Effects of Sleep-Related Disorders on the Prognosis of Amyotrophic Lateral Sclerosis

2019 ◽  
Vol 19 (3-4) ◽  
pp. 148-154 ◽  
Author(s):  
Aylin Reyhani ◽  
Gulcin Benbir Senel ◽  
Derya Karadeniz
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Sleep Apnea ◽  
Sleep Apnea Syndrome ◽  
Central Sleep Apnea ◽  
Periodic Leg Movements ◽  
Obstructive Sleep ◽  
The Mean ◽  
Apnea Syndrome ◽  
Lateral Sclerosis ◽  
Leg Movements

Background/Objective: In this study, we demonstrated the effects of obstructive sleep apnea syndrome (OSAS) on the prognosis of amyotrophic lateral sclerosis (ALS). However, the effects of sleep-related disorders other than breathing problems are still waiting to be delineated. Methods: In this longitudinal retrospective and prospective study, we investigated 73 patients with ALS compared to 20 healthy subjects, to determine sleep-related disorders and their impact on disease prognosis. Results: In patients with ALS, the mean respiratory disturbance index (RDI) was 28.0/h, which was significantly higher than that in the controls (p < 0.001). OSAS was present in 67% of the patients, sleep-related hypoxemia was observed in 13.7% of the patients, and 5.4% had central sleep apnea syndrome. In patients with bulbar-onset disease, higher RDI was almost significantly associated with lower survival (p = 0.056). The mean index of periodic leg movements in sleep was significantly higher in patients with ALS (34.0 ± 19.9/h) than that in the controls (12.5 ± 15.5/h; p < 0.001). Periodic leg movements disorder (PLMD) was diagnosed in 23 patients with ALS (31.5%); fragmentary myoclonus was present in 13.7% of patients, and REM-sleep behavior disorder was diagnosed in 4 patients (5.4%). The presence of PLMD in addition to OSAS was significantly associated with worse prognosis and poorer survival (p = 0.040). Conclusions: These findings emphasize that sleep-related disorders other than OSAS deserve attention in ALS. ALS is a catastrophic and frustrating disease for both patients and physicians; thus, the diagnosis and treatment of comorbid sleep disorders could improve the survival of patients with ALS.

scholarly journals Validation of the Spanish Version of the STOP-Bang Questionnaire: Usefulness as a Screening Tool for Obstructive Sleep Apnea in Adults

2020 ◽  
pp. 014556132093233
Author(s):  
Beatriz Delgado-Vargas ◽  
Leticia Acle-Cervera ◽  
Gianmarco Narciso López
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Screening Tool ◽  
Sleep Apnea Syndrome ◽  
Spanish Version ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
Good Internal Consistency ◽  
The Mean ◽  
Apnea Syndrome

Objectives: Obstructive sleep apnea syndrome (OSAS) is an increasing health problem, the diagnosis of which is generally delayed due to long waiting lists for the tests used to identify it. Therefore, tools that help on classifying patients at higher risk of suffering this syndrome have been developed. Methods: One hundred ninety-three consecutive patients, with and without OSAS, filled in the Spanish version of the STOP-Bang questionnaire in Hospital Universitario de Torrejón (Spain). Polysomnographies were performed to diagnose the presence and severity of the OSAS. Statistics analysis of the demographic characteristics of the sample and the questionnaire results was performed. Results: Most patients were male (73%) and the mean age was 50.4 years (ranging from 19-77 years). Cronbach α coefficient in the sample was 0.8072. A statistically significant difference was noted in the questionnaire scores between patients with OSAS and those without the syndrome. Conclusions: The Spanish version of the STOP-Bang questionnaire possess a good internal consistency that allows us to rely on it as a screening tool for patients with OSAS. In our sample, a difference in the questionnaire score was appreciated between patients with and without the syndrome, which strongly supports the utility of the questionnaire for its purpose.

scholarly journals The Association of Obstructive Sleep Apnea Syndrome and Accident Risk in Heavy Equipment Operators

Medicina ◽  
2019 ◽  
Vol 55 (9) ◽  
pp. 599 ◽  
Author(s):  
Hakan Celikhisar ◽  
Gulay Dasdemir Ilkhan
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
High Risk ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Upper Respiratory Tract ◽  
Heavy Equipment ◽  
Obstructive Sleep ◽  
The Mean ◽  
Apnea Syndrome

Background and Objectives: Obstructive sleep apnea syndrome (OSAS) is the most frequent sleep disorder, characterized by the repeated collapse of the upper respiratory tract during sleep. In this study, we aimed to determine the prevalence of OSAS in heavy equipment operators and to determine the relationship between the work accidents that these operators were involved in and the OSAS symptoms and severity. In doing this, we aimed to emphasize the association of OSAS, which is a treatable disease, and these accidents, which cause loss of manpower, financial hampering, and even death. Materials and Methods: STOP BANG questionnaire was provided to 965 heavy equipment operators and polysomnography (PSG) was performed, in Izmir Esrefpasa Municipality Hospital, to the operators at high risk for OSAS. Demographic data, health status, and accidents of these operators were recorded. Results: All operators who participated in the study were male. The ages of the cases ranged from 35 to 58 and the mean age was 45.07 ± 5.54 years. The mean STOP BANG questionnaire results were 4.36 ± 3.82. In total, 142 operators were identified with high risk for OSAS and PSG could be performed on 110 of these 142 operators. According to the PSG results of the operators, 41 (37.3%) patients had normal findings, while 35 (31.8%) had mild, 20 (18.2%) had moderate, and 14 (12.7%) had severe OSAS. Among those 110 patients, 71 (64.5%) of the cases had no history of any accidents, 25 (22.8%) were almost involved in an accident due to sleepiness, and 14 (12.7%) were actually involved in an accident. There was a statistically significant relationship between the accident rate and OSAS severity (p: 0.009). Conclusion: Based on the data acquired in the present study, a positive correlation was determined between the accident statuses of drivers with OSAS severity. We want to attract attention to the necessity of evaluating the OSAS symptoms in professional heavy equipment operators during the certification period and at various intervals afterwards, and to carry out OSAS evaluations by PSG for those having a certain risk.

Comparison of Obstructive Sleep Apnea Syndrome in Children with Cleft Palate following Furlow Palatoplasty or Pharyngeal Flap for Velopharyngeal Insufficiency

2004 ◽  
Vol 41 (2) ◽  
pp. 152-156 ◽  
Author(s):  
Yu-Fang Liao ◽  
M. Samuel Noordhoff ◽  
Chiung-Shing Huang ◽  
Philip K. T. Chen ◽  
Ning-Hung Chen ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Cleft Palate ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Velopharyngeal Insufficiency ◽  
Obstructive Sleep ◽  
The Mean ◽  
Pharyngeal Flap ◽  
Apnea Syndrome

Objective To evaluate the incidence and severity of obstructive sleep apnea syndrome (OSAS) in patients with cleft palate having a Furlow palatoplasty or pharyngeal flap for correction of velopharyngeal insufficiency (VPI). Patients A total of 48 nonsyndromic children with repaired cleft palate with VPI were enrolled in the study. Twenty of the children had a Furlow palatoplasty (F group) and 28 children had a pharyngeal flap (P group) for correction of VPI. Interventions An overnight polysomnography evaluation was done to evaluate the incidence and severity of OSAS 6 months or more postoperatively. Main Outcome Measures Symptoms of OSAS, respiratory disturbance index (RDI), oxyhemoglobin desaturation index (DI), and sleep stages were measured. Results In the P group, the mean percentage of stage 2 sleep was lower than the F group (p < .05). The mean RDI and DI were larger in the P group, compared with the F group (p < .001). The incidence and severity of OSAS were higher in the P group, compared with the F group (p < .001 and p = 0.05, respectively). Conclusions A Furlow palatoplasty should be used in deference to a pharyngeal flap whenever possible on the basis of the preoperative evaluation of VPI because of the decreased incidence and severity of OSAS.

scholarly journals Retinal Nerve Fiber Layer, Ganglion Cell Complex and Choroidal Thickness Evaluation in Patients with Obstructive Sleep Apnea Syndrome

2021 ◽  
Author(s):  
Ela Eren ◽  
Nilufer Ilhan ◽  
Sebahat Genc
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Apnea Syndrome ◽  
Control Group ◽  
Ganglion Cell Complex ◽  
Fiber Layer ◽  
Rnfl Thickness ◽  
Obstructive Sleep ◽  
The Mean ◽  
Apnea Syndrome

Abstract Purpose To evaluate the association of Obstructive Sleep Apnea Syndrome (OSAS) with Retinal Nerve Fiber Layer (RNFL), Ganglion Cell Complex (GCC) and choroidal tissue thickness (CCT). Methods: This cross-sectional study included 50 patients with OSAS and 50 controls between July 2014-January 2015). OSAS severity was classified by using the apnea-hypopnea index (AHI). RNFL thickness, GCC thickness and CCT analyses were performed by optic coherence tomography (OCT). Statistical analysis was performed using SPSS for Windows version 21 software. Results: The mean intraocular pressure (IOP) of the patients with OSAS 16.1±1.37, the cup/disc (C/D) ratio was 0.45±0.17 and vertical C/D ratio was 0.43±0.16. The control group mean IOP was 15.2±1.03, the C/D ratio was 0.36±0.20 and vertical C/D ratio was 0.34±0.19. These are all important measurements in glaucome and statisticallay significant (p=0.00, 0.022, 0.012). Althought the differences between the mean values of all quadrants RNFL thickness were similarly lower in OSAS group, this significance was not statistically different. Similarly the average GCC, minimum GCC and subfoveal CCT values between groups were not significant (p=0.79, 0.53, 0.9).Conclusion: In summary we found that peripapillary RNFL, GCC, CCT did not change with OSAS patients or the severity of OSAS. Further more we found that IOP, C/D ratio and vertical C/D ratio of patients were all significantly higher than control group. However multicenter longterm cohort studies are still needed to assess the definite changes of RNFL thickness, GCC and CCT in OSAS patients.

scholarly journals MAGNETIC RESONANCE TOMOGRAPHY IN SLEEP APNEA SYNDROME DIAGNOSTICS

2015 ◽  
Vol 14 (2) ◽  
pp. 58-61
Author(s):  
M. A. Shariya ◽  
E. A. Butorova ◽  
A. Yu. Litvin ◽  
D. V. Ustyuzhanin ◽  
Е. М. Elfimova ◽  
...  
Keyword(s):  
Sleep Apnea ◽  
Magnetic Resonance ◽  
Soft Tissues ◽  
Sleep Apnea Syndrome ◽  
Magnetic Resonance Tomography ◽  
Apnea Hypopnea Index ◽  
Upper Airways ◽  
Obstructive Sleep ◽  
The Mean ◽  
Apnea Syndrome

Aim. To study the specifics of soft tissues surrounding upper airways (STSUA) structure using magnetic resonance tomography (MRI) in patients with obesity and obstructive sleep apnea syndrome (OSAS). Material and methods. Totally 40 men studied with the mean age 44,7±9,6 y. Of those 20 had obesity of I-II grade — with body mass index (BMI) 35,1±3,4 кг/м2 and severe OSAS (apnea-hypopnea index — AHI — was 53,4±15,7). Controls consisted of 20 persons without obesity — BMI 23,8±1,3 kg/m2 . Assessment of upper airways was performed on Philips Achieva 3.0T tomograph. We measured the volumes of soft palate (VSP), tongue (VT), lateral pharyngeal walls (VLPW) and the squares of maximum upper airways narrowing (SMUAN) at retropharyngeal (RP) and retroglossal (RG) levels. Results. In obese patients with OSAS we found higher values of TV — 70,5±12,4 vs 45,0±5,7 cm3 , VSP — 7,5±1,7 vs 3,5±0,7 cm3 , VLPW at the level of RP — 11,7±4,1 vs 3,2±0,8 cm3 , VLPW at the level of RG — 10,4±2,8vs 3,1±8,4 cm3 and lower values of SMUAN at the level of RP — 6,3±3,5 vs 14,0±3,8 cm2 , as RG — 19,3±7,5 vs 27,0±5,0 mm2 . All differences were statistically significant (p<0,001). Conclusion. MRI can be successfully applied for the evaluation of STSUA parameters of upper airways openness.

scholarly journals The Effect of Positive Airway Pressure Therapy on Sexual Life and Quality of Life in Women with Moderate or Severe Obstructive Sleep Apnea Syndrome

2020 ◽  
Keyword(s):  
Quality Of Life ◽  
Sleep Apnea ◽  
Sexual Function ◽  
Sleep Apnea Syndrome ◽  
Female Sexual Function ◽  
Obstructive Sleep ◽  
The Mean ◽  
Apnea Syndrome ◽  
Pre Treatment

Background and Aim: Obstructive sleep apnea syndrome (OSAS) negatively affects quality of life and causes erectile dysfunction in men. However, there are few studies examining the effects of OSAS on women’s sexual health. This study used validated measurement tools to evaluate whether the presence and severity of OSAS had an impact on female sexual function and if there was a change after 6 months of CPAP treatment. Scores were compared before and after CPAP in the same and between groups. Material and Method: The patients were divided into moderate and severe groups based on the Apnea-Hypopnea Index (AHI). The female patients included in the study were administered the Female Sexual Function Index (FSFI), and the Calgary sleep apnea quality of life index (SAQLI) questionnaires to evaluate their sexual function. After CPAP treatment for 6 months, FSFI, and SAQLI questionnaires were compared with the results before treatment. Results: Among study participants, 72 had severe and 76 had moderate OSAS. The mean age (standard deviation or SD) in the severe OSAS group was 40.97±5.65 years and in the moderate OSAS group was 35.46 ± 5.43 years (p < 0.001). Body mass indexes of the severe and moderate OSAS groups were 33.10 ± 3.33 kg/m2and 31.04 ± 3.42 kg/m2, respectively (p < 0.001). The mean Epworth scores (SD) of the severe and moderate OSAS groups were 11.45 ± 3.27 and 9.52 ± 3.31, respectively (p = 0.001). Based on FSFI scores, in the pre-treatment period, desire, lubrication, and satisfaction were significantly better in the moderate OSAS group. After treatment, only desire and satisfaction were significantly better in the moderate OSAS group. In both groups, after treatment, all parameters of the FSFI score were significantly better compared with the pretreatment values (p = 0.001). When SAQLI scores were compared, in the pre-treatment period, all parameters were significantly better in the moderate OSAS group. In both groups, after treatment, all parameters of the SAQLI score were significantly better compared with the pre-treatment values (p = 0.001). Conclusion: In women with severe and moderate OSAS, sexual functions and satisfaction levels were negatively associated with OSAS severity. Sexual functions and quality of life were significantly improved with effective treatment of OSAS.

scholarly journals Help, I Can’t Breathe!

2019 ◽  
pp. 642-653
Author(s):  
Ai Ping Chua ◽  
Loutfi S. Aboussouan
Keyword(s):  
Sleep Apnea ◽  
Sleep Apnea Syndrome ◽  
Central Sleep Apnea ◽  
Apnea Hypopnea Index ◽  
Central Apnea ◽  
Arousal Index ◽  
Cpap Titration ◽  
Obstructive Sleep ◽  
Apnea Syndrome ◽  
Complex Sleep Apnea

This chapter presents a case of treatment-emergent central sleep apnea (TECSA), which is also known as complex sleep apnea syndrome or continuous positive airway pressure (CPAP)–emergent central sleep apnea. In this disorder, central apnea events emerge in patients with obstructive sleep apnea (OSA) after initiation of CPAP treatment. This phenomenon has been identified in up to 20% of patients with OSA who undergo CPAP titration. Polysomnography in those with TECSA usually shows an elevated residual Apnea–Hypopnea Index and arousal index after PAP initiation and occurs primarily during non–rapid-eye-movement sleep. Several mechanisms that have been postulated will be reviewed. The phenomenon is usually self-limiting, and recommended management includes applying the lowest PAP pressure needed to achieve reasonable control and avoiding modalities that exacerbate hypocapnia.

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