scholarly journals Predictive value of automated oxygen saturation analysis for the diagnosis and treatment of obstructive sleep apnoea in a home-based setting

Thorax ◽  
2007 ◽  
Vol 62 (5) ◽  
pp. 422-427 ◽  
Author(s):  
V Jobin ◽  
P Mayer ◽  
F Bellemare
Keyword(s):  
Oxygen Saturation ◽  
Obstructive Sleep Apnoea ◽  
Predictive Value ◽  
Sleep Apnoea ◽  
Diagnosis And Treatment ◽  
Home Based ◽  
Obstructive Sleep

scholarly journals Triglyceride-Glucose Index in Non-Diabetic, Non-Obese Patients with Obstructive Sleep Apnoea

2021 ◽  
Vol 10 (9) ◽  
pp. 1932
Author(s):  
Andras Bikov ◽  
Stefan M. Frent ◽  
Martina Meszaros ◽  
Laszlo Kunos ◽  
Alexander G. Mathioudakis ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Oxygen Saturation ◽  
Obstructive Sleep Apnoea ◽  
Sleep Time ◽  
Sleep Apnoea ◽  
Obese Patients ◽  
Triglyceride Glucose Index ◽  
Cigarette Pack ◽  
Obstructive Sleep ◽  
And Control

Obstructive sleep apnoea (OSA) is associated with increased insulin resistance. Triglyceride-glucose index (TyG) is a simple marker of insulin resistance; however, it has been investigated only by two studies in OSA. The aim of this study was to evaluate TyG in non-diabetic, non-obese patients with OSA. A total of 132 patients with OSA and 49 non-OSA control subjects were included. Following a diagnostic sleep test, fasting blood was taken for the analysis of the lipid profile and glucose concentrations. TyG was calculated as ln(triglyceride [mg/dL] × glucose [mg/dL]/2). Comparison analyses between OSA and control groups were adjusted for age, gender, body mass index (BMI) and smoking. TyG was higher in men (p < 0.01) and in ever-smokers (p = 0.02) and it was related to BMI (ρ = 0.33), cigarette pack-years (ρ = 0.17), apnoea–hypopnoea index (ρ = 0.38), oxygen desaturation index (ρ = 0.40), percentage of total sleep time spent with oxygen saturation below 90% (ρ = 0.34), and minimal oxygen saturation (ρ = −0.29; all p < 0.05). TyG values were significantly higher in OSA (p = 0.02) following adjustment for covariates. OSA is independently associated with higher TyG values which are related to disease severity in non-obese, non-diabetic subjects. However, the value of TyG in clinical practice should be evaluated in follow-up studies in patients with OSA.

scholarly journals Comparison of Hospital-Based and Home-Based Obstructive Sleep Apnoea Severity Measurements with a Single-Lead Electrocardiogram Patch

Sensors ◽  
2021 ◽  
Vol 21 (23) ◽  
pp. 8097
Author(s):  
Wen-Te Liu ◽  
Shang-Yang Lin ◽  
Cheng-Yu Tsai ◽  
Yi-Shin Liu ◽  
Wen-Hua Hsu ◽  
...  
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Sleep Time ◽  
Sleep Apnoea ◽  
Health Concern ◽  
Lower Percentage ◽  
Short Sleep Duration ◽  
Patch Type ◽  
Home Based ◽  
Obstructive Sleep ◽  
Supine Sleep

Obstructive sleep apnoea (OSA) is a global health concern, and polysomnography (PSG) is the gold standard for assessing OSA severity. However, the sleep parameters of home-based and in-laboratory PSG vary because of environmental factors, and the magnitude of these discrepancies remains unclear. We enrolled 125 Taiwanese patients who underwent PSG while wearing a single-lead electrocardiogram patch (RootiRx). After the PSG, all participants were instructed to continue wearing the RootiRx over three subsequent nights. Scores on OSA indices—namely, the apnoea–hypopnea index, chest effort index (CEI), cyclic variation of heart rate index (CVHRI), and combined CVHRI and CEI (Rx index), were determined. The patients were divided into three groups based on PSG-determined OSA severity. The variables (various severity groups and environmental measurements) were subjected to mean comparisons, and their correlations were examined by Pearson’s correlation coefficient. The hospital-based CVHRI, CEI, and Rx index differed significantly among the severity groups. All three groups exhibited a significantly lower percentage of supine sleep time in the home-based assessment, compared with the hospital-based assessment. The percentage of supine sleep time (∆Supine%) exhibited a significant but weak to moderate positive correlation with each of the OSA indices. A significant but weak-to-moderate correlation between the ∆Supine% and ∆Rx index was still observed among the patients with high sleep efficiency (≥80%), who could reduce the effect of short sleep duration, leading to underestimation of the patients’ OSA severity. The high supine percentage of sleep may cause OSA indices’ overestimation in the hospital-based examination. Sleep recording at home with patch-type wearable devices may aid in accurate OSA diagnosis.

Obstructive sleep apnoea and schizophrenia: a primer for psychiatrists

2011 ◽  
Vol 23 (5) ◽  
pp. 201-209 ◽  
Author(s):  
Abdulkader Alam ◽  
Kadiamada Nanaiah Roy Chengappa
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Daytime Sleepiness ◽  
Treatment Options ◽  
Clinical Manifestations ◽  
Sleep Apnoea ◽  
Diagnosis And Treatment ◽  
Adverse Health Outcomes ◽  
Ovid Medline ◽  
Obstructive Sleep ◽  
Osa Treatment

Alam A, Chengappa KNR. Obstructive sleep apnoea and schizophrenia: a primer for psychiatristsObjective:The main objective of this review is to improve psychiatric clinician awareness of obstructive sleep apnoea (OSA) and its potential consequences in patients with schizophrenia. This article will also discuss the diagnosis and treatment options for OSA while considering the significant role psychiatrists can play in facilitating the diagnosis and treatment of OSA.Data sources:Ovid, Medline and PsychInfo databases were searched for articles between 1960 and 2010. Search terms used wereSleep apnoeaorapnoeaandschizophreniaorpsychosis. The number of articles retrieved was 38. Articles were carefully reviewed for any data pertinent to OSA in patients with schizophrenia.Conclusions:OSA is a common disorder that is frequently unrecognised. As a chronic breathing condition, OSA is associated with adverse health outcomes and high mortality. OSA may co-occur with schizophrenia or evolve over time, especially with weight gain. The diagnosis should be considered whenever a patient presents with risk factors or clinical manifestations that are highly suggestive of OSA. Those who report snoring, daytime sleepiness and are obese or have a large neck circumference should be considered for an OSA diagnosis. Appropriate diagnosis and treatment of OSA can reduce daytime sleepiness, improve cardiovascular and other medical conditions, as well as reduce mortality. Psychiatrists can play very important role in suspecting OSA in their patients and making the initial referral. Furthermore, behavioural management, especially promoting weight loss and smoking cessation, are effective components of OSA treatment that psychiatrists are positioned to facilitate with their patients.

P4404Prognostic value of novel nocturnal oxygen saturation metrics in patients with obstructive sleep apnoea and high cardiovascular event risk

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
D Linz ◽  
K Loffler ◽  
P Sanders ◽  
P Catcheside ◽  
C Anderson ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Oxygen Saturation ◽  
Obstructive Sleep Apnoea ◽  
Controlled Trial ◽  
Characteristic Curve ◽  
Sleep Apnoea ◽  
Time Ratio ◽  
Event Risk ◽  
Obstructive Sleep

Abstract Aim To determine prognostic value of novel oximetry-derived metrics in patients with obstructive sleep apnoea (OSA) and high cardiovascular (CV) event risk. Methods and results Ancillary study of the Sleep Apnoea CV Endpoints (SAVE) randomised controlled trial, which investigated the effects of CPAP treatment on secondary CV event outcomes in 2687 participants with moderate-severe OSA and established CV disease. Associations between baseline characteristics, standard sleep and pulse oximetry-derived metrics, and CV outcomes were determined in Cox proportional hazards regression models stratified for treatment allocation. Metrics evaluated included: oxygen desaturation index, time below 90% oxygen saturation (SpO2), average SpO2across recordings (mean SpO2), across episodic desaturation events (desaturation SpO2), and baseline interpolated through episodic desaturation events (baseline SpO2); duration and desaturation/resaturation time ratio of episodic desaturation events; and mean and standard deviation of pulse rate. No SpO2 metric was associated with the composite outcome. Mean and baseline SpO2 were negatively associated with heart failure (hazard ratio [HR] 0.81, 95% confidence interval [CI] 0.69–0.95; P=0.009 and 0.78, 0.67–0.90; P=0.001, respectively) and myocardial infarction risk (0.86, 0.77–0.95; P=0.003 and 0.81, 0.73–0.90; P<0.001, respectively) and marginally positively associated with stroke risk (1.09, 1.00–1.20; P=0.065 and 1.13, 1.02–1.26; P=0.020, respectively). Desaturation duration and desaturation/resaturation time ratio, with established risk factors, predicted heart failure (area under the receiver-operating-characteristic curve 0.86, 95% CI 0.79–0.93). Conclusions Higher mean and baseline SpO2 were associated with reduced risk of heart failure and myocardial infarction, and small increases in stroke rate. Desaturation shape may have predictive utility for future CV events. Clinical trial registration: clinicaltrials (NCT00738179).

scholarly journals Nasopharyngeal airway stenting devices for obstructive sleep apnoea: A systematic review and meta-analysis

2014 ◽  
Vol 129 (1) ◽  
pp. 2-10 ◽  
Author(s):  
A R Kumar ◽  
C Guilleminault ◽  
V Certal ◽  
D Li ◽  
R Capasso ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Obstructive Sleep Apnoea ◽  
Meta Analysis ◽  
Sleep Apnoea ◽  
Cochrane Library ◽  
Limited Effectiveness ◽  
Obstructive Sleep ◽  
Airway Stenting ◽  
Nasopharyngeal Airway ◽  
The Mean

AbstractObjective:To systematically review outcomes of adults with obstructive sleep apnoea treated with nasopharyngeal airway stenting devices.Methods:Medline, Scopus, Web of Science and the Cochrane Library databases were searched, and data on device use and tolerability, sleepiness, oxygen saturation, apnoea index, apnoea–hypopnoea index, and sleep quality were collected.Results:Of 573 potential studies, 29 were retrieved for detailed evaluation and 16 met the study criteria. Polysomnography data for patients treated with nasal trumpets as an isolated therapy were pooled for meta-analysis. The mean apnoea index ± standard deviation, for 53 patients, decreased from 32.4 ± 15.9 to 9.0 ± 7.2 episodes per hour (p < 0.00001). The mean apnoea–hypopnoea index, for 193 patients, decreased from 44.1 ± 18.9 to 22.7 ± 19.3 episodes per hour (p < 0.00001). The mean lowest oxygen saturation, for 193 patients, increased from 66.5 ± 14.2 to 75.5 ± 13.9 per cent (p < 0.00001).Conclusion:Some studies have demonstrated limited effectiveness and low tolerability of nasopharyngeal airway stenting devices, while other studies have shown a significant benefit in treating obstructive sleep apnoea, with a high level of patient acceptance. Nasal trumpets have been successful in decreasing airway obstruction in the short term.

scholarly journals Sleep Disordered Breathing in Children

2016 ◽  
Vol 02 (02) ◽  
pp. 52
Author(s):  
Refika Ersu ◽  
Keyword(s):  
Sleep Disordered Breathing ◽  
Positive Airway Pressure ◽  
Residual Disease ◽  
Sleep Apnoea ◽  
Diagnosis And Treatment ◽  
Sleep Studies ◽  
Home Based ◽  
Obstructive Sleep ◽  
Overnight Oximetry ◽  
Predict Treatment Response

Although obstructive sleep apnoea (OSA) is a common problem in childhood, there are still unanswered questions regarding diagnosis and treatment. Polysomnography is the gold standard in diagnosing and assessing the severity of OSA. However, it is not always accessible and may not correlate with morbidity or predict treatment response. Home-based sleep studies and overnight oximetry are alternative diagnostic options. Adenotonsillectomy is the main treatment modality but residual disease is common. Continuous positive airway pressure is a treatment option in children who are not surgical candidates or have residual disease, but adherence is a significant issue. An individualised approach to diagnosis and treatment may improve both diagnosis and treatment in children with OSA, and prevent morbidity.

scholarly journals Sleeping Beauty or the Beast? – The Metabolic Syndrome from an Obstructive Sleep Apnoea Perspective

2010 ◽  
Vol 9 (1) ◽  
pp. 12 ◽  
Author(s):  
Lise Tarnow ◽  
Brigitte Klinkenbijl ◽  
Holger Woehrle ◽  
◽  
◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Obstructive Sleep Apnoea ◽  
Reduce Blood Pressure ◽  
Sleep Apnoea ◽  
Sleeping Beauty ◽  
The Metabolic Syndrome ◽  
Home Based ◽  
Obstructive Sleep

Obstructive sleep apnoea (OSA) is a significant health issue. Patients with cardiovascular disease as well as patients with diabetes have a high prevalence of OSA, and the prevalence of coronary heart disease, heart failure, stroke and diabetes is increased in patients with obstructive sleep apnoea. Physiological responses to OSA include sympathetic activation, neurohumoral changes and inflammation, all of which are precursors for cardiovascular disease and diabetes. International guidelines are starting to recognise the importance of OSA for patients with cardiovascular conditions such as heart failure and hypertension. Diagnosis is important, and home-based sleep testing devices can facilitate this process. Treating OSA with continuous positive airway pressure (CPAP) has been shown to reduce blood pressure (BP) in patients with hypertension, but more research is needed to determine which components of the metabolic syndrome respond best to the addition of CPAP therapy.

Smartphone videos to predict the severity of obstructive sleep apnoea

2021 ◽  
pp. archdischild-2020-320752
Author(s):  
Rahul J Thomas ◽  
Samuel Dalton ◽  
Katharine Harman ◽  
Julie Thacker ◽  
Rosemary S C Horne ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Obstructive Sleep Apnoea ◽  
Predictive Value ◽  
Work Of Breathing ◽  
Sleep Apnoea ◽  
Clinical Tool ◽  
Neck Extension ◽  
Obstructive Sleep ◽  
Sensitivity Specificity

ObjectiveDiagnosis of obstructive sleep apnoea (OSA) is made on overnight polysomnography (PSG). Given the widespread availability of smartphone video technology, we aimed to develop and test a standardised scoring system for smartphone videos and compare these scores to PSG results.MethodsChildren aged 1–16 years undergoing PSG for suspected OSA were included. Parents were asked to take 1–2 min videos of the breathing they were concerned about. Videos were scored using a newly developed and tested tool on five components: inspiratory obstructive noises (1–4), presence of obstructive events (0–1), increased work of breathing (0–1), mouth breathing (0–1) and neck extension (0–1). Video scores and the Obstructive Apnoea Hypopnoea Index (OAHI) were compared using Spearman correlation. Sensitivity, specificity, positive predictive value and negative predictive value were calculated for different cut-off scores to achieve the best results.ResultsVideos from 43 children (28 men (65.1%), median age 5.7 years (range 2.6–14.0 years), median OAHI 3.8/hour (range 0–82 events/hour) were included. Nine children (20.9%) had a video score of <3, all of whom had an OAHI of ≤5 events/hour. For a video score of ≥3, sensitivity was 100%; specificity was 36%; positive predictive value was 53%; and negative predictive value 100% for moderate to severe OSA (OAHI>5 events/hour) .ConclusionWe have developed and validated a simple clinical tool (the Monash Obstructive Sleep Apnoea Video Score) to quantify abnormalities in breathing seen on short video recordings made on a smartphone. A low score rules out moderate–severe OSA and may be valuable in the triage of children with symptoms of OSA.

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