scholarly journals Analyzing Neck Circumference as an Indicator of CPAP Treatment Response in Obstructive Sleep Apnea with Network Medicine

Diagnostics ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 86
Author(s):  
Stefan Mihaicuta ◽  
Lucreţia Udrescu ◽  
Mihai Udrescu ◽  
Izabella-Anita Toth ◽  
Alexandru Topîrceanu ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Treatment Response ◽  
Area Under The Curve ◽  
Positive Likelihood Ratio ◽  
Neck Circumference ◽  
Apnea Hypopnea Index ◽  
Anthropometric Measures ◽  
Cpap Treatment ◽  
Obstructive Sleep

We explored the relationship between obstructive sleep apnea (OSA) patients’ anthropometric measures and the CPAP treatment response. To that end, we processed three non-overlapping cohorts (D1, D2, D3) with 1046 patients from four sleep laboratories in Western Romania, including 145 subjects (D1) with one-night CPAP therapy. Using D1 data, we created a CPAP-response network of patients, and found neck circumference (NC) as the most significant qualitative indicator for apnea–hypopnea index (AHI) improvement. We also investigated a quantitative NC cutoff value for OSA screening on cohorts D2 (OSA-diagnosed) and D3 (control), using the area under the curve. As such, we confirmed the correlation between NC and AHI (ρ=0.35, p<0.001) and showed that 71% of diagnosed male subjects had bigger NC values than subjects with no OSA (area under the curve is 0.71, with 95% CI 0.63–0.79, p<0.001); the optimal NC cutoff is 41 cm, with a sensitivity of 0.8099, a specificity of 0.5185, positive predicted value (PPV) = 0.9588, negative predicted value (NPV) = 0.1647, and positive likelihood ratio (LR+) = 1.68. Our NC =41 cm threshold classified the D1 patients’ CPAP responses—measured as the difference in AHI prior to and after the one-night use of CPAP—with a sensitivity of 0.913 and a specificity of 0.859.

scholarly journals Cardiorespiratory Polygraphy for Detection of Obstructive Sleep Apnea in Patients With Atrial Fibrillation

2021 ◽  
Vol 8 ◽  
Author(s):  
Michiel Delesie ◽  
Lieselotte Knaepen ◽  
Johan Verbraecken ◽  
Karolien Weytjens ◽  
Paul Dendale ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Screening Tool ◽  
Area Under The Curve ◽  
Screening Tools ◽  
Apnea Hypopnea Index ◽  
Automated Algorithm ◽  
Obstructive Sleep ◽  
At Home

Background: Obstructive sleep apnea (OSA) is a modifiable risk factor of atrial fibrillation (AF) but is underdiagnosed in these patients due to absence of good OSA screening pathways. Polysomnography (PSG) is the gold standard for diagnosing OSA but too resource-intensive as a screening tool. We explored whether cardiorespiratory polygraphy (PG) devices using an automated algorithm for Apnea-Hypopnea Index (AHI) determination can meet the requirements of a good screening tool in AF patients.Methods: This prospective study validated the performance of three PGs [ApneaLink Air (ALA), SOMNOtouch RESP (STR) and SpiderSAS (SpS)] in consecutive AF patients who were referred for PSG evaluation. Patients wore one of the three PGs simultaneously with PSG, and a different PG during each of three consecutive nights at home. Severity of OSA was classified according to the AHI during PSG (&lt;5 = no OSA, 5–14 = mild, 15–30 = moderate, &gt;30 = severe).Results: Of the 100 included AF patients, PSG diagnosed at least moderate in 69% and severe OSA in 33%. Successful PG execution at home was obtained in 79.1, 80.2 and 86.8% of patients with the ALA, STR and SpS, respectively. For the detection of clinically relevant OSA (AHI ≥ 15), an area under the curve of 0.802, 0.772 and 0.803 was calculated for the ALA, STR and SpS, respectively.Conclusions: This study indicates that home-worn PGs with an automated AHI algorithm can be used as OSA screening tools in AF patients. Based on an appropriate AHI cut-off value for each PG, the device can guide referral for definite PSG diagnosis.

Utility of Neck, Height, and Tonsillar Size to Screen for Obstructive Sleep Apnea among Obese Youth

2017 ◽  
Vol 158 (4) ◽  
pp. 745-751 ◽  
Author(s):  
Indra Narang ◽  
Suhail Al-Saleh ◽  
Reshma Amin ◽  
Evan J. Propst ◽  
Saadoun Bin-Hasan ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Predictive Ability ◽  
Ambulatory Setting ◽  
Apnea Hypopnea Index ◽  
Predictive Tool ◽  
Anthropometric Measures ◽  
Cross Sectional ◽  
Obese Youth ◽  
Obstructive Sleep

Objectives To determine whether neck:height ratio combined with adenoid and tonsillar size is a good predictive tool for obstructive sleep apnea in obese youth. Study Design Cross-sectional study. Setting Sleep clinics at the Hospital for Sick Children, Toronto, Canada. Subjects and Methods Consented obese individuals aged 8 to 18 years were recruited between 2013 and 2015. Anthropometric measures were obtained by a trained research coordinator in a standardized manner. Otolaryngologists evaluated adenoid and tonsil sizes. Obstructive sleep apnea was diagnosed with an overnight polysomnogram as an obstructive apnea-hypopnea index ≥2. Multivariable logistic regressions investigated the relationship between potential predictors and obstructive sleep apnea. The C-statistic measured the predictive ability. Results Of the 53 subjects (median age, 13 years; 55% males), 28 (53%) were diagnosed with obstructive sleep apnea, with a median index of 10.6 per hour. In a logistic regression controlling for adenoid size, enlarged tonsils were significantly associated with the presence of obstructive sleep apnea ( P < .01). Adding neck:height ratio into the model improved the model predictive ability (C-index increased from 0.73 to 0.84). Controlling for tonsil and adenoid sizes, an increase in neck:height ratio was significantly associated with the presence of obstructive sleep apnea ( P = .01). Conclusion Our study suggests that neck:height ratio combined with tonsillar hypertrophy may have a strong predictive ability for obstructive sleep apnea and may be useful in an ambulatory setting to screen obese youth at high risk. These findings should be confirmed in a larger study.

scholarly journals Symptomatic response to CPAP in obstructive sleep apnea versus COPD- obstructive sleep apnea overlap syndrome: Insights from a large national registry

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256230
Author(s):  
Dan Adler ◽  
Sébastien Bailly ◽  
Paola Marina Soccal ◽  
Jean-Paul Janssens ◽  
Marc Sapène ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
National Registry ◽  
Overlap Syndrome ◽  
Apnea Hypopnea Index ◽  
Cpap Therapy ◽  
Exertional Dyspnea ◽  
Cpap Treatment ◽  
Obstructive Sleep ◽  
Design And Methods

Background The symptomatic response to continuous positive airway pressure (CPAP) therapy in COPD-obstructive sleep apnea overlap syndrome (OVS) compared to OSA syndrome (OSA) alone has not been well studied so far. The aim of this study is to explore main differences in the clinical response to CPAP treatment in OVS compared to OSA alone. Study design and methods Using prospective data from the French National Sleep Apnea Registry, we conducted an observational study among 6320 patients with moderate-to-severe OSA, available spirometry, and at least one follow-up visit under CPAP therapy. Results CPAP efficacy measured on the residual apnea-hypopnea index and median adherence were similar between OVS and OSA patients. In both groups, the overall burden of symptoms related to sleep apnea improved with CPAP treatment. In a multivariable model adjusted for age, gender, body mass index, adherence to treatment and residual apnea-hypopnea index, OVS was associated with higher odds for persistent morning headaches (OR: 1.37 [95% CI; 1.04; 1.79]; P = 0.02), morning tiredness (OR: 1.33 [95% CI: 1.12; 1.59]; P<0.01), daytime sleepiness (OR; 1.24 [95% CI: 1.4; 1.46]: P<0.01) and exertional dyspnea (OR: 1.26 [95% CI: 1.00;1.58]; P = 0.04) when compared with OSA alone. Interpretation CPAP therapy was effective in normalizing the apnea-hypopnea index and significantly improved OSA-related symptoms, regardless of COPD status. CPAP should be offered to patients with OVS on a trial basis as a significant improvement in OSA-related symptoms can be expected, although the range of response may be less dramatic than in OSA alone.

scholarly journals Association between neck circumference and the severity of obstructive sleep apnea

2020 ◽  
Author(s):  
Shah Ibrahim Mohd Irman ◽  
Mohamad Hazama ◽  
Mohamad Amran ◽  
Mohamad Irfan
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Pearson Correlation ◽  
Local Population ◽  
Multiple Linear Regression Model ◽  
Mean Value ◽  
Neck Circumference ◽  
Apnea Hypopnea Index ◽  
Obstructive Sleep ◽  
Tertiary Center

Introduction: Neck circumference (NC) is one of the parameters to be associated with obstructive sleep apnea (OSA). However, there is lack of research data reflecting our local population with regard to the size of NC in relation to the severity of OSA. Aim: The primary goal of this study was to investigate the association of NC with OSA and to compare NC with other parameters as a predictor of the severity of OSA, among local population. This future reliable parameter can be used in front line clinics as to guide the referral to the tertiary center. Material and methods: This was a prospective study conducted upon 120 OSA patients, aged within 18–55 years, who underwent overnight polysomnography with apnea/hypopnea index more than 5 and met all the inclusion criteria. All patients completed the Epworth sleepiness scale questionnaire while all the parameter measurement including height, weight, body mass index and NC were documented. Results and discussion: A Pearson correlation analysis showed NC was significantly associated with OSA (r = 0.495, P < 0.001) while multiple linear regression model displayed an association between NC and lowest SpO2 desaturation during sleep (LSAT) as predictors of OSA severity (P < 0.001). Mean value of NC also significantly higher among severe OSA compared to mild OSA (42.7 ± 0.9 cm vs. 39.0 ± 1.3 cm; P < 0.001). Conclusions: NC was significantly associated with OSA and both NC and LSAT were significantly correlated as predictors of OSA severity.

scholarly journals Polysomnographic and clinical characteristics of positional obstructive sleep apnea patients

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Seda Beyhan Sagmen ◽  
Sevda Cömert
Keyword(s):  
Body Mass Index ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Body Mass ◽  
Severe Disease ◽  
Upper Airway ◽  
Neck Circumference ◽  
Apnea Hypopnea Index ◽  
Obstructive Sleep ◽  
The Mean

Abstract Background Obstructive sleep apnea is a condition characterized by the complete or partial obstruction of the upper airway during sleep. This study aimed to compare the clinical and polysomnographic characteristics of our obstructive sleep apnea patients according to their positional and non-positional features. Results Two hundred eighty patients were included in the study. One hundred two patients (36.43%) were female, while 178 patients (63.57%) were male. While 88 (31.43%) of these patients were defined as positional patients, 192 (68.57%) were defined as non-positional patients. The mean age of the positional patients (46.78 ± 9.66) was lower than the mean age of the non-positional patients (50.90 ± 10.96) (p 0.001). Similarly, the mean body mass index of the positional patients (29.39 ± 3.80) was lower than the mean body mass index of the non-positional patients (33.30 ± 6.45) (p < 0.001). Neck circumference values of the positional patients (40.36 ± 2.65) were lower compared to the non-positional patients (43.32 ± 2.54) (p < 0.001). Sleep values were compared based on the presence of positional sleep apnea. In the positional patients, sleep duration, sleep efficiency (percentage), duration of stage N3, minimum, and mean saturation values were found to be higher compared to the non-positional patients, while nightlong apnea hypopnea index, apnea index, percentage of sleep time with oxygen saturation below 90%, oxygen desaturation index, mean heart rate, and periodic limb movement index values were found to be lower (p < 0.05). The rate of severe sleep apnea (7.95%) in the positional patients was lower than the non-positional patients (53.65%) (p < 0.001). Conclusion In the light of these data, positional OSA is a very important condition presented in 31.43% of OSA patients and it was determined that these patients were younger, had less body mass index, and shorter neck circumference. The rate of severe disease was found to be lower in positional OSA patients

scholarly journals Obstructive Sleep Apnea Is Associated With Altered Glycemic Patterns in Pregnant Women With Obesity

2019 ◽  
Vol 104 (7) ◽  
pp. 2569-2579 ◽  
Author(s):  
Sarah S Farabi ◽  
Linda A Barbour ◽  
Kristy Heiss ◽  
Nicole M Hirsch ◽  
Emily Dunn ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Pregnant Women ◽  
Area Under The Curve ◽  
Perinatal Outcomes ◽  
Late Pregnancy ◽  
Apnea Hypopnea Index ◽  
Oral Glucose ◽  
Continuous Glucose Monitor ◽  
Obstructive Sleep

AbstractObjectiveOften unrecognized, obstructive sleep apnea (OSA) worsens over pregnancy and is associated with poorer perinatal outcomes. The association between OSA in late pregnancy and metabolic biomarkers remains poorly understood. We tested the hypothesis that OSA in pregnant women with obesity is positively correlated with 24-hour patterns of glycemia and IR despite controlling for diet.DesignPregnant women (32 to 34 weeks’ gestation; body mass index, 30 to 40 kg/m2) wore a continuous glucose monitor for 3 days. OSA was measured in-home by WatchPAT 200™ [apnea hypopnea index (AHI), oxygen desaturation index (ODI; number per hour)]. Fasting blood was collected followed by a 2-hour, 75-g, oral glucose tolerance test to measure IR. Association between AHI and 24-hour glucose area under the curve (AUC) was the powered outcome.ResultsOf 18 women (29.4 ± 1.4 years of age [mean ± SEM]), 12 (67%) had an AHI ≥5 (mild OSA). AHI and ODI were correlated with 24-hour glucose AUC (r = 0.50 to 0.54; P ≤ 0.03) and mean 24-hour glucose (r = 0.55 to 0.59; P ≤ 0.02). AHI and ODI were correlated with estimated hepatic IR (r = 0.59 to 0.74; P < 0.01), fasting free fatty acids (fFFAs; r = 0.53 to 0.56; P < 0.05), and waking cortisol (r = 0.49 to 0.64; P < 0.05).ConclusionsMild OSA is common in pregnant women with obesity and correlated with increased glycemic profiles, fFFAs, and estimates of hepatic IR. OSA is a potentially treatable target to optimize maternal glycemia and metabolism, fetal fuel supply, and pregnancy outcomes.

scholarly journals Usefulness of Cathepsin S to Predict Risk for Obstructive Sleep Apnea among Patients with Type 2 Diabetes

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Wanwan Wen ◽  
Haili Sun ◽  
Yunxiao Yang ◽  
Yifan Jia ◽  
Fang Fang ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Fasting Blood Glucose ◽  
Area Under The Curve ◽  
Cathepsin S ◽  
Control Group ◽  
Apnea Hypopnea Index ◽  
Obstructive Sleep

Background. Obstructive sleep apnea (OSA) was highly prevalent in patients with type 2 diabetes (T2D). Cathepsin S (CTSS), a cysteine protease, is involved in the inflammatory activity in T2D and hypoxia conditions. The aim of the study was to evaluate whether CTSS could be involved in the inflammatory reaction of OSA in patients with T2D. Methods. We included 158 participants in this study matched for age, gender, and body mass index in 4 groups (control, non-OSA&T2D, OSA&non-T2D, and OSA&T2D). After overnight polysomnography, we collected the clinical data including anthropometrical characteristics, blood pressure, and fasting blood samples in the morning. Plasma CTSS concentration was evaluated using the human Magnetic Luminex Assay. Results. Compared with the control group, both the non-OSA&T2D group and the OSA&non-T2D group showed higher CTSS levels. Plasma CTSS expression was significantly increased in subjects with OSA&T2D compared to subjects with non-OSA&T2D. The OSA&T2D group had higher CTSS levels than the OSA&non-T2D group, but there were no statistically significant differences. Plasma CTSS levels showed significant correlation with the apnea-hypopnea index (AHI) (r=0.559, P<0.001) and plasma fasting blood glucose (r=0.427, P<0.001). After adjusting confounding factors, plasma CTSS levels were independently associated with the AHI (Beta: 0.386, 95% confidence intervals (CI): 21.988 to 57.781; P<0.001). Furthermore, we confirmed the higher pinpoint accuracy of plasma CTSS in the diagnosis of OSA (area under the curve: 0.868). Conclusions. Plasma CTSS expression was significantly elevated in the OSA&T2D group and was independently associated with the AHI; it could be a biomarker with a positive diagnostic value on diagnosing OSA among patients with T2D.

scholarly journals Effect of Obstructive Sleep Apnea and CPAP Treatment on Cardiovascular Outcomes in Acute Coronary Syndrome in the RICCADSA Trial

2020 ◽  
Vol 9 (12) ◽  
pp. 4051
Author(s):  
Yüksel Peker ◽  
Erik Thunström ◽  
Helena Glantz ◽  
Christine Eulenburg
Keyword(s):  
Obstructive Sleep Apnea ◽  
Acute Coronary Syndrome ◽  
Sleep Apnea ◽  
Reference Group ◽  
Cardiovascular Outcomes ◽  
Apnea Hypopnea Index ◽  
Coronary Syndrome ◽  
Cpap Treatment ◽  
Obstructive Sleep ◽  
The Impact

We aimed to address the impact of OSA and its treatment with continuous positive airway pressure (CPAP) on major adverse cardiovascular and cerebrovascular events (MACCE) in patients with acute coronary syndrome (ACS). In this current analysis of the revascularized ACS subgroup (n = 353) of the Randomized Intervention with CPAP in Coronary Artery Disease and Obstructive Sleep Apnea (RICCADSA) trial (Trial Registry: ClinicalTrials.gov; No: NCT 00519597), participants with non-sleepy OSA (apnea-hypopnea-index [AHI] ≥ 15 events/h on a home sleep apnea testing, and Epworth Sleepiness Scale [ESS] score < 10; n = 171) were randomized to CPAP (n = 86) or no-CPAP (n = 85). The sleepy OSA patients (AHI ≥ 15 events/h and ESS ≥ 10) who were offered CPAP, and the ones with no-OSA (AHI < 5 events/h) were included in the observational arm. A post-hoc analysis was done to compare untreated OSA (no-CPAP; n = 78) and nonadherent sleepy/non-sleepy OSA (n = 96) with the reference group without OSA (n = 81). The primary endpoint (the first event of repeat revascularization, myocardial infarction, stroke or cardiovascular mortality) during a median 4.7-year follow-up was evaluated in time-dependent Cox proportional hazards models adjusted for confounding factors. The incidence of MACCE did not differ significantly in intention-to-treat population. On-treatment analysis showed a significant risk reduction in those who used CPAP for ≥4 vs. <4 h/day or did not receive treatment (adjusted hazard ratio [HR] 0.17; 95% confidence interval [CI] 0.03–0.81; p = 0.03). Compared with the reference group, nonadherent/untreated OSA was associated with an increased cardiovascular risk (adjusted HR 1.97, 95% CI 1.03–3.77; p = 0.04). We conclude that OSA is an independent risk factor for adverse cardiovascular outcomes in patients with ACS. CPAP treatment may reduce this risk, if the device is used at least 4 h/day.

scholarly journals Are Sleep Questionnaires Valid in All Adult Age Groups as Screening Tools for Obstructive Sleep Apnea?

2020 ◽  
Vol 27 (2) ◽  
pp. 90-94
Author(s):  
Ho Min Lee ◽  
Jae Ki Kim ◽  
Jung Gwon Nam ◽  
Tae-Hoon Lee
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sensitivity And Specificity ◽  
Age Groups ◽  
Area Under The Curve ◽  
Screening Tools ◽  
Apnea Hypopnea Index ◽  
Adult Age ◽  
Age Related ◽  
Obstructive Sleep

Background and Objectives: Evaluation of Epworth Sleepiness Scale (ESS), Berlin, STOP, and STOP-Bang questionnaire validities for obstructive sleep apnea (OSA) screening among various adult age groups.Materials and Method: Results for each of those questionnaires were compared with diagnostic overnight polysomnography (PSG) data obtained for 396 patients suffering either insomnia, sleep apnea, excessive daytime sleepiness, or chronic snoring who had been divided into three age groups (20-39, 40-59, or ≥60 years). For each questionnaire, the sensitivity, specificity, accuracy, and area under the curve (AUC) were calculated.Results: Among the OSA group [apnea hypopnea index (AHI) cutoff ＞5], Berlin and STOP questionnaire sensitivity and specificity were significantly different among the age groups. Among the moderate-to-severe OSA sub-group (AHI cutoff ＞15), the specificity of Berlin, STOP, and STOP-Bang questionnaire was significantly different among age groups.Conclusion: The Berlin and STOP questionnaires differed with patient age in OSA screening. The ESS questionnaire, by contrast, did not show any age-related differences of sensitivity and specificity in OSA screening or moderate-to-severe OSA screening.

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