scholarly journals Clinical and PSG Characteristics of Children with Mild OSA and Respiratory Events Terminated Predominantly with Arousal

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Yunxiao Wu ◽  
Li Zheng ◽  
Panting Wu ◽  
Yufen Tang ◽  
Zhifei Xu ◽  
...  
Keyword(s):  
Life Questionnaire ◽  
Sleep Related Breathing Disorders ◽  
Arousal Index ◽  
Respiratory Events ◽  
Younger Age ◽  
Obstructive Sleep ◽  
Respiratory Event ◽  
Mild Obstructive Sleep Apnea ◽  
Stage 1

Objective. To analyze the clinical and polysomnographic characteristics in children with mild OSA and respiratory events terminated predominantly with arousal. Methods. Children aged 3–10 yrs who had mild obstructive sleep apnea (OSA) were enrolled. All children underwent polysomnography, and patients’ data were collected by using sleep-related breathing disorders (SRBD) questionnaire and OSA-18 quality of life questionnaire. Results. In total, five hundred and seventy-seven children were eligible. Children in arousal predominant group were younger and showed a lower rate of male and obesity. Compared with that of the nonarousal predominant group, the total arousal index, arousal index related to respiratory event, the percentage of NREM stage 1 (N1%), the fraction of respiratory events that were hypopnea, and the mean and minimum oxygen saturation in the arousal predominant group were significantly greater. The percentage of NREM stage 3 (N%), index of obstructive, central, mixed apnea, the fraction of respiratory events that were obstructive, and central and mixed apnea were significantly lower in arousal predominant group. Conclusion. Children with mild OSA in the arousal predominant group had specific characteristics, including younger age, lower rate of male and obesity, worse sleep architecture, higher rates of hypopnea events, and better oxygenation. This trial is registered with NCT02447614.

scholarly journals Influence of Sleep Disturbances on Quality of Life of Iranian Menopausal Women

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Zohreh Yazdi ◽  
Khosro Sadeghniiat-Haghighi ◽  
Amir Ziaee ◽  
Khadijeh Elmizadeh ◽  
Masomeh Ziaeeha
Keyword(s):  
Quality Of Life ◽  
Daytime Sleepiness ◽  
Sleep Disturbances ◽  
Negative Impact ◽  
Berlin Questionnaire ◽  
Life Questionnaire ◽  
Cross Sectional ◽  
Obstructive Sleep ◽  
Menopausal Women

Background. Subjective sleep disturbances increase during menopause. Some problems commonly encountered during menopause, such as hot flushes and sweating at night, can cause women to have difficulty in sleeping. These complaints can influence quality of life of menopausal women.Methods. This cross-sectional study was performed on menopausal women attending health centers in Qazvin for periodic assessments. We measured excessive daytime sleepiness by Epworth sleepiness scale (ESS), obstructive sleep apnea (OSA) by the Berlin questionnaire, and insomnia by the insomnia severity index (ISI). We evaluate quality of life by the Menopause specific quality of life questionnaire (MENQOL).Results. A total of 380 menopausal women entered the study. Mean age of participated women was 57.6 ± 6.02. Mean duration of menopause was 6.3 ± 4.6. The frequency of severe and moderate insomnia was 8.4% (32) and 11.8% (45). Severe daytime sleepiness (ESS ≥ 10) was present in 27.9% (80) of the participants. Multivariate analytic results show that insomnia and daytime sleepiness have independent negative impact on each domain and total score of MENQOL questionnaire.Conclusion. According to our findings, EDS and insomnia are frequent in menopausal women. Both EDS and insomnia have significant quality of life impairment.

scholarly journals The impact of therapy on the quality of life in asymptomatic patients with freshly detected hypertension

2019 ◽  
Vol 8 (9) ◽  
pp. 1983
Author(s):  
Satish Chandra Mishra ◽  
Vishal Singh ◽  
Sudeep Prakash ◽  
Pushkar Pandey
Keyword(s):  
Quality Of Life ◽  
Short Form ◽  
Female Gender ◽  
World Health ◽  
Life Questionnaire ◽  
Observation Study ◽  
Asymptomatic Patients ◽  
Stage 1 ◽  
The Impact

Background: Hypertension is an commonly encountered disease which adversely affect  all aspects of quality of life (QoL). The existing studies are confounded by the presence of multiple comorbidities and inclusion of elderly, which by themselves impairs the QoL. There is thus a need to study the impact of hypertension on QoL, in isolation.Method: This is a single center, prospective, intention to treat, observation study. The aim of the study is to evaluate the change in the QoL over six months, in newly diagnosed asymptomatic patients of hypertension. The tools used to assess the QoL included World Health Organisation’s Quality of Life Questionnaire (WHOQOL- BREF) and Short Form-36 (SF-36).Result: A total of 232 patients (172 males and 60 females) were enrolled in the study. The mean age was 44.66 years. A total of 102 patients (43.97%) had stage-1 and 130 patients (56.03%) had stage-2 hypertension. The female gender is associated with a higher likelihood of presentation with stage-2 hypertension. The male cohort had a better baseline QoL. The desired blood pressures was achieved in 40.52%. With therapy, the QoL improved significantly; sub-hoc analysis showed, the improvement was higher in males and those with stage-1 hypertension. There is an inverse relationship between the QoL and requirement for higher number of antihypertensive mediations.Conclusions: In patients with asymptomatic primary hypertension, treatment improves all aspects of QoL. The factors adversely affecting the QoL include female gender, higher stage of hypertension, poor blood pressure control and requirement of higher numbers of antihypertensive medicine.

scholarly journals Prevalence of hypothyroidism among patients with obstructive sleep apnea: A study in a tertiary care center

2021 ◽  
Vol 6 (3) ◽  
pp. 161-164
Author(s):  
D.S Sowjanya ◽  
M Ravindranath
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Epworth Sleepiness Scale ◽  
Care Center ◽  
Tertiary Care ◽  
Arousal Index ◽  
Obstructive Sleep ◽  
The Mean ◽  
Saturated Oxygen

Obstructive sleep apnea is a common disorder wherein there are recurrent episodes of sleep disordered breathing resulting in disrupted sleep and other sequelae. The symptoms of hypothyroidism are very similar to OSA, a number of studies have been performed to analyze their association with conflicting results. A questionnaire based on the Wisconsin Sleep Apnea questionnaire for quality of sleep, sleep pattern, symptoms during sleep, snoring were asked to 118 patients included in the study. The day time sleep patterns were assessed by the Epworth Sleepiness scale. Polysomnography testing, Saturated oxygen levels, sleep efficiency and arousal index were also done for all the patients. Blood was collected for the detection of thyroid hormones. There were 82 (69.5%) males and 36 (30.5%) females on the present study out of 118 patients. The mean age of the patients under study was 53.91 ± 4.69 years, the weight was 89.48 ± 12.83 kgs and the BMI was 34.86 ± 6.11. Amongst the patients with OSA and hypothyroid, the apnea hypoapnea index was 66.22 ± 18.31 episodes per hour, and Epworth sleepiness scale was 15.18 ± 5.26 while in patients with OSA and without hypothyroid, it was 24.17 ± 6.29 and 8.25 ± 5.82 respectively. Our study shows a significant association between OSA and hypothyroidism among patients, thus having a considerable implications in managing the thyroid condition of the patients.

scholarly journals Predictors of changes in cerebral perfusion and oxygenation during obstructive sleep apnea

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Zhongxing Zhang ◽  
Ming Qi ◽  
Gordana Hügli ◽  
Ramin Khatami
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Near Infrared ◽  
Sleep Apnea Syndrome ◽  
Apnea Hypopnea Index ◽  
Mixed Effect ◽  
Respiratory Events ◽  
Obstructive Sleep ◽  
Respiratory Event ◽  
Titration Protocol

AbstractObstructive sleep apnea syndrome (OSAS) is a common sleep disorder. Severe OSAS defined as apnea–hypopnea index (AHI) ≥ 30/h is a risk factor for developing cerebro-cardiovascular diseases. The mechanisms of how repetitive sleep apneas/hypopneas damage cerebral hemodynamics are still not well understood. In this study, changes in blood volume (BV) and oxygen saturation (StO2) in the left forehead of 29 newly diagnosed severe OSAS patients were measured by frequency-domain near-infrared spectroscopy during an incremental continuous positive airway pressure (CPAP) titration protocol together with polysomnography. The coefficients of variation of BV (CV-BV) and the decreases of StO2 (de-StO2) of more than 2000 respiratory events were predicted using linear mixed-effect models, respectively. We found that longer events and apneas rather than hypopneas induce larger changes in CV-BV and stronger cerebral desaturation. Respiratory events occurring during higher baseline StO2 before their onsets, during rapid-eye-movement sleep and those associated with higher heart rate induce smaller changes in CV-BV and de-StO2. The stepwise increased CPAP pressures can attenuate these changes. These results suggest that in severe OSAS the length and the type of respiratory event rather than widely used AHI may be better parameters to indicate the severity of cerebral hemodynamic changes.

scholarly journals Respiratory events in patients undergoing laparoscopic gastric bypass surgery

F1000Research ◽  
2012 ◽  
Vol 1 ◽  
pp. 44 ◽  
Author(s):  
Patrick Ziemann-Gimmel ◽  
Priscilla Hensel ◽  
Salam Abdo ◽  
John Koppman ◽  
Robert Marema
Keyword(s):  
Gastric Bypass ◽  
Laparoscopic Gastric Bypass ◽  
Bypass Surgery ◽  
Gastric Bypass Surgery ◽  
Postoperative Management ◽  
Cpap Therapy ◽  
Respiratory Events ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
Respiratory Event

Background: The incidence of morbid obesity is increasing and has led to an increase in bariatric procedures and previous studies have shown that 71% of these patients suffer from obstructive sleep apnea (OSA). Patients with OSA have a higher rate of postoperative complications. We investigated if patients with OSA undergoing laparoscopic gastric bypass surgery have an increased risk of postoperative respiratory events. In this observational study we examined the data of 89 consecutive patients undergoing gastric bypass surgery.Methods: All patients scheduled for gastric bypass surgery between 7/28/2010 and 02/15/2011 were enrolled and managed according to our routine clinical protocol (48 with OSA / 41 without OSA (NOSA)). Depending on the patient’s preoperative compliance with CPAP therapy, they were further assigned into a compliant (OSAc) and noncompliant (OSAn) group. A respiratory event was defined as a deviation from the regular postoperative management.Results: Both OSA and NOSA groups were similar based on clinical characteristics and narcotic consumption. Fourteen patients (29.2%) suffered from a respiratory event in the OSA group and 8 patients (19.5%) in the NOSA group (p=0.29). Patients compliant with continuous positive airway pressure CPAP had a similar complication rate to patients without OSA (p=0.96). 53.8% of patients with OSA that were noncompliant with CPAP therapy (OSAn) had a respiratory event in the direct postoperative period. This is statistically significant in comparison to patients diagnosed with OSA that are compliant with CPAP (OSAc) (p=0.03)Conclusion: It may be beneficial to encourage OSA patients to use CPAP preoperatively to reduce postoperative respiratory events. Furthermore, adequately treated OSA may not be an independent risk factor for postoperative respiratory events.

Quality of life assessment following adenotonsillectomy for obstructive sleep apnoea in children under three years of age

2012 ◽  
Vol 126 (12) ◽  
pp. 1241-1246 ◽  
Author(s):  
R Mandavia ◽  
V Dhar ◽  
K Kapoor ◽  
A Rachmanidou
Keyword(s):  
Quality Of Life ◽  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Life Assessment ◽  
Life Questionnaire ◽  
Inclusion Criteria ◽  
Questionnaire Score ◽  
Obstructive Sleep ◽  
Physical Suffering

AbstractAim:To investigate the effects of adenotonsillectomy on the quality of life of children under three years of age with obstructive sleep apnoea. To our knowledge, there have been no previously published studies on this topic.Method:Thirty-nine children under three years of age and treated with adenotonsillectomy for obstructive sleep apnoea met the inclusion criteria. A quality of life questionnaire was adapted from the validated, six-item instrument developed by de Serreset al.(2000). The questionnaire assessed improvement in specific domains following adenotonsillectomy. Carers scored each domain on a point scale ranging from ‘none’ (0) to ‘couldn't be more’ (6).Results:The quality of life of all children improved after surgery. The greatest mean improvement scores were in the domains of care-giver concern, physical suffering and sleep disturbance. The modal questionnaire score was 4 and the overall mean questionnaire score was 4.2.Conclusion:Adenotonsillectomy provides measurable improvements in quality of life for children under three years of age with obstructive sleep apnoea.

Efficacy of Adenoidectomy for the Treatment of Mild Sleep Apnea in Children

2020 ◽  
pp. 019459982095071
Author(s):  
Austin Tipold ◽  
Turaj Vazifedan ◽  
Cristina M. Baldassari
Keyword(s):  
Sleep Apnea ◽  
Case Series ◽  
Additional Treatment ◽  
Apnea Hypopnea Index ◽  
Obstructive Sleep ◽  
Mild Obstructive Sleep Apnea ◽  
The Mean ◽  
The Ideal

Objectives (1) To assess outcomes in children undergoing adenoidectomy for the treatment of mild obstructive sleep apnea (OSA). (2) To identify clinical factors that predict which children will have persistent obstruction following adenoidectomy. Study Design Case series with chart review over a 10-year period. Setting Tertiary children’s hospital. Subjects and Methods Children between 2 and 17 years old undergoing adenoidectomy for treatment of mild OSA (obstructive apnea-hypopnea index [AHI] between 1 and 5 on polysomnogram) were included. The need for additional medical or surgical intervention following adenoidectomy was recorded. When available, postoperative polysomnogram data were reviewed. Results In total, 134 children with a mean age of 5.4 years were included. Fifty-three percent (n = 71) were female and 57% (n = 76) were black. The mean (SD) baseline AHI was 2.2 (1.09). Caregivers reported a moderate impact of sleep disturbance on quality of life with a mean (SD) preoperative total OSA–18 score of 64.1 (19.28). Postadenoidectomy outcomes were reported for 105 patients (78%) with a mean follow-up time of 6 months. Sixty-nine percent (n = 72) of children had resolution of obstructive symptoms. While 31% (n = 33) of children required additional intervention following adenoidectomy, only 6.8% (n = 9) underwent a subsequent tonsillectomy. Demographic factors such as age and baseline AHI did not predict which children required additional treatment following adenoidectomy. Conclusion Adenoidectomy may be an effective treatment for mild OSA. A randomized trial comparing outcomes for adenoidectomy and adenotonsillectomy is needed to determine the ideal surgical treatment for nonsevere OSA in children.

Pulmonary disorders and sleep

2017 ◽  
Author(s):  
Sandrine H. Launois ◽  
Patrick Lévy
Keyword(s):  
Neuromuscular Disorders ◽  
Treatment Strategies ◽  
Chronic Obstructive ◽  
Sleep Related Breathing Disorders ◽  
Obstructive Pulmonary Disease ◽  
Breathing Disorders ◽  
Obstructive Sleep ◽  
Pulmonary Disorder ◽  
The Impact

Sleep disorders and pulmonary diseases are closely associated, a fact clearly underestimated in routine patient care, despite evidence that these disorders interact to impact on quality of life as well as on morbidity and mortality. The prevalence of chronic insomnia, sleep-related breathing disorders, and restless leg syndrome is high in patients with chronic pulmonary disorders such as asthma, chronic obstructive pulmonary disease, cystic fibrosis, interstitial lung disease, chest wall and neuromuscular disorders, and chronic respiratory failure. This association may be fortuitous and reflect the impact of a chronic condition on sleep quality, or it may be due to specific sleep-related phenomena adversely affecting an underlying pulmonary disorder. Furthermore, obstructive sleep apnea has been implicated as a risk factor for pulmonary hypertension and pulmonary embolism. This chapter outlines the implications for both pulmonary and sleep specialists, in terms of clinical management and treatment strategies.

scholarly journals Longer apneas and hypopneas are associated with greater ultra-short-term HRV in obstructive sleep apnea

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Salla Hietakoste ◽  
Henri Korkalainen ◽  
Samu Kainulainen ◽  
Saara Sillanmäki ◽  
Sami Nikkonen ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Short Term ◽  
Event Duration ◽  
Rr Intervals ◽  
Rr Interval ◽  
Respiratory Events ◽  
Obstructive Sleep ◽  
Respiratory Event ◽  
S Period

AbstractLow long-term heart rate variability (HRV), often observed in obstructive sleep apnea (OSA) patients, is a known risk factor for cardiovascular diseases. However, it is unclear how the type or duration of individual respiratory events modulate ultra-short-term HRV and beat-to-beat intervals (RR intervals). We aimed to examine the sex-specific changes in RR interval and ultra-short-term HRV during and after apneas and hypopneas of various durations. Electrocardiography signals, recorded as a part of clinical polysomnography, of 758 patients (396 men) with suspected OSA were analysed retrospectively. Average RR intervals and time-domain HRV parameters were determined during the respiratory event and the 15-s period immediately after the event. Parameters were analysed in three pooled sex-specific subgroups based on the respiratory event duration (10–20 s, 20–30 s, and > 30 s) separately for apneas and hypopneas. We observed that RR intervals shortened after the respiratory events and the magnitude of these changes increased in both sexes as the respiratory event duration increased. Furthermore, ultra-short-term HRV generally increased as the respiratory event duration increased. Apneas caused higher ultra-short-term HRV and a stronger decrease in RR interval compared to hypopneas. In conclusion, the respiratory event type and duration modulate ultra-short-term HRV and RR intervals. Considering HRV and the respiratory event characteristics in the diagnosis of OSA could be useful when assessing the cardiac consequences of OSA in a more detailed manner.

Sleep-related breathing disorders and pulmonary hypertension

2020 ◽  
Vol 57 (1) ◽  
pp. 2002258
Author(s):  
Yochai Adir ◽  
Marc Humbert ◽  
Ari Chaouat
Keyword(s):  
Pulmonary Hypertension ◽  
Sleep Apnoea ◽  
Sleep Related Breathing Disorders ◽  
Breathing Disorders ◽  
Respiratory Events ◽  
Obstructive Sleep ◽  
Pulmonary Haemodynamics ◽  
Pulmonary Arterial ◽  
Central Apnoea

Sleep-related breathing disorders (SBDs) include obstructive apnoea, central apnoea and sleep-related hypoventilation. These nocturnal events have the potential to increase pulmonary arterial pressure (PAP) during sleep but also in the waking state. “Pure” obstructive sleep apnoea syndrome (OSAS) is responsible for a small increase in PAP whose clinical impact has not been demonstrated. By contrast, in obesity hypoventilation syndrome (OHS) or overlap syndrome (the association of chronic obstructive pulmonary disease (COPD) with obstructive sleep apnoea (OSA)), nocturnal respiratory events contribute to the development of pulmonary hypertension (PH), which is often severe. In the latter circumstances, treatment of SBDs is essential in order to improve pulmonary haemodynamics.Patients with pulmonary arterial hypertension (PAH) or chronic thromboembolic pulmonary hypertension (CTEPH) are at risk of developing SBDs. Obstructive and central apnoea, as well as a worsening of ventilation–perfusion mismatch, can be observed during sleep. There should be a strong suspicion of SBDs in such a patient population; however, the precise indications for sleep studies and the type of recording remain to be specified. The diagnosis of OSAS in patients with PAH or CTEPH should encourage treatment with continuous positive airway pressure (CPAP). The presence of isolated nocturnal hypoxaemia should also prompt the initiation of long-term oxygen therapy. These treatments are likely to avoid worsening of PH; however, it is prudent not to treat central apnoea and Cheyne–Stokes respiration (CSR) with adaptive servo-ventilation in patients with chronic right-heart failure because of a potential risk of serious adverse effects from such treatment.In this review we will consider the current knowledge of the consequences of SBDs on pulmonary haemodynamics in patients with and without chronic respiratory disease (group 3 of the clinical classification of PH) and the effect of treatments of respiratory events during sleep on PH. The prevalence and consequences of SBDs in PAH and CTEPH (groups 1 and 4 of the clinical classification of PH, respectively), as well as therapeutic options, will also be discussed.

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