role of circulating adhesion molecules in patients with OSA, and how these may be part of the link between cardiovascular disease and OSA. There is evidence for the role of adhesion molecules in cardiovascular disease risk. Some studies, albeit with small sample sizes, also show higher levels of adhesion molecules in patients with OSA compared to controls. There are also studies that show that levels of adhesion molecules diminish with continuous positive airway pressure therapy. Limitations of these studies include small sample sizes, cross-sectional sampling, and inconsistent control for confounding variables known to influence adhesion molecule levels. There are potential novel therapies to reduce circulating adhesion molecules in patients with OSA to diminish cardiovascular disease. Understanding the role of cell adhesion molecules generated in OSA will help elucidate one mechanistic link to cardiovascular disease in patients with OSA.

  2. Character of diaphragm compound muscle action potential and phrenic nerve conduction time in patients with obstructive sleep apnea-hypopnea syndrome

    Institute of Scientific and Technical Information of China (English)

    Yuhong Hou; Rongchang Chen; Jinbing Pan; Yuanming Luo; Nanshan Zhong

    2008-01-01

    BACKGROUND: Both hypoxia and carbon dioxide retention can damage phrenic nerve and muscle conduction, as well as diaphragm function. Diaphragm compound muscle action potential and phrenic nerve conduction time are reliable indicators for measuring phrenic nerve and diaphragm function.OBJECTIVES: To verify the hypothesis that changes of phrenic nerve conduction time (PNCT) and diaphragm compound muscle action potential (CMAP) in obstructive sleep apnea-hypopnea syndrome (OSAHS) patients might contribute to the decline of phrenic nerve and diaphragm function. PNCT and CMAP were measured with multipair esophageal electrodes combined with unilateral magnetic stimulation.DESIGN, TIME AND SETTING: Case controlled study. The experiment was carried out in Guangzhou Institute of Respiratory Disease, Guangzhou Medical College, from June 2005 to April 2006.PARTICIPANTS: Twenty seven OSAHS patients and eight primary snoring subjects from Guangzhou Institute of Respiratory Disease, Guangzhou Medical College were recruited and all subjects were diagnosed by polysomnography (PSG). Sixteen healthy, non-snoring subjects in the hospital for medical examination during the same time period were selected as the control group.METHODS: Esophageal electrodes, made by Guangzhou Institute of Respiratory Disease, combined with unilateral magnetic stimulation, were used to measure PNCT and CMAP of all subjects. PNCT was defined as the time from stimulation artifact to the onset of CMAP and diaphragm CMAP amplitude was measured from peak to peak. Oxygen desaturation index and apnea-hypopnea index were measured using PSG, and their relevance to PNCT and CMAP were analyzed. PNCT and CMAP in five OSAHS patients were repeatedly measured after effective nasal continuous positive airway pressure treatment for more than 2 months.MAIN OUTCOME MEAAURES: (1) PNCT and diaphragm CMAP of suhjects in each group. (2) Relevance of oxygen desaturation index and apnea-hypopnea index to PNCT and CMAP. (3