Clinical utility of oximetric parameters to identify a high‐risk phenotype of moderate‐severe Obstructive Sleep Apnea (OSA)

2020 ◽  
Vol 14 (12) ◽  
pp. 1166-1175
Author(s):  
Gonzalo Labarca ◽  
Jorge Dreyse ◽  
Constanza Salas ◽  
Francisca Letelier ◽  
Alexia Schmidt ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
High Risk ◽  
Clinical Utility ◽  
Severe Obstructive Sleep Apnea ◽  
Obstructive Sleep

scholarly journals Home Unattended Portable Monitoring and Automatic CPAP Titration in Patients with High Risk for Moderate to Severe Obstructive Sleep Apnea

2013 ◽  
Vol 58 (7) ◽  
pp. 1178-1183 ◽  
Author(s):  
Ersilia Tedeschi ◽  
Pierluigi Carratù ◽  
Mario Francesco Damiani ◽  
Valentina Anna Ventura ◽  
Riccardo Drigo ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
High Risk ◽  
Severe Obstructive Sleep Apnea ◽  
Portable Monitoring ◽  
Cpap Titration ◽  
Obstructive Sleep

Acromegaly and Obstructive Sleep Apnea: Identifying the High-Risk Group

2019 ◽  
Author(s):  
Xiaojun Zhan ◽  
Chandala Chitguppi ◽  
Ethan Berman ◽  
Gurston Nyquist ◽  
Tomas Garzon-Muvdi ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
High Risk ◽  
Risk Group ◽  
High Risk Group ◽  
Obstructive Sleep

Postoperative monitoring of children with obstructive sleep apnea syndrome

2014 ◽  
Vol 155 (18) ◽  
pp. 703-707 ◽  
Author(s):  
Pálma Benedek ◽  
Gabriella Kiss ◽  
Eszter Csábi ◽  
Gábor Katona
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Preoperative Evaluation ◽  
Sleep Apnea Syndrome ◽  
Study Patient ◽  
Severe Obstructive Sleep Apnea ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
Apnea Syndrome

Introduction: Treatment of pediatric obstructive sleep apnea syndrome is surgical. The incidence of postoperative respiratory complications in this population is 5–25%. Aim: The aim of the authors was to present the preoperative evaluation and monitoring procedure elaborated in Heim Pál Children Hospital, Budapest. Method: 142 patients were involved in the study. Patient history was obtained and physical examination was performed in all cases. Thereafter, polysomnography was carried out, the severity of the obstructive sleep apnea syndrome was determined, and the patients underwent tonsilloadenotomy. Results: 45 patients with mild, 50 patients with moderate and 47 patients with severe obstructive sleep apnea syndrome were diagnosed. There was no complication in patients with mild disease, while complications were observed in 6 patients in the moderate group and 24 patients in the severe group (desaturation, apnea, stridor, stop breathing) (p<0.000). In patients with severe obstructive sleep apnea syndrome, no significant difference was noted in preoperative apnoea-hypapnea index (p = 0.23) and in nadir oxygen saturation values (p = 0.73) between patients with and without complication. Conclusions: Patients with severe obstructive sleep apnea syndrome should be treated in hospital where pediatric intensive care unit is available. Orv. Hetil., 2014, 155(18), 703–707.

420 Evaluating the Rate of Referral for Obstructive Sleep Apnea in a Pre-Doctoral Dental Clinic Using the STOP-Bang Questionnaire

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A166-A166
Author(s):  
Nathan Guess ◽  
Henry Fischbach ◽  
Andy Ni ◽  
Allen Firestone
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
High Risk ◽  
Electronic Health Record ◽  
Health Record ◽  
Dental Clinic ◽  
Neck Size ◽  
Previous Diagnosis ◽  
Obstructive Sleep ◽  
Electronic Health

Abstract Introduction The STOP-Bang Questionnaire is a validated instrument to assess an individual’s risk for obstructive sleep apnea (OSA). The prevalence of OSA is estimated at 20% in the US with only 20% of those individuals properly diagnosed. Dentists are being asked to screen and refer patients at high risk for OSA for definitive diagnosis and treatment. The aim of this study was to determine whether patients in a dental school student clinic who were identified as high-risk for OSA, were referred for evaluation of OSA. Methods All new patients over the age of 18 admitted to The Ohio State University - College of Dentistry complete an “Adult Medical History Form”. Included in this study were 21,312 patients admitted between July 2017 and March 2020. Data were extracted from the history form to determine the STOP-Bang Score for all patients: age, sex, BMI, self-reported snoring-, stopped breathing/choking/gasping while sleeping-, high blood pressure-, neck size over 17” (males) or 16” (females)-, and tiredness. Each positive response is a point, for a maximum of 8 points possible. Additionally, any previous diagnosis of sleep apnea, and the patient’s history of referrals were extracted from the health record. According to clinic policy, if the patient did not have a previous diagnosis for OSA noted in the health history, and scored 5 or more on the STOP-Bang Questionnaire, they should receive a referral for an evaluation for OSA. Notes and referral forms were reviewed to determine if the appropriate referrals occurred for patients at high risk without a previous diagnosis. Results Of the 21,312 patients screened; 1098 (5.2%) screened high-risk for OSA, of which 398 had no previous diagnosis of OSA. Of these 398 patients, none (0%) had referrals for further evaluation for OSA. Conclusion The rate of appropriate referrals from a student dental clinic with an electronic health record was unacceptably low. Continued education and changes to the electronic health record are needed to ensure those at high-risk for OSA are appropriately referred and managed. Support (if any):

Predictive Factors for Efficacious Oral Appliance Therapy in Moderate to Severe Obstructive Sleep Apnea Patients

2021 ◽  
Author(s):  
Guillaume Buiret ◽  
Maroun Bechara ◽  
Isabelle Plouin‐Gaudon ◽  
Frederique Bavozet ◽  
Olivia Dancea ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Predictive Factors ◽  
Oral Appliance ◽  
Severe Obstructive Sleep Apnea ◽  
Oral Appliance Therapy ◽  
Obstructive Sleep

scholarly journals Continuous Positive Airway Pressure-Mandibular Advancement Device Combination Therapy for Moderate-to-Severe Obstructive Sleep Apnea: A Preliminary Study

2021 ◽  
Author(s):  
Thyagaseely Sheela Premaraj ◽  
Jacob Stadiem ◽  
Shyamaly Arya Premaraj ◽  
Charles R. Davies ◽  
Matthew Dennis ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Daytime Sleepiness ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Mandibular Advancement Device ◽  
Mandibular Advancement ◽  
Severe Obstructive Sleep Apnea ◽  
Obstructive Sleep ◽  
The Mean

Abstract Objectives The purpose of this pilot study was to determine whether compliance to auto-adjusting positive airway pressure (APAP) improves with the addition of a mandibular advancement device (MAD). Secondary outcome measures included were APAP pressure, subjective daytime sleepiness, apnea–hypopnea index (AHI), and mask leaks. Setting and Sample Population Participants included were diagnosed with moderate-to-severe obstructive sleep apnea (OSA) and became noncompliant to prescribed APAP. Thirteen participants with a mean age of 61.6 years were recruited for this study. Materials and Methods All participants were given a MAD to use with their APAP. Parameters measured included APAP pressure, AHI, mask leak reported via ResMed AirViewTM software, and self-reported daytime sleepiness (Epworth Sleepiness Scale [ESS]). A paired two-sample for mean t-test was performed to determine significance. Results The mean difference of pre- and postintervention APAP compliance was 23.1%, which was statistically significant (p = 0.015). The mean APAP air pressures were unchanged. The difference between pre- and postintervention mean ESS scores was 1.4 and was statistically significant (p = 0.027). The mean difference between pre- and postintervention AHI values and mask leak showed no significant difference. Conclusion This study showed that combination of APAP-MAD therapy, for patients with moderate-to-severe OSA who were noncompliant to APAP use, significantly increased compliance with APAP therapy, and significantly decreased the daytime sleepiness of participants.

480 Cardiovascular and metabolic risk in patients with suspected comorbid insomnia and obstructive sleep apnea (COMISA)

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A189-A190
Author(s):  
Miguel Meira e Cruz ◽  
Luana Seixas ◽  
Augusto Santos ◽  
João Garrido ◽  
Yuri Lopes ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
High Risk ◽  
Arterial Hypertension ◽  
Sleep Time ◽  
Comorbid Condition ◽  
Therapeutic Success ◽  
Comorbid Insomnia ◽  
Systemic Arterial Hypertension ◽  
Obstructive Sleep

Abstract Introduction Only few studies looked for a possible association of cardiovascular disorders (CVD), in comorbid insomnia with obstructive sleep apnea (COMISA) even though this is a relevant topic in order to prevent one of the major causes of morbimortality. The present study aimed to investigate the association of insomnia symptoms in patients at risk for obstructive sleep apnea in terms of prevalence and clinical interactions and to evaluate the risk of CVD in patients with a risk for COMISA. Methods This is a cross-sectional study. All medical records with data such as age, sex, height, weight and BMI, time to sleep, time to wake up, total sleep time, the Epworth Sleepiness Scale (ESS), STOP-BANG Questionnaires were studied. Insomnia and comorbidities were also investigated, and the patientsanswered yes or no to systemic arterial hypertension, diabetes, CVD. Results 685 patients were enrolled on the present study. We observed that the mild, moderate, and high risk for COMISA presented progressively increasing levels for the frequency of hypertension, diabetes, and CVD. A binary logistic regression was performed to assess whether risk for COMISA could be a predictor for CVD, and it was found that the model containing risk for COMISA was statistically significant: [x2(1)=5.273;p&lt;0.021, R2 Negelkerke=0.014]. Risk for COMISA presented itself as a significant predictor for CVD (OR=1.672; 95% CI=1.079–2.592). Conclusion There was an increased frequency of associated comorbidities such as CVD, systemic arterial hypertension, and diabetes, according to the mild, moderate, or high risk. These findings highlight the need for a cardiometabolic evaluation in patients with this comorbid condition which may impact prognosis and therapeutic success. Support (if any):

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