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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. Obstructive Sleep Apnea Syndrome (OSAS) Increases Pedestrian Injury Risk in Children

    Science.gov (United States)

    Avis, Kristin T.; Gamble, Karen L.; Schwebel, David C

    2014-01-01

    Objectives To evaluate pedestrian behavior, including reaction time, impulsivity, risk-taking, attention, and decision-making, in children with obstructive sleep apnea syndrome (OSAS) compared with healthy controls. Study design Using a case control design, sixty 8- to 16-year-olds with newly diagnosed and untreated OSAS engaged in a virtual reality pedestrian environment. Sixty-one healthy children matched using a yoke-control procedure by age, race, gender and household income served as controls. Results Children with OSAS were riskier pedestrians than healthy children of the same age, race, and sex. Children with OSAS waited less time to cross (p<.01). The groups did not differ in looking at oncoming traffic or taking longer to decide to cross. Conclusions Results suggest OSAS may have significant consequences on children’s daytime functioning in a critical domain of personal safety, pedestrian skills. Children with OSAS appeared to have greater impulsivity when crossing streets. Results highlight the need for heightened awareness of the consequences of untreated sleep disorders and identify a possible target for pediatric injury prevention. PMID:25444002

  3. 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.

  4. 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

  5. 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.

  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. Changes of plasma IL-6 and TNF-α levels after CPAP treatment in patients with obstructive sleep apnea syndrome (OSAS)

    International Nuclear Information System (INIS)

    Objective: To investigate the changes of plasma IL-6 and TNF-α levels after continuous positive airway pressure (CPAP) therapy in patients with obstructive sleep apnea syndrome (OSAS). Methods: Plasma IL-6 and TNF-α levels were measured with RIA in 60 patients with OSAS both before and after CPAS therapy as well as in 30 controls. Results: Before CPAP therapy, the plasma IL-6 and TNF-α levels in patients with OSAS were significantly higher than those in controls (25.92 ± 4.48pg/ ml and 11.27 ± 2.60pg/ml vs 13.21 ± 1.97pg/ml and 5.83±0.99pg/mi, P2 level (r=-0.495, 0.483, P<0.05). After treatment with CPAP for three months, the plasma IL-6 and TNF-α levels were significantly decreased (15.37±1.78pg/ml and 6.79±0.87pg/ml, vs pre-treatment levels, P<0.05, P<0.01). Conclusion: CPAP therapy could effectively decrease the plasma IL-6 and TNF-α levels in patients with OSAS. (authors)

  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 clinical and polysomnographic features in complex sleep apnea syndrome

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    İNÖNÜ, Handan; ÇİFTÇİ, Tansu Ulukavak; KÖKTÜRK, Oğuz

    2010-01-01

    Complex sleep apnea syndrome (CompSAS) is characterized by the onset of central apneas or a Cheyne-Stokes breathing pattern in some patients with obstructive sleep apnea syndrome (OSAS) who were treated with continuous positive airway pressure (CPAP). The etiology of CompSAS is unclear, but derangement of respiratory control has been proposed. We sought to compare clinical and polysomnography (PSG) features of patients with CompSAS and OSAS. Materials and methods: Records of PSG were evaluat...

  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

    Institute of Scientific and Technical Information of China (English)

    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. Videoradiography at submental electrical stimulation during apnea in obstructive sleep apnea syndrome

    International Nuclear Information System (INIS)

    Percutaneous submental electrical stimulation during sleep may be a new therapeutic method for patients with obstructive sleep apnea syndrome (OSAS). Electrical stimulation to the submental region during obstructive apnea is reported to break the apnea without arousal and to diminish apneic index, time spent in apnea, and oxygen desaturation. The mode of breaking the apnea by electrical stimulation has not yet been shown. However, genioglossus is supposed to be the muscle responsible for breaking the apnea by forward movement of the tongue. To visualize the effect of submental electrical stimulation, one patient with severe OSAS has been examined with videoradiography. Submental electrical stimulation evoked an immediate complex muscle activity in the tongue, palate, and hyoid bone. This was followed by a forward movement of the tongue which consistently broke obstructive apnea without apparent arousal. Time spent in apnea was diminished but intervals between apnea were not affected. (orig.)

  14. Videoradiography at submental electrical stimulation during apnea in obstructive sleep apnea syndrome; A case report

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    Hillarp, B.; Rosen, I.; Wickstroem, O. (Malmoe Allmaenna Sjukhus (Sweden). Dept. of Diagnostic Radiology Malmoe Allmaenna Sjukhus (Sweden). Dept. of Clinical Neurophysiology)

    1991-05-01

    Percutaneous submental electrical stimulation during sleep may be a new therapeutic method for patients with obstructive sleep apnea syndrome (OSAS). Electrical stimulation to the submental region during obstructive apnea is reported to break the apnea without arousal and to diminish apneic index, time spent in apnea, and oxygen desaturation. The mode of breaking the apnea by electrical stimulation has not yet been shown. However, genioglossus is supposed to be the muscle responsible for breaking the apnea by forward movement of the tongue. To visualize the effect of submental electrical stimulation, one patient with severe OSAS has been examined with videoradiography. Submental electrical stimulation evoked an immediate complex muscle activity in the tongue, palate, and hyoid bone. This was followed by a forward movement of the tongue which consistently broke obstructive apnea without apparent arousal. Time spent in apnea was diminished but intervals between apnea were not affected. (orig.).

  15. OBSTRUCTIVE SLEEP APNEA AND METABOLIC DYSFUNCTION IN POLYCYSTIC OVARY SYNDROME

    OpenAIRE

    Nitsche, Katie; Ehrmann, David A.

    2010-01-01

    Obstructive sleep apnea (OSA) is an underrecognized, yet significant factor in the pathogenesis of metabolic derangements in polycystic ovary syndrome (PCOS). Recent findings suggest that there may be two “subtypes” of PCOS, i.e. PCOS with or without OSA, and these two subtypes may be associated with distinct metabolic and endocrine alterations. PCOS women with OSA may be at much higher risk for diabetes and cardiovascular disease than PCOS women without OSA and may benefit from therapeutic i...

  16. 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.

  17. Obstructive sleep apnea hypopnea syndrome:a proinflammatory disorder

    Institute of Scientific and Technical Information of China (English)

    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.

  18. Diagnosis and Treatment of Obstructive Sleep Apnea Syndrome in Children.

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    Tsubomatsu, Chieko; Shintani, Tomoko; Abe, Ayumi; Yajima, Ryoto; Takahashi, Nozomi; Ito, Fumie; Takano, Kenichi; Himi, Tetsuo

    2016-01-01

    Sleep is important for children pertaining to their physical and mental growth. Obstructive sleep apnea syndrome (OSAS) in children has been shown to have different effects as compared to OSAS in adults, including deficits in cognition and neuropsychological functions, hyperactivity, ADHD, behavior problems, aggressive behavior, learning problems and nocturnal enuresis. Hypertrophy of the adenoids and tonsils is a major cause of OSAS in children; therefore, adenotonsillectomy may decrease the effects of OSAS pertaining to physical and mental growth. It is important to accurately diagnose and appropriately treat OSAS in children to prevent OSAS in their adulthood. PMID:27115764

  19. Measurement properties of patient-reported outcome measures (PROMs) in adults with obstructive sleep apnea (OSA): A systematic review.

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    Abma, Inger L; van der Wees, Philip J; Veer, Vik; Westert, Gert P; Rovers, Maroeska

    2016-08-01

    This systematic review summarizes the evidence regarding the quality of patient-reported outcome measures (PROMs) validated in patients with obstructive sleep apnea (OSA). We performed a systematic literature search of all PROMs validated in patients with OSA, and found 22 measures meeting our inclusion criteria. The quality of the studies was assessed using the consensus-based standards for the selection of health status measurement instruments (COSMIN) checklist. The results showed that most of the measurement properties of the PROMs were not, or not adequately, assessed. For many identified PROMs there was no involvement of patients with OSA during their development or before the PROM was tested in patients with OSA. Positive exceptions and the best current candidates for assessing health status in patients with OSA are the sleep apnea quality of life index (SAQLI), Maugeri obstructive sleep apnea syndrome (MOSAS) questionnaire, Quebec sleep questionnaire (QSQ) and the obstructive sleep apnea patient-oriented severity index (OSAPOSI). Even though there is not enough evidence to fully judge the quality of these PROMs as outcome measure, when interpreted with caution, they have the potential to add value to clinical research and clinical practice in evaluating aspects of health status that are important to patients. PMID:26433776

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

    OpenAIRE

    Mihaela Teodorescu; Polomis, David A.; Gangnon, Ronald E.; Fedie, Jessica E.; Flavia B. Consens; Chervin, Ronald D.; Teodorescu, Mihai C.

    2013-01-01

    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 diagnosi...

  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. 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

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

    OpenAIRE

    Karaşen, Rıza Murat; ÇİFTÇİ, Bülent; Acar, Baran; 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...

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

    OpenAIRE

    Paolo Ronchi; Valentina Cinquini; Alessandro Ambrosoli; Alberto Caprioglio

    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...

  5. 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.

  6. 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.

  7. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  9. Complications of hyoid suspension in the treatment of obstructive sleep apnea syndrome.

    NARCIS (Netherlands)

    Richard, W.; Timmer, F.C.A.; Tinteren, H. van; Vries, N de

    2011-01-01

    The objectives of the study are to assess adverse events and complications of hyoid suspension (HS) as a treatment of obstructive sleep apnea syndrome (OSAS). The study design was cohort. Thirty-nine patients with OSAS and obstruction at tongue base level, as assessed by sleep endoscopy, underwent H

  10. Complex Sleep Apnea Syndrome

    OpenAIRE

    Muhammad Talha Khan; Rose Amy Franco

    2014-01-01

    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, continu...

  11. Diet, Body Fat Distribution, and Serum Leptin in Young Men with Undiagnosed Obstructive Sleep Apnea Syndrome

    OpenAIRE

    Jones, Emily Taylor

    2008-01-01

    Background and Purpose: Little is known about influences of obstructive sleep apnea syndrome (OSAS) on dietary intake and body composition. The purpose of this study was to evaluate dietary status, body fat distribution and leptin in overweight young men with and without OSAS in comparison to published values for normal weight counterparts. Methods: Groups were comprised of 24 sedentary overweight young men with and without OSAS, who had a body mass index (BMI) greater than 25 kg/m2. Serum ...

  12. Obstructive sleep apnea syndrome in children: Epidemiology, pathophysiology, diagnosis and sequelae

    OpenAIRE

    Chang, Sun Jung; Chae, Kyu Young

    2010-01-01

    The prevalence of pediatric obstructive sleep apnea syndrome (OSAS) is approximately 3% in children. Adenotonsillar hypertrophy is the most common cause of OSAS in children, and obesity, hypotonic neuromuscular diseases, and craniofacial anomalies are other major risk factors. Snoring is the most common presenting complaint in children with OSAS, but the clinical presentation varies according to age. Agitated sleep with frequent postural changes, excessive sweating, or abnormal sleep position...

  13. Association of Serum Hepcidin Levels with the Presence and Severity of Obstructive Sleep Apnea Syndrome

    OpenAIRE

    Liu, Yu; Yu, Zhengang; Hua, Defeng; Yan CHEN; Zheng, Shiliang; Wang, Leqiang

    2015-01-01

    Background Inflammation is thought to be involved in the pathogenesis of obstructive sleep apnea syndrome (OSAS). Hepcidin, a 25-kD peptide hormone produced by the liver, modulates acute inflammatory responses. This study aimed to determine the association of serum levels of hepcidin with the presence and severity of OSAS. Material/Methods We enrolled 184 patients with OSAS and 110 healthy subjects. Serum levels of hepcidin were evaluated using enzyme-linked immunosorbent assay (ELISA) method...

  14. 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.

  15. Complex Sleep Apnea Syndrome

    Directory of Open Access Journals (Sweden)

    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.

  16. 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.

  17. [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. PMID:11436699

  18. 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.

  19. 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

  20. Pure Obstructive Sleep Apnea Syndrome and Erectile Dysfunction

    Directory of Open Access Journals (Sweden)

    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.

  1. Relationships between Body Fat Distribution, Epicardial Fat and Obstructive Sleep Apnea in Obese Patients with and without Metabolic Syndrome

    OpenAIRE

    Carla Lubrano; Maurizio Saponara; Giuseppe Barbaro; Palma Specchia; Eliana Addessi; Daniela Costantini; Marta Tenuta; Gabriella Di Lorenzo; Giuseppe Genovesi; Donini, Lorenzo M; Andrea Lenzi; Lucio Gnessi

    2012-01-01

    BACKGROUND: Obstructive sleep apnea (OSA) and metabolic syndrome, both closely related to obesity, often coexist in affected individuals; however, body mass index is not an accurate indicator of body fat and thus is not a good predictor of OSA and other comorbidities. The aim of this study was to investigate whether the occurrence of OSA could be associated with an altered body fat distribution and a more evident cardio metabolic risk independently from obesity and metabolic syndrome. METHODS...

  2. 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.

  3. 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

  4. Obstructive Sleep Apnea

    Science.gov (United States)

    ... to find out more. Obstructive Sleep Apnea Obstructive Sleep Apnea Obstructive sleep apnea (OSA) is a serious ... to find out more. Obstructive Sleep Apnea Obstructive Sleep Apnea Obstructive sleep apnea (OSA) is a serious ...

  5. 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

  6. 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.

  7. The prevalence of obstructive sleep apnea in symptomatic patients with syndromic craniosynostosis.

    Science.gov (United States)

    Inverso, G; Brustowicz, K A; Katz, E; Padwa, B L

    2016-02-01

    The reported prevalence of obstructive sleep apnea (OSA) in patients with syndromic craniosynostosis (SCS) varies due to inconsistent definitions of OSA, lack of uniform diagnostic testing, and different mixes of syndromic diagnoses. The purpose of this study was to determine the prevalence of OSA in symptomatic patients with SCS, and to determine whether this differs by phenotypic diagnosis. A retrospective cohort study of children with SCS was conducted. The primary outcome was presence of OSA diagnosed by polysomnography. The prevalence of OSA was calculated and stratified by diagnosis to compare differences in prevalence and severity (mild, moderate, or severe). The prevalence of OSA in symptomatic patients was 74.2%. Patients with Apert syndrome had the highest prevalence (80.6%), followed by Pfeiffer, Crouzon with acanthosis nigricans, and Crouzon syndromes (72.7%, 66.7%, and 64.7%, respectively). Severe OSA was most common in patients with Pfeiffer syndrome (45.5%), while patients with Apert and Crouzon syndromes were more likely to have moderate OSA (29.0% and 23.5%, respectively). Given that 56.4% of patients with SCS are symptomatic and that 74.2% of these symptomatic patients have OSA, it is recommended that a screening level I polysomnography be part of the clinical care for all patients with SCS. PMID:26602951

  8. 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...

  9. 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.

  10. Neuroendocrine Alterations in Obese Patients with Sleep Apnea Syndrome

    Directory of Open Access Journals (Sweden)

    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.

  11. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  13. Evaluation of Ocular Surface Health in Patients with Obstructive Sleep Apnea Syndrome

    Directory of Open Access Journals (Sweden)

    Emine Esra Karaca

    2016-06-01

    Full Text Available Objectives: To evaluate ocular surface health in obstructive sleep apnea syndrome (OSAS and to investigate the tendency of these patients toward dry eyes. Materials and Methods: Fifty patients who underwent polysomnography and were diagnosed with OSAS and 50 normal control subjects were compared with respect to ocular surface disease index (OSDI, Schirmer I test and tear film break-up time (TBUT values. Results: Patients were grouped as mild (n=15, 30%, moderate (n=15, 30% and severe (n=20, 40% according to apnea-hypopnea index values. The right eyes of patients were included in both groups. OSDI values were as follows: control group, 18.7±8.5; mild OSAS group, 40.2±2.8; moderate OSAS group, 48.5±2.2 and severe OSAS group, 62.7±2.3 (p<0.001. TBUT values were as follows: control group, 12.3±4.9; mild OSAS group, 8.2±4.7; moderate OSAS group, 5.8±2.1 and severe OSAS group, 4.2±3.7 (p<0.001. Schirmer values were as follows: control group, 18±6.1 mm; mild OSAS group, 12.9±6.7 mm; moderate OSAS group, 8.5±5.2 mm and severe OSAS group, 7.9±4.7 mm (p<0.001. Conclusion: Patients with OSAS seem to have a tendency toward dry eyes. Clinicians should be aware of dry eye development in these patients

  14. 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.

  15. Sleep disordered breathing: OSA, CSA, Pathophysiology and Diagnosis

    OpenAIRE

    Vijayan, V. K.

    2014-01-01

    Obstructive sleep apnea syndrome (OSAS) is a prevalent disorder that has beenreported to occur in 2 to 4% of middle-aged adults. A similar prevalence of OSAS hasbeen reported from India as well. However, this condition is frequently unrecognizedand underdiagnosed. Important pathophysiological changes in patients withobstructive sleep apnea (OSA) is an alteration in human upper airway leading to areduction in cross-sectional area of the upper airway contributing to the easycollapsibility of up...

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

    Directory of Open Access Journals (Sweden)

    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.

  17. Analysis of the correlations between oxidative stress, gelatinases and their tissue inhibitors in the human subjects with obstructive sleep apnea syndrome.

    Science.gov (United States)

    Hopps, E; Lo Presti, R; Montana, M; Canino, B; Calandrino, V; Caimi, G

    2015-12-01

    Obstructive sleep apnea syndrome (OSAS) is commonly associated with endothelial dysfunction, atherosclerosis and cardiovascular disorders. On the basis of this observation, our aim was to examine the oxidative status and the matrix metalloproteases (MMP) profile in a group of subjects with OSAS. We enrolled 48 subjects with OSAS defined after a 1-night cardiorespiratory sleep study, who were subsequently subdivided in two subgroups according to the severity of OSAS (low grade = L-OSAS; high grade= H-OSAS). We measured the parameters of oxidative stress, such as lipid peroxidation, protein oxidation, total antioxidant status (TAS), nitric oxide metabolites (NOx), and the plasma concentrations of the gelatinases (MMP-2 and MMP-9) and their tissue inhibitors (TIMP-1 and TIMP-2). We found a significant impairment of oxidative status in H-OSAS compared to L-OSAS and higher plasma levels of MMP-9 and TIMP-1 in H-OSAS compared to L-OSAS. In this study we observed a positive correlation between TBARS and MMP-9, a positive correlation between PC and MMP-9, and a negative correlation between NOx and MMP-9, especially in the whole group of OSAS subjects. These data underline how strong interrelationships among some parameters of the oxidative stress, in particular those reflecting lipid peroxidation, protein oxidation and NOx, and MMP-9 are evident in OSAS subjects. All these information may be useful in the clinical practice keeping in mind the cardiovascular complications generally accompanying the obstructive sleep apnea syndrome. PMID:26769829

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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.  

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

    Science.gov (United States)

    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

  1. Intraoperative BiPAP in OSA Patients

    OpenAIRE

    Singh, Bhavna P; NS, Kodandaram

    2015-01-01

    Obstructive sleep apnea syndrome (OSA) is characterized by recurrent episodes of partial or complete upper airway obstructions during sleep. Severe OSA presents with a number of challenges to the anesthesiologist, the most life threatening being loss of the airway. We are reporting a case where we successfully used intraoperative bi level positive pressure ventilation (BiPAP) with moderate sedation and a regional technique in a patient with severe OSA posted for total knee replacement (TKR). ...

  2. 阻塞性睡眠呼吸暂停综合征动物模型的建立方法%An animal model of obstructive sleep apnea syndrome

    Institute of Scientific and Technical Information of China (English)

    杨蕾; 胡滢洁; 张孝文

    2012-01-01

    Obstructive sleep apnea syndrome(OSAS) is endangering human health seriously now. We had reviewed some typical animal model which had at least one OSAS character of intermittent hypoxia and/or hypercap-nia, upper airway obstruction and sleep structure disorder. However, all of these models could not simulate clinical and pathological features of OSAS completely. Establishing a suitable animal model to study OSAS and related diseases is very important.

  3. Bone mineral density and changes in bone metabolism in patients with obstructive sleep apnea syndrome.

    Science.gov (United States)

    Terzi, Rabia; Yılmaz, Zahide

    2016-07-01

    The aim of this study was to evaluate the differences between patients with obstructive sleep apnea syndrome (OSAS) and phenotypically similar subjects without OSAS in terms of bone mineral density (BMD) and bone turnover markers. The study was conducted on 30 males diagnosed with OSAS and 20 healthy males. All subjects underwent polysomnographic testing. Calcium, phosphorus parathyroid hormone, thyroid stimulating hormone, bone-specific alkaline phosphatase, 25-hydroxyvitamin D3, osteocalcin, and beta-CrossLaps (β-CTx) were measured. BMD in the lumbar spine (L1-L4) and femoral neck was measured by dual energy X-ray absorptiometry. There was no statistically significant difference between the two groups in terms of demographic data with the exception of bone mass index and waist circumference. (p < 0.05). Analyses showed significantly lower BMD measurements in the femoral neck and T-scores in the femoral neck in patients diagnosed with OSAS. Serum β-CTx levels were found to be statistically significantly higher in the OSAS group (p = 0.017). In multivariate assessments performed for apnea/hypopnea index values, mean saturation O2 levels were found to be significantly associated with osteocalcin levels and neck BMD. OSAS patients might represent a risk group with respect to loss of BMD and bone resorption. It is important to evaluate bone loss in these patients. Further studies should be carried out on larger study populations to evaluate the effects of chronic hypoxia on BMD in detail. PMID:26204846

  4. Obstructive sleep apnea syndrome and cardiovascular disease: The influence of C-reactive protein.

    Science.gov (United States)

    Bouloukaki, Izolde; Mermigkis, Charalampos; Kallergis, Eleftherios M; Moniaki, Violeta; Mauroudi, Eleni; Schiza, Sophia E

    2015-05-20

    Obstructive sleep apnea syndrome (OSAS) is a common medical condition, associated with atherosclerosis and cardiovascular disease (CVD). The underlying pathophysiologic mechanisms of this association have not been completely understood and may be multifactorial in origin. A number of studies suggest that inflammatory processes have emerged critical in the pathogenesis of CVD in OSAS. A range of circulating inflammatory molecules has been identified and measured, with a view to assess inflammation and predict vascular damage risk, such as plasma cytokines, adhesion molecules, and C-reactive protein (CRP). CRP is a relevant marker worthy of further study, because not only is elevated in patients with OSAS, but also is rapidly becoming a risk factor for cardiac disease. Furthermore, in selected OSAS patients, aggressive treatment of the disorder may lead to retarding or even improvement of CVD progression. However, still there is a debate on the true correlation between CRP and OSAS, as well as the clinical effect of any reduction after OSAS treatment. Further research is required to define those OSAS patients who will have a considerable reduction with treatment, as well as to understand the significance of the interaction between cardiovascular risk factor and CRP reduction in patients with OSAS. PMID:25992322

  5. 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

  6. 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

    2015-01-01

    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

  7. Normal-tension glaucoma and obstructive sleep apnea syndrome: a prospective study

    OpenAIRE

    Bilgin, Gorkem

    2014-01-01

    Background Today, identified risk factors for normal-tension glaucoma (NTG) include abnormal ocular blood flow, abnormal blood coagulation, systemic hypotension, ischemic vascular disorders, and autoimmune diseases. However, pathogenesis of the condition remains unclear. On the other hand, there are also a few studies suggesting that the obstructive sleep apnea syndrome (OSAS) may compromise optic nerve head perfusion and cause glaucomatous optic neuropathy by creating transient hypoxemia and...

  8. Relationship between obesity with symptoms and findings of obstructive sleep apnea syndrome

    OpenAIRE

    Ünlü, Murat; İriz, Ayşe; Doğan, Berçem Ayçiçek; Dinç, A. Seçil Kayalı; Dursun, Engin; Eryılmaz, Adil; Acar, Aydın

    2014-01-01

    Objective: To evaluate the effect of obesity on obstructive sleep apnea syndrome (OSAS) by means of objective and subjective data. Methods: A total of 70 patients were divided into obese (n=38; BMI>35 kg/m2) and non-obese patient groups (n=32; BMI Results: Obese patients had an average Mallampati score of Class III while the non-obese study participants had...

  9. Relationship between the severity of obstructive sleep apnea syndrome and asymptomatic cerebrovascular disease

    International Nuclear Information System (INIS)

    In this study, examined were prevalence of asymptomatic cerebrovascular disease (ACD) in patients with obstructive sleep apnea syndrome (OSAS) and relationship between its severity and ACD prevalence. Subjects were 192 cases (M 170/F 20, av. age 50.6 y) with chief complaint of snore, sleep apnea (apnea-hypopnea index/AHI 0-118.4/h), midday drowsiness and so on without CD history, who underwent the overnight polysomnographic recording, vascular risk assessment like life habits, blood pressure and impaired GT, and brain MRI. The last item was conducted with Siemence 1.5T machine to get T1-, T2-weighted and FLAIR images to evaluate asymptomatic lacunar infarction (ALI) and periventricular hyperintensity (PVH). Light (AHI<15/h), moderate (15≤AHI<30) and severe (AHI≥30) OSASs were found in 44, 35 and 61 cases, respectively. ALIs were found in 7 light, 17 moderate and 61 severe cases and PVH, in 9, 19 and 61 cases, respectively. Thus it was revealed that patients with moderate to severe OSAS had complication of ACD in a higher rate than those with light OSAS and that prevalence of ACD was higher in OSAS patients with AHI 15/h or more. (R.T.)

  10. Estudo epidemiológico das alterações estruturais da cavidade nasal associadas à síndrome da apnéia e hipopnéia obstrutiva do sono (SAHOS Epidemiological analysis of structural alterations of the nasal cavity associated with obstructive sleep apnea syndrome (OSA

    Directory of Open Access Journals (Sweden)

    Levon Mekhitarian Neto

    2005-08-01

    Full Text Available OBJETIVO: Mostrar que alterações estruturais da cavidade nasal, como desvio do septo do nariz e a hipertrofia dos cornetos inferiores, são altamente incidentes em pacientes com síndrome da apnéia e hipopnéia do sono e devem ser abordados associados aos procedimentos específicos da síndrome. FORMA DE ESTUDO: Clínico retrospectivo. CASUÍSTICA E MÉTODO: Realizamos um estudo retrospectivo em 200 pacientes, 196 homens e 4 mulheres, atendidos no ambulatório de otorrinolaringologia do Hospital Prof. Edmundo Vasconcelos e Unidade Paulista de Otorrinolaringologia, todos com controle polissonográfico, exame físico otorrinolaringológico, endoscópico e o tratamento cirúrgico com procedimentos nasais e faríngeos. RESULTADOS: Todos tiveram procedimento cirúrgico faríngeo: uvulopalatofaringoplastia ou uvulopalatoplastia, e no nariz: 176 septoplastias com turbinectomia parcial (88% e 24 turbinectomias isoladas (12%, com resultados satisfatórios. CONCLUSÃO: Podemos concluir que as alterações estruturais da cavidade nasal têm alta incidência nos pacientes com SAHOS.AIM: The objective of this paper is to demonstrate that structural alterations of the nasal cavity, e.g. septal deviation and conchal hypertrophy have high incidence in patients with sleep apnea and hypopnea syndrome and must be addressed with associated specific procedures of the syndrome. TYPE OF STUDY: Clinical retrospective. CASUISTIC AND METHOD: A retrospective study of 200 patients was performed, with 196 male and 4 female, attended at the otorhinolaryngology ambulatory of Hospital Prof. Edmundo Vasconcelos and Unidade Paulista de Otorrinolaringologia, all of them subjected to polysomnography, otorhinolaryngological physical exam, endoscopy exam, and surgical treatment with nasal and pharyngeal procedures. RESULTS: All of them were subjected to pharyngeal procedure: uvulopalatopharyngoplasty or uvulopalatoplasty and nose procedure: 176 septoplasty with partial

  11. 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.

  12. 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.

  13. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  14. Cerebral Blood Flow Response to Hypercapnia in Children with Obstructive Sleep Apnea Syndrome

    Science.gov (United States)

    Busch, David R.; Lynch, Jennifer M.; Winters, Madeline E.; McCarthy, Ann L.; Newland, John J.; Ko, Tiffany; Cornaglia, Mary Anne; Radcliffe, Jerilynn; McDonough, Joseph M.; Samuel, John; Matthews, Edward; Xiao, Rui; Yodh, Arjun G.; Marcus, Carole L.; Licht, Daniel J.; Tapia, Ignacio E.

    2016-01-01

    Study Objectives: Children with obstructive sleep apnea syndrome (OSAS) often experience periods of hypercapnia during sleep, a potent stimulator of cerebral blood flow (CBF). Considering this hypercapnia exposure during sleep, it is possible that children with OSAS have abnormal CBF responses to hypercapnia even during wakefulness. Therefore, we hypothesized that children with OSAS have blunted CBF response to hypercapnia during wakefulness, compared to snorers and controls. Methods: CBF changes during hypercapnic ventilatory response (HCVR) were tested in children with OSAS, snorers, and healthy controls using diffuse correlation spectroscopy (DCS). Peak CBF changes with respect to pre-hypercapnic baseline were measured for each group. The study was conducted at an academic pediatric sleep center. Results: Twelve children with OSAS (aged 10.1 ± 2.5 [mean ± standard deviation] y, obstructive apnea hypopnea index [AHI] = 9.4 [5.1–15.4] [median, interquartile range] events/hour), eight snorers (11 ± 3 y, 0.5 [0–1.3] events/hour), and 10 controls (11.4 ± 2.6 y, 0.3 [0.2–0.4] events/hour) were studied. The fractional CBF change during hypercapnia, normalized to the change in end-tidal carbon dioxide, was significantly higher in controls (9 ± 1.8 %/mmHg) compared to OSAS (7.1 ± 1.5, P = 0.023) and snorers (6.7 ± 1.9, P = 0.025). Conclusions: Children with OSAS and snorers have blunted CBF response to hypercapnia during wakefulness compared to controls. Noninvasive DCS blood flow measurements of hypercapnic reactivity offer insights into physiopathology of OSAS in children, which could lead to further understanding about the central nervous system complications of OSAS. Citation: Busch DR, Lynch JM, Winters ME, McCarthy AL, Newland JJ, Ko T, Cornaglia MA, Radcliffe J, McDonough JM, Samuel J, Matthews E, Xiao R, Yodh AG, Marcus CL, Licht DJ, Tapia IE. Cerebral blood flow response to hypercapnia in children with obstructive sleep apnea syndrome. SLEEP 2016

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

    Institute of Scientific and Technical Information of China (English)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  17. 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.

  18. 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

  19. Impact of non-dipping on cardiovascular outcomes in patients with obstructive sleep apnea syndrome.

    Science.gov (United States)

    Sasaki, Nobuo; Ozono, Ryoji; Edahiro, Yoshinobu; Ishii, Kiyomi; Seto, Ayako; Okita, Tomomi; Teramen, Kazushi; Fujiwara, Saeko; Kihara, Yasuki

    2015-01-01

    Obstructive sleep apnea syndrome (OSAS) is a risk factor for cardiovascular events. However, it is unclear how OSAS contributes to the events. We investigated the impact of non-dipping on the incidence of cardiovascular events in a retrospective cohort study comprising 251 patients with OSAS. OSAS was diagnosed by overnight polysomnography and all patients underwent 24-h ambulatory blood pressure monitoring. Non-dipping was diagnosed when reduction in sleep blood pressure was <10% of awake blood pressure. Over a mean 43-month follow-up period, 15 patients (6.0%) developed cardiovascular events including stroke, heart failure, and ischemic heart disease. Significantly higher cardiovascular events were observed in the non-dipping group than those without it by Kaplan-Meier analyses. Cox regression analysis revealed that the presence of non-dipping was significantly and independently associated with the incidence of cardiovascular events (hazard ratio, 3.88; 95% confidence interval, 1.19-17.41; p < 0.05), after adjusting for severity of OSAS, and CPAP therapy. Thus, non-dipping was a marker for a poor prognosis in patients with OSAS. PMID:26395950

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

    Institute of Scientific and Technical Information of China (English)

    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.

  1. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  3. Sleep disordered breathing: OSA, CSA, Pathophysiology and Diagnosis

    Directory of Open Access Journals (Sweden)

    V K Vijayan

    2014-03-01

    Full Text Available Obstructive sleep apnea syndrome (OSAS is a prevalent disorder that has beenreported to occur in 2 to 4% of middle-aged adults. A similar prevalence of OSAS hasbeen reported from India as well. However, this condition is frequently unrecognizedand underdiagnosed. Important pathophysiological changes in patients withobstructive sleep apnea (OSA is an alteration in human upper airway leading to areduction in cross-sectional area of the upper airway contributing to the easycollapsibility of upper airway during sleep. Other pathophysiological changes in OSAare oxidative stress, systemic inflammation, sympathetic nerve activation, endothelialdysfunction, procoagulant activity, intrathoracic pressure changes and metabolicdysregulation. The gold standard for diagnosis of OSA is full polysomnography.Key words: Obstructive sleep apnea, Central sleep apnea, Oxidative stress,Metabolic dysregulation, Polysomnography

  4. 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.

  5. Effect of continuous positive airway pressure ventilation on prethrombotic state in patients with obstructive sleep apnea-hypopnea syndrome

    International Nuclear Information System (INIS)

    To investigate the prethrombotic state (PTS) in patients with obstructive sleep apnea syndrome (OS-AS) and the effect of continuous positive airway pressure ventilation (CPAP) on their PTS, the blood samples of 49 patients with OSAS were taken before treatment and on day 30 after treatment respectively. The platelet aggregation ( PAG), P-selections, endothdlin-1 (ET-1) and plasma vom willebrand factor (vWF) in 49 patients and 42 health controls were detected by radioimmunoassay and enzyme-immunoassay. The results showed that the PAG, P-selections, ET-1 and vWF in patients with OSAS before treatment were significantly higher than those after treatment and in control group (P0.05). The results indicate that there were PTS in most patients with OSAS before treatment. The activity of platelet could be corrected, and the function of endotheliocyte could be repaired after CPAP treatment. It had certain effect in lightening the clinical symptoms. (authors)

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

    Directory of Open Access Journals (Sweden)

    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.

  7. 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.

  8. Obstructive sleep apnea syndrome in children: Epidemiology, pathophysiology, diagnosis and sequelae.

    Science.gov (United States)

    Chang, Sun Jung; Chae, Kyu Young

    2010-10-01

    The prevalence of pediatric obstructive sleep apnea syndrome (OSAS) is approximately 3% in children. Adenotonsillar hypertrophy is the most common cause of OSAS in children, and obesity, hypotonic neuromuscular diseases, and craniofacial anomalies are other major risk factors. Snoring is the most common presenting complaint in children with OSAS, but the clinical presentation varies according to age. Agitated sleep with frequent postural changes, excessive sweating, or abnormal sleep positions such as hyperextension of neck or abnormal prone position may suggest a sleep-disordered breathing. Night terror, sleepwalking, and enuresis are frequently associated, during slow-wave sleep, with sleep-disordered breathing. Excessive daytime sleepiness becomes apparent in older children, whereas hyperactivity or inattention is usually predominant in younger children. Morning headache and poor appetite may also be present. As the cortical arousal threshold is higher in children, arousals are not easily developed and their sleep architectures are usually more conserved than those of adults. Untreated OSAS in children may result in various problems such as cognitive deficits, attention deficit/hyperactivity disorder, poor academic achievement, and emotional instability. Mild pulmonary hypertension is not uncommon. Rarely, cardiovascular complications such as cor pulmonale, heart failure, and systemic hypertension may develop in untreated cases. Failure to thrive and delayed development are serious problems in younger children with OSAS. Diagnosis of pediatric OSAS should be based on snoring, relevant history of sleep disruption, findings of any narrow or collapsible portions of upper airway, and confirmed by polysomnography. Early diagnosis of pediatric OSAS is critical to prevent complications with appropriate interventions. PMID:21189956

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

    Science.gov (United States)

    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.

  10. 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.

  11. 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.

  12. Ophthalmic Diseases in Patients With Obstructive Sleep Apnea.

    Science.gov (United States)

    Skorin, Leonid; Knutson, Rachel

    2016-08-01

    Symptomatic obstructive sleep apnea (OSA) affects 2% of women and 4% of men, but the prevalence of asymptomatic OSA is significantly higher. Several ophthalmic conditions are associated with OSA, including floppy eyelid syndrome, glaucoma, nonarteritic anterior ischemic optic neuropathy, papilledema, keratoconus, and central serous chorioretinopathy. The purpose of this review is to provide primary care physicians with a general knowledge of the signs, symptoms, and management of the ophthalmic diseases associated with OSA. PMID:27455101

  13. Volumetric MR imaging of the upper airway in obstructive sleep apnea syndrome

    International Nuclear Information System (INIS)

    Structural abnormalities in the upper airway and surrounding soft tissues may contribute to the obstructive sleep apnea syndrome (OSAS). The authors have utilized MR imaging (3-mm contiguous T1-weighted sagittal images obtained with a local coil at 1.5 T) combined with a computer graphics-based analysis of three-dimensional geometry to study the upper airways of 10 awake, supine normal subjects (29--50 years-old), seven patients with OSAS (34--54 years old), and a nonapneic snorer (24 years old). Upper-airway anatomic segments were compared with regard to regional volumes, minimum cross-sectional areas, and pharyngeal wall thickness. Results to date show a smaller retropalatial airway volume in the patients with OSAS (1.8 cm3 ± 0.8 [SEM]) and a smaller minimum cross-sectional retropalatal area in patients with OSAS (0.45 cm2) than in the nonapneic snorer (0.9 cm2) and the normal subjects (2.5 cm2 ± 0.2)

  14. Hypothyroidism in patients with obstructive sleep apnea syndrome

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    Sibel Ayık

    2014-09-01

    Full Text Available Objective: In this study, we aimed to search the possible association between Obstructive Sleep Apnea Syndrome’s (OSAS severity and thyroid gland malfunctions, and the effects of hypothyroidism on the mode of sleep in patients with OSAS. Methods:Demographic features and thyroid function tests of 211 patients (59, 28% female with a mean age of 50.9 ± 10.4 years (ranging from 30 to 75 who underwent polysomnography between September 2010 and September 2011 were retrospectively evaluated. Results: Hypothyroidism was detected in 8.3% of the patients with simple snoring and 10.6% of those with OSAS (9.1% in mild OSAS, 20.3% in moderate OSASand 6.3% in severe OSAS. There was no correlation between the severity of OSAS and the rate of hypothyroidism (p=0.620. The incidence of ypothyroidism was 16.9% in women and 6.6% in men and this difference was statistically significant (p=0.024. The polysomnographic findings did not differ between the patients with hypothyroidism and the others (table 5. However, in patients with elevated TSH levels, the rate of desaturation during sleep was high despite a lower AHI (r=0.126, p=0.05. Conclusion: No correlation was seen between the severity of OSAS and the rate of hypothyroidism. Women with OSAS had higher incidence of hypothyroidism. The polysomnographic findings did not differ whether the patient had hypothyroidism or not. The rate of desaturation during sleep was relatively high in patients with elevated TSH levels.

  15. 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

  16. 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

  17. MRI analysis on soft tissue around upper airway in obese adolescent patients with obstructive sleep apnea syndrome

    International Nuclear Information System (INIS)

    Objective: To investigate the correlation of soft tissue structure of upper airway with the pathogenesis of obstructive sleep apnea syndrome (OSAS) in adolescents age group by analyzing magnetic resonance imaging (MRI) of upper airway. Methods: The subjects were divided into obese OSAS, obese controls and normal weight controls groups according to the results from polysomnography and body mass index measurements; Upper airway was scanned by MRI sagittally and axially; upper airway at all levels and soft tissue was analyzed by Amira Medical image analysis system. Results: Tongue volumes in obese OSAS and obese controls were significantly greater than that in normal weight controls (P<0.05); tonsil and adenoid volumes in obese OSAS were significantly higher than those in two control groups (P<0.05 or P<0.001), but no significant difference was found between two control groups. The volumes of lateral pharyngeal wall in obese OSAS were higher than those in obese controls and normal weight controls (P<0.05 or P<0.001), and they were higher in obese controls compared with normal weight controls (P<0.05). In obese OSAS group, positive correlations were found between volumes of lateral pharyngeal wall and apnea/hypopnea index (AHI) (r=0.879, P<0.01), as well volumes of tonsils and AHI (r=0.824, P<0.01). Conclusion: Obesity can increase the soft tissue volumes around upper airway, there by increase the upper airway obstruction; lateral pharyngeal wall and adenoid volumes play major roles in evaluating the severity of OSAS in adolescents. (authors)

  18. 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.

  19. Sleep apnea syndrome after irradiation of the neck

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    Herlihy, J.P.; Whitlock, W.L.; Dietrich, R.A.; Shaw, T. (Pulmonary Disease Service, Presidio of San Francisco, CA (USA))

    1989-12-01

    After irradiation of the neck for a squamous cell carcinoma of the tonsillar pillar and vocal cord, a 71-year-old man presented with a rapidly progressive sleep apnea syndrome. Previous reports describe the condition of patients with obstructive sleep apnea that developed after neck irradiation and secondary to supraglottic edema. Our patient had an obstructive component to his apnea similar to that described in previous cases, but, in addition, he had hypothyroidism. Myxedema is a well-described cause of both obstructive and central apnea. We believe both contributed to his condition. He was successfully treated by placement of a tracheostomy and by thyroid supplementation. In patients who present with sleep apnea after neck irradiation, especially with acute or severe symptoms, the differential diagnosis should include both a central cause from hypothyroidism as well as a peripheral obstructive cause from laryngeal edema.

  20. Sleep apnea syndrome after irradiation of the neck

    International Nuclear Information System (INIS)

    After irradiation of the neck for a squamous cell carcinoma of the tonsillar pillar and vocal cord, a 71-year-old man presented with a rapidly progressive sleep apnea syndrome. Previous reports describe the condition of patients with obstructive sleep apnea that developed after neck irradiation and secondary to supraglottic edema. Our patient had an obstructive component to his apnea similar to that described in previous cases, but, in addition, he had hypothyroidism. Myxedema is a well-described cause of both obstructive and central apnea. We believe both contributed to his condition. He was successfully treated by placement of a tracheostomy and by thyroid supplementation. In patients who present with sleep apnea after neck irradiation, especially with acute or severe symptoms, the differential diagnosis should include both a central cause from hypothyroidism as well as a peripheral obstructive cause from laryngeal edema

  1. 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.

  2. 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.

  3. [Depressive symptomatology and sleep apnea syndrome].

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    Pochat, M D; Ferber, C; Lemoine, P

    1993-01-01

    The sleep apnea syndrome (SAS), which is defined by more than 5 apneas or hypopneas per hour of sleep (9), is quite a frequent affection which concerns 1.4 to 10% of general population (1.7). The major daytime complaints of the SAS are daytime sleepiness, memory and attention disorders, headaches and asthenia especially in the morning, and sexual impotence (9). The nocturnal manifestations are dominated by sonorous and generally long standing snoring, increased by dorsal decubitus and intake of alcohol, with repeated interruptions by respiratory arrests. These manifestations are always noted but rarely spontaneously reported. The sleep, non refreshing, is agitated and perturbed by numerous awakenings. The findings of the clinical examination are poor: obesity is found in 2/3 of the cases and arterial hypertension in 1/2 of the cases (20). Polygraphic recording during sleep only permits an absolute diagnosis. This frequent affection is a real problem of public health because of its numerous complications (3, 10, 12, 13, 18, 21). Symptoms of depression are often found when a patient with a SAS is examined and conversely, symptoms which evoke a SAS can be found in the clinical examination of depressed patients. We decided so to study the thymic and anxious status of 24 patients investigated for a SAS and submitted to a polygraphic recording during sleep. Four clinical parameters were studied: DSM III-R diagnosis criteria, Montgomery and Asberg Depression Rating Scale (MADRS), Hamilton Anxiety Rating Scale (HARS) and thymasthenia rating scale of Lecrubier, Payan and Puech. We also reported Total Sleep Time (TST = 6.5 +/- 1.5), Apnea Hypopnea Index (AHI = 26.7 +/- 21.6), number (2.1 +/- 2.8/h) and duration (174.2 +/- 150.8 s/h) of hypoxic events. Results showed that among 24 patients, 8 were depressed according to DSM III-R diagnosis criteria and had MADRS > 25, 22 were anxious, 11 had a major anxiety (HARS > 15) and 15 presented thymasthenia (SET > 15). Significative

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

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    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.

  5. Evaluation of Autonomic Dysfunction in Obstructive Sleep Apnea Syndrome

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    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

  6. 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

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    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

  7. 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.

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

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    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.

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

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    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.

  10. 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.

  11. Endocrine and Metabolic Aspects of OSA

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    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.

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

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    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

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

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    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

  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. 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.

  16. Obstructive Sleep Apnea (OSA and depressive symptoms Sintomas depressivos e síndrome de apnéia obstrutiva do sono

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    Michele Dominici

    2009-03-01

    Full Text Available BACKGROUND: The relationship between obstructive sleep apnea (OSA and depressive symptoms is ambiguous in the literature. PURPOSE: To investigate if there is a correlation between depressive symptoms and the severity of OSA. METHOD: A retrospective, cross-sectional study of data from 123 consecutive adults patients with neither mental illness nor psychotropic drugs intake, referred to a sleep laboratory for an evaluation of OSA. For the statistical analysis (uni- and multivariate, we used the following variables: gender and age, as well as scores based on several scales and indexes such as Beck Depressive Inventory (BDI, Epworth Sleepiness Scale (ESS, Body Mass Index (BMI and Apnea-Hypopnea Index (AHI. RESULTS: Univariate analysis found a weak but statistically significant negative correlation between BDI and AHI. However, with the multivariate logistic regression analysis model, the inverse relation between AHI and BDI no longer has statistical significance. CONCLUSION: There is no causal relationship between OSA and depressive symptoms in the population studied.CONTEXTO: A relação entre apnéia obstrutiva do sono (AOS e sintomas depressivos é ambígua na literatura. OBJETIVO: Investigar se há relação entre sintomas depressivos e intensidade da AOS. MÉTODO: Estudo transversal e retrospectivo com 123 pacientes adultos, consecutivamente atendidos em laboratório de sono, para avaliar AOS, sem transtornos mentais nem uso de psicotrópicos. Para análise estatística (uni e multivariada, utilizamos as seguintes variáveis: sexo e idade, além de escores de diversas escalas: Escala de Depressão de Beck (EDB, Escala de Sonolência diurna de Epworth (EPW, Índice de Massa Corporal e o Índice de Apnéia /Hipopnéia (IAH. RESULTADOS: A análise univariada demonstrou fraca, mas estatisticamente significativa relação negativa entre EDB e IAH. Porém, na análise multivariada por regressão logística, esta relação inversa perdeu sua signific

  17. Risk assessment of obstructive sleep apnea syndrome in pediatric patients with vitamin D deficiency: A questionnaire-based study.

    Science.gov (United States)

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

    2016-09-01

    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

  18. 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.

  19. [Are there alternative therapeutical options other than CPAP in the treatment of the obstructive sleep apnea syndrome].

    Science.gov (United States)

    Randerath, W; Bauer, M; Blau, A; Fietze, I; Galetke, W; Hein, H; Maurer, J T; Orth, M; Rasche, K; Rühle, K-H; Sanner, B; Stuck, B A; Verse, T

    2007-07-01

    Many patients with the obstructive sleep apnea syndrome (OSAS) look for alternative conservative or surgical therapies to avoid to be treated with continuous positive airway pressure. In view of the high prevalence and the relevant impairment of the patients lots of methods are offered which promise definitive cure or relevant improvement of OSAS. The working group "Apnea" in the German Society of Sleep Medicine and Research established a task force to evaluate the scientific literature on non-CPAP therapies in the treatment of OSAS according to the standards of evidence-based medicine. This paper summarizes the results of the task force. The data were unsatisfactorily for most of the methods. Sufficient data were available for intraoral appliances (IOA) and the maxillomandibular osteotomy (MMO). IOA's can reduce mild to moderate respiratory disturbances, MMO are efficient in the short and long term but are performed only in special situations such as craniofacial dysmorphias. Weight reduction and body positioning cannot be recommended as a single treatment of OSAS. Most surgical procedures still lack sufficient data according to the criteria of evidence based medicine. Resections of muscular tissue within the soft palate have to be strictly avoided. But even success following gentle soft palate procedures is difficult to predict and often decreases after years. Results in other anatomical regions seem to be more stable over time. Today combined surgeries in the sense of multi-level surgery concepts are of increasing interest in the secondary treatment after failure of nasal ventilation therapy although more data from prospective controlled studies are needed. There is no evidence for any other treatment options. PMID:17538860

  20. Intraoperative BiPAP in OSA Patients.

    Science.gov (United States)

    Singh, Bhavna P; Ns, Kodandaram

    2015-04-01

    Obstructive sleep apnea syndrome (OSA) is characterized by recurrent episodes of partial or complete upper airway obstructions during sleep. Severe OSA presents with a number of challenges to the anesthesiologist, the most life threatening being loss of the airway. We are reporting a case where we successfully used intraoperative bi level positive pressure ventilation (BiPAP) with moderate sedation and a regional technique in a patient with severe OSA posted for total knee replacement (TKR). A 55-year-old lady with osteoarthritis of right knee joint was posted for total knee replacement. She had severe OSA with an apnea-hypopnea index of 35. She also had moderate pulmonary hypertension due to her long standing OSA. We successfully used in her a combined spinal epidural technique with intraoperative BiPAP and sedation. She had no complications intraoperatively or post operatively and was discharged on day 5. Patients with OSA are vulnerable to sedatives, anaesthesia and analgesia which even in small doses can cause complete airway collapse. The problem, with regional techniques is that it requires excellent patient cooperation. We decided to put our patient on intraoperative BiPAP hoping that this would allow us to sedate her adequately for the surgery. As it happened we were able to successfully sedate her with slightly lesser doses of the commonly used sedatives without any episodes of desaturation, snoring or exacerbation of pulmonary hypertension. Many more trials are required before we can conclusively say that intraoperative BiPAP allows us to safely sedate OSA patients but we hope that our case report draws light on this possibility. Planning ahead and having a BiPAP machine available inside the operating may allow us to use sedatives in these patients to keep them comfortable under regional anaesthesia. PMID:26023625

  1. Depressive symptoms and childhood sleep apnea syndrome

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    Carotenuto M

    2012-08-01

    Full Text Available Marco Carotenuto,1 Maria Esposito,1 Lucia Parisi,2 Beatrice Gallai,3 Rosa Marotta,4 Antonio Pascotto,1 Michele Roccella21Sleep Clinic for Developmental Age, Clinic of Child and Adolescent Neuropsychiatry, Second University of Naples, Naples, Italy; 2Child Neuropsychiatry, Department of Psychology, University of Palermo, Palermo, Italy; 3Unit of Child and Adolescent Neuropsychiatry, University of Perugia, Perugia, 4Department of Psychiatry, "Magna Graecia" University of Catanzaro, Catanzaro, ItalyBackground: The relationship between sleep and mood regulation is well known, and some reports suggest a key role of sleep-related breathing disorders (SRBD in the development of the symptomatology of depression, even if no conclusive data are actually found in the clinical literature. The aim of this study was to assess the relationship between SRBD and depressive symptoms in a population of school-aged children.Methods: The study population comprised 94 children affected by SRBD and 107 healthy children. To identify the severity of SRBD, an overnight respiratory evaluation was performed. All subjects filled out the Italian version of the Children Depression Inventory (CDI to screen for the presence of depressive symptoms.Results: The group with SRBD showed higher CDI scores than the group without SRBD, with a positive correlation found between CDI scores, apnea-hypopnea index, and oxygen desaturation index values. Logistic regression showed that an apnea-hypopnea index ≥ 3 and an oxygen desaturation index ≥ 1 could be risk factors for development of depressive symptoms. According to receiver-operating characteristic curve analysis, the cutoff point for the apnea-hypopnea index that could cause a pathological CDI score (≥19 was >5.66, and the cutoff point for the oxygen desaturation index was >4.2. The limitations of this study are that our data are derived from one single psychometric test and not from a complete psychiatric evaluation, and our

  2. 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.

  3. 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.

  4. MR Image Analytics to Characterize the Upper Airway Structure in Obese Children with Obstructive Sleep Apnea Syndrome

    Science.gov (United States)

    Tong, Yubing; Udupa, Jayaram K.; Sin, Sanghun; Liu, Zhengbing; Wileyto, E. Paul; Torigian, Drew A.; Arens, Raanan

    2016-01-01

    Purpose Quantitative image analysis in previous research in obstructive sleep apnea syndrome (OSAS) has focused on the upper airway or several objects in its immediate vicinity and measures of object size. In this paper, we take a more general approach of considering all major objects in the upper airway region and measures pertaining to their individual morphological properties, their tissue characteristics revealed by image intensities, and the 3D architecture of the object assembly. We propose a novel methodology to select a small set of salient features from this large collection of measures and demonstrate the ability of these features to discriminate with very high prediction accuracy between obese OSAS and obese non-OSAS groups. Materials and Methods Thirty children were involved in this study with 15 in the obese OSAS group with an apnea-hypopnea index (AHI) = 14.4 ± 10.7) and 15 in the obese non-OSAS group with an AHI = 1.0 ± 1.0 (p<0.001). Subjects were between 8–17 years and underwent T1- and T2-weighted magnetic resonance imaging (MRI) of the upper airway during wakefulness. Fourteen objects in the vicinity of the upper airways were segmented in these images and a total of 159 measurements were derived from each subject image which included object size, surface area, volume, sphericity, standardized T2-weighted image intensity value, and inter-object distances. A small set of discriminating features was identified from this set in several steps. First, a subset of measures that have a low level of correlation among the measures was determined. A heat map visualization technique that allows grouping of parameters based on correlations among them was used for this purpose. Then, through T-tests, another subset of measures which are capable of separating the two groups was identified. The intersection of these subsets yielded the final feature set. The accuracy of these features to perform classification of unseen images into the two patient groups was

  5. CT findings in adults with obstructive sleep apnea

    International Nuclear Information System (INIS)

    The obstructive sleep apnea syndrome (OSAS) is characterized by recurrent obstruction of the upper airway during sleep. In this study, we performed CT scans in 20 adult OSAS patients and 6 control subjects, and measured the airspaces in the nasopharynx, mesopharynx and hypopharynx, using an image analyzer. The airspaces were significantly smaller at all sites of the pharynx in OSAS patients than in the control subjects, but they did not show a positive correlation with the apnea index or the body mass index. In good responders whose apnea indexes improved more than 50% after uvulo-palato-pharyngoplasty (UPPP), the nasopharyngeal and mesopharyngeal airspaces were significantly smaller, and the hypopharyngeal space tended to be larger than in poor responders. Our results suggest that CT scan is a helpful method for analyzing the area of the upper airway, especially in relation to the response to UPPP in adults with OSAS. (author)

  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. Papilledema in obstructive sleep apnea syndrome

    International Nuclear Information System (INIS)

    We report a diagnostically challenging case of papilloedema in a morbidly obese, 25 year old male who presented to us with blurring of vision of both eyes, but more marked in the right. Fundus examination revealed severe papilloedema, with corresponding visual field and colour vision defects. He was worked up for possible life threatening causes of papilloedema like intracranial space occupying lesion but his CT scan was normal. As his hematocrit was in the polycythemic range, multiple venesections were performed in fear that the hyperviscosity picture could be a contributing factor. However there was no change in symptoms or the fundus appearance. We could not come to a diagnosis of idiopathic intracranial hypertension too because he refused lumbar puncture. A sleep study was done as he did give symptoms of mild obstructive sleep apnea but the results were that of severe disease. He was given therapeutic nocturnal oxygen by CPAP to prevent further cardiovascular and respiratory complications and interestingly enough it helped in treating the papilloedema. He was seen 2 months after commencement of continuous positive airway pressure (CPAP) with good functional and anatomical recovery. (author)

  8. Screening of surgical patients with obstructive sleep apnea syndrome%阻塞性睡眠呼吸暂停综合征术前评估方法的研究进展

    Institute of Scientific and Technical Information of China (English)

    邓莉; 方琰; 薛张纲

    2010-01-01

    阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS)是一种常见的因郡分或全部上呼吸道反复阻塞引起的睡眠障碍,其特征是睡眠时呼吸气流暂停超过10 s.手术患者合并OSAS可使患者更易发生围手术期并发症.目前OSAS诊断的金标准是多导睡眠图,其术前评估方法有量表法和便携式仪器诊断等多种方法.%Obstructive sleep apnea syndrome (OSAS) ,a common sleep disorder,is characterized by episodes of cessation of breathing during sleep lasting for more than 10 seconds, due to repetitive partial or complete obstruction of the upper airway. Surgical patients with OSAS may lead to peri-operative complications. An up-to-date "gold" diagnosis standard of OSAS remains polysomnogram. We review a variety of preoperative evaluation methods available for OSAS diagnosis,including questionnaires, portable devices,and other clinical screening tests.

  9. 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.

  10. The effectiveness of the epworth sleepiness scale as an auxiliary resource in the diagnosis of obstructive sleep apnea syndrome - doi:10.5020/18061230.2013.p56

    Directory of Open Access Journals (Sweden)

    Ingrid Correia Nogueira

    2013-08-01

    Full Text Available Objective: To analyze the effectiveness of the Epworth Sleepiness Scale (ESS as an auxiliary resource in the diagnosis of the Obstructive Sleep Apnea Syndrome (OSAS. Methods: Observational study, with a retrospective phase and a prospective one, comprising 475 patients who sought the Sleep Study Center in Fortaleza (Centro de Estudo do Sono de Fortaleza - CESF. Data was collected from medical records, which comprises ESS, amidst some questionnaires prepared by CESF professionals and answered by the patients. The study compared the results raised by the ESS to the polysomnography data. Data analysis was performed on SPSS, using Pearson chi-square test, considering as statistically significant p-value 30 kg/m2 were the most affected by OSAS, with 38.9%, 41% and 45.1%, respectively. A significant relationship was found between ESS score and OSAS (p = 0,001, showing that 25.9% (n = 123 of patients, who had values higher than 10 in the ESS, were diagnosed with OSAS. Conclusions: Data on this study shows that ESS fits as an auxiliary resource in the diagnosis of OSAS and it may be applied by any health professional while taking the clinical history. However, clinical signs are not sufficient to diagnose it, so that polysomnography is still required.

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

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    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. 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.

  13. 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.

  14. 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

  15. Obstructive sleep apnea and asthma*

    OpenAIRE

    Cristina Salles; Regina Terse-Ramos; Adelmir Souza-Machado; Cruz, Alvaro A

    2013-01-01

    Symptoms of sleep-disordered breathing, especially obstructive sleep apnea syndrome (OSAS), are common in asthma patients and have been associated with asthma severity. It is known that asthma symptoms tend to be more severe at night and that asthma-related deaths are most likely to occur during the night or early morning. Nocturnal symptoms occur in 60-74% of asthma patients and are markers of inadequate control of the disease. Various pathophysiological mechanisms are related to the worseni...

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

    International Nuclear Information System (INIS)

    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)

  17. 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)

  18. [A case report: perioperative management of adenotonsillectomy in a morbidly obese patient with severe obstructive sleep apnea syndrome].

    Science.gov (United States)

    Mine, Tomoko; Wada, Minori; Hashimoto, Ai; Minami, Kotaro; Nikai, Tetsuro; Imamachi, Noritaka; Saito, Yoji

    2014-11-01

    A male patient in his thirties was scheduled to undergo adenotonsillectomy due to dyspnea from bilateral tonsillar hypertrophy. He was morbidly obese (body mass index 56 kg x m(-2)) with severe obstructive sleep apnea syndrome (OSAS), and thus was evaluated with extreme risk for difficult ventilation and intubation. We planned awake intubation via video-assisted laryngoscopy and fiberoptic bronchoscopy under dexmedetomidine sedation, and the intubation was successfully performed. After adenotonsillectomy, upper airway obstruction due to hemorrhage and oropharyngeal swelling can be life-threatening requiring emergent airway management. Thus for postoperative airway management, due to the possibility of "cannot intubate, cannot ventilate" (CICV) and presumed difficult tracheotomy, we scheduled to perform tracheotomy during adenotonsillectomy, right after anesthetic induction and awake intubation. On postoperative day 1, he started walking with no need of sedative drugs. On day 4, after confirmation of minimal oropharyngeal swelling, tracheal cannulae was removed, and no further complications were observed in his postoperative course. We conclude that careful preoperative evaluation of the airway, retention of spontaneous breathing via awake intubation, and preventive tracheotomy for postoperative airway management are important points in perioperative management of a morbidly obese patient with severe obstructive sleep apnea syndrome. PMID:25731066

  19. [Automatic positive airway pressure in titration and treatment of the obstructive sleep apnea syndrome].

    Science.gov (United States)

    Randerath, W J

    2007-04-01

    Although continuous airway pressure therapy (CPAP) represents the standard treatment for obstructive sleep apnea syndrome (OSAS) auto-adjusting CPAP (APAP) devices were developed which adapt the treatment pressure to the actual requirement of the patients. The aim of automatic CPAP therapy is to improve the patients' acceptance of positive pressure treatment. The devices react to respiratory flow, flattening of the inspiratory flow contour, snoring, generator speed or the upper airway impedance. In recent years several studies showed that auto CPAP effectively treats respiratory disturbances, improves sleep profile and the self-assessment of the patients equally as good as the gold standard constant CPAP. Moreover, APAP reduces the treatment pressure substantially. Although an improvement of the patient's compliance has not consistently been proven, most patients prefer APAP versus constant CPAP. APAP devices use different algorithms depending on the primary purpose of the application. Therefore, a clear distinction between automatic titration and treatment is of major relevance. While titration devices aim at the finding of one single pressure which is fixed to a constant CPAP device, automatic treatment means the chronic use of APAP at home for optimal adaptation of the treatment pressure to the actual requirements of the patient. A high constant CPAP level, huge pressure variability, insufficient compliance with constant CPAP may be indications for APAP treatment. The main reason for automatic titration is the standardisation of the initiation process. PMID:17455137

  20. Clinical effect of surgical correction for nasal pathology on the treatment of obstructive sleep apnea syndrome.

    Directory of Open Access Journals (Sweden)

    Chong Yoon Park

    Full Text Available OBJECTIVES: This study aimed to evaluate the hypothesis that relief of nasal obstruction in subjects with obstructive sleep apnea (OSA would lead to reduce OSA severity and to discuss the available evidence on the clinical efficacy of nasal surgery as a treatment modality for OSA. STUDY DESIGN: Twenty-five subjects who had reduced patency of nasal cavity and narrowing of retroglossal or retropalatal airways were diagnosed with OSA and underwent nasal surgery, such as septoplasty or turbinoplasty to correct nasal pathologies. The effect of the surgery on nasal patency was quantified by measuring minimal cross-sectional area (MCA using acoustic rhinometry. The watch-PAT-derived respiratory disturbance index (RDI, apnea and hypopnea index (AHI, lowest oxygen saturation, and valid sleep time were measured before and after nasal surgery. RESULTS: The present study shows that the AHI and RDI decreased significantly and the lowest oxygen saturation and valid sleep time rose after nasal surgery in 25 OSA subjects. In addition, a reduction in subjective symptoms was observed in subjects and mean MCA increased after nasal surgery. Fourteen subjects were classified as responders and 11 subjects as non-responders. Responders showed considerable improvement of their subjective symptoms and the AHI and RDI were significantly lower after surgery. We found that the changes between pre- and post-operative AHI and RDI values were minimal in 11 non-responders. However, daytime somnolence and REM sleep time improved after nasal surgery in non-responders. CONCLUSIONS: Our study provides evidence that the surgical treatment of nasal pathology improves nasal airway patency and reduces OSA severity in 56% subjects. Furthermore, correction of nasal pathology appears to result in improved sleep quality in both responder and non-responders OSA subjects.

  1. EFFECT OF FLUOXETINE ON SLEEP ARCHITECTURE IN PATIENTS WITH METABOLIC SYNDROME AND OBSTRUCTIVE SLEEP APNEA SYNDROME

    Directory of Open Access Journals (Sweden)

    O. V. Lyubshina

    2010-01-01

    Full Text Available Aim. To study effect of fluoxetine on sleep architecture in patients with metabolic syndrome and obstructive sleep apnea syndrome.Material and methods. 98 patients with obstructive sleep apnea syndrome and metabolic syndrome (aged 54.3±8.7 y.o. were included into the study. All patients received fluoxetine 20 mg once daily during 6 months. Influence of fluoxetine on sleep architecture was evaluated with special questionnaire and by polysomnography, including electroencephalogram, electrooculogram, mentalis electromyogram and pulseoxymetry.Results. Decrease in wake time after sleep onset (Δ33%; р<0.05 was found at the end of treatment. It resulted in improvement of sleep efficacy index. Decrease in respiratory sleep disorders index (Δ20% and rising of blood oxygen saturation (Δ12%; р<0.05 was also found. Improvement of the sleep architecture (reduction in the 2nd phase of slow wave sleep by 15%, increase in delta-sleep (Δ71% and rapid eye movement sleep (Δ25%; р<0.05 was also observed. Besides reduction in body mass index after fluoxetine therapy (Δ12%; р<0.05 was found. Serious adverse effects were not registered.Conclusion. Fluoxetine use in patients with metabolic syndrome and obstructive sleep apnea syndrome shown positive effect on objective indices of sleep architecture and respiratory sleep disorders. It improved adaptive function of the sleep and contributed to reduction in sleep disorders.

  2. 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.

  3. 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.

  4. 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 careful driving or not, the rate of car accidents over a 5-year period was investigated. A questionnaire was addressed to 140 patients with and 142 controls without symptoms associated to SAS. Seventy-three of the patients had a complete triad of SAS-associated symptoms. Fifty-two percent...... with a complete triad of symptoms of SAS compared to controls (p less than 0.001). When corrected for mileage driven, the total number of single-car accidents was almost 12 times higher among patients with sleep spells whilst driving, compared to controls (p less than 0.001). It is concluded that drivers...

  5. 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

  6. The value of auto-adjustable CPAP devices in pressure titration and treatment of patients with obstructive sleep apnea syndrome.

    Science.gov (United States)

    Hertegonne, Katrien; Bauters, Fré

    2010-04-01

    In moderate to severe obstructive sleep apnea syndrome (OSAS), the use of Continuous Positive Airway Pressure (CPAP) is the gold standard therapy. In the last decade, new technologies such as auto-adjustable CPAP (APAP) have been promoted as having an added advantage over CPAP, because of their ability to adapt the pressure level to the patient's need at all times. This could logically result in the deliverance of lower pressures, which was hypothesized to improve patient acceptance and compliance for therapy. Several clinical trials have been performed with APAP in different modalities, as a titration tool in attended or unattended conditions, or as a treatment device for chronic use. Comparison of these trials is challenging, since APAP technology is evolving promptly and devices differ not only in how sleep-disordered breathing is detected, but also in how the operational algorithm responds accordingly. Although the question remains whether proof has yet been delivered of the superiority of this technology over CPAP, there is a tendency to accept it as common standard practice in OSAS titration and treatment. This review will bring available evidence on this subject into perspective. PMID:19716321

  7. 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. PMID:27489385

  8. CT findings in adults with obstructive sleep apnea; Measurement of pharyngeal spaces with an image analyzer

    Energy Technology Data Exchange (ETDEWEB)

    Matsuda, Fumiaki; Asakura, Kohji; Nakano, Yuji; Shintani, Tomoko; Akita, Nobuto; Kataura, Akikatsu (Sapporo Medical Coll. (Japan))

    1993-09-01

    The obstructive sleep apnea syndrome (OSAS) is characterized by recurrent obstruction of the upper airway during sleep. In this study, we performed CT scans in 20 adult OSAS patients and 6 control subjects, and measured the airspaces in the nasopharynx, mesopharynx and hypopharynx, using an image analyzer. The airspaces were significantly smaller at all sites of the pharynx in OSAS patients than in the control subjects, but they did not show a positive correlation with the apnea index or the body mass index. In good responders whose apnea indexes improved more than 50% after uvulo-palato-pharyngoplasty (UPPP), the nasopharyngeal and mesopharyngeal airspaces were significantly smaller, and the hypopharyngeal space tended to be larger than in poor responders. Our results suggest that CT scan is a helpful method for analyzing the area of the upper airway, especially in relation to the response to UPPP in adults with OSAS. (author).

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

    Directory of Open Access Journals (Sweden)

    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. 

  10. 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.

  11. 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 ...

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

    Directory of Open Access Journals (Sweden)

    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/.

  13. 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.

  14. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  16. Obstructive Sleep Apnea-Hypopnea Syndrome and Hearing in Children

    Institute of Scientific and Technical Information of China (English)

    HE Xiao-zheng; XU Yao-dong; CAI Qian; ZHENG Yi-qing

    2008-01-01

    Objective To explore the relationship between hypoxemia and hearing in children with obstructive sleep apnea-hypopnea syndrome. Methods Auditory brainstem responses (ABRs) were recorded in 68 ears and distortion product otoacoustic emissions (DPOAEs) in 60 ears in children with OSAHS and type "A" tympanograms, and in 30 ears in normal children. Results ABR latencies of waves Ⅰ, Ⅲ and Ⅴ, and Ⅰ-Ⅲ, Ⅲ-Ⅴ and Ⅰ-Ⅴ intervals were not statistically different between OSAHS and normal children. Wave Ⅰlatency was delayed in children with OSAHS compared to normal children3 (P<0.05). DPOAE amplitudes in children with mild OSAHS were lower than normal children at 8 kHz (P<0.05). DPOAEs were lower at 6 kHz and 8 kHz in children with moderate/severe OSAHS than normal children (P<0.05). Conclusion Cochlear function was affected when AHI was at or greater than lO/hour. ABR and DPOAE can be used to detect early changes in auditory function in children with OSAHS.

  17. Clinical application ultrafast MRI to the sleep apnea syndrome, 1

    International Nuclear Information System (INIS)

    To evaluate the site of obstruction within upper airway, we observed the Turbo-fast low angle shot (FLASH) imaging, in 10 patients with sleep apnea syndrome (SAS) during wakefulness and sleep. After intravenous injection of Gd-DTPA (0.1 mmol/kg), sequential images of pharyngeal portion were obtained in midline sagittal section. An imaging protocol was 1.13s per image with a 1s delay between images, for a total of 30s. Then sequential images were displayed in a cine on C. R. T.. In eight patients, upper airway obstructions were present during sleep, while narrowings were present in four cases during awake. The sites of obstruction were located at the velopharynx exclusively in three cases, velopharynx plus glosspharynx in three cases, velopharynx plus glosspharynx in one case. Velopharynx plus hypopharynx in one case, respectively. It was concluded that ultrafast MRI had an important role in evaluating the sites of obstruction within upper airway in patients with SAS. (author)

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

    Directory of Open Access Journals (Sweden)

    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.

  19. Obstructive Sleep Apnea Syndrome%阻塞性睡眠呼吸暂停综合征概述

    Institute of Scientific and Technical Information of China (English)

    殷忠

    2013-01-01

    Obstructive sleep apnea syndrome( OSAS ) is characterized by repeated airway collapse during sleep. Researches suggest that the disease has a lot of causes, among which the most important cause is a reduction of the expansion forces of the pharyngeal dilator muscles, such as genioglossal muscle dysfunction and discoordination between the inspiratory and expiratory activity of the muscle. Other described causes are soft tissue disorders, such as macroglossia or tonsillar hypertrophy, and skeletal structural alterations such as micrognathia deformity or jaw retrusion. The syndrome is more frequent in obese people, where the accumulation of fat in the neck region results in narrowing of the pharyngeal airway. Here is to make a review on the pathogenesis, epidemiology, main features, diagnosis and major surgical solution of the disease.%阻塞性睡眠呼吸暂停综合征(OSAS)的特征是睡眠过程中反复发生上呼吸道塌陷.研究提示疾病有很多种病因,其中最重要的是咽扩张肌张力降低,如颏舌肌功能失调,肌肉的吸气活动与呼气活动不协调.其他原因有软组织疾病(如巨舌症或扁桃体肥大)、骨骼结构改变(如小颌畸形或颌后缩).在肥胖人群中OSAS更常见,可能是因为颈部脂肪组织堆积导致咽呼吸道狭窄所致.该文简要描述OSAS的发病机制、流行病学、主要特征、诊断及主要手术治疗方案.

  20. Obesity and the Relationship between Obstructive Sleep Apnea Syndrome and type 2 Diabetes%肥胖与OSAS和2型糖尿病的关系

    Institute of Scientific and Technical Information of China (English)

    杨雪松; 朱红霞; 王敏哲

    2015-01-01

    肥胖一般是指体内贮积的脂肪量超过理想脂肪量的20%以上,体重指数(Body Mass Index)简称BMI可作为阻塞性睡眠呼吸暂停综合征(Obstructive Sleep Apnea Syndrome OSAS)的重要预测指标,其诊断通常按BMI来确定,在我国BMl≥28 kg/m2可诊断为肥胖。我国在200—2008年基于普通人群的全国流行病学调查数据显示,我国超重人群占总人群的32.9%,肥胖人群占总人群的14.6%。有研究显示,肥胖可能是引起OSAS和2型糖尿病(Type 2 Diabetes Mellitus T2DM)的共同危险因素,OSAS患者常合并有肥胖,肥胖又可通过使胰岛素受体数量减少、胰岛素敏感性下降引起胰岛素抵抗,与此同时还可通过OSAS病情的加重而影响糖代谢。%Generally obesity refers to the storage of fat deposition in the Body more than 20%of ideal Body fat, Body Mass Index(BMI) can be used as an important predictor of Obstructive Sleep Apnea Syndrome (OSAS), the diagnosis is usually determined according to BMI, BMl in China can be diagnosed with over 28 kg/m 2.In 2007—2008 in China is based on the general population, according to data from the national epidemiological survey of overweight people accounted for 32.9% of the total population in our country, the obesity account for 14.6% of the total population.Research shows that obesity is probably caused by OSAS and Type 2 Diabetes of the common risk factors, OSAS patients with obesity, and it make the de-crease in the number of insulin receptor and insulin sensitivity decreased, resulting in insulin resistance, at the same time, obesity can also be through OSAS illness aggravating and effecting the metabolism of sugar.

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

    International Nuclear Information System (INIS)

    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 SaO2 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 SaO2 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.)

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

    Energy Technology Data Exchange (ETDEWEB)

    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.).

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

    Directory of Open Access Journals (Sweden)

    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.

  4. 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.

  5. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    OpenAIRE

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

    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 ...

  8. 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

  9. Prevalence and Correlates of Insomnia and Obstructive Sleep Apnea in Chronic Kidney Disease

    OpenAIRE

    Shahbaj Ahmad; Manan Gupta; Ravi Gupta; Mohan Dhyani

    2013-01-01

    Background: Poor sleep quality, insomnia, and restless legs syndrome (RLS) and sleep apnea are common in patients with chronic kidney disease (CKD). Clinical correlates of these problems are poorly understood. Aims: This study was to find out the prevalence and correlates of insomnia and subjects with ′high risk for obstructive sleep apnea (OSA)′ in adults with chronic kidney disease. Materials and Methods: One hundred and four adults with CKD were included. Their demographic data, details re...

  10. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  12. 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

  13. 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.

  14. 阻塞性睡眠呼吸暂停综合征与心血管疾病相关性研究进展%Research Progress in Association between Obstructive Sleep Apnea Syndrome and Cardiovascular Disease

    Institute of Scientific and Technical Information of China (English)

    柴珍峰

    2012-01-01

    阻塞性睡眠呼吸暂停综合征(OSAS)是一种以睡眠状态下反复发生呼吸暂停和(或)低通气为主要表现的并发多器官损害的临床综合征.近年研究表明,OSAS与高血压、冠心病、心律失常、心力衰竭、猝死等心血管疾病的发生联系密切,其机制可能与OSAS导致的低氧血症、高碳酸血症、炎症、氧化应激、自主神经功能紊乱、血管内皮功能紊乱等有关,但其具体病理生理机制尚不明确.%Obstructive sleep apnea syndrome( OSAS )is characterized by repetitive apnea and/or hypopnea during sleep,and it can cause multiorgan dysfunction. Recent researches have shown OSAS is closely correlated with hypertension , coronary heart disease , arrhythmia, heart failure, and sudden death. Its definite mechanism is undefined , which may be related to hypoxemia, hypercapnia, inflammation , oxidative stress , and dysfunction of autonomic nerve and endothelium.

  15. 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.

  16. 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

  17. 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

  18. 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.

  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. 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.

  1. Implant-retained oral appliances : a novel treatment for edentulous patients with obstructive sleep apnea-hypopnea syndrome

    NARCIS (Netherlands)

    Hoekema, Aarnoud; de Vries, Frist; Heydenrijk, Kees; Stegenga, Boudewijn

    2007-01-01

    Objectives: Mandibular repositioning appliances (MRAs) are a viable treatment alternative in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). Because these appliances require retention in the patient's dentition, edentelous patients generally do not qualify for this treatment. This s

  2. 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

  3. Computational Modeling of Airway Obstruction in Sleep Apnea in Down Syndrome: A Feasibility Study.

    Science.gov (United States)

    Mylavarapu, Goutham; Subramaniam, Dhananjay; Jonnagiri, Raghuvir; Gutmark, Ephraim J; Fleck, Robert J; Amin, Raouf S; Mahmoud, Mohamed; Ishman, Stacey L; Shott, Sally R

    2016-07-01

    Current treatment options are successful in 40% to 60% of children with persistent obstructive sleep apnea after adenotonsillectomy. Residual obstruction assessments are largely subjective and do not clearly define multilevel obstruction. We endeavor to use computational fluid dynamics to perform virtual surgery and assess airflow changes in patients with Down syndrome and persistent obstructive sleep apnea. Three-dimensional airway models were reconstructed from respiratory-gated computed tomography and magnetic resonance imaging. Virtual surgeries were performed on 10 patients, mirroring actual surgeries. They demonstrated how surgical changes affect airflow resistance. Airflow and upper airway resistance was calculated from computational fluid dynamics. Virtual and actual surgery outcomes were compared with obstructive apnea-hypopnea index values. Actual surgery successfully treated 6 of 10 patients (postoperative obstructive apnea-hypopnea index <5). In 8 of 10 subjects, both apnea-hypopnea index and the calculated upper airway resistance after virtual surgery decreased as compared with baseline values. This is a feasibility and proof-of-concept study. Further studies are needed before using these techniques in surgical planning. PMID:27048669

  4. 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.

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

    OpenAIRE

    Hirata Raquel P; Aguiar Isabella C; Nacif Sergio R; Giannasi Lilian C; Leitão Filho Fernando SS; Santos Israel R; Romano Salvatore; De Faria Newton S; Nonaka Paula N; Sampaio Luciana MM; Oliveira Claudia S; Carvalho Paulo TC; Lorenzi-Filho Geraldo; Braghiroli Alberto; Salvaggio Adriana

    2011-01-01

    Abstract Background Obstructive sleep apnea (OSA) is a respiratory disease characterized by the collapse of the extrathoracic airway and has important social implications related to accidents and cardiovascular risk. The main objective of the present study was to investigate whether the drop in expiratory flow and the volume expired in 0.2 s during the application of negative expiratory pressure (NEP) are associated with the presence and severity of OSA in a population of professional interst...

  6. 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

  7. 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。

  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. 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

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

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    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.

  11. Impact of gender on snore-based obstructive sleep apnea screening

    International Nuclear Information System (INIS)

    Obstructive sleep apnea syndrome (OSA) is a serious widespread disease in which upper airways (UA) are collapsed during sleep. OSA has marked male predominance in prevalence. Although women are less vulnerable to OSA, under-diagnosed OSA in women may associate with serious consequences. Snoring is commonly associated with OSA and one of the earliest symptoms. Snore sounds (SS) are generated due to vibration of the collapsing soft tissues of the UA. Structural and functional properties of the UA are gender dependent. SS capture these time varying gender attributed UA properties and those could be embedded in the acoustic properties of SS. In this paper, we investigate the gender-specific acoustic property differences of SS and try to exploit these differences to enhance the snore-based OSA detection performance. We developed a snore-based multi-feature vector for OSA screening and one time-measured neck circumference was augmented. Snore features were estimated from SS recorded in a sleep laboratory from 35 females and 51 males and multi-layer neural network-based pattern recognition algorithms were used for OSA/non-OSA classification. The results were K-fold cross-validated. Gender-dependent modeling resulted in an increase of around 7% in sensitivity and 6% in specificity at the decision threshold AHI = 15 against a gender-neutral model. These results established the importance of adopting gender-specific models for the snore-based OSA screening technique. (paper)

  12. 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.

  13. An evaluation of a novel mask in four patients with obstructive sleep apnea and overlap syndromes.

    Science.gov (United States)

    Yarahmadi, Alireza; Nader, Nader D; Zadeii, Gino; Porhomayon, Jahan

    2013-01-01

    We present four cases of adults with obstructive sleep apnea in whom positive airway pressure therapy alone failed to provide adequate oxygenation. We have previously reported the use of dual mask for ventilatory support of a patient postoperatively (Porhomayon et al., 2013). Here, we report an evaluation of the dual mask in four patients with overlap syndromes. Application of dual mask provided adequate oxygenation with lower continuous positive airway pressure (CPAP)/bilevel positive airway pressure (BIPAP) pressure levels. PMID:23970903

  14. An Evaluation of a Novel Mask in Four Patients with Obstructive Sleep Apnea and Overlap Syndromes

    OpenAIRE

    Alireza Yarahmadi; Nader, Nader D; Gino Zadeii; Jahan Porhomayon

    2013-01-01

    We present four cases of adults with obstructive sleep apnea in whom positive airway pressure therapy alone failed to provide adequate oxygenation. We have previously reported the use of dual mask for ventilatory support of a patient postoperatively (Porhomayon et al., 2013). Here, we report an evaluation of the dual mask in four patients with overlap syndromes. Application of dual mask provided adequate oxygenation with lower continuous positive airway pressure (CPAP)/bilevel positive airway...

  15. An Evaluation of a Novel Mask in Four Patients with Obstructive Sleep Apnea and Overlap Syndromes

    Directory of Open Access Journals (Sweden)

    Alireza Yarahmadi

    2013-01-01

    Full Text Available We present four cases of adults with obstructive sleep apnea in whom positive airway pressure therapy alone failed to provide adequate oxygenation. We have previously reported the use of dual mask for ventilatory support of a patient postoperatively (Porhomayon et al., 2013. Here, we report an evaluation of the dual mask in four patients with overlap syndromes. Application of dual mask provided adequate oxygenation with lower continuous positive airway pressure (CPAP/bilevel positive airway pressure (BIPAP pressure levels.

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

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    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.

  17. 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.

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

    Science.gov (United States)

    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 continuity and architecture with the elimination of obstructive apneas. PMID:27668098

  19. 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

  20. 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.

  1. 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

  2. Study of low dose and dynamic multi-slice CT about obstructive sleep apnea syndrome in sleeping

    International Nuclear Information System (INIS)

    Objective: To perform Low dose dynamic MSCT(multi-slice CT) in sleeping obstructive sleep apnea syndrome (OSAS) patients correcting the imprecise measure values in waking state, and to exactly analyse the location and extension of the dynamic changes about the condition. Methods: Sixteen OSAS patients were scanned both in waking and naturally sleeping period (end phase of inspiration and expiration). Measured at the narrowest part of the retropalatal (RP) and retroglossal (RG) and 5 mm under the tip of epiglottis at the epiglottal (EPG)at the end period of inspiration in sleeping, respectively, and compared the accurate position of the narrowest or occlusive level in 3 phases. All patients were also scanned using cine mode at the narrowest level at the end period of inspiration in sleeping to show the pharyngeal cavity changes during sleep. Results: The smallest XSA of RP region (Mw=47.50 mm2, Me=73.00 mm2, Mi=2.00 mm2; Zwe=2.897, Pwe=0.003; Zwi=4.192, Pwiie=4.538, Piew=8.00 mm, Me=9.50 mm, Mi=1.50 mm; Zwe=1.933, Pwe=0.056; Zwi=3.720, Pwiie=4.230, Piew=8.00 mm, Me=9.00 mm, Mi=1.00 mm; Zwe=1.210, Pwe=0.246; Zwi=4.203, Pwiie=4.557, Piew=4.00 mm3, Me=5.50 mm3, Mi=1.50 mm3; Zwe=1.576, Pwe=0.125; Zwi=3.532, Pwiie=4.077, Piew=7.00 mm, Me=6.00 mm, Mi=10.50 mm; Zwe=0.557, Pwe=0.603; Zwi=2.541, Pwi=0.011; Zie=2.852, Pie=0.004) and RG regions (Mw=5.00 mm, Me=3.00 mm, Mi=9.50 mm; Zwe=0.747, Pwe=0.482; Zwi=2.657, Pwi=0.007; Zie=3.075, Pie=0.001), were different between inspiration and expiration of sleeping or awake. The dynamic cine CT scan during sleeping could show pharyngeal change, clearly. Conclusion: At the end period of inspiration in sleeping, the location of narrow or obstructive of airway is the most precise and sensitive and the false negative at the waking could be obviously reduced. Low dose MSCT scan reduced exposure and expense. (authors)

  3. An Obstructive Sleep Apnea Detection Approach Using a Discriminative Hidden Markov Model From ECG Signals.

    Science.gov (United States)

    Song, Changyue; Liu, Kaibo; Zhang, Xi; Chen, Lili; Xian, Xiaochen

    2016-07-01

    Obstructive sleep apnea (OSA) syndrome is a common sleep disorder suffered by an increasing number of people worldwide. As an alternative to polysomnography (PSG) for OSA diagnosis, the automatic OSA detection methods used in the current practice mainly concentrate on feature extraction and classifier selection based on collected physiological signals. However, one common limitation in these methods is that the temporal dependence of signals are usually ignored, which may result in critical information loss for OSA diagnosis. In this study, we propose a novel OSA detection approach based on ECG signals by considering temporal dependence within segmented signals. A discriminative hidden Markov model (HMM) and corresponding parameter estimation algorithms are provided. In addition, subject-specific transition probabilities within the model are employed to characterize the subject-to-subject differences of potential OSA patients. To validate our approach, 70 recordings obtained from the Physionet Apnea-ECG database were used. Accuracies of 97.1% for per-recording classification and 86.2% for per-segment OSA detection with satisfactory sensitivity and specificity were achieved. Compared with other existing methods that simply ignore the temporal dependence of signals, the proposed HMM-based detection approach delivers more satisfactory detection performance and could be extended to other disease diagnosis applications. PMID:26560867

  4. Comparison of 3 titration methods of positive airway pressure for obstructive sleep apnea syndrome: a random, single-blind and self-control clinical study

    Directory of Open Access Journals (Sweden)

    Yan LI

    2013-05-01

    Full Text Available Objective  To evaluate the efficacy and safety of polysomnography-manual continuous positive airway pressure titration (PSG-CPAP, polysomnography-automatic positive airway pressure titration (PSG-APAP, or automatic positive airway pressure titration (APAP in patients with moderate or severe simple obstructive sleep apnea syndrome (OSAS. Methods  Twenty patients with moderate or severe OSAS sequentially underwent PSG-CPAP, PSG-APAP and APAP titration 3 days apart, and then 3 primary efficacy indicators (titration pressure, remaining respiratory event and state of sleep, and safety indicators (compression injury of face skin, the subjective evaluation on degree of comfort or any complaint during titration were compared. Results  The results of efficacy indicators revealed that all PSG-APAP, APAP and PSG-CPAP were effective. Compared with the optimal pressure of PSG-CPAP titration, PSG-APAP and APAP pressures were 3.05 and 2.55cmH2O higher, respectively, in 90% of occasion (P0.05. There was no statistically significant difference between the optimal pressure of PSG-CPAP and the mean pressures of PSG-APAP and APAP (P>0.05. There was no statistically significant difference between the 3 titration methods on residue apnea/hypopnea index (AHI, P>0.05. The oxygen desaturation index (ODI decreased significantly after titration treatment (P0.05. Both PSG-CPAP and PSG-APAP titrations showed the same effects in improving ODI. Compared with basic PSG, no obvious improvement was found in sleep efficiency (SE after PSG-CPAP and PSG-APAP titration (P>0.05, however, the arousal index (ArI decreased obviously (P0.05. The results of safety indicators showed that no face skin compression injury or severe adverse event related to the titration was found in all the patients during the study. The main complaints of the patients were sleep disturbance, dryness of eyes or mouth, headache, breath holding and abdominal distention. Conclusion  Both PSG-APAP and

  5. 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 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

  6. 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.

  7. 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.

  8. Management of Obstructive Sleep Apnea

    OpenAIRE

    Vijayan, V.K.

    2014-01-01

    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) treatmen...

  9. Comparison of lingual tonsil size as depicted on MR imaging between children with obstructive sleep apnea despite previous tonsillectomy and adenoidectomy and normal controls

    International Nuclear Information System (INIS)

    Cine MRI has become a useful tool in the evaluation of patients with persistent obstructive sleep apnea (OSA) despite previous surgical intervention and in patients with underlying conditions that render them susceptible to multilevel airway obstruction. Findings on cine MRI studies have also increased our understanding of the mechanisms and anatomic causes of OSA in children. To compare lingual tonsil size between children with OSA and a group of normal controls. In addition, a subanalysis was made of the group of children with OSA comparing lingual tonsils between children with and without underlying Down syndrome. Children with persistent OSA despite previous palatine tonsillectomy and adenoidectomy and controls without OSA underwent MR imaging with sagittal fast spin echo inversion-recovery images, and lingual tonsils were categorized as nonperceptible at imaging or present and measurable. When present, lingual tonsils were measured in the maximum anterior-posterior diameter. If lingual tonsils were greater than 10 mm in diameter and abutting both the posterior border of the tongue and the posterior pharyngeal wall, they were considered markedly enlarged. There were statistically significant differences between the OSA and control groups for the presence vs. nonvisualization of lingual tonsils (OSA 33% vs. control 0%, P=0.0001) and mean diameter of the lingual tonsils (OSA 9.50 mm vs. control 0.0 mm, P=0.00001). Within the OSA group, there were statistically significant differences between children with and without Down syndrome for the three lingual tonsil width categories (P=0.0070) and occurrence of markedly enlarged lingual tonsils (with Down syndrome 35% vs. without Down syndrome 3%, P=0.0035). Enlargement of the lingual tonsils is relatively common in children with persistent obstructive sleep apnea after palatine tonsillectomy and adenoidectomy. This is particularly true in patients with Down syndrome. (orig.)

  10. Comparison of lingual tonsil size as depicted on MR imaging between children with obstructive sleep apnea despite previous tonsillectomy and adenoidectomy and normal controls

    Energy Technology Data Exchange (ETDEWEB)

    Fricke, Bradley L. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Emory University School of Medicine, Department of Radiology, Atlanta, GA (United States); Donnelly, Lane F. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Cincinnati Children' s Hospital Medical Center, Department of Pediatrics, Cincinnati, OH (United States); Shott, Sally R. [Cincinnati Children' s Hospital Medical Center, Division of Otolaryngology, Cincinnati, OH (United States); Kalra, Maninder; Poe, Stacy A.; Chini, Barbara A.; Amin, Raouf S. [Cincinnati Children' s Hospital Medical Center, Department of Pediatrics, Cincinnati, OH (United States)

    2006-06-15

    Cine MRI has become a useful tool in the evaluation of patients with persistent obstructive sleep apnea (OSA) despite previous surgical intervention and in patients with underlying conditions that render them susceptible to multilevel airway obstruction. Findings on cine MRI studies have also increased our understanding of the mechanisms and anatomic causes of OSA in children. To compare lingual tonsil size between children with OSA and a group of normal controls. In addition, a subanalysis was made of the group of children with OSA comparing lingual tonsils between children with and without underlying Down syndrome. Children with persistent OSA despite previous palatine tonsillectomy and adenoidectomy and controls without OSA underwent MR imaging with sagittal fast spin echo inversion-recovery images, and lingual tonsils were categorized as nonperceptible at imaging or present and measurable. When present, lingual tonsils were measured in the maximum anterior-posterior diameter. If lingual tonsils were greater than 10 mm in diameter and abutting both the posterior border of the tongue and the posterior pharyngeal wall, they were considered markedly enlarged. There were statistically significant differences between the OSA and control groups for the presence vs. nonvisualization of lingual tonsils (OSA 33% vs. control 0%, P=0.0001) and mean diameter of the lingual tonsils (OSA 9.50 mm vs. control 0.0 mm, P=0.00001). Within the OSA group, there were statistically significant differences between children with and without Down syndrome for the three lingual tonsil width categories (P=0.0070) and occurrence of markedly enlarged lingual tonsils (with Down syndrome 35% vs. without Down syndrome 3%, P=0.0035). Enlargement of the lingual tonsils is relatively common in children with persistent obstructive sleep apnea after palatine tonsillectomy and adenoidectomy. This is particularly true in patients with Down syndrome. (orig.)

  11. 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

  12. 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

  13. 关于阻鼾器在治疗阻塞性睡眠呼吸暂停综合征的应用%On the application of snoreguard for obstructive sleep apnea syndrome in the treatment of

    Institute of Scientific and Technical Information of China (English)

    张洁; 李娅楠; 章月雪

    2015-01-01

    Objective:to analyze the snoreguard for obstructive sleep apnea syndrome (OSAS) in the treatment of application. Methods:the research object?in our hospital in 2014 January to2014 December treated 40 cases of OSAS patients,all patients with snoreguard fortherapeutic intervention on quality of life,before and after the treatment related effectsevaluation.Results:in the monitoring indexes of sleep,after treatment were better than before treatment.Conclusion:the appliance can effectively improve the quality of life in patients with OSAS to improve the sleep disordered breathing condition,reduce the frequency andduration of apnea, the treatment effect is significant.%目的:分析阻鼾器在治疗阻塞性睡眠呼吸暂停综合征(OSAS)的应用效果。方法:研究对象为我院在2014年1月至2014年12月期间接诊的OSAS病患40例,所有患者运用阻鼾器做治疗干预,对治疗前后进行生活质量情况相关效果做评估。结果:在睡眠监测各指标上,治疗后均优于治疗前。结论:阻鼾器可以有效的改善OSAS患者的生活质量,改善睡眠呼吸紊乱状况,减少呼吸暂停等频次和时长,治疗效果显著。

  14. [A case of X-linked alpha-thalassemia/mental retardation (ATR-X) syndrome with repeated apnea attacks due to laryngomalacia].

    Science.gov (United States)

    Ebishima, Yuko; Misaki, Takako; Owa, Kenji; Okuno, Takehiko; Wada, Takahito; Suehiro, Yutaka

    2013-01-01

    We report a case of X-linked alpha-thalassemia/mental retardation syndrome (ATR-X) with repeated apnea attacks dating from the patient's 12th year. We initially diagnosed them as obstructive apnea due to upper pharyngeal stenosis and laryngomalacia by polysomnography and laryngo-fiberscopy. However, reevaluation after one and a half years revealed that the boy had central and mixed apnea, as well as obstructive apnea. To date, few reports have been published on the causes of apnea attacks in ATR-X patients. We clinicians should therefore consider laryngomalacia as one cause of apnea attacks in ATR-X patients, and choose the appropriate therapy for a pattern of apnea that can change during its clinical course. PMID:23593745

  15. 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.

  16. Copeptin: a new predictor for severe obstructive sleep apnea

    Directory of Open Access Journals (Sweden)

    Çınarka H

    2015-04-01

    Full Text Available Halit Çinarka,1 Servet Kayhan,1 Mevlüt Karataş,1 Asiye Yavuz,1 Aziz Gümüş,1 Songül Özyurt,1 Medine Cumhur Cüre,2 Ünal Şahin1 1Department of Chest Diseases, 2Department of Biochemistry, Recep Tayyip Erdoğan University, Rize, Turkey Introduction: Copeptin which is the C-terminal fragment of antidiuretic hormone (ADH, is a biomarker that has been reported to be increased in various cardiovascular disorders, cerebrovascular diseases and associated with prognosis. Patients with obstructive sleep apnea syndrome (OSAS have a tendency to develop coronary and cerebral atherosclerotic diseases. Objectives: The aim of the present study was to study copeptin levels in patients with obstructive sleep apnea and in a control group in order to determine whether copeptin could be used as a biomarker predicting the severity of OSAS and possible complications in this group. Methods: A total of 116 patients with OSAS, diagnosed by polysomnography, and 27 controls were included in the study. Blood samples were collected after overnight fasting, and copeptin levels were measured with enzyme-linked immunosorbent assay. Results: Copeptin levels were significantly higher in the OSAS group compared to control group (2,156±502; 1,845±500 pg/mL, respectively, P=0.004. Mean copeptin level of the patients having apnea-hypopnea index (AHI ≥30 was significantly higher than that of the patients having AHI <30 (2,392±415; 2,017±500 pg/mL, respectively, P<0.001. A multivariate regression analysis showed that copeptin level, (hazard ratio: 1.58; 95% confidence interval: 1.09–2.30 was a predictor of severe OSAS (P=0.016. Copeptin levels showed significant positive correlation with AHI (r=0.32; P<0.001, desaturation index (r=0.23; P=0.012, arousal index (r=0.24; P=0.010 and CRP (r=0.26; P=0.011 respectively. Conclusion: Copeptin levels are high in OSAS patients and copeptin is a potential marker for identifying patients with a high risk of early cardiovascular

  17. 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.

  18. The pathogenesis of obstructive sleep apnea

    OpenAIRE

    Pham, Luu V.; Schwartz, Alan R.

    2015-01-01

    Obstructive sleep apnea (OSA) is a major source of cardiovascular morbidity and mortality, and represents an increasing burden on health care resources. Understanding underlying pathogenic mechanisms of OSA will ultimately allow for the development of rational therapeutic strategies. In this article, we review current concepts about the pathogenesis of OSA. Specifically, we consider the evidence that the upper airway plays a primary role in OSA pathogenesis and provide a framework for modelli...

  19. 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.

  20. MR image analytics to characterize upper airway architecture in children with OSAS

    Science.gov (United States)

    Tong, Yubing; Udupa, Jayaram K.; Torigian, Drew A.; Matsumoto, Monica M. S.; Sin, Sanghun; Arens, Raanan

    2015-03-01

    Mechanisms leading to Obstructive Sleep Apnea Syndrome (OSAS) in obese children are not well understood. We previously analyzed polysomnographic and demographic data to study the anatomical characteristics of the upper airway and body composition in two groups of obese children with and without OSAS, where object volume was evaluated. In this paper, in order to better understand the disease we expand the analysis considering a variety of features that include object-specific features such as size, surface area, sphericity, and image intensity properties of fourteen objects in the vicinity of the upper airway, as well as inter-object relationships such as distance between objects. Our preliminary results indicate several interesting phenomena: volumes and surface areas of adenoid and tonsils increase statistically significantly in OSAS. Standardized T2-weighted MR image intensities differ statistically significantly between the two groups, implying that perhaps intrinsic tissue composition undergoes changes in OSAS. Inter-object distances are significantly different between the two groups for object pairs (skin, oropharynx), (skin, fat pad), (skin, soft palate), (mandible, tongue), (oropharynx, soft palate), (left tonsil, oropharynx), (left tonsil, fat pad) and (left tonsil, right tonsil). We conclude that treatment methods for OSAS such as adenotonsillectomy should respect proportional object size relationships and spatial arrangement of objects as they exist in control subjects.

  1. 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.

  2. Development of sleep apnea syndrome screening algorithm by using heart rate variability analysis and support vector machine.

    Science.gov (United States)

    Nakayama, Chikao; Fujiwara, Koichi; Matsuo, Masahiro; Kano, Manabu; Kadotani, Hiroshi

    2015-08-01

    Although sleep apnea syndrome (SAS) is a common sleep disorder, most patients with sleep apnea are undiagnosed and untreated because it is difficult for patients themselves to notice SAS in daily living. Polysomnography (PSG) is a gold standard test for sleep disorder diagnosis, however PSG cannot be performed in many hospitals. This fact motivates us to develop an SAS screening system that can be used easily at home. The autonomic nervous function of a patient changes during apnea. Since changes in the autonomic nervous function affect fluctuation of the R-R interval (RRI) of an electrocardiogram (ECG), called heart rate variability (HRV), SAS can be detected through monitoring HRV. The present work proposes a new HRV-based SAS screening algorithm by utilizing support vector machine (SVM), which is a well-known pattern recognition method. In the proposed algorithm, various HRV features are derived from RRI data in both apnea and normal respiration periods of patients and healthy people, and an apnea/normal respiration (A/N) discriminant model is built from the derived HRV features by SVM. The result of applying the proposed SAS screening algorithm to clinical data demonstrates that it can discriminate patients with sleep apnea and healthy people appropriately. The sensitivity and the specificity of the proposed algorithm were 100% and 86%, respectively. PMID:26738189

  3. 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.

  4. The association between Obstructive Sleep Apnea and Alzheimer's Disease: a Meta-analysis perspective

    Directory of Open Access Journals (Sweden)

    Farnoosh eEmamian

    2016-04-01

    Full Text Available Alzheimer’s disease (AD and obstructive sleep apnea (OSA are highly prevalent, chronic conditions with intriguing, yet poorly understood epidemiological overlap. To date, the amount of OSA syndrome present in patients with AD across literature remains unknown. To address this question, we collected all available published clinical data and analyzed them through a quantitative meta-analytical approach. The results of our quantitative meta-analysis suggest that the aggregate odds ratio for OSA in AD versus healthy control was 5.05 and homogeneous. This reflects that patients with AD have a five times higher chance of presenting with OSA than cognitively non-impaired individuals of similar age. Moreover, these data suggest that around half of patients with AD have experienced OSA at some point after their initial diagnosis. The additive impact of progressive changes in sleep quality and structure, changes in cerebral blood flow and the cellular redox status in OSA patients may all be contributing factors to cognitive decline and may further aggravate AD progression. It is hoped that the high OSA rate in AD patients, as suggested by the findings of our meta-analysis, might provide a sufficient clinical incentive to alert clinicians the importance of screening patients for OSA in AD, and stimulate further research in this area.

  5. 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.

  6. Remarkable differences between three evidence-based guidelines on management of obstructive sleep apnea-hypopnea syndrome

    NARCIS (Netherlands)

    Aarts, M.C.; Heijden, G.J. van der; Rovers, M.M.; Grolman, W.

    2013-01-01

    OBJECTIVES/HYPOTHESIS: The aim of this study was to compare available guidelines for the diagnosis and treatment of patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) regarding their content, conclusions on the available evidence, and recommendations. STUDY DESIGN: Literature review/sys

  7. 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

  8. 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

  9. 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-

  10. 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.

  11. 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.

  12. New therapies for obstructive sleep apnea-hypopnea syndrome%治疗阻塞性睡眠呼吸暂停的新疗法介绍

    Institute of Scientific and Technical Information of China (English)

    付晓燕(综述); 汪建(审校)

    2015-01-01

    阻塞性睡眠呼吸暂停低通气综合征( obstructive sleep apnea-hypopnea syndrome , OSAHS)是一类常见疾病,可造成多系统功能障碍。当前的治疗方法存在患者依存性低和疗效差等不足。近年来,2种新的疗法在国外正处于临床试验阶段,其中一种方法的原理是基于上气道扩张肌在维持咽腔稳定性中所起的重要作用,利用电刺激颏舌肌扩大咽腔及改善上气道阻力,目前已通过了Ⅱ期临床实验,但研究发现不同患者在呼吸暂停低通气指数(apnea-hypopnea index, AHI)的改善程度方面存在差异,且长期安全性也有待进一步研究;另一种方法是利用一种鼻腔佩戴的双向阀门装置来增加呼气时的鼻阻力,该装置对于睡眠呼吸暂停相关症状的改善效果已得到前期临床试验的证实,且患者依存性好,但对于不同患者在疗效上仍存在差异。%Obstructive sleep apnea-hypopnea syndrome ( OSAHS) is a prevalent disorder often associated with multisystem dys-function.Available therapies are limited by either lack of long-term adherence or low response rates .Two emerging therapies hold promise in providing alternatives to patients with OSA .The first stems from the importance of the upperairway dilator muscles in main-taining pharyngeal stability .Electrical stimulation of the genioglossus muscle improves both upper-airway diameter and ameliorates pha-ryngeal obstruction .The results of phase ⅠandⅡclinical trials hold promise , but the reported improvements in the apnea-hypopnea index vary between subjects and long-term safety needs further studies .The second technology relies on creating an increased expiratory nasal resistance via a bidirectional valve designed to be worn just inside the nostrils .Initial findings of clinical trials suggest reduction in severity of sleep apnea and subjective daytime sleepiness .Considerable heterogeneity in response to the nasal device was

  13. 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.

  14. 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

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. 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

  20. Comparison of the effects of continuous positive airway pressure, oral appliance and exercise training in obstructive sleep apnea syndrome

    Directory of Open Access Journals (Sweden)

    Teresa Cristina Barros Schutz

    2013-01-01

    Full Text Available OBJECTIVE: There are several treatments for obstructive sleep apnea syndrome, such as weight loss, use of an oral appliance and continuous positive airway pressure, that can be used to reduce the signs and symptoms of obstructive sleep apnea syndrome. Few studies have evaluated the effectiveness of a physical training program compared with other treatments. The aim of this study was to assess the effects of physical exercise on subjective and objective sleep parameters, quality of life and mood in obstructive sleep apnea patients and to compare these effects with the effects of continuous positive airway pressure and oral appliance treatments. METHODS: Male patients with moderate to severe obstructive sleep apnea and body mass indices less than 30 kg/m2 were randomly assigned to three groups: continuous positive airway pressure (n = 9, oral appliance (n = 9 and physical exercise (n = 7. Polysomnographic recordings, blood samples and daytime sleepiness measurements were obtained prior to and after two months of physical exercise or treatment with continuous positive airway pressure or an oral appliance. Clinicaltrials.gov: NCT01289392 RESULTS: After treatment with continuous positive airway pressure or an oral appliance, the patients presented with a significant reduction in the apnea-hypopnea index. We did not observe changes in the sleep parameters studied in the physical exercise group. However, this group presented reductions in the following parameters: T leukocytes, very-low-density lipoprotein and triglycerides. Two months of exercise training also had a positive impact on subjective daytime sleepiness. CONCLUSIONS: Our results suggest that isolated physical exercise training was able to modify only subjective daytime sleepiness and some blood measures. Continuous positive airway pressure and oral appliances modified the apnea-hypopnea index.

  1. 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.

  2. Sleep apnea syndrome and snoring in patients with hypothyroidism with relation to overweight.

    Science.gov (United States)

    Misiolek, M; Marek, B; Namyslowski, G; Scierski, W; Zwirska-Korczala, K; Kazmierczak-Zagorska, Z; Kajdaniuk, D; Misiolek, H

    2007-03-01

    The relation between snoring and obstructive sleep apnea as well as hypothyroidism is the object of interest of many authors. The respiratory disturbances during sleep are often observed in patients suffering from hypothyroidism. The relation of snoring to overweight in those patients has not been taken into account. The aim of the study was to evaluate the relations between hypothyroidism and quantitative and qualitative respiratory disturbances during sleep. Additional aim was to establish the relations of sleep apnea syndrome, snoring, hypothyroidism and overweight. The subjects included 15 patients (11 females and 4 males) aged from 28 to 73 (mean 50.3) suffering from hypothyroidism. All of them underwent thyroid testing before and after the hormonal treatment. TSH and fT4 concentrations were determined. At the same time the sleep assessment (PolyMESAM) was performed twice. Data were obtained from sleep studies and questionnaires (Epworth sleepiness scale). After the thyroid hormones stabilization significant decrease of snoring severity was observed. On the contrary, the respiratory disturbance index (RDI), desaturation index (DI), the lowest saturation (LSAT) did not change significantly, however, the Epworth scale score showed significant improvement. The correlations showed the strong relation between loud snoring and TSH (r=0.73, p<0.01) and fT4 (r=-0.66, p<0.003) concentrations before the treatment. The analysis showed no correlation between body mass (BMI) and snoring. The hormonal stabilization in patients suffering from hypothyroidism causes improvement in snoring severity. Based on our investigation the relationship between hypothyroidism and severity of snoring and excessive daytime somnolence was confirmed. It indicates a possible connection between hypothyroidism and upper airway resistance syndrome. PMID:17443029

  3. 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.

  4. Role of oxidative stress in obstructive sleep apnea hypopnea syndrome%氧化应激在阻塞性睡眠呼吸暂停低通气综合征中的作用

    Institute of Scientific and Technical Information of China (English)

    苏艳娜; 张庆

    2015-01-01

    Obstructive sleep apnea hypopnea syndrome(OSAHS) is a common respiratory disease . It can cause serious complications of many systems ,such as cardiovascular and cerebrovascular ,endocrine and nervous systems .In a result ,OSAHS is definitely a systemic disease .Recently a growing number of studies have comfired that OSAHS is closely connected with oxidative stress and a variety of inflammatory cytokines .Therefore ,on the basis of renewed cognition of pathogenesis in OSAHS ,the paper focuses on current status of antioxidatant treatment in OSA HS .%OSA HS是一种常见的呼吸系统疾病,能引起心脑血管系统、内分泌系统、神经系统等多系统损害,因此OSAHS更是一种系统性疾病。近年来有越来越多的研究证实OSAHS与氧化应激及多种炎性因子关系密切,本文旨在对其发病机制重新认识的基础上阐述OSAHS目前的抗氧化治疗现状。

  5. Comparison of Cephalometric Variables in Non-obese and Obese Patients with Obstructive Sleep Apnea

    Directory of Open Access Journals (Sweden)

    Önder Öztürk

    2011-09-01

    Full Text Available Objective: To compare the cephalometric variables of obese (body mass index (BMI ≥30 and non-obese (BMI<30 Turkish male patients with obstructive sleep apnea syndrome (OSAS. Materials and Methods: OSAS diagnosed 85 patients who were obese [n=37; mean age (±SE, 49.41±1.54 year] and non-obese [n=48; mean age (±SE 46.92±1.39 year] were included in the study. The cephalometric measurements and polysomnographic data of the patients were compared and a discriminatory analysis was performed.Results: The apnea-hypopnea index (AHI was significantly higher in obese patients (p<0.01. Bimaxillary protrusion was found in obese patients (p<0.05. The non-obese patients with AHI ≥ 30 had an increased mandibular plane angle In the stepwise discriminant analysis done separately in obese and non-obese patients according to AHI; only the hyoid bone position was included in the model in obese patients and the estimated success of discrimination of AHI’s level (<30 and ≥30 was 70.3%. Age, anterior face and posterior face height were included to the model in non-obese patients and the estimated success of discrimination was found as 79.2%. Conclusion: Craniofacial morphology has an effect on the severity of OSAS. If the craniofacial morphology tends toward a worsening of OSAS with obesity, the severity of the OSAS increases.

  6. 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.

  7. The Correlation of Serum Growth Differentiation Factor-15 Level in Patients with Obstructive Sleep Apnea

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    Kamran Sari

    2015-01-01

    Full Text Available Purpose. Growth differentiation factor-(GDF- is a prognostic biomarker in cardiovascular disorders (CVD. GDF-15 level was not studied in patients with obstructive sleep apnea syndrome (OSAS before. In this study, we investigated serum GDF-15 levels in OSAS patients and compared them with healthy controls. Material and Methods. Polysomnographically, confirmed forty consecutive OSAS patients (20 men and 20 women and forty consecutive healthy controls (23 men and 17 women were enrolled in the study. The samples in each group had similar demographic characteristics and body mass index (BMI values. Results. In the study, no significant correlation was found about GDF-15 levels of OSAS group and healthy controls. However, there was a significant statistical correlation between age and GDF-15 level. In correlation analysis, there was not any significant correlation between age and BMI. Conclusion. Although various developing biomarkers have been studied in cardiovascular disorders, GDF-15 levels have attracted a widespread interest as predictors of cardiovascular risk. GDF-15 level has not been evaluated previously in patients with OSAS. A significant statistical correlation was found between age and GDF-15 level. To reveal close relation between OSAS and GDF-15, further studies are needed with combination of GDF-15 and other biomarkers in OSAS.

  8. Co-morbidities associated with obstructive sleep apnea

    Directory of Open Access Journals (Sweden)

    V K Vijayan

    2014-03-01

    Full Text Available There are many co-morbid conditions that are associated with obstructive sleep apnea(OSA. Though a causative relationship between OSA and some of the co-morbiditiesis well established or strongly associated, many risk factors of OSA (age, male genderand obesity are also known risk factors especially for cardiovascular diseases. Otherimportant co-morbid conditions associated with OSA are neurocognitive dysfunctionand, erectile dysfunction. Recently there are reports that ocular manifestations areassociated with OSA. It is expected that more co-morbidities will be reported in OSA asthe research in this area progresses.Key words: Co-morbidities in OSA, Hypertension, Cardiac arrhythmias, Stoke,Erectile dysfunction

  9. 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.

  10. Identification and Treatment of New Inflammatory Triggers for Complex Regional Pain Syndrome: Small Intestinal Bacterial Overgrowth and Obstructive Sleep Apnea.

    Science.gov (United States)

    Weinstock, Leonard B; Myers, Trisha L; Walters, Arthur S; Schwartz, Oscar A; Younger, Jarred W; Chopra, Pradeep J; Guarino, Anthony H

    2016-05-01

    Complex regional pain syndrome (CRPS) is evoked by conditions that may be associated with local and/or systemic inflammation. We present a case of long-standing CRPS in a patient with Ehlers-Danlos syndrome in which prolonged remission was attained by directing therapy toward concomitant small intestinal bacterial overgrowth, obstructive sleep apnea, and potential increased microglia activity. We theorize that cytokine production produced by small intestinal bacterial overgrowth and obstructive sleep apnea may act as stimuli for ongoing CRPS symptoms. CRPS may also benefit from the properties of low-dose naltrexone that blocks microglia Toll-like receptors and induces production of endorphins that regulate and reduce inflammation. PMID:26867023

  11. 阻塞性睡眠呼吸暂停综合征相关性高血压交感神经递质的研究进展%Research advancement of sympathetic neurotransmitter of obstructive sleep apnea syndrome pathogenesis of hypertension

    Institute of Scientific and Technical Information of China (English)

    杨晶晶; 王红梅; 李南方

    2010-01-01

    阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS)是一种常见的睡眠调节障碍性疾患,最显著的病理生理变化是低氧血症和高碳酸血症,伴有睡眠中的觉醒及睡眠结构的改变,并与多种疾病尤其是心血管疾病密切相关,其最主要的心血管合并症即为高血压病(hypertension,HTN).研究发现,OSAS相关性HTN发病机制多样,其中交感神经兴奋性增强是疾病发生、发展的主要机制,而作为神经递质的儿茶酚胺、神经肽Y、降钙素基因相关肽、5-羟色胺等物质也发挥了重要作用.通过了解OSAS患者交感神经递质及递质之间的关系,将对全面地认识和有效地防治HTN起尤为重要的作用,这篇文章将对目前OSAS合并HTN患者交感神经递质的研究现状作一综述报道.%Obstructive sleep apnea syndrome (OSAS) is a common ailment of sleep regulation disorders. The most notable changes of pathophysiology are hypoxemia and hypercapnia, which are accompanied with sudden waking up and changes of sleeping structure during the sleep. OSAS is closely connected with many other diseases, especially hypertension (HTN). A number of studies found that OSAS pathogenesis of HTN is complicated,and the main mechanism is the enhancing of the sympathetic excitation. However, as neurotransmitter Catecholamines, Neuropeptide Y, Calcitonin gene related peptide,5-hydroxy tryptamine substances also play an important role. Through understanding the relationship between sympathetic delivery and transmitter in OSAS patients, it is facility to us comprehensively recognize and effectively prevent and treat HTN. This paper will provide a present research situation of sympathetic neurotransmitter in patients with the disease of HTN and OSAS.

  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. 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.

  14. Lack of Impact of Mild Obstructive Sleep Apnea on Sleepiness, Mood and Quality of Life

    OpenAIRE

    Quan SF; Budhiraja R; Batool-Anwar S; Gottlieb DJ; Eichling P; Patel S; Shen W; Walsh JK; Kushida CA

    2014-01-01

    Background and Objectives: Obstructive sleep apnea (OSA) is associated with sleepiness, depression and reduced quality of life. However, it is unclear whether mild OSA has these negative impacts. Using data from the Apnea Positive Pressure Long-term Efficacy Study (APPLES), this study determined whether participants with mild OSA had greater sleepiness, more depressive symptoms and poorer quality of life in comparison to those without OSA. Methods: 239 persons evaluated for participation ...

  15. A Novel Method for Recognition of Bioradiolocation Signal Breathing Patterns for Noncontact Screening of Sleep Apnea Syndrome

    OpenAIRE

    Maksim Alekhin; Lesya Anishchenko; Alexander Tataraidze; Sergey Ivashov; Vladimir Parashin; Lyudmila Korostovtseva; Yurii Sviryaev; Alexey Bogomolov

    2013-01-01

    A novel method for recognition of breathing patterns of bioradiolocation signals breathing patterns (BSBP) in the task of noncontact screening of sleep apnea syndrome (SAS) is proposed and implemented on the base of wavelet transform (WT) and neural network (NNW) applications. Selection of the optimal parameters of WT includes determination of the proper level of wavelet decomposition and the best basis for feature extraction using modified entropy criterion. Selection of the optimal properti...

  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. Multivoxel 1H-MR spectroscopy in obstructive sleep apnea hypopnea syndrome

    International Nuclear Information System (INIS)

    Objective: To investigate the clinical value of multivoxel 1H magnetic resonance spectroscopy (1H-MRS) in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Materials and Methods: 20 patients (case group) with moderate to severe clinically diagnosed OSAHS and 20 age-gender matched healthy volunteers (control group) underwent brain multivoxel 1H-MRS examinations. The ratios of brain metabolites of centrum ovale and basal ganglia were recorded respectively. Related clinical indexes, including sleep apnea and hypopnea index (AHI) and the average night-time oxygen saturation (SpO2), were recorded. Results: In region of centrum ovale, the NAA/Cho and NAA/Cr of the case group decreased and were significantly lower than that of control group (P<0.05). The Cho/Cr of the case group was significantly increased compared to the controls (P<0.05). In region of basal ganglia, the NAA/Cho, NAA/Cr, and Cho/Cr had no significantly difference between the two groups (P>0.05). Lactate peak was not detected in the two groups. In the region of centrum ovale, the AHI showed inverse correlation to the NAA/Cho (P<0.05). The SpO2 showed positive correlations to the NAA/Cho (P<0.05). There was no correlation between clinical indexes and NAA/Cr or Cho/Cr (P>0.05). Conclusion: Multivoxel 1H-MRS could early detect the changes of cerebral metabolism in patients with OSAHS. It provides an objective imaging basis for the clinical diagnosis and treatment. (authors)

  18. Poincaré analysis of an overnight arterial oxygen saturation signal applied to the diagnosis of sleep apnea hypopnea syndrome

    International Nuclear Information System (INIS)

    The analysis of oxygen desaturations is a basic variable in polysomnographic studies for the diagnosis of sleep apnea. Several algorithms operating in the time domain already exist for sleep apnea detection via pulse oximetry, but in a disadvantageous way—they achieve either a high sensitivity or a high specificity. The aim of this study was to assess whether an alternative analysis of arterial oxygen saturation (SaO2) signals from overnight pulse oximetry could yield essential information on the diagnosis of sleep apnea hypopnea syndrome (SAHS). SaO2 signals from 117 subjects were analyzed. The population was divided into a learning dataset (70 patients) and a test set (47 patients). The learning set was used for tuning thresholds among the applied Poincaré quantitative descriptors. Results showed that the presence of apnea events in SAHS patients caused an increase in the SD1 Poincaré parameter. This conclusion was assessed prospectively using the test dataset. 90.9% sensitivity and 84.0% specificity were obtained in the test group. We conclude that Poincaré analysis could be useful in the study of SAHS, contributing to reduce the demand for polysomnographic studies in SAHS screening

  19. Efficacy of mandibular advancement device in the treatment of obstructive sleep apnea syndrome: A randomized controlled crossover clinical trial

    Science.gov (United States)

    Crovetto-Martínez, Rafael; Alkhraisat, Mohammad-Hamdan; Crovetto, Miguel; Municio, Antonio; Kutz, Ramón; Aizpuru, Felipe; Miranda, Erika; Anitua, Eduardo

    2015-01-01

    Background Evaluation of the efficacy and safety of a mandibular advancement device (MAD) (KlearwayTM) in the treatment of mild-to-moderate obstructive sleep apnea and chronic roncopathy. Material and Methods A randomized, placebo-controlled, double blinded, and crossover clinical trial was conducted. Placebo device (PD) defined as a splint in the centric occlusion that did not induce a mandibular advancement served as a control. The mandible was advanced to the maximum tolerable distance or to a minimum of 65% of the maximum protrusion. After each sequence of treatment, patients were assessed by questionnaires, conventional polysomnography, and objective measurement of snoring at the patient’s own home. Results Forty two patients participated in the study and 38 completed the study. Patients mean age was 46 ±9 years and the 79% were males. The mean mandibular advancement was 8.6 ±2.8 mm. Patients used the MAD and the PD for 6.4 +2.4 hours and 6.2 +2.0 hours, respectively. Secondary effects (mostly mild) occurred in the 85.7% and the 86.8% of the users of MAD and PD, respectively. The MAD induced a decrease in the apnea-hypopnea index (AHI) from 15.3 +10.2 to 11.9 +15.5. The 50% reduction in the AHI was achieved in the 46.2% and the 18.4% of the patients treated with MAD and PD, respectively. The use of the MAD induced a reduction in the AHI by 3.4 +15.9 while the PD induced an increase by 10.6 +26.1. The subjective evaluation of the roncopathy indicated an improvement by the MAD and an increase in the perceptive quality of sleep. However, the objective evaluation of the roncopathy did not show significant improvements. Conclusions The use of MAD is efficient to reduce the AHI and improve subjectively the roncopathy. MAD could be considered in the treatment of mild-to-moderate OSA and chronic roncopathy. Key words:Obstructive sleep apnea (OSA), mandibular advance device, treatment, efficacy, clinical assay. PMID:26241460

  20. BMI in patients with obstructive sleep apnea

    OpenAIRE

    Dobrowolska-Zarzycka Magdalena; Dunin-Wilczynska Izabella; Mitura Iwona; Szymanska Jolanta

    2015-01-01

    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...

  1. 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

  2. Patients with Obstructive Sleep Apnea at Altitude.

    Science.gov (United States)

    Bloch, Konrad E; Latshang, Tsogyal D; Ulrich, Silvia

    2015-06-01

    Bloch, Konrad E., Tsogyal D. Latshang, and Silvia Ulrich. Patients with obstructive sleep apnea at altitude. High Alt Med Biol 16:110-116, 2015.--Obstructive sleep apnea (OSA) is highly prevalent in the general population, in particular in men and women of older age. In OSA patients sleeping near sea level, the apneas/hypopneas associated with intermittent hypoxemia are predominantly due to upper airway collapse. When OSA patients stay at altitudes above 1600 m, corresponding to that of many tourist destinations, hypobaric hypoxia promotes frequent central apneas in addition to obstructive events, resulting in combined intermittent and sustained hypoxia. This induces strong sympathetic activation with elevated heart rate, cardiac arrhythmia, and systemic hypertension. There are concerns that these changes expose susceptible OSA patients, in particular those with advanced age and co-morbidities, to an excessive risk of cardiovascular and other adverse events during a stay at altitude. Based on data from randomized trials, it seems advisable for OSA patients to use continuous positive airway pressure treatment with computer controlled mask pressure adjustment (autoCPAP) in combination with acetazolamide during an altitude sojourn. If CPAP therapy is not feasible, acetazolamide alone is better than no treatment at all, as it improves oxygenation and sleep apnea and prevents excessive blood pressure rises of OSA patients at altitude. PMID:25973669

  3. Sleep Position Trainer versus Tennis Ball Technique in Positional Obstructive Sleep Apnea Syndrome

    Science.gov (United States)

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

    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 were treated with the sleep position trainer (SPT), 26 patients with the tennis ball technique (TBT). At baseline and 1 month polysomnography, Epworth Sleepiness Scale (ESS) and the Quebec Sleep Questionnaire (QSQ) were taken. Daily compliance was objectively measured in both groups. Results: Both therapies prevent supine sleep position to a median of 0% (min-max: SPT 0.0% to 67%, TBT 0.0% to 38.9%), resulting in a treatment success (AHI < 5) in 68.0% of the SPT and 42.9% of the TBT patients. The ESS at baseline was < 10 in both groups. Sleep quality parameters, such as wake after sleep onset (WASO; p = 0.001) and awakenings (p = 0.006), improved more in the SPT group. Total QSQ scores (0.4 ± 0.2, p = 0.03), the QSQ domains nocturnal symptoms (0.7 ± 0.2, p = 0.01), and social interactions (0.8 ± 0.3, p = 0.02) changed in favor of the SPT group. Effective compliance (≥ 4 h/night + ≥ 5 days/week) was 75.9% for the SPT and 42.3% for the TBT users (p = 0.01). Conclusion: In mild POSAS with normal EES the new SPT device and the standard TBT are equally effective in reducing respiratory indices. However, compared to the TBT, sleep quality, quality of life, and compliance improved significantly more in the SPT group. Citation: Eijsvogel MM, Ubbink R, Dekker J, Oppersma E, de Jongh FH, van der Palen J, Brusse-Keizer MG. Sleep position trainer versus tennis ball technique in positional obstructive sleep apnea syndrome. J Clin Sleep Med 2015;11(2):139–147. PMID:25515276

  4. 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

  5. Pathophysiology of Sleep Apnea

    OpenAIRE

    Dempsey, Jerome A; Veasey, Sigrid C.; Morgan, Barbara J.; O'Donnell, Christopher P.

    2010-01-01

    Sleep-induced apnea and disordered breathing refers to intermittent, cyclical cessations or reductions of airflow, with or without obstructions of the upper airway (OSA). In the presence of an anatomically compromised, collapsible airway, the sleep-induced loss of compensatory tonic input to the upper airway dilator muscle motor neurons leads to collapse of the pharyngeal airway. In turn, the ability of the sleeping subject to compensate for this airway obstruction will determine the degree o...

  6. Intention to Exercise in Patients with Obstructive Sleep Apnea

    OpenAIRE

    Smith, Simon S.; Doyle, Geoffrey; Pascoe, Thomas; Douglas, James A; Jorgensen, Greg

    2007-01-01

    Obstructive sleep apnea (OSA) is a common and serious health issue that is strongly associated with excess weight. Exercise may be an effective mechanism for reducing the severity of OSA both in association with, and independent of, reduction in body weight. As such, increased exercise has been suggested as a potential intervention for OSA, particularly for patients with mild to moderate clinical severity. However, it is unknown how ready to engage in exercise patients with OSA are. Self-repo...

  7. 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.

  8. Attention Deficit/Hyperactivity Disorder in Adults with Sleep Apnea

    OpenAIRE

    Oğuztürk, Ömer; Ekici, Mehmet; Çimen, Dilay; Ekici, Aydanur; Senturk, Erol

    2012-01-01

    AAttention deficit hyperactivity disorder (ADHD) is a common childhood illness. In some patients, this illness may persist into adulthood and an association between ADHD and Obstructive Sleep Apnea (OSA) has been found in childhood. However, it is unclear how OSA and ADHD coincide in adulthood. Therefore, to explore the relationship between OSA and adult ADHD the current investigation utilized a clinically-based cross-sectional survey. Subjects consisted of 81 treatment-naïve OSA patients and...

  9. 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.

  10. Obstructive sleep apnea, diagnosed by the Berlin questionnaire and association with coronary artery disease severity

    Science.gov (United States)

    Ghazal, Abdullatef; Roghani, Farshad; Sadeghi, Masoumeh; Amra, Babak; Kermani-Alghoraishi, Mohammad

    2015-01-01

    BACKGROUND Obstructive sleep apnea syndrome (OSAS) is a highly prevalent sleep-related disorder that is associated with increased risk of hypertension (HTN) and coronary heart disease. This study aimed to evaluate the correlation between the OSAS and coronary artery disease (CAD) severity. METHODS The cross-sectional study was conducted from September 2012 to December 2013. We enrolled 127 patients with chronic stable angina who were referred for coronary angiographic studies in Shahid Chamran and Nour Hospitals in Isfahan, Iran. The Berlin questionnaire (BQ) was used for estimate the probability of OSAS in patients as a low or high probability. Demographic characteristics and metabolic risk factors including diabetes mellitus, HTN, obesity, and smoking also were recorded. The severity of CAD was assessed and compared based on the Gensini score with Mann-Whitney U statistical test. Independent t-test for continuous variables and chi-square test for categorical variables were used. RESULTS Totally, 65.4% of subjects were considered as high and 34.6% as low probability for OSAS, which 81.1% of them had CAD. There was a significant difference between body mass index, systolic blood pressure, diastolic blood pressure, and ischemic heart disease drug consumption with OSAS probability (P < 0.0500). CAD was accompanied by OSAS significantly (P = 0.0260). The Gensini score was significantly higher in patients with high OSAS probability (100.4 ± 69.1 vs. 65.3 ± 68.9; P = 0.0030). OSAS also increase odds of CAD based on regression analysis (odds ratio, 95% confidence interval = 2.7). CONCLUSION This study indicates that more severe CAD is associated with high OSAS probability identified by BQ. PMID:26715932

  11. 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.

  12. 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. PMID:27672073

  13. 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.

  14. Evaluation of sleep apnea syndrome (SAS) with low field MR fluoroscopy

    International Nuclear Information System (INIS)

    Eight cases of clinically diagnosed sleep apnea syndrome (SAS) and two normal volunteers were studied with low field MR fluoroscopy in order to monitor the waking and sleeping status of the upper airway. MR fluoroscopy revealed that only the sleeping patients showed occlusions of the upper airway. This technique provided us with useful information about the level, frequency and duration of occlusion in each case. Four of the eight patients demonstrated simple retropalatal occlusion, whereas the other four demonstrated mixed retropalatal and retropalato-retroglossal occlusion. Thus long-time monitoring, which is only possible with MR fluoroscopy, is needed to appreciate the complex nature of the disease. In addition, the comfortable surroundings and low noise level provided by the low field enabled physiological study to be performed without any tranquilizers in most of the patients, which is again only possible with MR fluoroscopy. MR fluoroscopy may become a tool of great clinical value, providing much important information for disease evaluation and treatment selection. (author)

  15. Evaluation of sleep apnea syndrome (SAS) with low field MR fluoroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Fukatsu, Hiroshi; Ando, Yoko; Ishigaki, Takeo [Nagoya Univ. (Japan). School of Medicine; Okada, Tamotsu

    1995-02-01

    Eight cases of clinically diagnosed sleep apnea syndrome (SAS) and two normal volunteers were studied with low field MR fluoroscopy in order to monitor the waking and sleeping status of the upper airway. MR fluoroscopy revealed that only the sleeping patients showed occlusions of the upper airway. This technique provided us with useful information about the level, frequency and duration of occlusion in each case. Four of the eight patients demonstrated simple retropalatal occlusion, whereas the other four demonstrated mixed retropalatal and retropalato-retroglossal occlusion. Thus long-time monitoring, which is only possible with MR fluoroscopy, is needed to appreciate the complex nature of the disease. In addition, the comfortable surroundings and low noise level provided by the low field enabled physiological study to be performed without any tranquilizers in most of the patients, which is again only possible with MR fluoroscopy. MR fluoroscopy may become a tool of great clinical value, providing much important information for disease evaluation and treatment selection. (author).

  16. 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...

  17. [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.

  18. 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

  19. 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

  20. Reliability of SleepStrip as a screening test in obstructive sleep apnea patients.

    Science.gov (United States)

    Dinç, Aykut Erdem; Yılmaz, Metin; Tutar, Hakan; Aydil, Utku; Kızıl, Yusuf; Damar, Murat; Kemaloğlu, Yusuf K

    2014-10-01

    Obstructive sleep apnea syndrome (OSAS) is a common sleep disorder and related to multiple conditions that cause mortality in adults. In the present study, reliability of SleepStrip, a disposable screening device for detection of OSAS, is tested. In this prospective, nonrandomized double-blinded single cohort study at an academic health center, the performance of the SleepStrip in detecting respiratory events and establishing an SleepStrip score (Sscore) in domestic use were compared to the apnea-hypopnea index (AHI) obtained by the standard polysomnography (PSG) recordings in the sleep laboratory. Forty-one patients who have the PSG results participated the study and wore the SleepStrips at home. Test efficiency rate was 75% and there was a positive correlation between PSG-AHI scores and Sscores (r = 0.71, p 30 levels. The SleepStrip has 100% specificity and positive predictive values, but it also has low negative predictive and sensitivity values. The SleepStrip is not a reliable screening test in differential diagnosis among simple snorers, mild, moderate and severe OSAS patients. However, high Sscores highly indicate the presence of moderate-severe OSAS. We can safely send these patients to split-night PSG and continuous, automatic, bi-level positive airway pressure (CPAP/BPAP/APAP) titration at the same night. The SleepStrip may increase the effective use of the sleep laboratories. PMID:24861563

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

    Directory of Open Access Journals (Sweden)

    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.

  2. 儿童阻塞性睡眠呼吸暂停低通气综合征筛查评分标准的探讨%Exploration of screening scores for pediatric obstructive sleep apnea hypopnea syndrome

    Institute of Scientific and Technical Information of China (English)

    杨扬; 许志飞; 陈敏; 张亚梅

    2012-01-01

    目的:探讨采用儿童睡眠呼吸生活质量问卷、体格检查及电子鼻咽镜检查结果筛查儿童OSAHS的可行性.方法:对2009年以睡眠打鼾为主诉来我院儿童睡眠中心行PSG监测的患儿527例进行OSA-18问卷调查、体格检查以及电子鼻咽镜检查.以PSG监测结果作为诊断OSAHS的标准,将入组患儿分为OSAHS组和非OSAHS组,并将该2组患儿的临床资料进行统计学分析.结果:2组间年龄、扁桃体大小评分、腺样体大小评分、OSA-18总评分、OSA-18问题1(响亮的鼾声)评分、OSA-18问题3(睡眠中有气喘或窒息)评分、OSA-18问题16(担心孩子夜间不能得到足够氧气)评分之间差异有统计学意义(P<0.05).用Logistic回归(Backward:LR法)建立Y的回归方程并做ROC曲线分析.Y的界限值为0.735,即Y>0.735,则患有OSAHS的可能性增加,其敏感度为62.7%,特异度为79.4%.结论:以OSA-18问卷调查、体格检查及电子鼻咽镜的检查结果对患儿进行临床评估,以此对儿童OSAHS进行初步筛查的方法是可行的.%To evaluate the feasibility of screening for pediatric obstructive sleep apnea hypopnea syndrome(OSAHS) according to OSA-18, physical examination and electroic nasopharyngoscopy. Method: Outpatients with snoring received qustionnaire, physical examination and electroic nasopharyngoscopy in Pediatric Sleep Center of Beijing Chilidren's Hospital from 2009. 1 to 2009. 12. All children were divided into OSAHS or non-OS-AHS group based on the results of polysomnography (PSG). The materail was compared between these two groups. Result:The differences of age, tonsil scores, adenoid scores, total OSA-18 sores, the loudness of snoring scores, sleep asthma or suffocation scores, worrying lack of oxygen scores were significant(P<0. 05). And then put them into the Logistic equation Y and make ROC analysis, if Y is higher than 0. 735, these children were more likely with OSAHS. The sensitivity was 62. 7% and the specificity

  3. 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.

  4. 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.

  5. Identifying sleep apnea syndrome using heart rate and breathing effort variation analysis based on ballistocardiography.

    Science.gov (United States)

    Weichao Zhao; Hongbo Ni; Xingshe Zhou; Yalong Song; Tianben Wang

    2015-08-01

    Sleep apnea syndrome (SAS) is regarded as one of the most common sleep-related breathing disorders, which can severely affect sleep quality. Since SAS is usually accompanied with the cyclical heart rate variation (HRV), many studies have been conducted on heart rate (HR) to identify it at an earlier stage. While most related work mainly based on clinical devices or signals (e.g., polysomnography (PSG), electrocardiography (ECG)), in this paper we focus on the ballistocardiographic (BCG) signal which is obtained in a non-invasive way. Moreover, as the precision and reliability of BCG signal are not so good as PSG or ECG, we propose a fine-grained feature extraction and analysis approach in SAS recognition. Our analysis takes both the basic HRV features and the breathing effort variation into consideration during different sleep stages rather than the whole night. The breathing effort refers to the mechanical interaction between respiration and BCG signal when SAS events occur, which is independent from autonomous nervous system (ANS) modulations. Specifically, a novel method named STC-Min is presented to extract the breathing effort variation feature. The basic HRV features depict the ANS modulations on HR and Sample Entropy and Detrended Fluctuation Analysis are applied for the evaluations. All the extracted features along with personal factors are fed into the knowledge-based support vector machine (KSVM) classification model, and the prior knowledge is based on dataset distribution and domain knowledge. Experimental results on 42 subjects in 3 nights validate the effectiveness of the methods and features in identifying SAS (90.46% precision rate and 88.89% recall rate). PMID:26737303

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

    Science.gov (United States)

    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.

  7. 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

  8. Global brain blood-oxygen level 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 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

  9. Effect of adenotonsillectomy on endothelium dependent flow-mediated dilation in children with moderate to severe obstructive sleep apnea syndrome%扁桃体腺样体切除术对中、重度OSAS患儿血流介导的血管扩张功能的影响

    Institute of Scientific and Technical Information of China (English)

    杨海波; 王英; 董明敏

    2012-01-01

    目的 评价儿童中、重度阻塞性睡眠呼吸暂停综合征(OSAS)患儿血流介导的血管扩张功能(FMD)改变及扁桃体腺样体切除术对患儿FMD的影响.方法 选取经多导睡眠图(PSG)确诊且未经治疗并排除其他疾病的中、重度OSAS患儿54例为试验组,35例PSG检查正常者为对照组,应用高频超声测定2组FMD水平,试验组接受扁桃体腺样体切除术后6个月复查PSG及FMD.结果 试验组与对照组相比FMD明显降低((9.5±2.8)%VS(16.2±4.9)%,P<0.01),且接受扁桃体腺样体切除术后6个月FMD较术前明显改善((13.7±3.7)% VS (9.5±2.8)%,P<0.01).结论 儿童中、重度OSAS患儿FMD减弱,扁桃体腺样体切除术可改善FMD.%Objective It is to explore the changes of endothelial function by endothelium dependent flow-mediated dilation ( FMD ) in children with moderate to severe obstructive sleep apnea syndrome ( OSAS ) and the effects of adenotonsillectomy on it. Methods 35 healthy subjects and 54 children with moderate to severe OSAS who undergone adenotonsillectomy were pro-spectively enrolled. FMD was measured by high-resolution B - mode ultrasonography. All subjects participated in polysomnog-raphy ( PSG )sleep studies. These studies were repeated 6 months after Adenotonsillectomy in children with moderate to severe OSAS. Results There was significant difference in FMD between children with moderate to severe OSAS and healthy subjects at baseline( 9. 5 ± 2. 8% VS 16. 2 ± 4. 9% , P < 0.01 ). 6 months after adenotonsillectomy FMD increased obviously from 9. 5 ± 2. 8% to 13.7 ±3.7% in children with OSAS. Conclusion FMD is decreased in children with moderate to severe OSAS, adenotonsillectomy treatment leads to improvement of FMD.

  10. 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

    Directory of Open Access Journals (Sweden)

    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.

  11. Obstructive sleep apnea and hypertension: a critical review.

    Science.gov (United States)

    Mohsenin, Vahid

    2014-10-01

    Obstructive sleep apnea (OSA) is a prevalent sleep disorder which is characterized by recurrent upper closure with oxygen desaturation and sleep disruption. OSA increases the risk of vascular disorders in the form of stroke, myocardial infarction, congestive heart failure, and hypertension. The mechanisms underlying the vascular disorders are several and include intermittent hypoxia with release of cytokines, angiogenic inhibitors, free radicals, and adhesion molecules. During apneas, arterial blood pressure gradually rises and surges abruptly after the termination of apnea. Two thirds of patients with OSA will ultimately have diurnal hypertension. This review discusses the literature supporting the significant role of OSA in hypertension and the effect of OSA treatment on blood pressure. PMID:25139780

  12. Innovative treatments for adults with obstructive sleep apnea

    Directory of Open Access Journals (Sweden)

    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

  13. 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

  14. Management of Obstructive Sleep Apnea in an Edentulous Lower Jaw Patient with a Mandibular Advancement Device

    OpenAIRE

    Filiz Keyf; Bülent Çiftci; Selma Fırat Güven

    2014-01-01

    Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder with periodic reduction or cessation of airflow during sleep. It is associated with loud snoring, disrupted sleep, and witnessed apneas. Treatment of OSA varies from simple measures such as oral appliances and nasal continuous positive airway pressure (CPAP) to surgical procedures like uvulopalatopharyngoplasty and tracheostomy. Oral appliances are a viable nonsurgical treatment alternative in patients with OSA,...

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

    Directory of Open Access Journals (Sweden)

    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.

  16. Flash CT扫描对OSAS患者的动态成像及辐射剂量研究%Study of Dynamic Scanning in High-pitch Spiral by Flash CT on Obstructive Sleep Apnea Syndrome and Radiation Dose

    Institute of Scientific and Technical Information of China (English)

    何桂茹; 杨进军; 刘艳; 古丽巴哈; 杨君; 李江红

    2015-01-01

    Objective To asses the application value of flash CT amomg the patients with obstructive sleep apnea syndrome (OSAS). Methods 11 patients with OSAS were scanned by high-pitch spiral scanning in sleeping and nonsleeping status respectively ,and upper airway were reconstruct in group A,and the cross-section area with its corresponding sagital,axial,cornal diameters were mesureed respectively. In MSCT scanning mode were applied in group B.The CT dose (ED) were compared between two groups. Results OSAS patients were obviously smaller in sleeping status than in nonsleeping status .There are statistically significant difference at the uvula levels (P<0.05).The ED in group A and B was (0.43±0.019) msv and (0.76±0.033) msv(P<0.05).The effective dose was decreased by 43.43% for group A. Conclusion Flash CT helps evaluating the degree and range of stenois of the upper airway in OSAS patients and is useful in treatment planning. The diagnosis of OSAS disease using flash scan mode can reduce radiation expose than using MSCT scanning mode.%目的:探讨Flash CT在阻塞性睡眠呼吸暂停综合征(OSAS)诊断中的应用价值。方法 A组:11例OSAS患者在睡眠前、后分别进行大螺距Flash CT扫描,然后进行气道三维重建,多层面重建(MPR),容积显示(VR)进行观察,测量上气道的矢状径、冠状径及截面积;B组:常规MSCT扫描OSAS患者11例,分析比较两组病例的辐射剂量。结果 OSAS患者睡眠呼吸暂停时气道最狭窄处面积比清醒时明显变小,在悬雍垂区差异有统计学意义(P<0.05)。A组有效辐射剂量ED(0.43±0.019)msv, B组为(0.76±0.033)msv,A组比B组减少了43.43%的有效辐射剂量,有统计学差异(P<0.05)。结论双源CT flash扫描可动态观察气道,并对狭窄部位和范围进行定位,为选择治疗方案包括外科手术方式提供可靠依据,并可降低辐射剂量。

  17. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  1. 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.)

  2. 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

  3. Mechanisms of endothelial dysfunction in obstructive sleep apnea

    Directory of Open Access Journals (Sweden)

    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

  4. Management of Obstructive Sleep Apnea

    Directory of Open Access Journals (Sweden)

    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

  5. 77 FR 25226 - Proposed Recommendations on Obstructive Sleep Apnea

    Science.gov (United States)

    2012-04-27

    ... was published in the Federal Register on April 20, 2012 (77 FR 23794) announcing proposed regulatory... Federal Motor Carrier Safety Administration Proposed Recommendations on Obstructive Sleep Apnea AGENCY... withdrawing its proposed regulatory guidance for obstructive sleep apnea (OSA) and request for comment...

  6. 77 FR 23794 - Proposed Recommendations on Obstructive Sleep Apnea

    Science.gov (United States)

    2012-04-20

    ... Privacy Act Statement for the FDMS published in the Federal Register on January 17, 2008 (73 FR 3316), or... Federal Motor Carrier Safety Administration Proposed Recommendations on Obstructive Sleep Apnea AGENCY...) and the Medical Review Board (MRB) on Obstructive Sleep Apnea (OSA) and the medical certification...

  7. 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 (P<0.001) even after controlling for measures of adiposity and medical conditions. Females over the age of 45 years were much more likely to have OSA compared to their younger counterparts (78.7% vs 42.5%, respectively; odds ratio: 5.0) versus males (88.1% vs 68.8%, respectively; odds ratio: 3.4). Snoring, although more frequently reported by males, was similarly predictive of OSA for both sexes. Witnessed apneas and measures of adiposity were better predictors of OSA for males than females. Insomnia, 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 (P<0.001), even after controlling for age, measures of adiposity, and other medical conditions. Diabetes, heart disease, stroke, and sleepiness did not contribute unique variance in OSA in adjusted models. Conclusion This study found that males and females report different symptoms upon clinical evaluation for suspected sleep apnea, with some of the “classic” OSA features to be more common in and robustly predictive for males. The finding that advancing age uniquely and robustly

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

    Directory of Open Access Journals (Sweden)

    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.    

  9. 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 ...

  10. Childhood Obstructive Sleep Apnea

    Directory of Open Access Journals (Sweden)

    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

  11. [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).

  12. 阻塞性睡眠呼吸暂停综合征患者眼压的变化观察%Stydy on the changes of intraocular pressure in obstructive sleep apnea syndrome

    Institute of Scientific and Technical Information of China (English)

    赵春梅; 喻昌利; 张云玲; 刘湘云; 刘立杰

    2013-01-01

    Objective To compare the changes of intraocular pressure (IOP) in 24 hours between obstructive sleep apnea syndrome(OSAS) and the non-obstructive sleep apnea syndrome(non-OSAS).Methods Sixty patients with OSAS were divided into two groups:OSAS group(n =30) and non-OSAS group (n =30).The following indicators were detected:(1) Awake oxygen saturation ((HSaO2) %),(2) The lowest oxygen saturation (LSaO2) %) ; (3) Mean oxygen saturation ((MSaO2 %)) ; (4) Oxygen desaturation index ((DI4),time/h:number of times that the hourly oxygen desaturation ≥ 4%) ; (5) The percentage of the time that oxygen saturation ≤ 90% accounts the total time ((SIT90)%) and 24-hour IOP.IOP was measured from early morning 5:00 and measured once every four hours.The measurement results were compared between two groups.Results There was no significant difference on age ((62.60 ± 12.44) years old vs (65.20 ± 10.66)years old,t =1.48),Course of disease ((22.40 ± 6.88) month vs (25.49 ± 7.22) month,t =1.97),gender (The ratio of male to female is(20/10)vs (17/13),x2 =0.007) between the OSAS and the non-OSAS(P >0.05).Value of AHI(h-1) ((27.9 ±6.0) vs (2.5 ±1.1),t =8.78),LSaO2 ((74.7 ±11.7)% vs (91.8 ±5.9)%,t=3.44),SIT90((13.2±12.4)% vs(0.2±1.1)%,t=9.92) and ODI4(h-1) ((28.9 ±13.9)vs (6.1 ±4.1),t =8.09) of OSAS was significantly higher than that of non-OSAS(P <0.05 or P <0.01).Value of IOP of 21:00 o'clock((20.61±4.15)mm Hg vs(19.60 ± 4.03)mm Hg,t =2.18),1:00 o'clock((23.12 ±3.11)mm Hg vs (20.60 ± 3.29) mm Hg,t =4.64) and 5:00 o' clock ((22.82 ± 2.99)mm Hg vs (17.21 ±3.55) mm Hg,t =4.23) of OSAS was significantly higher than that of non-OSAS (P < 0.05 or P < 0.01).The wave ((10.40 ± 2.85)mm Hg vs (8.40 ± 2.55) mm Hg,t =4.15) and maximal ((23.60 ± 3.29) mm Hg vs (21.23 ±3.43)mm-Hg,t =2.60) value of IOP of OSAS was significantly higher than that of non-OSAS(P <0.05 or P <0.01).There was no significant difference on minimum of IOP between the OSAS

  13. [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. PMID:21300219

  14. Relationship between craniofacial photographic analysis and severity of obstructive sleep apnea/hypopnea syndrome in Iranian patients

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    Babak Amra

    2015-01-01

    Full Text Available Background: Considering the effectiveness of craniofacial photographic analysis for diagnosis and management of obstructive sleep apnea-hypopnea syndrome (OSAHS as well as ethnic differences in indexes measured by this method, this study designed to compare the surface facial dimensions, including nose width, intercanthal width and mandibular width of Iranian patients with mild, moderate and severe OSAHS. Materials and Methods: In this cross sectional study subjects with mild, moderate and severe OSAHS based on apnea-hypopnea index, were studied. To determine cephalometric measurements, face and neck digital photographs were taken from participants following a standardized procedure. Cephalometric measurements including face, intercanthal and mandibular widths were compared between studied groups. Results: In this study, 100 participants enrolled. From which 20 (20.8%, 35 (36.45% and 41 (42.7% of them had mild, moderate and severe OSAHS, respectively. Mean of nose, intercanthal and mandibular width were significantly higher in patients with severe OSAHS than those with mild or moderate OSAHS (P < 0.05.In both genders, mandibular width were higher in severe forms of OSAHS. Disease severity was significantly associated with increased age and mandibular width (P < 0.05. Conclusion: Mandibular width was the most important index, which had a significant association with the disease severity. It seems that our results could be used both for diagnosis and follow-up of OSAHS management. They could be used as baseline information as well as a clinical and research tool in the field of OSAHS.

  15. 不同程度阻塞性呼吸暂停低通气综合征患者脉冲振荡测定的临床研究%CLINICAL APPLICATION OF IMPLUSE OSCILLOMETRY IN PATIENTS WITH OBSTRUC-TIVE SLEEP APNEA HYPOPNEA SYNDROME WITH DIFFERENT APNEA HYPOPNEA IN-DEXES

    Institute of Scientific and Technical Information of China (English)

    曹梅; 陈飞鹏; 田利奇; 黄华兴; 陈晓军; 张弋

    2014-01-01

    目的:研究脉冲振荡(Impulse Oscillometry System,IOS)在不同程度阻塞性睡眠呼吸暂停低通气综合征(Obstructive Sleep Apnea-hypopnea Syndrome OSAHS)患者气道阻力监测中的应用。方法对 OSAHS患者67例( OSAHS组)行IOS和多导睡眠仪( PSG)监测,对正常人20例(对照组)行IOS监测,分析两组气道阻力;按呼吸暂停低通气指数( Apnea hypopnea index,AHI)将OSAHS组分为轻度、中度和重度3组,比较组间气道阻力。结果 OS-AHS组总呼吸阻抗( Zrs)、中心气道阻抗( Rc)、R5、R20高于对照组;中度、重度组 Zrs、Rc、R5、R20高于轻度组;重度组Rc、R5、R20高于中度组。在OSAHS组,Zrs、Rc、R5、R20、X35与AHI呈正相关,与SaO2呈负相关;X5与SaO2呈正相关,与AHI呈负相关。结论 IOS能监测并量化不同程度OSAHS患者气道阻力,可用于OSAHS患者的初筛及病情的观察。%Objective To study the application of Impulse Oscillometry(IOS) in patients with obstructive sleep ap-nea hypopnea syndrome(OSAHS) with different Apnea Hypopnea Indexes(AHI).Methods The respiratory impedance in OSAHS group(67 OSAHS patients) measured by IOS and polysomnography(PSG) and in control group(20 normal subjects) measured by IOS were compared and analyzed.According to AHI, OSAHS group was divided into three groups( severe group, moderate group and mild group) in which the respiratory impedance were compared.Results Total respiratory impedance (Zrs), central airway resistance(Rc), R5 and R20 of OSAHS group were superior to that of control group.In severe group and moderate group, Zrs, Rc, R5 and R20 were superior to mild group.Rc, R5 and R20 of severe group were superior to that of moderate group.In OSAHS group, Zrs, Rc, R5, R20 and X35 were positively correlated to AHI, and were negatively correlated to SaO2 .In OSAS group, X5 was correlated to SaO2 positively, to AHI negatively.Conclusion IOS could be used to measure

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

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    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.

  17. 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

  18. 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)

  19. 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 ...

  20. Intelligent approach for analysis of respiratory signals and oxygen saturation in the sleep apnea/hypopnea syndrome.

    Science.gov (United States)

    Moret-Bonillo, Vicente; Alvarez-Estévez, Diego; Fernández-Leal, Angel; Hernández-Pereira, Elena

    2014-01-01

    This work deals with the development of an intelligent approach for clinical decision making in the diagnosis of the Sleep Apnea/Hypopnea Syndrome, SAHS, from the analysis of respiratory signals and oxygen saturation in arterial blood, SaO2. In order to accomplish the task the proposed approach makes use of different artificial intelligence techniques and reasoning processes being able to deal with imprecise data. These reasoning processes are based on fuzzy logic and on temporal analysis of the information. The developed approach also takes into account the possibility of artifacts in the monitored signals. Detection and characterization of signal artifacts allows detection of false positives. Identification of relevant diagnostic patterns and temporal correlation of events is performed through the implementation of temporal constraints. PMID:25035712

  1. 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.

  2. Application of Dual Mask for Postoperative Respiratory Support in Obstructive Sleep Apnea Patient

    Directory of Open Access Journals (Sweden)

    Jahan Porhomayon

    2013-01-01

    Full Text Available In some conditions continuous positive airway pressure (CPAP or bilevel positive airway pressure (BIPAP therapy alone fails to provide satisfactory oxygenation. In these situations oxygen (O2 is often being added to CPAP/BIPAP mask or hose. Central sleep apnea and obstructive sleep apnea (OSA are often present along with other chronic conditions, such as chronic obstructive pulmonary disease (COPD, congestive heart failure, pulmonary fibrosis, neuromuscular disorders, chronic narcotic use, or central hypoventilation syndrome. Any of these conditions may lead to the need for supplemental O2 administration during the titration process. Maximization of comfort, by delivering O2 directly via a nasal cannula through the mask, will provide better oxygenation and ultimately treat the patient with lower CPAP/BIPAP pressure.

  3. Application of dual mask for postoperative respiratory support in obstructive sleep apnea patient.

    Science.gov (United States)

    Porhomayon, Jahan; Zadeii, Gino; Nader, Nader D; Bancroft, George R; Yarahamadi, Alireza

    2013-01-01

    In some conditions continuous positive airway pressure (CPAP) or bilevel positive airway pressure (BIPAP) therapy alone fails to provide satisfactory oxygenation. In these situations oxygen (O2) is often being added to CPAP/BIPAP mask or hose. Central sleep apnea and obstructive sleep apnea (OSA) are often present along with other chronic conditions, such as chronic obstructive pulmonary disease (COPD), congestive heart failure, pulmonary fibrosis, neuromuscular disorders, chronic narcotic use, or central hypoventilation syndrome. Any of these conditions may lead to the need for supplemental O2 administration during the titration process. Maximization of comfort, by delivering O2 directly via a nasal cannula through the mask, will provide better oxygenation and ultimately treat the patient with lower CPAP/BIPAP pressure. PMID:23662212

  4. Contemporary Insights and Novel Treatment Approaches to Central Sleep Apnea Syndrome in Heart Failure

    OpenAIRE

    Grayburn, Ryan L.; Kaka, Yaquta; Wilson Tang, W. H.

    2014-01-01

    Central sleep apnea (CSA) is a common and under-diagnosed condition commonly associated with Cheyne-Stokes respiration. It is particularly prevalent in the heart failure population affecting up to 40% of all patients with heart failure. The pathophysiology associated with CSA is based on the underlying effects of hypoventilation and hyperventilation, with neurologic dysregulation of respiratory control as the primary defect. However, therapeutic options are limited due to the prevailing perce...

  5. Evaluation of the effect of use of occlusal splints and increase of vertical dimension of occlusion based on polysomnographic parameters in patients with obstructive sleep apnea syndrome

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    Gilson Luiz HOFFMANN

    2010-03-01

    Full Text Available Introduction: Obstructive sleep apnea and hypopnea syndrome is thecomplete obstruction of the airways by the collapse of the oropharynx,soft palate and dorsal tongue for approximately 10 seconds, with afrequency of at least five to ten times per hour during sleep. The four basic treatments are: continuous positive airway pressure; surgery of the palate and sometimes surgical tongue reduction; surgical mandibular advancement followed by hyoid bone movement; use of a dental appliance that keeps the structures of the mandible and tongue advanced during the night. Objective, material and methods: Thepurpose of this research was to demonstrate the results obtainedwith the use of occlusal splints and increase of vertical dimension ofocclusion in patients with obstructive sleep apnea syndrome, by meansof a polysomnography performed initially without the use of splints and afterwards with the use of splints. Results and conclusion: If we do not take into consideration the body mass index and type of occlusion (Angle among the participants of the research that revealed apnea and hypopnea indexes above the normal range, 9 of them (70% had their indexes reduced to normal ranges, 2 (15% had this index reduced,however they did not achieve normal ranges of apnea and hypopnea indexes, and the remaining 2 patients (15% unexplainably had indexes that were higher with the use of splints than without.

  6. Bimaxillary Advancement as the Initial Treatment of Obstructive Sleep Apnea: Five Years Follow-Up of the Pori Experience

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    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.

  7. 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

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    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

  8. Obstructive sleep apnea: management considerations in psychiatric patients

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    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

  9. 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.

  10. Sleep Apnea Clinical Score, Berlin Questionnaire, or Epworth Sleepiness Scale: which is the best obstructive sleep apnea predictor in patients with COPD?

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    Faria AC

    2015-08-01

    Full Text Available Anamelia Costa Faria, Cláudia Henrique da Costa, Rogério Rufino Cardiopulmonology Department, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil Introduction: The Sleep Apnea Clinical Score (SACS and the Berlin Questionnaire (BQ are used to predict the likelihood of obstructive sleep apnea (OSA. The Epworth Sleepiness Scale (ESS is used to assess daytime sleepiness, a common OSA symptom. These clinical tools help prioritize individuals with the most severe illness regarding on whom polysomnography (PSG should be performed. It is necessary to check the applicability of these tools in patients with chronic obstructive pulmonary disease (COPD. The aim of this study is to compare SACS, BQ, and ESS performance in patients with COPD. Methods: The SACS, BQ, and ESS were applied to 91 patients with COPD. From this group, 24 underwent PSG. In this transversal study, these three tests were compared regarding their likelihood to predict OSA in patients with COPD using receiver-operating characteristic curve statistics. Results: In this sample, 58 (63.7% patients were men, and their mean age was 69.4±9.6 years. Fourteen patients (15.4% had a high probability of OSA by SACS, 32 (32.5% had a high probability by BQ, and 37 (40.7% had excessive diurnal somnolence according to the ESS. From the 24 patients who underwent PSG, OSA diagnosis was confirmed in five (20.8%, according to the American Academy of Sleep Medicine criteria. BQ and ESS did not accurately predict OSA in this group of patients with COPD, with a receiver-operating characteristic curve area under the curves of 0.54 (95% CI: 0.329–0.745, P=0.75 and 0.69 (95% CI: 0.47–0.860, P=0.10, respectively. SACS performance was significantly better, with an area under the curve of 0.82 (95% CI: 0.606–0.943, P=0.02. Conclusion: SACS was better than BQ and ESS in predicting OSA in this group of patients with COPD. Keywords: overlap syndrome, COPD, emphysema, questionnaire, polysomnography

  11. 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

  12. State of the art transoral robotic surgery for obstructive sleep apnea-hypopnea syndrome

    OpenAIRE

    Toh, Song-Tar

    2016-01-01

    Mahalakshmi Rangabashyam,1 Wenjie Huang,2 Ying Hao,3 Hong Juan Han,1,4,5 Shaun Loh,1 Song Tar Toh1,2,4,5 1Sleep Apnea Surgery Service, Department of Otolaryngology, Singapore General Hospital,2Yong Loo Lin School of Medicine, National University of Singapore, 3Health Services Research and Biostatistics Unit, Singapore General Hospital, 4Sleep Disorders Unit, Singapore General Hospital, 5Duke-NUS Graduate School of Medicine, Singapore Objective: To review the existing literature on the role o...

  13. Correlation Analysis between Polysomnography Diagnostic Indices and Heart Rate Variability Parameters among Patients with Obstructive Sleep Apnea Hypopnea Syndrome.

    Science.gov (United States)

    Gong, Xuehao; Huang, Leidan; Liu, Xin; Li, Chunyue; Mao, Xuhua; Liu, Weizong; Huang, Xian; Chu, Haiting; Wang, Yumei; Wu, Wanqing; Lu, Jun

    2016-01-01

    Heart rate variability (HRV) can reflect the changes in the autonomic nervous system (ANS) that are affected by apnea or hypopnea events among patients with obstructive sleep apnea hypopnea syndrome (OSAHS). To evaluate the possibility of using HRV to screen for OSAHS, we investigated the relationship between HRV and polysomnography (PSG) diagnostic indices using electrocardiography (ECG) and PSG data from 25 patients with OSAHS and 27 healthy participants. We evaluated the relationship between various PSG diagnostic indices (including the apnea hypopnea index [AHI], micro-arousal index [MI], oxygen desaturation index [ODI]) and heart rate variability (HRV) parameters using Spearman's correlation analysis. Moreover, we used multiple linear regression analyses to construct linear models for the AHI, MI, and ODI. In our analysis, the AHI was significantly associated with relative powers of very low frequency (VLF [%]) (r = 0.641, P = 0.001), relative powers of high frequency (HF [%]) (r = -0.586, P = 0.002), ratio between low frequency and high frequency powers (LF/HF) (r = 0.545, P = 0.049), normalized powers of low frequency (LF [n.u.]) (r = 0.506, P = 0.004), and normalized powers of high frequency (HF [n.u.]) (r = -0.506, P = 0.010) among patients with OSAHS. The MI was significantly related to standard deviation of RR intervals (SDNN) (r = 0.550, P = 0.031), VLF [%] (r = 0.626, P = 0.001), HF [%] (r = -0.632, P = 0.001), LF/HF (r = 0.591, P = 0.011), LF [n.u.] (r = 0.553, P = 0.004), HF [n.u.] (r = -0.553, P = 0.004), and absolute powers of very low frequency (VLF [abs]) (r = 0.525, P = 0.007) among patients with OSAHS. The ODI was significantly correlated with VLF [%] (r = 0.617, P = 0.001), HF [%] (r = -0.574, P = 0.003), LF [n.u.] (r = 0.510, P = 0.012), and HF [n.u.] (r = -0.510, P = 0.012) among patients with OSAHS. The linear models for the PSG diagnostic indices were AHI = -38.357+1.318VLF [%], MI = -13.389+11.297LF/HF+0.266SDNN, and ODI = -55

  14. [A clinical case of hemangioma of the face and tongue concurrent with severe obstructive sleep apnea syndrome complicated by cardiac arrhythmias and conduction disturbances].

    Science.gov (United States)

    Konovalova, K I; Elfimova, E M; Butorova, E A; Aksenova, A V; Galitsin, P V; Bulkina, O S; Litvin, A Yu; Chazova, I E

    2016-01-01

    The paper describes a clinical case of a female patient with severe obstructive sleep apnea syndrome in the presence of congenital hemangioma of the face, soft palate, and tongue concurrent with paroxysmal atrial fibrillation and atrial flutter, paroxysmal supraventricular tachycardia, and sinoatrial block (maximally up to 3.9 sec). Continuous positive airway pressure therapy could reduce the number of paroxysms of atrial fibrillation and atrial flutter, supraventricular tachycardia and eliminate sinoatrial block. PMID:27636935

  15. Localizing obstructive sites with dynamic MRI and consequentially proper therapy selection for obstructive sleep apnea/hypopnea syndrome

    International Nuclear Information System (INIS)

    At present, selection of therapies for obstructive sleep apnea/hypopnea syndrome (OSAHS) relies on the localizing the obstructive sites and determination of its severity by polysomnography (PSG). Many methods have been applied to localize the obstructive sites. We attempted to evaluate the morphology of upper airway during sleep with dynamic MRI, and assessed the severity of OSAHS and results of therapies in groups classified by the patterns of obstructive sites. A categorizing system was set up, by which the obstructive sites were reviewed on axial and sagittal sections and accordingly classified into four patterns: front-to-back pattern, left-to-right pattern, circular pattern and epiglottis pattern. Comparison of apnea/hypopnea index (AHI), lowest SpO2 and BMI was performed between the different patterns. The results showed that the left-to-right pattern and circular pattern had a higher AHI and lower lowest SpO2, and more cases of obesity with higher BMI were found in these two groups. We also evaluated the results of different therapies for different obstructive site patterns. Radiofrequency coblation of soft palate was found to be effective for the front-to-back pattern. Improvement was found in 67% of all the cases that received uvulopalatopharyngoplasty (UPPP), while a significant postoperative improvement of AHI was confirmed in left-to-right pattern and circular pattern groups. No significant difference in the results was found between different obstructive sites or patterns when nasal continuous positive airway pressure (n-CPAP) was applied alone. Being completely free from CPAP (completed treatment with improvement of symptoms) was achieved in 71.4% of all the cases and 85.7% in the left-to-right pattern group who received UPPP. We conclude that an optimal treatment results could be achieved by selecting the therapies based on the severity of OSAHS and result of localizing the obstructive sites by dynamic MRI. (author)

  16. Spectral Heart Rate Variability analysis using the heart timing signal for the screening of the Sleep Apnea-Hypopnea Syndrome.

    Science.gov (United States)

    Alvarez-Estevez, Diego; Moret-Bonillo, Vicente

    2016-04-01

    Some approaches have been published in the past using Heart Rate Variability (HRV) spectral features for the screening of Sleep Apnea-Hypopnea Syndrome (SAHS) patients. However there is a big variability among these methods regarding the selection of the source signal and the specific spectral components relevant to the analysis. In this study we investigate the use of the Heart Timing (HT) as the source signal in comparison to the classical approaches of Heart Rate (HR) and Heart Period (HP). This signal has the theoretical advantage of being optimal under the Integral Pulse Frequency Modulation (IPFM) model assumption. Only spectral bands defined as standard for the study of HRV are considered, and for each method the so-called LF/HF and VLFn features are derived. A comparative statistical analysis between the different resulting methods is performed, and subject classification is investigated by means of ROC analysis and a Naïve-Bayes classifier. The standard Apnea-ECG database is used for validation purposes. Our results show statistical differences between SAHS patients and controls for all the derived features. In the subject classification task the best performance in the testing set was obtained using the LF/HF ratio derived from the HR signal (Area under ROC curve=0.88). Only slight differences are obtained due to the effect of changing the source signal. The impact of using the HT signal in this domain is therefore limited, and has not shown relevant differences with respect to the use of the classical approaches of HR or HP. PMID:26866445

  17. 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.

  18. Portable Prescreening System for Sleep Apnea

    DEFF Research Database (Denmark)

    Guul, Martin Kjær; Jennum, Poul; Sørensen, Helge Bjarup Dissing

    2016-01-01

    of suffering from OSA would be beneficial. The system must be able to identify individuals with a high pre-test reliability regarding OSA with the aim of referral and further investigation. We aimed to develop a portable, smartphone, and homebased monitoring system to classify whether a patient screened...... 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...... the user to navigate through the data and the detected apnea events. The events are classified using both features from the audio and the signal from the accelerometer placed on sternum. Furthermore using the accelerometer data the sleep position is estimated and the morphology from the respiratory pattern...

  19. 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

  20. [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.

  1. Effects of Adenotonsillectomy on Plasma Inflammatory Biomarkers in Obese Children with Obstructive Sleep Apnea: A Community-Based Study

    Science.gov (United States)

    Kheirandish-Gozal, Leila; Gileles-Hillel, Alex; Alonso-Álvarez, María Luz; Peris, Eduard; Bhattacharjee, Rakesh; Terán-Santos, Joaquin; Duran-Cantolla, Joaquin; Gozal, David

    2015-01-01

    Background Obesity and obstructive sleep apnea syndrome (OSA) are highly prevalent and frequently overlapping conditions in children that lead to systemic inflammation, the latter being implicated in the various end-organ morbidities associated with these conditions. Aim To examine the effects of adenotonsillectomy (T&A) on plasma levels of inflammatory markers in obese children with polysomnographically diagnosed OSA who were prospectively recruited from the community. Methods Obese children prospectively diagnosed with OSA, underwent T&A and a second overnight polysomnogram (PSG) after surgery. Plasma fasting morning samples obtained after each of the 2 PSG were assayed for multiple inflammatory and metabolic markers including interleukin-6 (IL-6), IL-18, plasminogen activator inhibitor-1 (PAI-1), monocyte chemoattractant protein-1 (MCP-1), matrix metalloproteinase- (MMP-9), adiponectin, apelin C, leptin and osteocrin. Results Out of 122 potential candidates, 100 obese children with OSA completed the study with only 1/3 exhibiting normalization of their PSG after T&A (i.e., AHI≤1/hrTST). However, overall significant decreases in MCP-1, PAI-1, MMP-9, IL-18 and IL-6, and increases in adropin and osteocrin plasma concentrations occurred after T&A. Several of the T&A responsive biomarkers exhibited excellent sensitivity and moderate specificity to predict residual OSA (i.e., AHI≥/hrTST). Conclusions A defined subset of systemic inflammatory and metabolic biomarkers is reversibly altered in the context of OSA among community-based obese children, further reinforcing the concept on the interactive pro-inflammatory effects of sleep disorders such as OSA and obesity contributing to downstream end-organ morbidities. PMID:25801692

  2. 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

  3. 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.

  4. Upper airway resistance syndrome.

    Science.gov (United States)

    Hasan, N; Fletcher, E C

    1998-07-01

    Many clinicians are familiar with the clinical symptoms and signs of obstructive sleep apnea (OSA). In its most blatant form, OSA is complete airway obstruction with repetitive, prolonged pauses in breathing, arterial oxyhemoglobin desaturation; followed by arousal with resumption of breathing. Daytime symptoms of this disorder include excessive daytime somnolence, intellectual dysfunction, and cardiovascular effects such as systemic hypertension, angina, myocardial infarction, and stroke. It has been recently recognized that increased pharyngeal resistance with incomplete obstruction can lead to a constellation of symptoms identical to OSA called "upper airway resistance syndrome" (UARS). The typical findings of UARS on sleep study are: (1) repetitive arousals from EEG sleep coinciding with a (2) waxing and waning of the respiratory airflow pattern and (3) increased respiratory effort as measured by esophageal pressure monitoring. There may be few, if any, obvious apneas or hypopneas with desaturation, but snoring may be a very prominent finding. Treatment with nasal positive airway pressure (NCPAP) eliminates the symptoms and confirms the diagnosis. Herein we describe two typical cases of UARS. PMID:9676067

  5. The link between rhinitis and rapid-eye-movement sleep breathing disturbances in children with obstructive sleep apnea

    OpenAIRE

    Huseni, Shehlanoor; Gutierrez, Maria J.; Rodriguez-Martinez, Carlos E.; Nino, Cesar L.; Perez, Geovanny F.; Pancham, Krishna; Nino, Gustavo

    2014-01-01

    Background: Rhinitis and obstructive sleep apnea (OSA) often coexist during childhood. To delineate this clinical association, we examined OSA severity and polysomnogram (PSG) features in children with rhinitis and OSA. Given that rapid-eye-movement (REM) sleep is characterized by nasal congestion, we hypothesized that children with rhinitis have more REM-related breathing abnormalities. Methods: We conducted a retrospective cross-sectional analysis of 145 children with PSG-diagnosed OSA. Out...

  6. 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.

  7. Comparability of pulse oximeters used in sleep medicine for the screening of OSA

    International Nuclear Information System (INIS)

    Obstructive sleep apnea syndrome (OSA) is a frequent clinical picture. It is characterized by repetitive respiratory arrest with a consecutive decrease in arterial oxygen saturation (SaO2). In clinical practice, the number of desaturations per hour, oxygen desaturation index (ODI), is used as an important diagnostic criterion. Medical literature, however, mentions different threshold values that are defined as pathological. By means of systematic comparative measurements, the study presented here will examine to what extent the diagnosis and the quantification of OSA severity are affected by the device-specific measurement technique, thus impacting the predictive value of nighttime pulse oximetry in outpatient OSA screening. Different pulse oximeters commonly used in clinical practice were analyzed comparatively regarding technical parameters, temporal dynamics and the reproducibility of measuring results. The measurements were executed simultaneously and time synchronized in a reference group of five test subjects (four males, one female, average age 33.0 ± 9.4 years), in a group of five patients (all males, average age 51.8 ± 18.4 years) and using a simulator (pulse oximeter simulator index 2). All devices underestimate the simulator's predetermined oxygen desaturation of 10%. The dispersion of values is high. The device-specific characteristics have a significant influence on the collected data. The fundamental weakness of the systems lies in the reproducibility of measuring results (this only seems adequate at a signal resolution in steps of 0.1%) as well as the differing temporal dynamics. In the synchronous use of different systems on patients for the purpose of a direct comparison of devices, the dispersion of values is serious, reaching a fluctuation range of up to factor 1.42. In measuring dynamic events (apneas), different pulse oximeters do not record identical values. This is due to the different internal signal processing of the devices. Without

  8. EK Sign: A Wrinkling of Uvula and the Base of Uvula in Obstructive Sleep Apnea-Hypopnea Syndrome

    Directory of Open Access Journals (Sweden)

    Venkata Koka

    2015-01-01

    Full Text Available Introduction. Diagnosis of obstructive sleep apnea-hypopnea syndrome (OSAHS is suspected in the presence of symptoms and/or pharyngeal alterations and skeletal abnormalities of maxilla and mandible. Our aim is to find a new clinical sign that leads to suspicion of OSAHS in snorers. Methods. We reviewed the clinical data of 69 snoring patients with or without OSAHS. We defined EK sign as the presence of horizontal wrinkling of uvula and the base of uvula and tried to correlate its presence with OSAHS. Results. EK sign was present in 25 of 69 patients. The positive predictive value of EK sign is 100%. The presence of EK sign significantly correlated with OSAHS (44% if AHI ≥ 5 and 0% if AHI < 5; p = 0.01 and severity of OSAHS (7% if AHI < 15 and 58% with AHI ≥ 15; p < 0.001. Conclusions. The EK sign is a strong predictor of OSAHS with a specificity of 100%. We recommend performing sleep tests in presence of EK sign in snorers even in the absence of other abnormalities or symptoms.

  9. Clinical application ultrafast MRI to the sleep apnea syndrome, 1; Evaluation of the site of obstruction within upper airway

    Energy Technology Data Exchange (ETDEWEB)

    Suto, Yuji; Nakamura, Kiyoshi; Kato, Terumi (Tottori Univ., Yonago (Japan). School of Medicine) (and others)

    1992-07-01

    To evaluate the site of obstruction within upper airway, we observed the Turbo-fast low angle shot (FLASH) imaging, in 10 patients with sleep apnea syndrome (SAS) during wakefulness and sleep. After intravenous injection of Gd-DTPA (0.1 mmol/kg), sequential images of pharyngeal portion were obtained in midline sagittal section. An imaging protocol was 1.13s per image with a 1s delay between images, for a total of 30s. Then sequential images were displayed in a cine on C. R. T.. In eight patients, upper airway obstructions were present during sleep, while narrowings were present in four cases during awake. The sites of obstruction were located at the velopharynx exclusively in three cases, velopharynx plus glosspharynx in three cases, velopharynx plus glosspharynx in one case. Velopharynx plus hypopharynx in one case, respectively. It was concluded that ultrafast MRI had an important role in evaluating the sites of obstruction within upper airway in patients with SAS. (author).

  10. Comparison of MRI fast SPGR single slice scan and continuous dynamic scan in patients with obstructive sleep apnea-hypopnea syndrome

    International Nuclear Information System (INIS)

    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.

  11. 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.

  12. 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

  13. 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.

  14. Relationship between obstructive sleep apnea syndrome and type 2 diabetes mellitus%浅谈阻塞性睡眠呼吸暂停综合征与2型糖尿病的关系

    Institute of Scientific and Technical Information of China (English)

    艾哈买提·牙哈甫

    2015-01-01

    significantly higher than those in the control group. In the observation group, there were 3 cases of diabetes, while the control group was not found in patients with diabetes. Mild OSAS in the observation group was significantly lower than that in moderate and severe patients, and the level of insulin and blood glucose was significantly lower in the observation group, while in moderate and severe patients, insulin level and blood glucose were significantly decreased in patients with moderate to severe. Conclusion: obstructive sleep apnea syndrome can lead to abnormal glucose metabolism, which can induce and promote the occurrence and development of type 2 diabetes. The degree of sleep disordered breathing and glucose metabolism disorder and high serum insulin level were significantly correlated. Timely discovery and treatment of diabetes has important significance for the prevention and treatment of diabetes.

  15. 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

  16. 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.

  17. 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.

  18. 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.

  19. Sleep Apnea (For Parents)

    Science.gov (United States)

    ... 5 Things to Know About Zika & Pregnancy 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 ...

  20. Whole blood hypoxia-related gene expression reveals novel pathways to obstructive sleep apnea in humans.

    Science.gov (United States)

    Perry, Juliana C; Guindalini, Camila; Bittencourt, Lia; Garbuio, Silverio; Mazzotti, Diego R; Tufik, Sergio

    2013-12-01

    In this study, our goal was to identify the key genes that are associated with obstructive sleep apnea (OSA). Thirty-five volunteers underwent full in-lab polysomnography and, according to the sleep apnea hypopnea index (AHI), were classified into control, mild-to-moderate OSA and severe OSA groups. Severe OSA patients were assigned to participate in a continuous positive airway pressure (CPAP) protocol for 6 months. Blood was collected and the expression of 84 genes analyzed using the RT(2) Profiler™ PCR array. Mild-to-moderate OSA patients demonstrated down-regulation of 2 genes associated with induction of apoptosis, while a total of 13 genes were identified in severe OSA patients. After controlling for body mass index, PRPF40A and PLOD3 gene expressions were strongly and independently associated with AHI scores. This research protocol highlights a number of molecular targets that might help the development of novel therapeutic strategies. PMID:23994550

  1. 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

  2. Obstructive sleep apnea is related to impaired cognitive and functional status after stroke

    NARCIS (Netherlands)

    J.A. Aaronson; C.A.M. van Bennekom; W.F. Hofman; T. van Bezeij; J.G. van den Aardweg; E. Groet; W.A. Kylstra; B.A. Schmand

    2015-01-01

    Study Objectives: Obstructive sleep apnea (OSA) is a common sleep disorder in stroke patients and is associated with prolonged hospitalization, decreased functional outcome, and recurrent stroke. Research on the effect of OSA on cognitive functioning following stroke is scarce. The primary objective

  3. 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...... and decreased vasoreactivity in cerebral cortical vessels as measured with near-infrared spectroscopy (NIRS), and if this may be reversed by CPAP treatment....

  4. 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.

  5. Circulating KL-6, a Biomarker of Lung Injury, in Obstructive Sleep Apnea

    OpenAIRE

    Lederer, David J.; Jelic, Sanja; Basner, Robert C.; Ishizaka, Akitoshi; Bhattacharya, Jahar

    2009-01-01

    In obstructive sleep apnea (OSA), oxidative stress contributes to endothelial dysfunction in the peripheral circulation. In the lung, oxidative stress can lead to alveolar injury. We hypothesized that patients with obstructive sleep apnea would have biomarker evidence of increased alveolar wall permeability.

  6. Obstructive Sleep Apnea and Kidney Disease: A Potential Bidirectional Relationship?

    OpenAIRE

    Abuyassin, Bisher; Sharma, Kumar; Ayas, Najib T.; Laher, Ismail

    2015-01-01

    Chronic kidney disease (CKD) is associated with high mortality rates and heavy economic and social burdens. Nearly 10% of the United States population suffer from CKD, with fatal outcomes increased by 16–40 times even before reaching end-stage renal disease. The prevalence of obstructive sleep apnea (OSA) is between 3% and 7% in the general population, and has increased dramatically during the last 2 decades along with increased rates of obesity. However, the prevalence of OSA is much greater...

  7. Compliance with Positive Airway Pressure Treatment for Obstructive Sleep Apnea

    OpenAIRE

    Kim, Ji Heui; Kwon, Min Su; Song, Hyung Min; Lee, Bong-Jae; Jang, Yong Ju; Chung, Yoo-Sam

    2009-01-01

    Objectives Positive airway pressure (PAP) is considered a standard treatment for moderate-to-severe obstructive sleep apnea (OSA) patients. However, compliance with PAP treatment is suboptimal because of several types of discomfort experienced by patients. This study investigated compliance with PAP therapy, and affecting factors for such compliance, in OSA patients. Methods We performed a survey on 69 patients who engaged in PAP therapy between December 2006 and November 2007. After diagnost...

  8. 右美托咪定对阻塞性睡眠呼吸暂停综合征患者腭咽成型术后睡眠功能的影响%Effect of Dexmedetomidine on Sleeping Function in Patients with Obstructive Sleep Apnea Syndrome Undergoing Uvulopalatopharyngoplasty

    Institute of Scientific and Technical Information of China (English)

    徐意钗; 蒋宗明; 仲俊峰; 陈忠华

    2011-01-01

    OBJECTIVE: To investigate the effect of dexmedetomidine on sleeping function in patients with obstructive sleep apnea syndrome (OSAS) undergoing uvulopalatopharyngoplasty (UPPP). METHODS: 147 OSAS patients undergoing selective UPPP were enrolled and divided into group C (n=70) and group D (n=77). In group D, patients received intravenous infusion of dexmedetomidine 0.35 μg·kg-1·h-1 after anesthesia induction and terminated 30 min before the completion of surgery; the other treatments were the same in 2 groups. Hemodynamics data were recorded at corresponding time points and Polysomnography monitoring was instituted after admission to the ward. RESULTS: The time of spontaneous awake, time of endotracheal extubation and amount of intra-operative additional amount of fentanyl in group D were significantly decreased, compared with group C (P< 0.01). The heart rate-systolic blood pressure product (RPP) in group D were markedly lower than in group C at T1, T2, T3, T4 and T5 (P<0.01). Results of polysomnography indicated that in group D apnea hypoventilation index was decreased, the lowest pulse oxygenation saturation was increased, and proportions of stage 3~4 sleep and rapid eye movement sleep were elevated (P<0.05 or P<0.01). CONCLUSION: The application of dexmedetomidine in the UPPP operation of OSAS patients can decrease the use of opioid, fentanyl for example, display a protective effect on respiration management in OSAS patients, reduce the risk after operation and improve sleeping function.%目的:研究右美托咪定对阻塞性睡眠呼吸暂停综合征(OSAS)患者腭咽成型术(UPPP)后睡眠功能的影响.方法:选取择期行UPPP的OSAS患者147例,分为C组(n=70)和D组(n=77).D组麻醉诱导完成后输注右美托咪定0.35 μtg·kg -1·h-1并于手术结束前30 min停止,其余操作2组相同.记录观察期间相应时间点血流动力学数据;术后第1~2晚用多导睡眠仪进行监测.结果:D组患者睁眼时间、拔出气管导

  9. Mild obstructive sleep apnea: beyond the AHI

    Directory of Open Access Journals (Sweden)

    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 ...

  10. 持续气道正压通气对阻塞性睡眠呼吸暂停综合征患者血ICAM-1的影响%Effect of continuous positive airway pressure on blood ICAM-1 in obstructive sleep apnea syndrome patients

    Institute of Scientific and Technical Information of China (English)

    刘远程; 刘毅; 钱效森; 李浩波; 魏棉

    2013-01-01

    目的 评价阻塞性睡眠呼吸暂停综合征(OSAS)血清细胞间黏附分子-1(ICAM-1)水平及持续气道正压通气治疗(CPAP)对OSAS患者血清ICAM-1水平的影响.方法 收集20例健康对照者及20例OSAS患者的临床资料,回顾性分析两组患者多导睡眠呼吸监测结果,比较两组血清ICAM-1水平的差异;比较持续气道正压通气治疗前后OSAS患者血清ICAM-1水平的差异.结果 OSAS组患者治疗前血清ICAM-1含量为(105.26±37.470)μg/L,健康对照组血清ICAM-1含量为(99.98±18.78)μg/L,两组比较差异有统计学意义,P=0.018.经过CPAP治疗3个月后,OSAS组患者血清ICAM-1水平降至(93.34±21.24)μg/L,与治疗前血清ICAM-1水平比较,两组差异有统计学意义,P=0.037.结论 OSAS患者血清ICAM-1水平升高,持续气道正压通气治疗可有效降低OSAS患者血清ICAM-1水平.%Objective To analyze the influence of continuous positive airway pressure(CPAP) on serum intercellular adhesion molecule-1 (ICAM-1) in patients with obstructive sleep apnea syndrome(OSAS).Methods Clinical data and PSG results were collected in 20 patients with OSAS and 20 healthy subjects.Serum ICAM-1 level in all subjects were detected by ELISA method.Results Serum ICAM-1 content in OSAS patients was(105.26±37.47)μg/L and in healthy controls was (99.98±18.78)μg/L.Serum levels of ICAM-1 between the two groups were significantly different(P = 0.018).After 3 months treatment of CPAP, serum ICAM-1 level in OSAS patients fell to (93.34±21.24) μg/L, which was significantly different with that before treatment(P = 0.037).Conclusion Serum ICAM-1 content in OSAS patients might be greatly improved.CPAP treatment could effectively reduce serum ICAM-1 in OSAS patients.

  11. 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。

  12. Management of obstructive sleep apnea in edentulous patients: an overview of the literature

    OpenAIRE

    Heidsieck, David S. P.; de Ruiter, Maurits H. T.; Lange, Jan

    2015-01-01

    Purpose A high prevalence of obstructive sleep apnea (OSA) is seen in edentulous individuals. Treatment options for edentulous OSA patients however are limited with continuous positive airway pressure therapy (CPAP) remaining the current therapy of choice. As CPAP is associated with high non-adherence rates and oral appliance therapy requiring sufficient dentition, there is a clinical need for effective treatment strategies aimed at edentulous OSA patients. The purpose of this study was to pr...

  13. Obstructive sleep apnea is associated with higher healthcare utilization in elderly patients

    OpenAIRE

    Karla Diaz; Paola Faverio; Angela Hospenthal; Marcos I. Restrepo; Amuan, Megan E; Pugh, Mary Jo V.

    2014-01-01

    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 inpa...

  14. Wait Times for Sleep Apnea Care in Ontario: A Multidisciplinary Assessment

    OpenAIRE

    Rotenberg, Brian W; George, Charles F.; Sullivan, Kevin M; Eric Wong

    2010-01-01

    BACKGROUND: Obstructive sleep apnea (OSA) is a highly prevalent disorder that is associated with significant patient morbidity and societal burden. In general, wait times for health care in Ontario are believed to be lengthy; however, many diseases lack specific corroborative wait time data.OBJECTIVE: To characterize wait times for OSA care in Ontario.METHODS: Cross-sectional survey. A survey tool was designed and validated to question physicians involved in OSA care about the length of the w...

  15. The More the Merrier? Working Towards Multidisciplinary Management of Obstructive Sleep Apnea and Comorbid Insomnia

    OpenAIRE

    Ong, Jason C.; Crisostomo, M. Isabel

    2013-01-01

    Obstructive sleep apnea (OSA) is a sleep-related breathing disorder that is associated with negative cardiovascular consequences and adverse events from excessive daytime sleepiness. Insomnia is the inability to initiate or maintain sleep accompanied by daytime dysfunction. OSA and insomnia co-occur at a high rate, and such patients appear to have distinct clinical features of both disorders. Although empirically supported treatments are now available for OSA and insomnia independently, there...

  16. Obstructive Sleep Apnea, Oxidative Stress, and Cardiovascular Disease: Evidence from Human Studies

    OpenAIRE

    Hans-Joachim Eisele; Philipp Markart; Richard Schulz

    2015-01-01

    Obstructive sleep apnea (OSA) is a frequent disease mainly affecting obese people and caused by repetitive collapse of the upper airways during sleep. The increased morbidity and mortality of OSA are mainly thought to be the consequence of its adverse effects on cardiovascular (CV) health. In this context, oxidative stress induced by nocturnal intermittent hypoxia has been identified to play a major role. This is suggested by biomarker studies in OSA patients showing excessively generated rea...

  17. Lack of impact of mild obstructive sleep apnea on sleepiness, mood and quality of life

    Directory of Open Access Journals (Sweden)

    Quan SF

    2014-07-01

    Full Text Available Background and Objectives: Obstructive sleep apnea (OSA is associated with sleepiness, depression and reduced quality of life. However, it is unclear whether mild OSA has these negative impacts. Using data from the Apnea Positive Pressure Long-term Efficacy Study (APPLES, this study determined whether participants with mild OSA had greater sleepiness, more depressive symptoms and poorer quality of life in comparison to those without OSA. Methods: 239 evaluated for participation in APPLES with a baseline apnea hypopnea index (AHI < 15 /hour were assigned to 1 of 2 groups: No OSA (N=40, AHI < 5 /hour or Mild OSA (N=199, 5 to <15 /hour based on their screening polysomnogram. Scores on their Epworth Sleepiness Scale (ESS, Stanford Sleepiness Scale (SSS, Hamilton Rating Scale for Depression (HAM-D, Profile of Mood States (POMS and Sleep Apnea Quality of Life Index (SAQLI were compared between groups. Results: There were no significant differences between the No OSA and Mild OSA groups on any of the 5 measures: ESS (OSA, 9.8 + 3.5 vs Mild OSA, 10.6 + 4.3, p=0.26, SSS,(2.8 + 0.9 vs. 2.9 + 1.0, p=0.52, HAM-D (4.6 + 3.0 vs. 4.9 + 4.7, p=0.27, POMS (33.5 + 22.3 vs. 28.7 + 22.0, p=0.70, SAQLI (4.5 + 0.8 vs. 4.7 + 0.7, p=0.39. Conclusion: Individuals with mild OSA in this cohort do not have worse sleepiness, mood or quality of life in comparison to those without OSA.

  18. The effect of upper airway neuromuscular function on apnea duration in patients with obstructive sleep apnea syndrome%阻塞性睡眠呼吸暂停患者神经肌肉功能因素对呼吸暂停时程影响的相关研究

    Institute of Scientific and Technical Information of China (English)

    曹鑫; 叶京英

    2011-01-01

    Objective To assess neuromuscular factors influencing the apnea duration in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods Totally 64 male patients were diagnosed OSAHS by sleep study and were monitored with surface electromyography( EMG). We compared different apnea events with different duration through the percent of compensated EMG value(PCEV) . PCEV was determined from awake to early stage of obstructive apnea. Results There was significant difference between PCEVs in different apnea( P < 0. 05 ). Conclusion Neuromuscular factors have a certain impact on apnea duration.%目的 通过对不同长短呼吸暂停事件的下颌表面肌电分析,探讨神经肌肉因素对呼吸暂停事件时间长短的影响.方法 睡眠监测并同步行表面肌电图诊断为阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)的64例男性患者,比较不同长短呼吸暂停事件时下颌肌电补偿值的差异.结果 不同长短呼吸暂停的下颌肌电补偿值差异有统计学意义(P<0.05).结论 神经肌肉功能因素对呼吸暂停时程有一定的影响,较差的肌肉反应性可能导致更长的呼吸暂停.

  19. 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

  20. Association between Obstructive Sleep Apnea and Community-Acquired Pneumonia.

    Directory of Open Access Journals (Sweden)

    Eusebi Chiner

    Full Text Available We hypothesized that obstructive sleep apnea (OSA can predispose individuals to lower airway infections and community-acquired pneumonia (CAP due to upper airway microaspiration. This study evaluated the association between OSA and CAP.We performed a case-control study that included 82 patients with CAP and 41 patients with other infections (control group. The controls were matched according to age, sex and body mass index (BMI. A respiratory polygraph (RP was performed upon admission for patients in both groups. The severity of pneumonia was assessed according to the Pneumonia Severity Index (PSI. The associations between CAP and the Epworth Sleepiness Scale (ESS, OSA, OSA severity and other sleep-related variables were evaluated using logistic regression models. The associations between OSA, OSA severity with CAP severity were evaluated with linear regression models and non-parametric tests.No significant differences were found between CAP and control patients regarding anthropometric variables, toxic habits and risk factors for CAP. Patients with OSA, defined as individuals with an Apnea-Hypopnea Index (AHI ≥10, showed an increased risk of CAP (OR = 2·86, 95%CI 1·29-6·44, p = 0·01. Patients with severe OSA (AHI≥30 also had a higher risk of CAP (OR = 3·18, 95%CI 1·11-11·56, p = 0·047. In addition, OSA severity, defined according to the AHI quartile, was also significantly associated with CAP (p = 0·007. Furthermore, OSA was significantly associated with CAP severity (p = 0·0002, and OSA severity was also associated with CAP severity (p = 0·0006.OSA and OSA severity are associated with CAP when compared to patients admitted to the hospital for non-respiratory infections. In addition, OSA and OSA severity are associated with CAP severity. These results support the potential role of OSA in the pathogenesis of CAP and could have clinical implications. This link between OSA and infection risk should be explored to investigate the

  1. Association between Obstructive Sleep Apnea and Community-Acquired Pneumonia

    Science.gov (United States)

    Chiner, Eusebi; Llombart, Mónica; Valls, Joan; Pastor, Esther; Sancho-Chust, José N.; Andreu, Ada Luz; Sánchez-de-la-Torre, Manuel; Barbé, Ferran

    2016-01-01

    Background We hypothesized that obstructive sleep apnea (OSA) can predispose individuals to lower airway infections and community-acquired pneumonia (CAP) due to upper airway microaspiration. This study evaluated the association between OSA and CAP. Methods We performed a case-control study that included 82 patients with CAP and 41 patients with other infections (control group). The controls were matched according to age, sex and body mass index (BMI). A respiratory polygraph (RP) was performed upon admission for patients in both groups. The severity of pneumonia was assessed according to the Pneumonia Severity Index (PSI). The associations between CAP and the Epworth Sleepiness Scale (ESS), OSA, OSA severity and other sleep-related variables were evaluated using logistic regression models. The associations between OSA, OSA severity with CAP severity were evaluated with linear regression models and non-parametric tests. Findings No significant differences were found between CAP and control patients regarding anthropometric variables, toxic habits and risk factors for CAP. Patients with OSA, defined as individuals with an Apnea-Hypopnea Index (AHI) ≥10, showed an increased risk of CAP (OR = 2·86, 95%CI 1·29–6·44, p = 0·01). Patients with severe OSA (AHI≥30) also had a higher risk of CAP (OR = 3·18, 95%CI 1·11–11·56, p = 0·047). In addition, OSA severity, defined according to the AHI quartile, was also significantly associated with CAP (p = 0·007). Furthermore, OSA was significantly associated with CAP severity (p = 0·0002), and OSA severity was also associated with CAP severity (p = 0·0006). Conclusions OSA and OSA severity are associated with CAP when compared to patients admitted to the hospital for non-respiratory infections. In addition, OSA and OSA severity are associated with CAP severity. These results support the potential role of OSA in the pathogenesis of CAP and could have clinical implications. This link between OSA and infection risk

  2. 经鼻持续气道正压通气对糖尿病肾病伴阻塞性睡眠呼吸暂停患者VEGF及ICAM-1的影响%Effects of Nasal Continuous Positive Airway Pressure on VEGF and ICAM - 1 of Diabetic Nephropathy Complicated with Obstructive Sleep Apnea Syndrome

    Institute of Scientific and Technical Information of China (English)

    邓刚; 姚丽君; 王小溶; 陈望燕

    2012-01-01

    Objective:To investigate the effects of nasal continuous positive airway pressure (nCPAP) on VEGF and ICAM - 1 of diabetic nephropathy (DN) complicated with obstructive sleep apnea syndrome (OSAS) patients. Methods :35 -62 years old subjects who presented as DN complicated with moderate to severe OSAS were recruited and divided into nCPAP treated group and control group. The plasma levels of blood glucose, cholesterol, glycosylated hemoglobin, creatinine and urinary protein excretion were measured by auto biochemistry analysis machine. The plasma levels of VEGF (vascular endothelial growth factor) and ICAM - 1 (intercellular Adhesion Molecule -1) were determined by ELISA. Results: After 3 months of nCPAP treatment, there was a significant decrease in circulating levels of VEGF and ICAM -1 as well as 24 hours urinary protein excretion in nCPAP treated group. Decreased urinary protein excretion rate presented a positive relationship to reduced plasma VEGF and ICAM - 1 levels separately. Conclusion: nCPAP treatment could reduce urinary protein excretion by decreasing plasma levels of VEGF and ICAM - 1 in DN complicated with OSAS patients.%目的:探讨经鼻持续气道正压通气( nasal continuous positive air pressure,nCPAP)治疗对糖尿病肾病(diabetic nephropathy,DN)伴阻塞性睡眠呼吸暂停综合征(obstructive sleep apnoea syndrome,OSAS)患者VEGF及ICAM -1的影响.方法:选择临床确诊的DN伴中度鼾症患者36例,年龄35岁~62岁.随机分为治疗组及对照组,对照组给予常规治疗血糖、血压以及血脂等药物,治疗组系在对照组基础上,同时给予nCPAP治疗3个月,检测指标:(1)血压、血糖、糖化血红蛋白、肾功能、血脂及24h尿蛋白定量等.(2)采用定量酶联免疫吸附试验(ELISA)检测血清VEGF、ICAM -1水平.(3)常规检测血氧饱和度(Sa02)及呼吸暂停低通气指数( apnea - hypopnea index,AHI).结果:经过3月的nCPAP治疗,两组治疗后患者血压、血肌酐、空腹血

  3. Piecing Together Phenotypes of Brain Injury and DysfunctionIn Obstructive Sleep Apnea

    Directory of Open Access Journals (Sweden)

    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.

  4. Assessment of Anatomic Parameters on Lateral Cephalogram in Patients with Obstructive Sleep Apnea Symptoms and Comparison with the Healthy Population

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    Baharooz Zandi

    2009-01-01

    Full Text Available "nIntroduction: Snoring is a relatively constant characteristic of a serious and life threatening disorder that is called Obstructive Sleep Apnea Syndrome (OSAS. It is much more common than is thought. Despite its high prevalence, our knowledge about the etiology is not sufficient. It makes the treatment difficult. We conducted this study to clarify some cephalometric characteristics that are commoner in snorers rather than the healthy population. "nMaterials and Methods: In this analytic cross-sectional survey, we studied 127 patients older than 25 years. Sixty of them were loud snorers and 67 did not snore at all. All of them underwent skull CT scan and we obtained a lateral cephalogram to assess some anatomical parameters in each group and compare them. "nResults: The mean±SD perpendicular distance between the hyoid bone and mandibular plane was 15.17± 6.25 in patients with OSAS symptoms and 9.88±5.33 in non-snorers (P-value=0.001. The soft palate was larger in patients with OSA than in non-snorers. The mean±SD length of the soft palate was 35.63±5.10 in snorers and 33.15±-5.14 in non-snorers (P-value=0.007. The mean±SD maximum width of the soft palate was 8.90±2.18 in patients with OSA symptoms and 33.15±5.14 in non-snorers (P-value=0.038. The other cephalometric features did not show significant differences. "nConclusion: There are some differences in cephalometric features among patients with OSA symptoms and non-snorers. Hyoid bone is displaced inferiorly in patients with OSAS symptoms and the soft palate is larger in such patients compared to healthy people. We can conclude that increased soft tissue compartment is associated with the OSA symptoms. "nKeywords: snoring, obstructive sleep apnea, cephalometric  

  5. Development of the Korean Version of the Sleep Apnea Quality of Life Index

    OpenAIRE

    Jang, Hyun-Uk; Park, Ki-Soo; Cheon, Sang-Myung; Lee, Ho-Won; Kim, Sung-Wan; Lee, Seung-Hoon; Kim, Jung-Soo

    2014-01-01

    Objectives Obstructive sleep apnea (OSA) is a disorder characterized by repetitive partial or complete occlusion of the upper airway during sleep that affects quality of life. The aim of this study was to develop the Korean version of the sleep apnea quality of life index (K-SAQLI) and apply it in Korean patients with OSA. Methods Ninety-three patients with OSA completed the K-SAQLI. Its construct validity and responsiveness were tested by comparing the baseline and change scores obtained in ...

  6. 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

  7. 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.

  8. Obstructive sleep apnea prevents the expected difference in craniofacial growth of boys and girls

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    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.

  9. Radiological findings in patients with obstructive sleep apnea

    International Nuclear Information System (INIS)

    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)

  10. 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)

  11. 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

  12. 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

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

    Science.gov (United States)

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

    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 OSAS vs healthy subjects (p < 0.05). Increased right thalamic Glx/Cr, Glu/Cr, Gln/Cr, Asc/Cr, and decreased GPC/Cr and decreased left thalamic tNAA/Cr, NAA/Cr were detected. The right putamen showed increased mI/Cr and decreased tCho/Cr, and the left, decreased PE/Cr ratio. ROC curve analyses demonstrated 60–100% sensitivity and specificity for the metabolite ratios in differentiating OSAS vs. controls. Positive correlations were found between: left thalamus mI/Cr and baseline oxygen saturation (SaO2); right putamen tCho/Cr and apnea hypopnea index; right putamen GABA/Cr and baseline SaO2; left putamen PE/Cr and baseline SaO2; and left putamen NAA/Cr and SaO2 nadir (all p < 0.05). Negative correlations were found between left putamen PE/Cr and SaO2 nadir. These findings suggest underlying inflammation or glial activation, with greater alterations accompanying lower oxygen saturation. These metabolite levels may provide biomarkers for future neurochemical interventions by pharmacologic or other means. PMID:27596614

  14. 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.

  15. 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.

  16. The relationship between hypoxemia and ambulatory blood pressure in obstructive sleep apnea syndrome%阻塞性睡眠呼吸暂停综合征患者低氧血症与动态血压变化关系的研究

    Institute of Scientific and Technical Information of China (English)

    周燕斌; 谢灿茂; 严英硕; 高修仁

    2001-01-01

    目的:探讨阻塞性睡眠呼吸暂停综合征(OSAS)患者夜间低氧血症与动态血压变化的相互关系。方法:选择诊断为OSAS患者60例和正常对照组20例进行多导睡眠图检查和24小时动态血压监测。结果:①在OSAS组中,睡眠呼吸暂停低通气指数(AHI)、经皮血氧饱和度(SpO2)降低大于0.04的总次数、SpO2低于0.90的时间及SpO2降低幅度均明显高于正常对照组(P均<0.001);睡眠中SpO2最低值、SpO2平均值均低于正常对照组(P均<0.001);在轻、中、重度组间两两比较,上述指标也有显著性差异(P均<0.001)。②轻度OSAS患者的动态血压及其昼夜节律的改变与正常组无显著性差异;中度OSAS患者的夜间平均收缩压(nMDP)及血压昼夜节律与正常对照组有显著性差异(P均<0.05);而重度OSAS组的动态血压改变更加明显(与正常对照组、轻、中度组相比有显著差异,P均<0.05),同时有夜间血压下降、节律紊乱,昼夜血压差值减少,尤其是舒张压昼夜变化差值减少更为明显。结论:OSAS病情越重,睡眠时SpO2降低的程度越显著,低氧血症也越明显。OSAS患者各期血压的平均水平与AHI、呼吸暂停持续时间及SpO2降低的程度显著相关,OSAS的病情越重,这种血压变化及昼夜节律改变越显著。%Objective:To study the relationship between hypoxemia and ambulatory blood pressure (ABP) in obstructive sleep apnea syndrome (OSAS) during sleep.Methods:Sixty OSAS patients and 20 normal volunteers were measured by polysomnography (PSG) during sleep and ABP was monitored for a period of 24 hours.Results:In OSAS group,apnea hypopnea index (AHI) and the occurrence of saturation of oxygen from skin(SpO2) were decreased to more than 0.04,the duration of lowered SpO2 to less those 0.90 and the extent of SpO2 decrease were significantly higher than those in control group (all P<0.001).The minimum value of SpO2 and the mean of SpO2 in

  17. 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.

  18. BMI in patients with obstructive sleep apnea

    Directory of Open Access Journals (Sweden)

    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.

  19. 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.

  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. The effect of allergic rhinitis on the degree of stress, fatigue and quality of life in OSA patients.

    Science.gov (United States)

    Park, Cheol Eon; Shin, Seung Youp; Lee, Kun Hee; Cho, Joong Saeng; Kim, Sung Wan

    2012-09-01

    Both allergic rhinitis (AR) and obstructive sleep apnea (OSA) are known to increase stress and fatigue, but the result of their coexistence has not been studied. The objective of this study was to evaluate the amount of stress and fatigue when AR is combined with OSA. One hundred and twelve patients diagnosed with OSA by polysomnography were enrolled. Among them, 37 patients were diagnosed with AR by a skin prick test and symptoms (OSA-AR group) and 75 patients were classified into the OSA group since they tested negative for allergies. We evaluated the Epworth sleepiness scale (ESS), stress score, fatigue score, ability to cope with stress, and rhinosinusitis quality of life questionnaire (RQLQ) with questionnaires and statistically compared the scores of both groups. There were no significant differences in BMI and sleep parameters such as LSAT, AHI, and RERA between the two groups. However, the OSA-AR group showed a significantly higher ESS score compared to the OSA group (13.7 ± 4.7 vs. 9.3 ± 4.8). Fatigue scores were also significantly higher in the OSA-AR group than in the OSA group (39.8 ± 11.0 vs. 30.6 ± 5.4). The OSA-AR group had a significantly higher stress score (60.4 ± 18.6 vs. 51.2 ± 10.4). The ability to cope with stress was higher in the OSA group, although this difference was not statistically significant. RQLQ scores were higher in the OSA-AR group (60.2 ± 16.7 compared to 25.1 ± 13.9). In conclusion, management of allergic rhinitis is very important in treating OSA patients in order to eliminate stress and fatigue and to minimize daytime sleepiness and quality of life. PMID:22207526

  2. Manejo del SAHS mediante dispositivos de avance mandibular: Estudio preliminar Sleep apnea-hypopnea syndrome management using a mandibular advancement device: Preliminary study

    Directory of Open Access Journals (Sweden)

    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

  3. Nasal Expiratory Positive Airway Pressure Devices (Provent) for OSA: A Systematic Review and Meta-Analysis

    OpenAIRE

    Muhammad Riaz; Victor Certal; Gaurav Nigam; Jose Abdullatif; Soroush Zaghi; Kushida, Clete A.; Macario Camacho

    2015-01-01

    Objective. To quantify the effectiveness of nasal expiratory positive airway pressure (nasal EPAP) devices or Provent as treatment for obstructive sleep apnea (OSA). Methods. PubMed and six other databases were searched through November 15, 2015, without language limitations. Results. Eighteen studies (920 patients) were included. Pre- and post-nasal EPAP means ± standard deviations (M ± SD) for apnea-hypopnea index (AHI) in 345 patients decreased from 27.32 ± 22.24 to 12.78 ± 16.89 events/hr...

  4. Management of Obstructive Sleep Apnea in an Edentulous Lower Jaw Patient with a Mandibular Advancement Device

    Directory of Open Access Journals (Sweden)

    Filiz Keyf

    2014-01-01

    Full Text Available Obstructive sleep apnea (OSA is the most common sleep-related breathing disorder with periodic reduction or cessation of airflow during sleep. It is associated with loud snoring, disrupted sleep, and witnessed apneas. Treatment of OSA varies from simple measures such as oral appliances and nasal continuous positive airway pressure (CPAP to surgical procedures like uvulopalatopharyngoplasty and tracheostomy. Oral appliances are a viable nonsurgical treatment alternative in patients with OSA, of which mandibular advancement devices are most common. Edentulism which contributes to the worsening of OSA reduces the number of available therapeutic strategies and is considered a contraindication to oral appliance therapy. This clinical report describes the treatment of a 63-year-old edentulous OSA patient for whom a mandibular advancement device was designed.

  5. 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. PMID:26164371

  6. 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.

  7. 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…

  8. 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.

  9. Sleep Apnea Information Page

    Science.gov (United States)

    ... Awards Enhancing Diversity Find People About NINDS NINDS Sleep Apnea Information Page Table of Contents (click to ... en Español Additional resources from MedlinePlus What is Sleep Apnea? Sleep apnea is a common sleep disorder ...

  10. Changes in the heart rate variability in patients with obstructive sleep apnea and its response to acute CPAP treatment

    OpenAIRE

    Ernesto Kufoy; Jose-Alberto Palma; Jon Lopez; Manuel Alegre; Elena Urrestarazu; Julio Artieda; Jorge Iriarte

    2012-01-01

    Obstructive Sleep Apnea (OSA) is a major risk factor for cardiovascular disease. The goal of this study was to demonstrate whether the use of CPAP produces significant changes in the heart rate or in the heart rate variability of patients with OSA in the first night of treatment and whether gender and obesity play a role in these differences. METHODS: Single-center transversal study including patients with severe OSA corrected with CPAP. Only ...

  11. Assessment of central chemosensitivity and cardiac sympathetic nerve activity using I-123 MIBG imaging in central sleep apnea syndrome in patients with dilated cardiomyopathy

    International Nuclear Information System (INIS)

    Iodine-123 m-iodobenzylguanidine (MIBG) imaging has been used to study cardiac sympathetic function in various cardiac diseases. Central sleep apnea syndrome (CSAS) occurs frequently in patients with chronic heart failure (CHF) and is reported to be associated with a poor prognosis. One of the mechanisms of its poor prognosis may be related to impaired cardiac sympathetic activity. However, the relationship between chemosensitivity to carbon dioxide, which is reported to correlate with the severity of CSAS, and cardiac sympathetic activity has not been investigated. Therefore, this study was undertaken to assess cardiac sympathetic function and chemosensitivity to carbon dioxide in CHF patients. The oxygen desaturation index (ODI) was evaluated in 21 patients with dilated cardiomyopathy (male/female: 19/2, left ventricular ejection fraction (LVEF)5 times/h underwent polysomnography. Patients with an apnea hypopnea index >15/h but without evidence of obstructive apnea were defined as having CSAS. Early (15 min) and delayed (4 hr) planar MIBG images were obtained from these patients. The mean counts in the whole heart and the mediastinum were obtained. The heart-to-mediastinum count ratio of the delayed image (H/M) and the corrected myocardial washout rate (WR) were also calculated. The central chemoreflex was assessed with the rebreathing method using a hypercapnic gas mixture (7% CO2 and 93% O2). Ten of the 21 patients had CSAS. The H/M ratio was similar in patients both with and without CSAS (1.57±0.18 vs. 1.59±0.14, p=0.82). However, the WR was higher in patients with CSAS than in patients without CSAS (40±8% vs. 30±12%, p<0.05). ODI significantly correlated with central chemosensitivity to carbon dioxide. Moreover, there was a highly significant correlation between WR and central chemosensitivity (r=0.65, p<0.05). However, there was no correlation between ODI and the WR (r=0.36, p=0.11). Cardiac sympathetic nerve activity in patients with CHF and CSAS is

  12. 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

  13. Mild obstructive sleep apnea does not modulate baroreflex sensitivity in adult patients

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    Blomster H

    2015-06-01

    Full Text Available Henry Blomster,1 Tomi P Laitinen,2 Juha EK Hartikainen,3,6 Tiina M Laitinen,2 Esko Vanninen,2 Helena Gylling,4,8 Johanna Sahlman,1 Jouko Kokkarinen,5 Jukka Randell,5 Juha Seppä,1 Henri Tuomilehto4,7 1Department of Otorhinolaryngology, Institute of Clinical Medicine, 2Department of Clinical Physiology and Nuclear Medicine, 3Department of Internal Medicine, 4Department of Clinical Nutrition, School of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, 5Department of Respiratory Medicine, 6Heart Center, Kuopio University Hospital, 7Oivauni Sleep Clinic, Kuopio, 8Department of Medicine, Division of Internal Medicine, University of Helsinki, Helsinki, Finland Background: Obstructive sleep apnea (OSA is a chronic and progressive disease. OSA is associated with increased cardiovascular morbidity and mortality, the risk being more frequently encountered with severe degrees of OSA. Increased sympathetic activation and impaired cardiac autonomic control as reflected by depressed baroreceptor reflex sensitivity (BRS are possible mechanisms involved in the cardiovascular complications of OSA. However, it is not known at what stage of OSA that changes in BRS appear. The aim of this study was to evaluate BRS in patients with mild OSA. Methods: The study population consisted of 81 overweight patients with mild OSA and 46 body weight-matched non-OSA subjects. BRS, apnea-hypopnea index, body mass index, and metabolic parameters were assessed. The phenylephrine test was used to measure BRS. Results: Patients in the OSA group were slightly but significantly older than the non-OSA population (50.3±9.3 years vs 45.7±11.1 years, P=0.02. Body mass index, percentage body fat, blood pressure, fasting glucose, insulin, and lipid levels did not differ between the OSA patients and non-OSA subjects. Absolute BRS values in patients with mild OSA and non-OSA subjects (9.97±6.70 ms/mmHg vs 10.51±7.16 ms/mmHg, P=0.67 and BRS values proportional

  14. The Comparisons of Cerebral Hemodynamics Induced by Obstructive Sleep Apnea with Arousal and Periodic Limb Movement with Arousal: A Pilot NIRS Study.

    Science.gov (United States)

    Zhang, Zhongxing; Schneider, Maja; Laures, Marco; Qi, Ming; Khatami, Ramin

    2016-01-01

    Obstructive sleep apnea syndrome (OSA) and restless legs syndrome (RLS) with periodic limb movement during sleep (PLMS) are two sleep disorders characterized by repetitive respiratory or movement events associated with cortical arousals. We compared the cerebral hemodynamic changes linked to periodic apneas/hypopneas with arousals (AHA) in four OSA-patients with periodic limb movements (PLMA) with arousals in four patients with RLS-PLMS using near-infrared spectroscopy (NIRS). AHA induced homogenous pattern of periodic fluctuations in oxygenated (HbO2) and deoxygenated (HHb) hemoglobin, i.e., the decrease of HbO2 was accompanied by an increase of HHb during the respiratory event and resolved to reverse pattern when cortical arousal started. Blood volume (BV) showed the same pattern as HHb but with relative smaller amplitude in most of the AHA events.These changing patterns were significant as Wilcoxon signed-rank tests gave p tests, p test, p test, p test, p sleep disorder events. PMID:27630539

  15. 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.

  16. Research advance of palatal implants for obstructive sleep apnea-hypopnea syndrome%软腭植入临床应用的研究进展

    Institute of Scientific and Technical Information of China (English)

    张天翔

    2011-01-01

    软腭植入是将柱状聚对苯二甲酸乙二酯植入软腭肌层内,诱导局部纤维化,达到硬化软腭目的.它是治疗鼾症和阻塞性睡眠呼吸暂停低通气综合征的一种新型技术.文中主要介绍近年来软腭植入技术的临床应用进展.%Palatal implants which are made of polyethylene terephthalate and cylindrical in shape, had been designed to create scar tissue in soft palate in order to achieve palatal stiffening. Palatal implants was a new method for the treatment of snoring and obstructive sleep apnea-hypopnea syndrome ( OSAHS). In this review, we descried its clinical effect on OSAHS.

  17. Biomarkers of cardiovascular stress in obstructive sleep apnea.

    Science.gov (United States)

    Maeder, Micha T; Mueller, Christian; Schoch, Otto D; Ammann, Peter; Rickli, Hans

    2016-09-01

    Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder associated with "cardiovascular stress", i.e. cardiovascular risk factors, cardiovascular diseases, and an increased risk of heart failure, stroke, and death. Experimental and clinical studies have characterized potential underlying mechanisms including biventricular dysfunction, atherosclerosis, and arrhythmia. Assessment of these cardiovascular features of OSA requires a spectrum of clinical tools including ECG, echocardiography, exercise testing, and angiography. In contrast to many cardiovascular diseases, the role of blood biomarkers to characterize cardiovascular function and cardiovascular risk in OSA is poorly defined. In the present review we summarize the available data on biomarkers potentially providing information on cardiovascular features in OSA patients without overt cardiovascular disease. The vast majority of studies on biomarkers of cardiovascular stress in OSA evaluated B-type natriuretic peptide (BNP)/N-terminal-B-type natriuretic peptide (NT-proBNP), and cardiac troponins (cTn). Although some studies found significant associations between these cardiac biomarkers and the presence and severity of OSA, data remain conflicting. Also, the detailed pathophysiological mechanisms underlying the link between OSA and hemodynamic cardiac stress (BNP/NT-proBNP) and cardiomyocyte damage (cTn) are poorly understood. Major research efforts are required to establish the clinical role of cardiovascular biomarkers in patients with OSA. PMID:27380998

  18. Resistant Hypertension and Obstructive Sleep Apnea

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    Akram Khan

    2013-01-01

    Full Text Available Hypertension (HTN is a modifiable, highly prevalent risk factor for cardiovascular morbidity and renal dysfunction worldwide. In the United States, HTN affects one in three adults, contributes to one out of every seven deaths and to nearly half of all cardiovascular disease-related deaths. HTN is considered resistant when the blood pressure remains above goal despite lifestyle modification and administration of three antihypertensive agents of different classes including a diuretic. Large population-based studies have suggested that obstructive sleep apnea (OSA is a risk factor for resistant HTN. The mechanism proposed is a pattern of intermittent hypoxia associated with hyperaldosteronism, increased sympathetic tone, endothelial dysfunction, and inflammation. In this review we discuss the association between OSA and resistant HTN, the physiologic mechanisms linking OSA with resistant HTN, and the effect of continuous positive airway pressure therapy (CPAP on blood pressure in patients with resistant HTN. While the reduction in blood pressure with CPAP is usually modest in patients with OSA, a decrease of only a few mmHg in blood pressure can significantly reduce cardiovascular risk. Patients presenting to a center specializing in management of hypertension should be screened and treated for OSA as a potentially modifiable risk factor.

  19. Adaptive detection and severity level characterization algorithm for Obstructive Sleep Apnea Hypopnea Syndrome (OSAHS) via oximetry signal analysis

    OpenAIRE

    Georgiou, Harris V.

    2013-01-01

    In this paper, an abstract definition and formal specification is presented for the task of adaptive-threshold OSAHS events detection and severity characterization. Specifically, a low-level pseudocode is designed for the algorithm of raw oximetry signal pre-processing, calculation of the 'drop' and 'rise' frames in the related time series, detection of valid apnea/hypopnea events via SpO2 saturation level tracking, as well as calculation of corresponding event rates for OSAHS severity charac...

  20. Relationship between excessive daytime sleepiness and oxygen saturation in obstructive sleep apnea-hypopnea syndrome%阻塞性睡眠呼吸暂停低通气综合征患者日间嗜睡与清醒安静状态下动脉血氧饱和度的相关性研究

    Institute of Scientific and Technical Information of China (English)

    钟泽其; 陶媛; 张宗平; 周俊英; 雷飞; 杜丽娜; 唐向东

    2011-01-01

    目的 探讨清醒安静状态下动脉血氧饱和度(SaO2)在阻塞性睡眠呼吸暂停低通气综合征(OSAS)患者合并日间嗜睡发病机制的作用.方法 回顾性收集2010年1至4月在华西医院睡眠医学中心就诊的OSAS患者410例,呼吸暂停低通气指数(AHI)≥5次/h,每例都详细地询问病史和自评Epworth嗜睡量表(ESS),并将OSAS患者分为日间过度嗜睡组(EDS)和非日间过度嗜睡组(No-EDS);比较两组之间的人群结构特点及其睡眠参数.结果 176例EDS(ESS评分:15±3)与234例No-EDS(ESS评分:6±3)纳入研究,与No-EDS相比较,EDS组具有较大的体质量指数(BMI)(28±4比26±4,P<0.001)、清醒安静状态下动脉血氧饱和度降低(93.4±4.3比95.5±1.9,P<0.001)、REM睡眠潜伏期缩短(99±65比125±80,P=0.011)、AHI明显增加(56±21比45±22,P=0.006);此外,两者间最低动脉血氧饱和度、氧减饱和指数和觉醒指数的差异均有统计学意义.EDS组清醒状态下平均SaO2(93.4±4.3比95.7±1.9)和重度OSAS患者清醒安静状态下SaO2(92.8±4.4比94.9±1.9)明显低于No-EDS组(P<0.001).结论 长期处于缺氧状态是重度OSAS患者合并嗜睡重要发生机制,纠正低氧血症是改善患者生活质量和嗜睡症状的重要手段.结合测定清醒安静状态下SaO2以及ESS评分,可以初步筛查和预测患者病情程度.%Objective To investigate polysomnographic determinants of excessive daytime sleepiness (EDS) and potential relationship in Chinese patients with obstructive sleep apnea-hypopnea syndrome (OSAS). Methods A total of 410 patients with obstructive sleep apnea-hypopnea syndrome were analyzed retrospectively who were obtained in Sleep medicine center of West China hospital from January to April in 2010. All of the patients with an apnea-hypopnea index (AHI) greater than 5 h-1 were evaluated using the Epworth Sleepiness Scale (ESS) and sleep disorders questionnaire. The patients who ESS score was more than 10 were defined as EDS

  1. Factores de riesgo para el síndrome metabólico en una población con apnea del sueño: evaluación en un grupo de pacientes de Granada y provincia; estudio GRANADA Risk factors for metabolic syndrome in a population with sleep apnea: evaluation in a population of Granada; the Granada study

    Directory of Open Access Journals (Sweden)

    M.ª C. Valenza

    2012-08-01

    Full Text Available Introducción: El síndrome metabólico se está convirtiendo en uno de los principales problemas de salud pública del siglo XXI. Se considera que la aparición del síndrome metabólico está determinada por la interacción de factores genéticos, ambientales y nerviosos centrales (disfunción de los centros hipotalámicos de hambre y saciedad que generan dos alteraciones metabólicas importantes: la resistencia a la acción de la insulina y la obesidad visceral. La relación de este síndrome, que concentra en la actualidad al mundo científico, con las alteraciones del sueño sigue siendo un punto sin esclarecer. Aunque se ha teorizado sobre la relación causa efecto, se desconoce aún su interrelación convirtiéndose su estudio en un objetivo primario de la investigación epidemiológica. Muestra y métodos: Se reclutaron 1016 sujetos que acudieron al servicio de Fisiología Respiratoria del Hospital Universitario "San Cecilio" de Granada (España por sospecha de Apnea de Sueño. Resultados: Se encontró una correlación significativa (p Introduction: The Metabolic Syndrome is one of the first health problems in the public health of the century. It's consider that the beginning of the syndrome is determined by numerous factors that developed two main metabolic disturbances: the insulin resistance and the central obesity. This relationship is concentrating the scientific world. As the cause-effect relationship has to be answered, the epidemiologic research has focused on without results. Material and methods: 1,016 subjects were recruited in the sleep disorders laboratory in San Cecilio Hospital with sleep apnea suspicion. Results: Significant correlation (p < 0,001 was found between sleep apnea severity and nocturnal saturation values and the different metabolic disturbances related to the metabolic syndrome (Hypertension, Diabetes and obesity. By the contrary, we doesn't found significant differences between No-Sleep apnea group and

  2. The clinical characteristics of elderly patients with obstructive sleep apnea hypopnea syndrome%81例老年阻塞性睡眠呼吸暂停低通气综合征临床特点分析

    Institute of Scientific and Technical Information of China (English)

    李忠万; 杨贵军; 方红雁; 李晓晓; 廖修富; 李劲松

    2016-01-01

    Objective To discuss the differences of clinical features and characteristics and features of polysomnography be‐tween elderly patients and middle‐aged patients with obstructive sleep apnea hypopnea syndrome (OSAHS) ,so as to provide refer‐ence for the diagnosis and individualized intervention of elderly OSAHS .Methods Totally 81 aged OSAHS cases and 123 youth OSAHS cases were analyzed in terms of general condition ,clinical manifestations and polysomnographic characteristics ,and the clin‐ical manifestations and polysomnographic difference indicators of the two groups were matched according to body mass index (BMI) .Results Most OSAHS patients were males in both groups ,with BMI and neck waist circumference in the aged group less than those in the middle‐aged group ,and the difference was statistically significant (P0 .05);clinical symptoms of senile groups such as drowsiness ,snoring ,morning headaches ,dry mouth and nighttime awakenings were lower than the middle‐aged group ,the difference was statistically significant (P0 .05);REM AHI was more than the middle‐aged group ,the difference was statistically significant (P0 .05) .Conclusion The incidence of typical clinical manifestations of aged OSAHS patients was lower than that in the middle‐aged group ,but high blood pressure ,diabetes and other complications prevalence were significantly higher than those in the middle‐aged group ,with similar severity of OSAHS in both groups ,there were differences PSG monitoring results with the middle‐aged group ,and the difference of REM AHI was significant .%目的:探讨老年阻塞性睡眠呼吸暂停低通气综合征(OSAHS)与中年OSAHS临床特点和多导睡眠监测特征的差异,为诊断及个体化干预老年OSA HS提供参考依据。方法分析81例老年OSA HS和123例中年OSA HS的一般情况、临床表现和多导睡眠图特点,并按BM I匹配比较两组临床表现及多导睡眠指标差异。结果老年及中年OSA

  3. Validation of housekeeping genes in the brains of rats submitted to chronic intermittent hypoxia, a sleep apnea model.

    Science.gov (United States)

    Julian, Guilherme Silva; de Oliveira, Renato Watanabe; Perry, Juliana Cini; Tufik, Sergio; Chagas, Jair Ribeiro

    2014-01-01

    Obstructive sleep apnea (OSA) is a syndrome characterized by intermittent nocturnal hypoxia, sleep fragmentation, hypercapnia and respiratory effort, and it has been associated with several complications, such as diabetes, hypertension and obesity. Quantitative real-time PCR has been performed in previous OSA-related studies; however, these studies were not validated using proper reference genes. We have examined the effects of chronic intermittent hypoxia (CIH), which is an experimental model mainly of cardiovascular consequences of OSA, on reference genes, including beta-actin, beta-2-microglobulin, glyceraldehyde-3-phosphate dehydrogenase, hypoxanthine guanine phosphoribosyl transferase and eukaryotic 18S rRNA, in different areas of the brain. All stability analyses were performed using the geNorm, Normfinder and BestKeeper software programs. With exception of the 18S rRNA, all of the evaluated genes were shown to be stable following CIH exposure. However, gene stability rankings were dependent on the area of the brain that was analyzed and varied according to the software that was used. This study demonstrated that CIH affects various brain structures differently. With the exception of the 18S rRNA, all of the tested genes are suitable for use as housekeeping genes in expression analyses.

  4. Validation of housekeeping genes in the brains of rats submitted to chronic intermittent hypoxia, a sleep apnea model.

    Directory of Open Access Journals (Sweden)

    Guilherme Silva Julian

    Full Text Available Obstructive sleep apnea (OSA is a syndrome characterized by intermittent nocturnal hypoxia, sleep fragmentation, hypercapnia and respiratory effort, and it has been associated with several complications, such as diabetes, hypertension and obesity. Quantitative real-time PCR has been performed in previous OSA-related studies; however, these studies were not validated using proper reference genes. We have examined the effects of chronic intermittent hypoxia (CIH, which is an experimental model mainly of cardiovascular consequences of OSA, on reference genes, including beta-actin, beta-2-microglobulin, glyceraldehyde-3-phosphate dehydrogenase, hypoxanthine guanine phosphoribosyl transferase and eukaryotic 18S rRNA, in different areas of the brain. All stability analyses were performed using the geNorm, Normfinder and BestKeeper software programs. With exception of the 18S rRNA, all of the evaluated genes were shown to be stable following CIH exposure. However, gene stability rankings were dependent on the area of the brain that was analyzed and varied according to the software that was used. This study demonstrated that CIH affects various brain structures differently. With the exception of the 18S rRNA, all of the tested genes are suitable for use as housekeeping genes in expression analyses.

  5. Validation of Housekeeping Genes in the Brains of Rats Submitted to Chronic Intermittent Hypoxia, a Sleep Apnea Model

    Science.gov (United States)

    Julian, Guilherme Silva; de Oliveira, Renato Watanabe; Perry, Juliana Cini; Tufik, Sergio; Chagas, Jair Ribeiro

    2014-01-01

    Obstructive sleep apnea (OSA) is a syndrome characterized by intermittent nocturnal hypoxia, sleep fragmentation, hypercapnia and respiratory effort, and it has been associated with several complications, such as diabetes, hypertension and obesity. Quantitative real-time PCR has been performed in previous OSA-related studies; however, these studies were not validated using proper reference genes. We have examined the effects of chronic intermittent hypoxia (CIH), which is an experimental model mainly of cardiovascular consequences of OSA, on reference genes, including beta-actin, beta-2-microglobulin, glyceraldehyde-3-phosphate dehydrogenase, hypoxanthine guanine phosphoribosyl transferase and eukaryotic 18S rRNA, in different areas of the brain. All stability analyses were performed using the geNorm, Normfinder and BestKeeper software programs. With exception of the 18S rRNA, all of the evaluated genes were shown to be stable following CIH exposure. However, gene stability rankings were dependent on the area of the brain that was analyzed and varied according to the software that was used. This study demonstrated that CIH affects various brain structures differently. With the exception of the 18S rRNA, all of the tested genes are suitable for use as housekeeping genes in expression analyses. PMID:25289636

  6. Cervical vertebral anomalies in patients with obstructive sleep apnea

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    Saugat Ray

    2015-01-01

    Full Text Available Objective: The aim of this study was to find an association between the patients with obstructive sleep apnea (OSA and with cervical vertebral anomalies and any further correlation between various anomalies with varying severities of OSA. Materials and Methods: The sample consisted lateral cephalograms of 70 subjects who were diagnosed with OSA and 70 other orthodontic patients who were selected as a control group. The lateral radiographs of both cases and controls were traced and findings were recorded. Results: In total, 21.42% of subjects in the OSA group and 8.57% in the control group were affected with cervical vertebrae anomalies. The statistical analysis reveals that the number of subjects affected with cervical vertebrae anomalies in OSA group is highly significant. A number of cases of fusion were higher than posterior arch deficiency in OSA group and equal in the control group. However, in both the groups, the number of cases with two vertebrae fusion was higher. Further, the higher number of two vertebrae fusion cases in OSA group was found to be statistically significant. The findings of one-way ANOVA for OSA cases reveals the number of cases affected with cervical vertebrae anomalies were statistically highly significant (P < 0.01 in severe cases of OSA. Conclusion: Patients of cervical vertebral anomalies may be at higher risk of developing OSA, and the possibility of the presence of cervical vertebral anomalies may increase with the increase in the severity of OSA. The most common vertebral anomaly was found to be two vertebral fusions.

  7. Topography-specific spindle frequency changes in Obstructive Sleep Apnea

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    V Suzana

    2012-07-01

    Full Text Available Abstract Background Sleep spindles, as detected on scalp electroencephalography (EEG, are considered to be markers of thalamo-cortical network integrity. Since obstructive sleep apnea (OSA is a known cause of brain dysfunction, the aim of this study was to investigate sleep spindle frequency distribution in OSA. Seven non-OSA subjects and 21 patients with OSA (11 mild and 10 moderate were studied. A matching pursuit procedure was used for automatic detection of fast (≥13Hz and slow (Hz spindles obtained from 30min samples of NREM sleep stage 2 taken from initial, middle and final night thirds (sections I, II and III of frontal, central and parietal scalp regions. Results Compared to non-OSA subjects, Moderate OSA patients had higher central and parietal slow spindle percentage (SSP in all night sections studied, and higher frontal SSP in sections II and III. As the night progressed, there was a reduction in central and parietal SSP, while frontal SSP remained high. Frontal slow spindle percentage in night section III predicted OSA with good accuracy, with OSA likelihood increased by 12.1%for every SSP unit increase (OR 1.121, 95% CI 1.013 - 1.239, p=0.027. Conclusions These results are consistent with diffuse, predominantly frontal thalamo-cortical dysfunction during sleep in OSA, as more posterior brain regions appear to maintain some physiological spindle frequency modulation across the night. Displaying changes in an opposite direction to what is expected from the aging process itself, spindle frequency appears to be informative in OSA even with small sample sizes, and to represent a sensitive electrophysiological marker of brain dysfunction in OSA.

  8. 鼻内镜下腺样体低温等离子消融术和动力切割术的疗效比较%The Clinical Observation of Coblation-assisted adenoidectomy and nasal dynamical system-assisted adenoidectomy for Treatment of Children with Obstructive Sleep Apnea Hypopnea Syndrome

    Institute of Scientific and Technical Information of China (English)

    陈钢; 刘凤荣; 吴慧莉; 孙汝山; 王俊阁

    2014-01-01

    Objective To investigate the clinical efficacy and safety of the adenoidectomy assisted by the coblation-assisted or the nasal dynamical system for the children with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods From January 2008 to December 2011, the adenoidectomy had been done assisted by ENT Coblator surgical instrument or nasal dynamical system for 75 children, aged 3 to 13 years old. The follow-ups were conducted by telephone interview and the follow up time was 6 months after the operation. The responses were recorded on a standardized questionnaire (pediatric OSAHS disease-specific quality of life survey (OSA-18)).Results here was no significant difference in the operation times between two groups and the amount of bleeding of the adenoidectomy assisted by the nasal dynamical system was more than those of the coblation. Both ways decrease the scores of the OSA-18 in patients statistically after 6 months.ConclusionThe adenoidectomy assisted by the coblation-assisted or the nasal dynamical system both had good clinical efficacy and can be especially suitable for surgical treatment of children with OSAHS.%目的:分别通过低温等离子射频消融和鼻动力切割进行腺样体切除,观察两种手术方式的手术时间、出血量及疗效,分析两种手术方式的优缺点。方法收集2008年1月~2011年12月我院收治的儿童阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)中,扁桃体和/或腺样体肥大的患儿共75例,其中30例行鼻动力切割腺样体切除术,45例行低温等离子射频消融腺样体切除术,统计两种术式的手术时间、出血量及术后半年疗效(儿童OSAHS疾病特异性生活质量调查(OSA-18))评估有无差异。结果鼻动力切割组与等离子消融组比较,两者切除腺样体手术时间差异无统计学意义,但是鼻动力切割组出血量明显多于等离子消融组,差异

  9. Obstructive sleep apnea as a risk factor for type 2 diabetes mellitus

    Science.gov (United States)

    Rajan, Preethi; Greenberg, Harly

    2015-01-01

    Obstructive sleep apnea (OSA) is independently associated with cardiovascular and cardiometabolic risk in several large epidemiologic studies. OSA leads to several physiologic disturbances such as intermittent hypoxia, sleep fragmentation, and increase in autonomic tone. These disturbances have been associated with insulin resistance and type 2 diabetes mellitus (T2DM) in animal and human studies. Studies also suggest a bidirectional relationship between OSA and T2DM whereby T2DM itself might contribute to the features of OSA. Moreover, successful treatment of OSA may reduce these risks, although this is controversial. The purpose of this article is to review 1) the links and bidirectional associations between OSA and T2DM; 2) the pathogenic mechanisms that might link these two disease states; 3) the role of continuous positive airway pressure therapy in improving glucose tolerance, sensitivity, and resistance; and 4) the implications for clinical practice. PMID:26491377

  10. Prevalence and incidence of hypertension in obstructive sleep apnea patients and the relationship between obstructive sleep apnea and its confounders

    Institute of Scientific and Technical Information of China (English)

    FENG Jing; CHEN Bao-yuan

    2009-01-01

    @@ Based on available population-based studies, Obstructive Sleep Apnea (OSA) associated with accompanying daytime sleepiness affects 3% to 7% of adult men and 2% to 5% of adult women in the general population. In some population subsets, like obese or older people, this prevalence is even higher. The health risk in OSA patients shows a strong association with acute cardiovascular events such as stroke, myocardial infarction and nocturnal sudden death.1,2 And with chronic conditions such as coronary artery disease, heart failure, and especially, systemic hypertension.3,4 In this review, prevalence and incidence of hypertension in OSA patients and the relationships between OSA and its confounders are considered, and of course, these confounders are also generally taken as risk factors for hypertension.

  11. Obstructive sleep apnea and endothelial progenitor cells

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    Wang Q

    2013-10-01

    Full Text Available Qing Wang,1,* Qi Wu,2,* Jing Feng,3,4 Xin Sun5 1The Second Respiratory Department of the First People's Hospital of Kunming, Yunnan, People's Republic of China; 2Tianjin Haihe Hospital, Tianjin, People's Republic of China; 3Respiratory Department of Tianjin Medical University General Hospital, Tianjin, People's Republic of China; 4Division of Pulmonary and Critical Care Medicine, Duke University Medical Center, Durham, NC, USA; 5Respiratory Department of Tianjin Haihe Hospital, Tianjin, People's Republic of China *These authors contributed equally to this work Background: Obstructive sleep apnea (OSA occurs in 4% of middle-aged men and 2% of middle-aged women in the general population, and the prevalence is even higher in specific patient groups. OSA is an independent risk factor for a variety of cardiovascular diseases. Endothelial injury could be the pivotal determinant in the development of cardiovascular pathology in OSA. Endothelial damage ultimately represents a dynamic balance between the magnitude of injury and the capacity for repair. Bone marrow–derived endothelial progenitor cells (EPCs within adult peripheral blood present a possible means of vascular maintenance that could home to sites of injury and restore endothelial integrity and normal function. Methods: We summarized pathogenetic mechanisms of OSA and searched for available studies on numbers and functions of EPCs in patients with OSA to explore the potential links between the numbers and functions of EPCs and OSA. In particular, we tried to elucidate the molecular mechanisms of the effects of OSA on EPCs. Conclusion: Intermittent hypoxia cycles and sleep fragmentation are major pathophysiologic characters of OSA. Intermittent hypoxia acts as a trigger of oxidative stress, systemic inflammation, and sympathetic activation. Sleep fragmentation is associated with a burst of sympathetic activation and systemic inflammation. In most studies, a reduction in circulating EPCs has

  12. Obstructive Sleep Syndrom in Patient with Plonjon Guatr: Case Report

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    Haldun sevketbeyoglu

    2014-08-01

    Full Text Available A large number of predisposing factors (obesity, nasal obstruction, adenoid hypertrophy, macroglossia, etc. are reported to be associated with obstructive sleep apnea syndrome (OUAS. In addition to these factors, the large goiter and hypothyroidism were reported to be associated with OSAS as well. However, this relationship could not yet be fully demonstrated. In our case related to plonjon goiter, we wanted to show the effect of hyroidectomy to OSAS and #8211;if there is- and the relationship between pressure and OSAS. Two years ago, a 72-year-old female with BMI: 26.8 kg/m2 patient was admitted to our clinic with complaints of respiratory standstill during sleep, snoring, morning headaches and drowsiness during daylight. In the chest X-ray, chest computed tomography and ultrasonography applied to the patient, it was detected that the trachea was deviated to the left due to euthyroid plonjon goiter and severe OSAS and polisomnografisi (PSG was diagnosed for the patient. The patients apnea-hypopnea index (AHI was measured 63.1/h. With the aim of treatment, in 7cm H2O pressure, nasal continuous positive airway pressure (nCPAP was applied to the patient and AHI decreased to the level of 11.4/h. Thyroidectomy was performed one month after the diagnosis. AHI was found 34.8 /h on the PSG applied for the purpose of 8 week-postoperative control. There were recovery on the levels of total sleep time, AHI, obstructive apnea index, hypopnea index, average desaturation index, stage 3 and REM as 16%, 44.8%, 84.7%, 19%, 38.3%, 52.4% and 28% respectively when compared the preoperative term with and postoperative term. It was demonstrated that there was no change of the in the degree of OSAS after thyroidectomy but only some partial improvement in the OSAS. The conclusion that there may be some improvements in nCPAP pressures after thyroidectomy and nCPAP treatment should not be stopped was reached. Also, it should be kept in mind that patients who apply to

  13. Prospective study of first night effect on 2-night pdolysomnographic parameters in adult Chinese snorers with suspected obstructive sleep apnea hypopnea syndrome

    Institute of Scientific and Technical Information of China (English)

    MA Jing; ZHANG Cheng; ZHANG Jue; HU Jie; FANG Jing; ZHANG Jie; JIA Peng; WANG Guang-fa

    2011-01-01

    Background A prospective 2-night polysomnographic (PSG) study in Chinese snorers was designed to assess the role of the first night effect (FNE) in PSG parameters and the diagnosis of obstructive sleep apnea hypopnea syndrome (OSAHS).Methods Seventy-two snorers from two teaching hospitals underwent overnight PSG on two consecutive nights.The night-to-night variability of PSG parameters were recorded and analyzed.Results Sixty-six patients were analyzed.Among all the PSG parameters,only the total time of stage 2 presented a significant difference between two nights:219.50 (83.50-353.50) vs.215.25 (59.50-342.50) (P=0.000).Subgroup assessment showed a slight night-to-night difference in about 1-2 parameters in the group with the apnea-hypopnea index (AHI) ≥20 events per hour as well as the group with AHI <20 events per hour,but there was no night-to-night difference in the AHI in each group.And slighter FNE was found among patients ≥40 years old.There was no significant difference in diagnosis of OSAHS.In the decision of severity,a slight difference was found between the two nights with a Kappa value=0.531.Conclusions Only mild FNE can be found on two consecutive nights of PSG in adult Chinese snorers,but it has no effect on the diagnosis of OSAHS.A single polysomnographic night may be adequate for the diagnosis of OSAHS.

  14. E valuation and clinical significance of serum C-reactive protein and homocysteine level in obstructive sleep apnea/hypopnea syndrome complicated with coronary heart disease patients

    International Nuclear Information System (INIS)

    Objective: To explore the relationship between homocysteine (HCY) and C-reactive protein (CRP) in obstructive sleep apnea/hypopnea syndrome (OSAHS) patients and OSAHS patients complicated with coronary heart disease by detecting the scrum level of HCY and CRP on the mechanism of OSAHS complicated with coronary heart disease. Methods: Ninety-one patients were divided into three groups, 30 patients as control group, 36 patients as OSAHS group, and 25 patients as OSAHS complicated with CHD group. Serum HCY level was detected through chemiluminescence. Serum CRP level was detected through radioimmunity. The serum level of HCY and CRP was compared among these groups. OSAHS patients were divided into mild OSAHS subgroup, moderate OSAHS subgroup and severe OSAHS subgroup. The morbidity rate of CHD and the serum level of HCY and CRP were compared among these subgroups. Meanwhile the parameters of polysomnogram such as activity apnea-hypopnea index (AHI) and blood oxygen saturation (SaO2) were compared between OSAHS group and OSAHS complicated with coronary heart disease group. Results: (1) There was significant difference among the serum level of HCY and CRP of control group, OSAHS group and OSAHS complicated with CHD group (FHCY=15.80, FCRP=19.21, P allHCY=4.74, tCRP=5.14, P all HCY=7.31, tCRP=8.17, P all 2=6.96, χ2=4.18, PHCY=16.38, FCRP=12.97, P all2 of OSAHS group and OSAHS complicated with CHD group (tAHI=5.46, percentage of SaO2 2: t=4.68, average lowest SaO2: t=3.65, longest duration of disordered breathing events: t=4.73, P all<0.01 ). Conclusion: The serum level of HCY and CRP rose because of hypoxia in OSAHS patients,and might play an important role in the mechanism of OSAHS complicated with CHD. (authors)

  15. Continuous positive airway pressure ameliorated severe pulmonary hypertension associated with obstructive sleep apnea.

    Directory of Open Access Journals (Sweden)

    Ogawa,Aiko

    2006-06-01

    Full Text Available

    A 52-year-old obese woman was admitted to our institution for evaluation of dyspnea and pulmonary hypertension (PH. Polysomnography revealed severe obstructive sleep apnea (OSA with an apnea hypopnea index of 99.8. Treatment with nocturnal continuous positive airway pressure (CPAP resulted in correction of daytime hypoxemia, hypercapnia, and near-normalization of pulmonary artery pressure. To our knowledge, this is the most severe case of OSA-associated PH (approximately70 mmHg reported to date, and it was successfully treated with nocturnal CPAP. This case demonstrates that OSA should be considered and polysomnography performed in all patients with PH, irrespective of severity, and that nocturnal CPAP has therapeutic effects on both OSA and daytime PH.

  16. Síndrome da apnéia-hipopnéia obstrutiva do sono. Fisiopatologia Physiopathology of obstructive sleep apnea-hypopnea syndrome

    Directory of Open Access Journals (Sweden)

    Andrea Barral Martins

    2007-02-01

    Full Text Available A fisiopatogenia da apnéia obstrutiva do sono é multifatorial. O sexo, a obesidade, os fatores genéticos, anatômicos e hormonais e o controle da ventilação interagem diversamente na fisiopatogenia e expressão clínica da doença. A obesidade é o principal fator de risco, sendo a elevação do índice de massa corpórea, da gordura visceral e da circunferência do pescoço, fortes preditores de sua ocorrência. A progesterona, por aumentar a atividade dos músculos dilatadores das vias aéreas superiores, tem papel protetor nas mulheres antes da menopausa, justificando a maior prevalência da doença na pós-menopausa, no sexo masculino e na síndrome dos ovários policísticos. Evidências apontam para o fato de que o aumento da idade promove diminuição do tônus muscular, com redução da luz das vias aéreas superiores. O dismorfismo crânio-facial, como na retrognatia ou micrognatia, está associado ao posicionamento posterior da língua, e pode resultar em estreitamento da luz das vias aéreas superiores. Finalmente, comando ventilatório reduzido tem sido detectado em pacientes com síndrome de apnéia obstrutiva do sono e hipercapnia.The physiopathology of obstructive sleep apnea syndrome is multifactorial. Gender and obesity status, as well as genetic, anatomic, and hormonal factors, together with ventilatory drive, interact in a diverse manner in the physiopathology and clinical expression of the disease. Obesity is the main risk factor, since increases in body mass index, visceral fat, and neck circumference are strong predictors of the disease. Progesterone increases the activity of the upper airway dilator muscles and therefore plays a protective role in premenopausal women. This explains the fact that the prevalence of the disease is higher in postmenopausal patients, in patients with polycystic ovary syndrome, as well as in males. Evidence supports the fact that, as individuals grow older, there is a decrease in muscle

  17. Psychological factors effect on obstructive sleep apnea ayndrome comorbid insomnia%心理因素在阻塞性睡眠呼吸暂停综合征共病失眠中的作用

    Institute of Scientific and Technical Information of China (English)

    彭华; 贺斌; 张琳; 郑莹; 杨洋; 赵忠新

    2015-01-01

    Objective This study aimed to further explore sleep-related psychological factors that may contribute to insomnia in obstructive sleep apnea syndrome (OSAS) patients .Methods Total of 60 patients were divided into OSAS group (20 patients) ,primary insomnia (20 patients) and OSAS+ In‐somnia group (20 patients) .All subjects underwent poly-somnography (PSG) overnight and completed a package of questionnaires ,including the Pittsburgh Sleep Quality Index (PSQI) ,Epworth Sleepiness Scale (ESS) ,Self -rating Anxiety Scale (SAS) ,Self - rating Depression Scale(SDS) .Results The OSAS+Insomnia and Insomnia groups had significantly higher levels of anxiety and depression than the OSAS group .The OSAS group had significantly more lethargy than the OSAS+Insomnia and Insomnia groups .Conclusions Although OSAS patients with insomnia showed a similar degree of respiratory dis‐turbances as patients with OSAS only ,their psychological and behavioral profiles resembled the features of primary insomnia patients .The results support the new concept of OSAS comorbid insomnia and sug‐gest the importance of evaluating and treating psychological factors in these patients .%目的:探讨在阻塞性睡眠呼吸暂停综合征(OSAS)患者中的睡眠相关的心理障碍归因于失眠。方法本研究共60例患者,其中20例为单纯OSAS组,20例单纯性失眠组,20例为OSAS共病失眠组。所有患者均行一夜PSG检查及睡眠量表(包括PSQI ,ESS)和心理量表(包括SDS ,SAS)检测。结果 OSAS共病失眠与单纯失眠组均比单纯OSAS组有明显焦虑和抑郁,单纯OSAS组比OSAS共病失眠与单纯失眠组嗜睡明显。结论虽然OSAS共病失眠组与OSAS组睡眠呼吸紊乱程度在同一水平,心理和白天思睡与单纯性失眠的患者相似。这个结论提出了OSAS共病失眠的新概念,同时建议在这些患者中进行心理治疗。

  18. Screening for Pediatric Obstructive Sleep Apnea before Ambulatory Surgery

    Science.gov (United States)

    Ishman, Stacey L.; Tawfik, Kareem O.; Smith, David F.; Cheung, Kristin; Pringle, Lauren M.; Stephen, Matthew J.; Everett, Tiffany L.; Stierer, Tracey L.

    2015-01-01

    Purpose: The American Society of Anesthesia practice guidelines recommend that pediatric and adult patients who undergo ambulatory surgery be screened for obstructive sleep apnea (OSA). With this in mind, our objective was to assess the frequency of screening by anesthesia providers for the signs and symptoms of OSA in children undergoing surgery in an ambulatory setting. Methods: Prospective single-blinded observational study of anesthesia providers' preoperative interview of caregivers of consecutive patients younger than age 18 who were scheduled for ambulatory surgery. Results: One hundred one children (30 females) were identified, with a mean age of 6.9 ± 5.0 years; 54 were classified as white, 33 as black, and 14 as other. Total OSA-18 scores ranged from 18 to 97, with a mean of 33.1 ± 14.8. The mean score for adenotonsillectomy patients was higher than that for children who underwent procedures other than adenotonsillectomy. Thirty-one percent of children were screened for OSA, and snoring was the most common symptom recorded (28%). Patients who were screened for OSA were more likely to have snoring (p Tawfik KO, Smith DF, Cheung K, Pringle LM, Stephen MJ, Everett TL, Stierer TL. Screening for pediatric obstructive sleep apnea before ambulatory surgery. J Clin Sleep Med 2015;11(7):751–755. PMID:25902820

  19. Obstructive Sleep Apnea and Kidney Disease: A Potential Bidirectional Relationship?

    Science.gov (United States)

    Abuyassin, Bisher; Sharma, Kumar; Ayas, Najib T; Laher, Ismail

    2015-08-01

    Chronic kidney disease (CKD) is associated with high mortality rates and heavy economic and social burdens. Nearly 10% of the United States population suffer from CKD, with fatal outcomes increased by 16-40 times even before reaching end-stage renal disease. The prevalence of obstructive sleep apnea (OSA) is between 3% and 7% in the general population, and has increased dramatically during the last 2 decades along with increased rates of obesity. However, the prevalence of OSA is much greater in patients with CKD. In addition, aggressive dialysis improves OSA. The current literature suggests a bidirectional association between CKD and OSA through a number of potential pathological mechanisms, which increase the possibility of both diseases being possible risk factors for each other. CKD may lead to OSA through a variety of mechanisms, including alterations in chemoreflex responsiveness, pharyngeal narrowing due to fluid overload, and accumulation of uremic toxins. It is also being increasingly recognized that OSA can also accelerate loss of kidney function. Moreover, animals exposed to intermittent hypoxia suffer histopathological renal damage. Potential mechanisms of OSA-associated renal dysfunction include renal hypoxia, hypertension, endothelial dysfunction, activation of the sympathetic nervous system, and increased oxidative stress. PMID:25845900

  20. Nonalcoholic fatty liver disease and obstructive sleep apnea.

    Science.gov (United States)

    Aron-Wisnewsky, Judith; Clement, Karine; Pépin, Jean-Louis

    2016-08-01

    Obstructive sleep apnea (OSA) and more importantly its hallmark, chronic intermittent hypoxia (CIH), are established factors in the pathogenesis and exacerbation of nonalcoholic fatty liver disease (NAFLD). This has been clearly demonstrated in rodent models exposed to intermittent hypoxia, and strong evidence now also exists in both paediatric and adult human populations. OSA and CIH induce insulin-resistance and dyslipidemia which are involved in NAFLD physiopathogenesis. CIH increases the expression of the hypoxia inducible transcription factor HIF1α and that of downstream genes involved in lipogenesis, thereby increasing β-oxidation and consequently exacerbating liver oxidative stress. OSA also disrupts the gut liver axis, increasing intestinal permeability and with a possible role of gut microbiota in the link between OSA and NAFLD. OSA patients should be screened for NAFLD and vice versa those with NAFLD for OSA. To date there is no evidence that treating OSA with continuous positive airway pressure (CPAP) will improve NAFLD but it might at least stabilize and slow its progression. Nevertheless, these multimorbid patients should be efficiently treated for all their metabolic co-morbidities and be encouraged to follow weight stabilization or weight loss programs and physical activity life style interventions. PMID:27324067

  1. Relationship between obstructive sleep apnea and 30-day mortality among patients with pulmonary embolism

    OpenAIRE

    Farzin Ghiasi; Amin Ahmadpoor; Babak Amra

    2015-01-01

    Background: Pulmonary embolism (PE) is the most life-threatening form of venous thrombosis which causes the majority of mortalities in this category. Obstructive sleep apnea (OSA) has been indicated as one of the risk factors for thromboembolism because of hemostatic alterations. The present study was designed to seek for the relationship between OSA and 30-day mortality of patients with PE. Materials and Methods: This prospective cohort study was conducted among 137 consecutive patients refe...

  2. Physiology in Medicine: Obstructive sleep apnea pathogenesis and treatment—considerations beyond airway anatomy

    OpenAIRE

    Dempsey, Jerome A.; Xie, Ailiang; Patz, David S.; Wang, David

    2013-01-01

    We review evidence in support of significant contributions to the pathogenesis of obstructive sleep apnea (OSA) from pathophysiological factors beyond the well-accepted importance of airway anatomy. Emphasis is placed on contributions from neurochemical control of central respiratory motor output through its effects on output stability, upper airway dilator muscle activation, and arousability. In turn, we consider the evidence demonstrating effective treatment of OSA via approaches that addre...

  3. 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...... dimensions between the groups were assessed by unpaired t tests. RESULTS: No significant differences were seen between groups I and III. Between groups I and II, significant differences were seen in jaw relationship (P

  4. The potential association between obstructive sleep apnea and diabetic retinopathy in severe obesity-the role of hypoxemia.

    Directory of Open Access Journals (Sweden)

    Dev Banerjee

    Full Text Available BACKGROUND: Obstructive sleep apnea (OSA is common in obese patients with type 2 diabetes mellitus (DM and may contribute to diabetic microvascular complications. METHODS: To investigate the association between OSA, hypoxemia during sleep, and diabetic retinal complications in severe obesity. This was a prospective observational study of 93 obese patients mean (SD age: 52(10 years; mean (SD body mass index (BMI: 47.3(8.3 kg/m(2 with DM undergoing retinal screening and respiratory monitoring during sleep. OSA was defined as apnea-hypopnea index (AHI of ≥15 events/hour, resulting in two groups (OSA+ vs. OSA-. RESULTS: Forty-six patients were OSA+: median (95% CI AHI = 37(23-74/hour and 47 were OSA-ve (AHI = 7(4-11/hour. Both groups were similar for ethnicity, BMI, cardiovascular co-morbidities, diabetes duration, HbA1c, and insulin treatment (p>0.05. The OSA+ group was significantly more hypoxemic. There was no significant difference between OSA+ and OSA- groups for the presence of retinopathy (39% vs. 38%. More OSA+ subjects had maculopathy (22% vs. 13%, but this did not reach statistical significance. Logistic regression analyses showed that AHI was not significantly associated with the presence of retinopathy or maculopathy (p>0.05. Whilst minimum oxygen saturation was not significantly associated with retinopathy, it was an independent predictor for the presence of maculopathy OR = 0.79 (95% CI: 0.65-0.95; p<0.05, after adjustment. CONCLUSIONS: The presence of OSA, as determined by AHI, was not associated with diabetic retinal complications. In contrast, severity of hypoxemia during sleep (minimum oxygen saturations may be an important factor. The importance of hypoxia in the development of retinal complications in patients with OSA remains unclear and further studies assessing the pathogenesis of hypoxemia in patients with OSA and diabetic retinal disease are warranted.

  5. Application of Dual Mask for Postoperative Respiratory Support in Obstructive Sleep Apnea Patient

    OpenAIRE

    Jahan Porhomayon; Gino Zadeii; Nader, Nader D; Bancroft, George R.; Alireza Yarahamadi

    2013-01-01

    In some conditions continuous positive airway pressure (CPAP) or bilevel positive airway pressure (BIPAP) therapy alone fails to provide satisfactory oxygenation. In these situations oxygen (O2) is often being added to CPAP/BIPAP mask or hose. Central sleep apnea and obstructive sleep apnea (OSA) are often present along with other chronic conditions, such as chronic obstructive pulmonary disease (COPD), congestive heart failure, pulmonary fibrosis, neuromuscular disorders, chronic narcotic us...

  6. Data-Driven Phenotyping: Graphical models for model-based phenotyping of sleep apnea

    OpenAIRE

    Nemati, S; Orr, J.; Malhotra, A

    2014-01-01

    © 2010-2012 IEEE. Sleep apnea is a multifactorial disease with a complex underlying physiology, which includes the chemoreflex feedback loop controlling ventilation. The instability of this feedback loop is one of the key factors contributing to a number of sleep disorders, including Cheyne?Stokes respiration and obstructive sleep apnea (OSA). A major limitation of the conventional characterization of this feedback loop is the need for labor-intensive and technically challenging experiments. ...

  7. High Mallampati score, obesity and obstructive sleep apnea: triple insult to lung function?

    Directory of Open Access Journals (Sweden)

    Nazia Uzma

    2014-07-01

    Full Text Available The paper assesses the combined effect of high Mallampati score, obesity and obstructive sleep apnea (OSA on lung function as measured by spirometry. Our results showed that the combination of sleep apnea, obesity and high Mallampati score resulted in a degree of restriction that was significantly greater than that produced by each factor alone. These observations underscore the importance of factoring in the Mallampati score in the assessment of respiratory disease.

  8. Hindi translation of Berlin questionnaire and its validation as a screening instrument for obstructive sleep apnea

    OpenAIRE

    Ravi Gupta; Ramjan Ali; Mohan Dhyani; Sourav Das; Ashwini Pundir

    2016-01-01

    Background: Obstructive sleep apnea (OSA) is a fairly common problem with adverse health consequences. However, any screening questionnaire is not available in Hindi to screen sleep apnea. Materials and Methods: Subjects undergoing video-synchronized in laboratory attended polysomnography were requested to participate in this study. They were screened with the help of Hindi version of Berlin questionnaire (BQ). Outcome of the BQ was tested against the gold standard polysomnography. Descriptiv...

  9. KL-6、ET-1在阻塞性睡眠呼吸暂停低通气综合征患者中的血清水平及其意义%Serum KL-6 and ET-1 Levels in Patients with Obstructive Sleep Apnea Hypopnea Syndrome and the Significance

    Institute of Scientific and Technical Information of China (English)

    冯晓辉; 邓晓雯; 李湘胜; 王继华; 肖旭平

    2013-01-01

    [Objective]To explore the serum KL-6 and ET-1 levels in patients with obstructive sleep apnea hypopnea syndrome(OSAHS ) and the significance .[Methods]According to drowsiness scale and sleep respiratory monitoring (PSG) ,75 adult patients were chosen and divided into non-OSAHS group ,mild to moderate OSAHS group and severe OSAHS group with 25 cases in each group .ELISA was used to examine serum levels of KL-6 and ET-1 in each group be-fore intervention therapy .[Results] There was no significant difference in serum levels of KL-6 and ET-1 between non-OSAHS group and mild to moderate OSAHS group ( P>0 .05) ,but those in severe OSAHS group were obviously higher than those in mild to moderate OSAHS group and non-OSAHS group( P0 .05) .There was positive linear correlation between serum KL-6 and ET-1(r=0 .942 ,P <0 .05) .[Conclusion]Severe OSAHS patients have sub-clinical vascular endothelial cell(VEC) injury ,which is related to the severity of OSAHS ,but not related to the gender and age of patients .The risk of cardiovascular complications in severe OSAHS patients is obviously higher than that in mild to moderate OSA HS patients and non-OSA HS patients .%[目的]探讨人Ⅱ型肺泡细胞表面抗原(KL-6)、ET-1在阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血清中的水平及意义。[方法]根据嗜睡量表、睡眠呼吸监测(PSG)选取75例鼾症患者,将其分为非OSAHS组、轻中度OSAHS组、重度OSAHS组三组,每组各25例,采用酶联免疫分析技术(ELISA)测定各组患者治疗干预前外周血清KL-6与ET-1水平。[结果]①血清KL-6、ET-1在非OSAHS组对象和轻中度OSAHS组血清水平差异均无统计学意义( P >0.05);重度OSAHS组患者中的水平明显高于轻中度OSAHS组和非OSAHS组( P <0.05)。②血清KL-6、ET-1水平与OSAHS病情严重程度有关( P <0.05),与患者性别、年龄无关( P >0.05)。③OSAHS患者血清中KL-6、ET-1

  10. Age-Group-Specific Associations between the Severity of Obstructive Sleep Apnea and Relevant Risk Factors in Male and Female Patients

    OpenAIRE

    Xingqi Deng; Wei Gu; Yanyan Li; Mei Liu; Yan Li; Xiwen Gao

    2014-01-01

    Aim To seek accurate and credible correlation manner between gender, age, and obesity; and the severity of obstructive sleep apnea (OSA) in large-scale population. Methods Totals of 1,975 male and 378 female OSA patients were sequentially recruited. Centralized covariant tendencies between age, body mass index (BMI), and waist hip ratio (WHR); and OSA severity, were explored in a gender-specific manner via multiple statistical analyses. The accuracies of observed correlations were further eva...

  11. Exploring the link between nocturnal heart rate, sleep apnea and cardiovascular function in African and Caucasian men : the SABPA study / Y. van Rooyen.

    OpenAIRE

    Van Rooyen, Yolandi

    2012-01-01

    Motivation: There is a rapid escalation in urbanization amongst South Africans and it is known that urbanized South Africans are subjected to lifestyle factors conducive to an increase in the risk for cardiovascular disease (CVD). Obstructive sleep apnea (OSA) has been described as an independent risk factor for CVD, especially hypertension. OSA has also been associated with insomnia, and plays a contributory role in the co-morbidity of this disorder. The mechanisms employed by OSA, which pro...

  12. The histology of human right atrial tissue in patients with high-risk Obstructive Sleep Apnea and underlying cardiovascular disease: A pilot study

    OpenAIRE

    Erik M. van Oosten; Boag, Alexander H; Kris Cunningham; John Veinot; Andrew Hamilton; Dimitri Petsikas; Darrin Payne; Hopman, Wilma M; Redfearn, Damian P; WonJu Song; Shawn Lamothe; Shetuan Zhang; Adrian Baranchuk

    2015-01-01

    Background: Obstructive Sleep Apnea (OSA) results in intermittent hypoxia leading to atrial remodeling, which, among other things, facilitates development of atrial fibrillation. While much data exists on the macrostructural changes in cardiac physiology induced by OSA, there is a lack of studies looking for histologic changes in human atrial tissue induced by OSA which might lead to the observed macrostructural changes. Methods: A case control study was performed. Patients undergoing coro...

  13. Comparison of cardiovascular co-morbidities and CPAP use in patients with positional and non-positional mild obstructive sleep apnea

    OpenAIRE

    Huang, Yi-Chih; Lin, Chun-Yao; Lan, Chou-Chin; Wu, Yao-Kuang; Lim, Chor-Shen; Huang, Chun-Yao; Huang, Hsuan-Li; Yeh, Kuan-Hung; Liu, Yu-Chih; Yang, Mei-Chen

    2014-01-01

    Background This retrospective cohort study aimed to determine if there are differences in cardiovascular co-morbidities, blood pressure (BP) and continuous positive airway pressure (CPAP) use between patients with positional-dependent and nonpositional-dependent obstructive sleep apnea (OSA). Methods Patients who were referred for overnight polysomnography for suspected OSA between 2007 and 2011 were screened. A total of 371 patients with OSA were included for analysis and divided into six gr...

  14. Upper airway finding on CT scan with and without nasal CPAP in obstructive sleep apnea patients

    Energy Technology Data Exchange (ETDEWEB)

    Akashiba, Tsuneto; Sasaki, Iwao; Kurashina, Keiji; Yoshizawa, Takayuki; Otsuka, Kenzo; Horie, Takashi (Nihon Univ., Tokyo (Japan). School of Medicine)

    1991-04-01

    The area of upper airway (from the nasopharynx to the hypopharynx) was measured by means of computed tomography (CT) scan in 15 confirmed cases of obstructive sleep apnea (OSA) and in 4 normal controls while they were awake. The minimum cross-sectional area (MA) of the upper airway was 14.7+-20.0 mm{sup 2} in OSA patients and 80.0+-33.1 mm{sup 2} in normal controls and the difference was statistically significant (p<0.01). In OSA patients, MA did not correlate with age, body weight, apnea index, desaturation index, mean nadir-SO{sub 2} and lowest SO{sub 2}. MA was also measured with OSA patients while nasal continuous positive airway pressure (NCPAP) of 10 cmH{sub 2}O was applied and it was found that MA was significantly widened when NCPAP therapy was performed. We conclude that upper airway narrowing is consistent finding in OSA patients but the degree of narrowing does not correlate with parameters of apnea and gas exchange during sleep, and NCPAP is effective to widen the area of upper airway in OSA patients. (author).

  15. Obstructive sleep apnea screening by NIRS imaging

    Science.gov (United States)

    Kashefi, Feraydune; Watenpaugh, Donald E.; Liu, Hanli

    2007-02-01

    This study aimed at determining cerebral hemodynamic parameters in human subjects during breath holding using near infrared spectroscopy (NIRS). Breath holding serves as a method of simulation OSA (Obstructive Sleep Apnea). Data was acquired non-invasively from 40 subjects, twenty OSA sufferers (10 females, 10 males, age 20-70 years), and twenty normal volunteers (10 females, 10 males, age 20-65 years). Measurements were conducted using a LED Imager (LEDI) during breath holding. In comparing OSA subjects with controls during breath holding, a consistent increase or even a decrease in oxy- ([O IIHb]), deoxy- ([HHb]), total hemoglobin ([tHb]) concentrations, and tissue hemoglobin oxygen saturation (SO II) in the regional brain tissue were observed. The LEDI probe consists of 4 sources and 10 detectors serving as 4 sets of 1 source and 4 detectors each. A three wavelength (730, 805, and 850 nm) LED was used and the wavelengths were switched sequentially. The distance between sources and the source-detector separation were 2.5 cm. Data acquisition consisted of three segments, baseline for one minute, followed by a period of breath holding, and then 2 minutes of recovery time. The duration of the breath holding was subject-dependent. Our investigation proves that NIR spectroscopy could be used as a tool for detecting cerebral hemodynamics and also serves as a method of screening patients with OSA.

  16. Mouth breathing children have cephalometric patterns similar to those of adult patients with obstructive sleep apnea syndrome Crianças respiradoras bucais apresentam padrão cefalométrico semelhante àquele observado em pacientes adultos com síndrome da apnéia obstrutiva do sono

    Directory of Open Access Journals (Sweden)

    Maria Ligia Juliano

    2009-09-01

    Full Text Available OBJECTIVE: To determine whether mouth breathing children present the same cephalometric patterns as patients with obstructive sleep apnea syndrome (OSAS. METHOD: Cephalometric variables were traced and measured on vertical lateral cephalometric radiographs. The cephalometric measurements of 52 mouth and 90 nose breathing children were compared with apneic patients. The children had not undergone adenoidectomy or tonsillectomy and had not had or were not receiving orthodontic or orthopedic treatment. RESULTS: Mouth breathing children showed same cephalometric pattern observed in patients with OSAS: a tendency to have a retruded mandible (p=0.05, along with greater inclination of the mandibular and occlusal planes (pOBJETIVO: Determinar se crianças respiradoras bucais apresentam o mesmo padrão cefalométrico que os pacientes que tem síndrome da apnéia obstrutiva do sono (SAOS. MÉTODO: Foram traçadas radiografias laterais verticais da cabeça para a mensuração das variáveis cefalométricas. As medidas cefalométricas de 52 crianças respiradoras bucais e de 90 crianças respiradoras nasais foram comparadas à de pacientes com apnéia. Foram excluídas as crianças que haviam sido submetidas à cirurgia de remoção de amídalas ou adenóides, ou que haviam recebido tratamento ortodôntico prévio ou em andamento. RESULTADOS: As crianças respiradoras bucais apresentaram o mesmo padrão cefalométrico observado em pacientes com SAOS: tendência a ter retrusão de mandíbula (p=0,05, assim como uma maior inclinação dos planos mandibular e oclusal (p<0,01 e tendência a ter maior inclinação dos incisivos superiores (p=0,08. O espaço da nasofaringe e o espaço aéreo posterior se apresentaram muito diminuídos nas crianças respiradoras bucais, como é observado em pacientes com SAOS (p<0,01. CONCLUSÃO: Crianças respiradoras bucais apresentam padrão cefalométrico alterado e sua morfologia craniofacial é semelhante àquela observada

  17. Mandibular distraction osteogenesis for improving respiratory function in patients with micrognathia complicated by obstructive sleep apnea syndrome%下颌骨牵引成骨术矫治小颌畸形伴阻塞性睡眠呼吸暂停综合征患者改善呼吸功能的作用

    Institute of Scientific and Technical Information of China (English)

    吴国平; 滕利; 孙晓梅; Andrew A.Heggie; Anthony D.Holmes

    2005-01-01

    BACKGROUND: Obstructive sleep apnea syndrome(OSAS) in patients with serious micrognathia affects the respiratory function and can be life-threatening. Conventional surgical therapies are often highly risky and unsuitable in patients with the craniomaxillofacial skeleton still in development.OBJECTIVE: To assess the value of mandibular distraction osteogenesis in treatment of OSAS in patients with congenital micrognathia and the effect of the surgery on the patients' respiratory functions.DESIGN: A self-controlled study.SETTING: Plastic Surgery Hospital of Peking Union Medical College and Plastic and Maxillofacial Surgery Unit of Royal Children's Hospital of Melbourne, Australia.PARTICIPANTS: Eight consecutive patients with congenital micrognathia who developed OSAS were hospitalized from October 2001 to July 2004 at the Center of Craniomaxillofacial Surgery, Plastic Surgery Hospital of Peking Union Medical College and Plastic and Maxillofacial Surgery Unit of Royal Children's Hospital of Melbourne, Australia. This group included 5 male and 3 female patients aged 4 months to 17 years.METHODS: The 8 patients underwent mandibular distraction osteogenesis,and altogether 16 distractors were placed through extraoral or intraoral incisions for bilateral distraction. The distraction device proceeded at the rate of 1 to 1.5 mm per day and consolidated for 4 to 12 weeks. The follow-up lasted for 2 to 18 months. Each patient was evaluated pre-and postoperatively with cephalometry or polysomnography (PSG).MAIN OUTCOME MEASURES: The distraction distance, posterior airway space, and improvement of the respiratory function of the patients were recorded.RESULTS: Osteotomy and distraction procedures were smooth in all the patients who had good ontogenesis. The average distraction distance was 19.12 mm(ranging from 15 to 25 mm) . The posterior airway space was increased from a mean of 4.5 mm preoperatively to 11 mm after the surgery. Seven patients had normal respiration and sleep

  18. Polysomnographic characteristics of obstructive sleep apnea syndrome with dream enacting behavior%具有梦境展现行为的阻塞性睡眠呼吸暂停综合征的多导睡眠监测特点

    Institute of Scientific and Technical Information of China (English)

    畅怡; 聂秀红; 魏兵; 肖汉; 张连国; 李艳; 詹淑琴; 陈彪

    2016-01-01

    目的 研究具有梦境展现行为(dream enacting behavior,DEB)的阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS)的视频多导睡眠监测(video-polysomnography,vPSG)特点.方法 选取2012年1月1日至2013年10月31日因各种睡眠主诉就诊于首都医科大学宣武医院睡眠门诊且年龄大于18岁的患者共224人.所有受试者均行快速动眼睡眠疾病(rapid eyes movement sleep behavior disorder,RBD)香港问卷(RBD questionnaire-Hong Kong,RBDQ-HK)筛查(阈值为18/19)以及一整夜vPSG检查,并分为伪RBD(Pseudo-RBD)组、OSAS组、特发性RBD (idiopathic RBD,iRBD)组并对其睡眠参数进行分析.结果 伪RBD组呼吸暂停低通气指数(apnea-hypopnea index,AHI)、非快速动眼睡眠(non-rapid eye movement,NREM)期AHI、REM期AHI及低通气指数高于OSAS对照组,基础血氧饱和度及最低血氧饱和度则低于OSAS对照组,低通气最长时间及血氧饱和度低于90%的时间比OSAS对照组长;与iRBD组相比,伪RBD组的梦境展现行为常常在各个睡眠期的呼吸相关觉醒时出现.结论 具有DEB症状的OSAS多为中重度OSAS患者,并且DEB的发作时间往往发生于呼吸暂停相关觉醒时.

  19. Obstructive Sleep Apnea and Hypertension in Adolescents: Effect on Neurobehavioral and Cognitive Functioning

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    Madaeva, Irina; Polyakov, Vladimir; Kolesnikov, Sergey

    2016-01-01

    Background. There are limited published data in regard to the relationship between obstructive sleep apnea (OSA) and hypertension and neurobehavioral and mental status in adolescence. The aim of our study was to evaluate neurobehavioral patterns and cognitive functions in adolescents with hypertension according to absence or presence of OSA. Methods. This was a retrospective cohort study completed at the Scientific Center for Family Health and Human Reproduction Problems. Participants included adolescents aged 14–17 years and referred for 24-hour ambulance blood pressure monitoring (ABPM) and polysomnographic (PSG) studies between 2007 and 2009, inclusive. Results. 18 hypertensive OSA (the 1st group) and 20 hypertensive non-OSA adolescents (the 2nd group) were included in the study. Significant changes of neurobehavioral functioning in OSA patients were shown. Cognitive abilities also were impaired. Verbal and visual memory indexes and attention index were 2.1 and 2.2 times lower, accordingly, in the 1st group than in the 2nd group (P < 0.05). Speech index was significantly 2.8 times lower in OSA patients than in non-OSA patients (P < 0.05). In hypertensive OSA adolescents more significant Spearman correlations between classic sleep parameters and cognitive measures were found compared to patients without OSA. Conclusions. These results suggest that OSA is closely associated with neurobehavioral and cognitive functioning in hypertensive adolescents. PMID:27445534

  20. Prevalence and Diagnostic Approach to Sleep Apnea in Hemodialysis Patients: A Population Study

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    Valentina Forni Ogna

    2015-01-01

    Full Text Available Background. Previous observations found a high prevalence of obstructive sleep apnea (OSA in the hemodialysis population, but the best diagnostic approach remains undefined. We assessed OSA prevalence and performance of available screening tools to propose a specific diagnostic algorithm. Methods. 104 patients from 6 Swiss hemodialysis centers underwent polygraphy and completed 3 OSA screening scores: STOP-BANG, Berlin’s Questionnaire, and Adjusted Neck Circumference. The OSA predictors were identified on a derivation population and used to develop the diagnostic algorithm, which was validated on an independent population. Results. We found 56% OSA prevalence (AHI ≥ 15/h, which was largely underdiagnosed. Screening scores showed poor performance for OSA screening (ROC areas 0.538 [SE 0.093] to 0.655 [SE 0.083]. Age, neck circumference, and time on renal replacement therapy were the best predictors of OSA and were used to develop a screening algorithm, with higher discriminatory performance than classical screening tools (ROC area 0.831 [0.066]. Conclusions. Our study confirms the high OSA prevalence and highlights the low diagnosis rate of this treatable cardiovascular risk factor in the hemodialysis population. Considering the poor performance of OSA screening tools, we propose and validate a specific algorithm to identify hemodialysis patients at risk for OSA for whom further sleep investigations should be considered.

  1. Prevalence and Diagnostic Approach to Sleep Apnea in Hemodialysis Patients: A Population Study

    Science.gov (United States)

    Forni Ogna, Valentina; Ogna, Adam; Pruijm, Menno; Bassi, Isabelle; Zuercher, Emilie; Halabi, Georges; Phan, Olivier; Bullani, Roberto; Teta, Daniel; Gauthier, Thierry; Cherpillod, Anne; Mathieu, Claudine; Mihalache, Alexandra; Cornette, Francoise; Haba-Rubio, José; Burnier, Michel; Heinzer, Raphaël

    2015-01-01

    Background. Previous observations found a high prevalence of obstructive sleep apnea (OSA) in the hemodialysis population, but the best diagnostic approach remains undefined. We assessed OSA prevalence and performance of available screening tools to propose a specific diagnostic algorithm. Methods. 104 patients from 6 Swiss hemodialysis centers underwent polygraphy and completed 3 OSA screening scores: STOP-BANG, Berlin's Questionnaire, and Adjusted Neck Circumference. The OSA predictors were identified on a derivation population and used to develop the diagnostic algorithm, which was validated on an independent population. Results. We found 56% OSA prevalence (AHI ≥ 15/h), which was largely underdiagnosed. Screening scores showed poor performance for OSA screening (ROC areas 0.538 [SE 0.093] to 0.655 [SE 0.083]). Age, neck circumference, and time on renal replacement therapy were the best predictors of OSA and were used to develop a screening algorithm, with higher discriminatory performance than classical screening tools (ROC area 0.831 [0.066]). Conclusions. Our study confirms the high OSA prevalence and highlights the low diagnosis rate of this treatable cardiovascular risk factor in the hemodialysis population. Considering the poor performance of OSA screening tools, we propose and validate a specific algorithm to identify hemodialysis patients at risk for OSA for whom further sleep investigations should be considered. PMID:26229952

  2. Prevalence of obstructive sleep apnea in Asian adults: a systematic review of the literature

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    Mirrakhimov Aibek E

    2013-02-01

    Full Text Available Abstract Background Obstructive sleep apnea (OSA is a common disease, affecting approximately 2% of women and 4% of men residing in Western communities. No systematically reviewed data are available about the prevalence of this disease in Asia, the most heavily populated continent. Methods PubMed/Medline, Scopus and Google Scholar were searched for articles published from 1993 to May 2012 that reported the prevalence of OSA diagnosed via sleep monitoring and the prevalence of patients at risk for OSA as assessed by symptomatology and/or sleep questionnaires. We have also searched abstract database of major pulmonary and sleep scientific societies for relevant abstracts presented from 2010 to 2012. The following inclusion criteria were used: articles published in English, age ≥ 18 years, ≥ 100 participants in studies using sleep monitoring for the diagnosis of OSA, ≥ 300 participants in studies using questionnaires to detect patients at high risk for OSA. Exclusion criteria: duplicate publications, studies reporting the prevalence of central sleep apnea only, hospital based studies as well as studies assessing OSA prevalence among patients with resistant arterial hypertension, chronic kidney disease, heart failure and in patients with concomitant neurological disease. Results Twenty four articles were found to meet the inclusion criteria, covering 47,957 subjects (26,042 men and 21,915 women and four relevant abstracts were noted. OSA prevalence ranged from 3.7% to 97.3%. Male gender, older age, a higher BMI and waist to hip ratio, greater neck circumference, arterial hypertension, smoking, snoring and daytime sleepiness were associated with OSA. Sample size, difference between the populations studied and the fact that some works included patients with a high pre-test probability of OSA explain the difference in prevalence rates. Conclusion This systematic review highlights the lack of data regarding the prevalence of OSA in Asians

  3. Craniocervical Posture in Patients with Obstructive Sleep Apnea

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    Piccin, Chaiane Facco; Pozzebon, Daniela; Scapini, Fabricio; Corrêa, Eliane Castilhos Rodrigues

    2016-01-01

    Introduction  Obstructive Sleep Apnea (OSA) is characterized by repeated episodes of upper airway obstruction during sleep. Objective  The objective of this study is to verify the craniofacial characteristics and craniocervical posture of OSA and healthy subjects, determining possible relationships with the apnea/hypopnea index (AHI). Methods  This case-control study evaluated 21 subjects with OSA, who comprised the OSA group (OSAG), and 21 healthy subjects, who constituted the control group (CG). Cephalometry analyzed head posture measurements, craniofacial measurements, and air space. Head posture was also assessed by means of photogrammetry. Results  The groups were homogeneous regarding gender (12 men and 9 women in each group), age (OSAG = 41.86 ± 11.26 years; GC = 41.19 ± 11.20 years), and body mass index (OSAG = 25.65 ± 2.46 kg/m2; CG = 24.72 ± 3.01 kg/m2). We found significant differences between the groups, with lower average pharyngeal space and greater distance between the hyoid bone and the mandibular plane in OSAG, when compared with CG. A positive correlation was found between higher head hyperextension and head anteriorization, with greater severity of OSA as assessed by AHI. Conclusion  OSAG subjects showed changes in craniofacial morphology, with lower average pharyngeal space and greater distance from the hyoid bone to the mandibular plane, as compared with healthy subjects. Moreover, in OSA subjects, the greater the severity of OSA, the greater the head hyperextension and anteriorization. PMID:27413397

  4. Medium Increased Risk for Central Sleep Apnea but Not Obstructive Sleep Apnea in Long-Term Opioid Users: A Systematic Review and Meta-Analysis

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    Filiatrault, Marie-Lou; Chauny, Jean-Marc; Daoust, Raoul; Roy, Marie-Pier; Denis, Ronald; Lavigne, Gilles

    2016-01-01

    Study Objective: Opioids are associated with higher risk for ataxic breathing and sleep apnea. We conducted a systematic literature review and meta-analysis to assess the influence of long-term opioid use on the apnea-hypopnea and central apnea indices (AHI and CAI, respectively). Methods: A systematic review protocol (Cochrane Handbook guidelines) was developed for the search and analysis. We searched Embase, Medline, ACP Journal Club, and Cochrane Database up to November 2014 for three topics: (1) narcotics, (2) sleep apnea, and (3) apnea-hypopnea index. The outcome of interest was the variation in AHI and CAI in opioid users versus non-users. Two reviewers performed the data search and extraction, and disagreements were resolved by discussion. Results were combined by standardized mean difference using a random effect model, and heterogeneity was tested by χ2 and presented as I2 statistics. Results: Seven studies met the inclusion criteria, for a total of 803 patients with obstructive sleep apnea (OSA). We compared 2 outcomes: AHI (320 opioid users and 483 non-users) and 790 patients with CAI (315 opioid users and 475 non-users). The absolute effect size for opioid use was a small increased in apnea measured by AHI = 0.25 (95% CI: 0.02–0.49) and a medium for CAI = 0.45 (95% CI: 0.27–0.63). Effect consistency across studies was calculated, showing moderate heterogeneity at I2 = 59% and 29% for AHI and CAI, respectively. Conclusions: The meta-analysis results suggest that long-term opioid use in OSA patients has a medium effect on central sleep apnea. Citation: Filiatrault ML, Chauny JM, Daoust R, Roy MP, Denis R, Lavigne G. Medium increased risk for central sleep apnea but not obstructive sleep apnea in long-term opioid users: a systematic review and meta-analysis. J Clin Sleep Med 2016;12(4):617–625. PMID:26943709

  5. Treatment Experience in Patients With Obstructive Sleep Apnea Hypopnea Syndrome and Nocturnal Angina%阻塞性睡眠呼吸低通气综合征并夜间心绞痛的治疗体会

    Institute of Scientific and Technical Information of China (English)

    朱梅生

    2016-01-01

    目的:探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)对夜间心绞痛的影响及有效治疗的方法。方法对39例阻塞性睡眠呼吸暂停低通气综合征合并夜间心绞痛患者给予经鼻持续正压通气治疗,采用多导睡眠监测系统进行整夜睡眠监测,比较治疗前后指标改善及症状改善情况。结果患者治疗后睡眠呼吸暂停低通气指数、心肌缺血发作率、心肌梗死发作率、心电图异常率降低(P<0.05),夜间最低血氧饱和度、血压控制良好率增加(P<0.05),夜间心绞痛发作次数减少(P<0.05),左室射血分数改善差异无统计学意义(P>0.05)。结论阻塞性睡眠呼吸暂停低通气综合征诱发加重夜间心绞痛,经鼻持续正压通气治疗可改善阻塞性睡眠呼吸暂停低通气综合征合并夜间心绞痛患者的症状。%Objective To investigate effect and effective treat methods of patients with obstructive sleep apnea hypopnea syndrome and nocturnal angina.Methods 39 patients with obstructive sleep apnea hypopnea syndrome and nocturnal angina treated by nasal continuous positive airway pressure. Sleep monitoring was carried out by multi-guide sleep monitoring system. Improvement of indicators and disorders were compared before and after treatment.Results Sleep apnea hypopnea index,myocardial ischemic attack rate,myocardial infarction attack rate,ECG abnormal rate decreased significantly after treatment(P0.05). Conclusion Obstructive sleep apnea hypopnea syndrome can induce exacerbation of nocturnal angina. Nasal continuous positive airway pressure therapy can improve the symptoms of patients with obstructive sleep apnea hypopnea syndrome and nocturnal angina.

  6. Treatment of obstructive sleep apnea with mandibular advancement appliance over prostheses: A case report

    Science.gov (United States)

    Guimarães, Thais Moura; Colen, Sâmia; Cunali, Paulo Afonso; Rossi, Rowdley; Dal-Fabbro, Cibele; Ferraz, Otávio; Tufik, Sergio; Bittencourt, Lia

    2015-01-01

    Treatment with a mandibular advancement device (MAD) is recommended for mild obstructive sleep apnea (OSA), primary snoring and as a secondary option for Continuous Positive Airway Pressure, because it has better adherence and acceptance. However, edentulous patients do not have supports to hold the MAD. This study aimed to present a possible to OSA treatment with MAD in over complete upper and partial lower dentures. The patient, a 38-year-old female with mild OSA, was treated with a MAD. The respiratory parameter, such as apnea–hypopnea index, arousal index and oxyhemoglobin saturation was improved after treatment. PMID:26483952

  7. Obstructive sleep apnea and cardiovascular disease: back and forward in time over the last 25 years

    Directory of Open Access Journals (Sweden)

    Quan SF

    2012-10-01

    Full Text Available Over the past 25 years, there have been significant advances made in understanding the pathophysiology and cardiovascular consequences of obstructive sleep apnea (OSA. Substantial evidence now implicates OSA as an independent risk factor for the development of hypertension, coronary artery disease, congestive heart failure and stroke, as well as increased risk of death. Pathophysiologic mechanisms include release of inflammatory mediators, oxidative stress, metabolic dysfunction, hypercoagulability and endothelial dysfunction. Although non-randomized intervention studies suggest that treatment of OSA with continuous positive airway pressure may mitigate its impact of the development of cardiovascular disease, randomized clinical trials are lacking.

  8. Cardiac autonomic control in the obstructive sleep apnea

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    Nouha Gammoudi

    2015-04-01

    Full Text Available Introduction: The sympathetic activation is considered to be the main mechanism involved in the development of cardiovascular diseases in obstructive sleep apnea (OSA. The heart rate variability (HRV analysis represents a non-invasive tool allowing the study of the autonomic nervous system. The impairment of HRV parameters in OSA has been documented. However, only a few studies tackled the dynamics of the autonomic nervous system during sleep in patients having OSA. Aims: To analyze the HRV over sleep stages and across sleep periods in order to clarify the impact of OSA on cardiac autonomic modulation. The second objective is to examine the nocturnal HRV of OSA patients to find out which HRV parameter is the best to reflect the symptoms severity. Methods: The study was retrospective. We have included 30 patients undergoing overnight polysomnography. Subjects were categorized into two groups according to apnea–hypopnea index (AHI: mild-to-moderate OSAS group (AHI: 5–30 and severe OSAS group (AHI>30. The HRV measures for participants with low apnea–hypopnea indices were compared to those of patients with high rates of apnea–hypopnea across the sleep period and sleep stages. Results: HRV measures during sleep stages for the group with low rates of apnea–hypopnea have indicated a parasympathetic activation during non-rapid eye movement (NREM sleep. However, no significant difference has been observed in the high AHI group except for the mean of RR intervals (mean RR. The parasympathetic activity tended to increase across the night but without a statistical difference. After control of age and body mass index, the most significant correlation found was for the mean RR (p=0.0001, r=−0.248. Conclusion: OSA affects sympathovagal modulation during sleep, and this impact has been correlated to the severity of the disease. The mean RR seemed to be a better index allowing the sympathovagal balance appreciation during the night in OSA.

  9. Automatic anatomy recognition in post-tonsillectomy MR images of obese children with OSAS

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    Tong, Yubing; Udupa, Jayaram K.; Odhner, Dewey; Sin, Sanghun; Arens, Raanan

    2015-03-01

    Automatic Anatomy Recognition (AAR) is a recently developed approach for the automatic whole body wide organ segmentation. We previously tested that methodology on image cases with some pathology where the organs were not distorted significantly. In this paper, we present an advancement of AAR to handle organs which may have been modified or resected by surgical intervention. We focus on MRI of the neck in pediatric Obstructive Sleep Apnea Syndrome (OSAS). The proposed method consists of an AAR step followed by support vector machine techniques to detect the presence/absence of organs. The AAR step employs a hierarchical organization of the organs for model building. For each organ, a fuzzy model over a population is built. The model of the body region is then described in terms of the fuzzy models and a host of other descriptors which include parent to offspring relationship estimated over the population. Organs are recognized following the organ hierarchy by using an optimal threshold based search. The SVM step subsequently checks for evidence of the presence of organs. Experimental results show that AAR techniques can be combined with machine learning strategies within the AAR recognition framework for good performance in recognizing missing organs, in our case missing tonsils in post-tonsillectomy images as well as in simulating tonsillectomy images. The previous recognition performance is maintained achieving an organ localization accuracy of within 1 voxel when the organ is actually not removed. To our knowledge, no methods have been reported to date for handling significantly deformed or missing organs, especially in neck MRI.

  10. Correlation of Epworth Sleepiness Scale with multiple sleep latency test and its diagnostic accuracy in assessing excessive daytime sleepiness in patients with obstructive sleep apnea hypopnea syndrome

    Institute of Scientific and Technical Information of China (English)

    CAI Si-jie; CHEN Rui; ZHANG Yan-lin; XIONG Kang-ping; LIAN Yi-xin; LI Jie; SHEN Jiu-cheng

    2013-01-01

    Background Excessive daytime sleepiness (EDS) is often associated with obstructive sleep apnea hypopnea syndrome (OSAHS) and contributes to a number of comorbidities in these patients.Therefore,eady detection of EDS is critical in disease management.We examined the association between Epworth Sleepiness Scale (ESS) and multiple sleep latency test (MSLT) and diagnostic accuracy of ESS in assessing EDS in OSAHS patients.Methods The ESS,MSLT and overnight polysomnography were administered to 107 Chinese patients to assess EDS and its correlations with polysomnographic parameters.The diagnostic accuracy of ESS in classifying EDS (mean sleep latency (MSL) <10 minutes) was evaluated by calculating the area under ROC curve.Results As the severity of OSAHS increased,MSL decreased with increase in ESS score.Conversely,patients with worsening EDS (shorter MSL) were characterized by advanced nocturnal hypoxaemia and sleep disruption compared to those with normal MSL,suggesting EDS is associated with more severe OSAHS.There was a negative correlation between ESS score and MSL and both moderately correlated with some polysomnographic nocturnal hypoxaemic parameters.The area under ROC curve of ESS for identifying EDS was 0.80 (95% C/:0.71 to 0.88) and ESS score >12provided the best predictive value with a sensitivity of 80% and specificity of 69%.Conclusion The ESS score moderately correlates with MSL and our ROC study supports ESS as a screening strategy for assessing EDS in OSAHS.

  11. Obstructive sleep apnea is associated with impaired glucose metabolism in Han Chinese subjects

    Institute of Scientific and Technical Information of China (English)

    GU Chen-juan; LI Min; LI Qing-yun; LI Ning; SHI Guo-chao; WAN Huan-ying

    2013-01-01

    Background Increasingly,evidence from population,clinic-based and laboratory studies supports an independent association between obstructive sleep apnea syndrome (OSAS) and an increased risk of type 2 diabetes; however,this observation has yet to be replicated in China and the potential mechanisms that link these two conditions are not clear.Methods A total of 179 Han Chinese subjects were enrolled in this study.All subjects underwent polysomnography,the oral glucose tolerance-insulin releasing test (OGTT-IRT) and serum HbA1c measurement.Indexes including homeostasis model assessment-IR (HOMA-IR),Matsuda index,HOMA-β,early phase insulinogenic index (△I30 / △G30),AUC-I180 and oral disposition index (DIo) were calculated for the assessment of insulin resistance and pancreatic β-cell function.Results Based on OGTT,25.4%,44.6% and 54.5% subjects were diagnosed having glucose metabolic disorders respectively in control,mild to moderate and severe OSAS groups (P <0.05).Serum HbA1c levels were highest in subjects with severe OSAS (P <0.05).In contrast,compared with normal subjects,HOMA-β,△I30/△G30 and DIo were lower in severe OSAS group (P <0.05).In stepwise multiple linear regressions,0-min glucose and HbA1c were positively correlated with the percentage of total sleep time below an oxyhemoglobin saturation of 90% (T90) (Beta =0.215 and 0.368,P <0.05); 30-min and 60-min glucose was negatively correlated with the lowest SpO2 (LSpO2) (Beta =-0.214 and -0.241,P <0.05).HOMA-β and Dlowere negatively correlated with T90 (Beta =-0.153 and-0.169,P <0.05) while body mass index (BMI) was the only determinant of HOMA-IR and Matsuda index.Conclusions OSAS is associated with impairment in glucose tolerance and pancreatic β-cell function in Han Chinese subjects while insulin sensitivity is mainly determined by obesity.

  12. Speckle tracking echocardiography in chronic obstructive pulmonary disease and overlapping obstructive sleep apnea

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    Pizarro C

    2016-08-01

    Full Text Available Carmen Pizarro,* Fabian van Essen,* Fabian Linnhoff, Robert Schueler, Christoph Hammerstingl, Georg Nickenig, Dirk Skowasch, Marcel Weber Department of Internal Medicine II, Cardiology, Pneumology and Angiology, University Hospital Bonn, Bonn, Germany *These authors contributed equally to this work Background: COPD and congestive heart failure represent two disease entities of growing global burden that share common etiological features. Therefore, we aimed to identify the degree of left ventricular (LV dysfunction in COPD as a function of COPD severity stages and concurrently placed particular emphasis on the presence of overlapping obstructive sleep apnea (OSA.Methods: A total of 85 COPD outpatients (64.1±10.4 years, 54.1% males and 20 controls, matched for age, sex, and smoking habits, underwent speckle tracking echocardiography for LV longitudinal strain imaging. Complementary 12-lead electrocardiography, laboratory testing, and overnight screening for sleep-disordered breathing using the SOMNOcheck micro® device were performed.Results: Contrary to conventional echocardiographic parameters, speckle tracking echocardiography revealed significant impairment in global LV strain among COPD patients compared to control smokers (-13.3%±5.4% vs -17.1%±1.8%, P=0.04. On a regional level, the apical septal LV strain was reduced in COPD (P=0.003 and associated with the degree of COPD severity (P=0.02. With regard to electrocardiographic findings, COPD patients exhibited a significantly higher mean heart rate than controls (71.4±13.0 beats per minute vs 60.3±7.7 beats per minute, P=0.001 that additionally increased over Global Initiative for Chronic Obstructive Lung Disease stages (P=0.01. Albeit not statistically significant, COPD led to elevated N-terminal pro-brain natriuretic peptide levels (453.2±909.0 pg/mL vs 96.8±70.0 pg/mL, P=0.08. As to somnological testing, the portion of COPD patients exhibiting overlapping OSA accounted for 5.9% and

  13. CO(2) homeostasis during periodic breathing in obstructive sleep apnea.

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    Berger, K I; Ayappa, I; Sorkin, I B; Norman, R G; Rapoport, D M; Goldring, R M

    2000-01-01

    The contribution of apnea to chronic hypercapnia in obstructive sleep apnea (OSA) has not been clarified. Using a model (D. M. Rapoport, R. G. Norman, and R. M. Goldring. J. Appl. Physiol. 75: 2302-2309, 1993), we previously illustrated failure of CO(2) homeostasis during periodic breathing resulting from temporal dissociation between ventilation and perfusion ("temporal V/Q mismatch"). This study measures acute kinetics of CO(2) during periodic breathing and addresses interapnea ventilatory compensation for maintenance of CO(2) homeostasis in 11 patients with OSA during daytime sleep (37-171 min). Ventilation and expiratory CO(2) and O(2) fractions were measured on a breath-by-breath basis by means of a tight-fitting full facemask. Calculations included CO(2) excretion, metabolic CO(2) production, and CO(2) balance (metabolic CO(2) production - exhaled CO(2)). CO(2) balance was tabulated for each apnea/hypopnea event-interevent cycle and as a cumulative value during sleep. Cumulative CO(2) balance varied (-3,570 to +1,388 ml). Positive cumulative CO(2) balance occurred in the absence of overall hypoventilation during sleep. For each cycle, positive CO(2) balance occurred despite increased interevent ventilation to rates as high as 45 l/min. This failure of CO(2) homeostasis was dependent on the event-to-interevent duration ratio. The results demonstrate that 1) periodic breathing provides a mechanism for acute hypercapnia in OSA, 2) acute hypercapnia during periodic breathing may occur without a decrease in average minute ventilation, supporting the presence of temporal V/Q mismatch, as predicted from our model, and 3) compensation for CO(2) accumulation during apnea/hypopnea may be limited by the duration of the interevent interval. The relationship of this acute hypercapnia to sustained chronic hypercapnia in OSA remains to be further explored. PMID:10642388

  14. The Severity of Nocturnal Hypoxia but Not Abdominal Adiposity Is Associated with Insulin Resistance in Non-Obese Men with Sleep Apnea

    OpenAIRE

    Anne-Laure Borel; Denis Monneret; Renaud Tamisier; Jean-Philippe Baguet; Patrice Faure; Patrick Levy; Serge Halimi; Jean-Louis Pépin

    2013-01-01

    BACKGROUND: Beyond obesity, sleep