scholarly journals Positional Dependency in Asian Patients With Obstructive Sleep Apnea and Its Implication for Hypertension

2011 ◽  
Vol 137 (8) ◽  
pp. 786 ◽  
Author(s):  
Ji-Hun Mo
Respiration ◽  
2021 ◽  
pp. 1-10
Author(s):  
Wei-Hsiu Chang ◽  
Hsien-Chang Wu ◽  
Chou-Chin Lan ◽  
Yao-Kuang Wu ◽  
Mei-Chen Yang

<b><i>Background:</i></b> Most patients with mild obstructive sleep apnea (OSA) are positional dependent. Although mild OSA worsens over time, no study has assessed the natural course of positional mild OSA. <b><i>Objectives:</i></b> The aim of this study was to evaluate the natural course of positional mild OSA, its most valuable progression predictor, and its impact on blood pressure (BP) and the autonomic nervous system (ANS). <b><i>Methods:</i></b> This retrospective observational cohort study enrolled 86 patients with positional mild OSA and 26 patients with nonpositional mild OSA, with a follow-up duration of 32.0 ± 27.6 months and 37.6 ± 27.8 months, respectively. Polysomnographic variables, BP, and ANS functions were compared between groups at baseline and after follow-up. <b><i>Results:</i></b> In patients with positional mild OSA after follow-up, the apnea/hypopnea index (AHI) increased (9.1 ± 3.3/h vs. 22.0 ± 13.2/h, <i>p</i> = 0.000), as did the morning systolic BP (126.4 ± 13.3 mm Hg vs. 130.4 ± 15.9 mm Hg, <i>p</i> = 0.011), and the sympathetic activity (49.4 ± 12.3% vs. 55.3 ± 13.1%, <i>p</i> = 0.000), while the parasympathetic activity decreased (50.6 ± 12.3% vs. 44.7 ± 13.1%, <i>p</i> = 0.000). The body mass index changes were the most important factor associated with AHI changes among patients with positional mild OSA (Beta = 0.259, adjust <i>R</i><sup>2</sup> = 0.056, <i>p</i> = 0.016, 95% confidence interval 0.425 and 3.990). The positional dependency disappeared over time in 66.3% of patients with positional mild OSA while 69.2% of patients with nonpositional mild OSA retained nonpositional. <b><i>Conclusions:</i></b> In patients with positional mild OSA, disease severity, BP, and ANS regulation worse over time. Increased weight was the best predictor for its progression and the loss of positional dependency. Better treatments addressing weight control and consistent follow-up are needed for positional mild OSA.


2017 ◽  
Vol 143 (2) ◽  
pp. 147 ◽  
Author(s):  
Hsin-Ching Lin ◽  
Michael Friedman ◽  
Hsueh-Wen Chang ◽  
Lauren Bonzelaar ◽  
Anna M. Salapatas ◽  
...  

2017 ◽  
Vol 13 (11) ◽  
pp. 1265-1271 ◽  
Author(s):  
Wei Li Neo ◽  
Adele C.W. Ng ◽  
Mahalakshmi Rangabashyam ◽  
Ying Hao ◽  
Kah Leng Ho ◽  
...  

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A239-A240
Author(s):  
C A Png ◽  
J Liang ◽  
Y Mok ◽  
J Chang

Abstract Introduction Adherence for the gold standard Continuous Positive Airway Pressure (CPAP) treatment for obstructive sleep apnea (OSA) is poor worldwide. Studies have explored factors impacting CPAP adherence but data is limited for Asian patients where cultural and social norms differ. This study aimed to examine the role of disease and treatment-related perceptions in short-term CPAP adherence among patients from a multi-ethnic Southeast Asian country. Methods 34 patients with newly diagnosed OSA were recruited from Changi General Hospital, a 1000-bed tertiary hospital in Singapore between September 2018 and February 2019. Psychological factors of self-efficacy, risk-perception and outcome expectancies were assessed with the Self-Efficacy Measure for Sleep Apnea (SEMSA) questionnaire. The SEMSA questionnaire has been previously validated for the evaluation of adherence-related cognitions. Patients were administered the SEMSA questionnaire before commencement of CPAP treatment and 1 month after. Results 73.5% (25/34) of the patients were male (82.4% Chinese, 11.8% Malays, 2.9% Indians, 2.9% others). Mean age was 43.3 ± 11.8 years, mean apnea hypopnea index (AHI) was 45.2 ± 29.6 events/hr and mean CPAP usage at one month was 3.6±2.0 hours. 47% were adherent to CPAP, defined as average device use &gt; 4 hrs/day. Pre-treatment self-efficacy was significantly correlated with CPAP adherence (r = 0.498, P&lt;0.01). Outcome expectancies and self-efficacy measured after one-month CPAP use were significantly correlated with CPAP adherence (r = 0.702, P&lt;0.01; r = 0.467, P&lt;0.01, respectively). However, no association between risk perception and CPAP adherence was noted at either time points. Conclusion Consistent with previous literature in Western population, our study demonstrated that patients’ cognitive perceptions of outcome expectancies and sense of self-efficacy have an impact on CPAP adherence in a Southeast Asian population. Strategies targeting these aspects would be important in designing patient education programs. Support  


2014 ◽  
Vol 140 (7) ◽  
pp. 624 ◽  
Author(s):  
Song-Tar Toh ◽  
Hong-Juan Han ◽  
Hin-Ngan Tay ◽  
Kimberley Li-Qin Kiong

2015 ◽  
Vol 19 (4) ◽  
pp. 1273-1277 ◽  
Author(s):  
Dong-Kyu Kim ◽  
Jihye Choi ◽  
Kyung Rae Kim ◽  
Kyung-Gyun Hwang ◽  
Seungho Ryu ◽  
...  

2013 ◽  
Vol 149 (3) ◽  
pp. 506-512 ◽  
Author(s):  
Hsueh-Yu Li ◽  
Wen-Nuan Cheng ◽  
Li-Pang Chuang ◽  
Tuan-Jen Fang ◽  
Li-Jen Hsin ◽  
...  

2010 ◽  
Vol 4 (4) ◽  
pp. 645-650 ◽  
Author(s):  
Parima Hirunwiwatkul ◽  
Vilavun Puangsricharern ◽  
Nisa Sothornwit ◽  
Prin Rojana Pongpun ◽  
Jeerawat Sawatdiwithayayong ◽  
...  

Abstract Background: Sleep apnea syndrome is one of the leading causes of excessive daytime sleepiness. There is no literature exploring the prevalence of sleep-associated disorders in the eye of Asians with obstructive sleep apnea syndrome (OSA). Objective: Study the prevalence of eye abnormalities in Asian patients with OSA. Material and method: Asian patients with definite OSA diagnosis via the polysomnography were recruited into the study. Complete eye examination and special investigations were performed to define eye diseases: floppy eyelids, dry eyes, keratoconus, Fuchs’ endothelial dystrophy, recurrent corneal erosions, open-angle glaucoma, ophthalmoplegia, papilledema and optic neuropathy. Results: One-hundred Asian OSA patients were examined. We found that floppy eyelids, dry eyes, and normal tension glaucoma were more prevalent compared to the normal population. Abnormal endothelial change and papilledema were detected. Optic neuropathy and ophthalmoplegia were not found in this study, although some patients did have subnormal contrast sensitivity. Conclusion: There is a higher prevalence of floppy eyelids, dry eyes, and glaucoma in OSA patients. Complete eye examination is recommended in OSA patients to detect early eye abnormalities.


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