The predictive value of Muller maneuver in REM-dependent obstructive sleep apnea

2013 ◽  
Vol 270 (10) ◽  
pp. 2759-2762 ◽  
Author(s):  
Kursat Murat Ozcan ◽  
Muge Ozcan ◽  
Fatih Ozdogan ◽  
Omer Hizli ◽  
Huseyin Dere ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Predictive Value ◽  
Obstructive Sleep ◽  
Müller Maneuver

Abstract TP221: Using Berlin Questionnaire and Epworth Sleepiness Scale to Identify Stroke Patients at Risk for the Sleep Apnea Syndrome

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Millene Camilo ◽  
Alan Eckeli ◽  
Heidi Sander ◽  
Regina Fernandes ◽  
Joao Leite ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Ischemic Stroke ◽  
Sleep Apnea ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Epworth Sleepiness Scale ◽  
Berlin Questionnaire ◽  
Stroke Patients ◽  
Obstructive Sleep

Background: Sleep-disordered breathing (SDB) is frequent in the acute phase of stroke. Obstructive sleep apnea (OSA) has been found in 62% of stroke patients. The impact of OSA is significant after ischemic stroke, including early neurological deterioration, poor functional outcome and increased long-term mortality. However, performing polysomnography (PSG) for all patients with acute stroke for diagnose OSA is still impracticable. Therefore clinical tools to select patients at higher risk for OSA would be essential. The aim of this study was to determine the validity of the Berlin Questionnaire (BQ) and the Epworth Sleepiness Scale (ESS) to identify stroke patients in whom the PSG would be indicated. Methods: Subjects with ischemic stroke were stratified into high and low risk groups for SDB using a BQ. The ESS ≥ 10 was used to define excessive daytime sleepiness. The BQ and ESS were administered to the relatives of stroke patients at hospital admission. All patients were submitted to a full overnight PSG at the first night after symptoms onset. OSA severity was measured by the apnea-hypopnea index (AHI). Results: We prospectively studied 40 ischemic stroke patients. The mean age was 62 ± 12.1 years and the obstructive sleep apnea (AHI ≥ 15) was present in 67.5%. On stratifying risk of OSA in these patients based on the QB, 77.5% belonged to the high-risk and 50% to the ESS ≥ 10. The sensitivity of QB was 85%, the specificity 35%, the positive predictive value 74% and the negative predictive value 55%. For ESS was respectively 63%, 85%, 89% and 52%. The diagnostic value of the BQ and ESS in combination to predict OSA had a sensitivity of 58%, a specificity of 89%, a positive predictive value of 95% and a negative predictive value of 38%. Conclusions: The QB even applied to the bed-partners of stroke patients is a useful screening tool for OSA.

scholarly journals The Role of Modified Expansion Sphincter Pharyngoplasty in Multilevel Obstructive Sleep Apnea Syndrome Surgery

2018 ◽  
Vol 22 (04) ◽  
pp. 432-436 ◽  
Author(s):  
Francesco Lorusso ◽  
Francesco Dispenza ◽  
Domenico Modica ◽  
Salvatore Gallina
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Daytime Sleepiness ◽  
Sleep Apnea Syndrome ◽  
Upper Airway ◽  
Obstructive Sleep ◽  
Müller Maneuver ◽  
Expansion Sphincter Pharyngoplasty ◽  
Sphincter Pharyngoplasty ◽  
Apnea Syndrome

Introduction Obstructive sleep apnea syndrome (OSAS) is a sleep disorder caused by an excessive narrowing of the pharyngeal airway that also collapses during inspiration, with an important role played by the lateral pharyngeal wall in the development of the obstruction. Objective To describe our surgical experience with modified expansion sphincter pharyngoplasty (MESP) in the management of lateral collapse in upper airway multilevel surgery. Methods A total of 20 patients with moderate to severe OSAS were recruited in the Ear, Nose and Throat (ENT) Department of the University of Palermo, Italy. All of the enrolled patients refused the ventilatory therapy. The subjects were evaluated for snoring, and daytime sleepiness had a clinical evaluation including collection of anthropometric data and ENT examination and rhinofibroscopy with Müller maneuver. The patients undergoing upper airway multilevel surgery and we selected for MESP the patients with an oropharyngeal transverse pattern of collapse at Müller maneuver. Results In the postoperative assessment, all of the patients reported a reduction in snoring scores and daytime sleepiness. We observed a reduction in the mean apnea-hypopnea index (AHI) of 57.5% of the sample, which decreased from a mean value of 41.7 ( ± 21.5) to 17.4 ( ±  8.9) (p < 0.05), with a success rate, according to the Sher criteria, of 65%. We observed very few postoperative complications. Conclusion Modified expansion sphincter pharyngoplasty in multilevel surgical therapy preceded by a careful selection of patients has proven to be effective in treating patients with moderate to severe syndromes.

Predictive value of Berlin Questionnaire and Epworth Sleepiness Scale for obstructive sleep apnea in a sleep clinic population

2014 ◽  
Vol 8 (3) ◽  
pp. 292-296 ◽  
Author(s):  
Sevinc Sarinc Ulasli ◽  
Ersin Gunay ◽  
Tulay Koyuncu ◽  
Olcay Akar ◽  
Bilal Halici ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Predictive Value ◽  
Epworth Sleepiness Scale ◽  
Berlin Questionnaire ◽  
Obstructive Sleep ◽  
Clinic Population

scholarly journals Predictors of long-term adherence to continuous positive airway pressure in patients with obstructive sleep apnea and cardiovascular disease

SLEEP ◽  
2019 ◽  
Vol 42 (10) ◽  
Author(s):  
Emer Van Ryswyk ◽  
Craig S Anderson ◽  
Nicholas A Antic ◽  
Ferran Barbe ◽  
Lia Bittencourt ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Continuous Positive Airway Pressure ◽  
Predictive Value ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Obstructive Sleep ◽  
Predictors Of Adherence

Abstract Study Objectives Poor adherence to continuous positive airway pressure (CPAP) commonly affects therapeutic response in obstructive sleep apnea (OSA). We aimed to determine predictors of adherence to CPAP among participants of the Sleep Apnea and cardioVascular Endpoints (SAVE) trial. Methods SAVE was an international, randomized, open trial of CPAP plus usual care versus usual care (UC) alone in participants (45–75 years) with co-occurring moderate-to-severe OSA (≥12 episodes/h of ≥4% oxygen desaturation) and established cardiovascular (CV) disease. Baseline sociodemographic, health and lifestyle factors, OSA symptoms, and 1-month change in daytime sleepiness, as well as CPAP side effects and adherence (during sham screening, titration week, and in the first month), were entered in univariate linear regression analyses to identify predictors of CPAP adherence at 24 months. Variables with p <0.2 were assessed for inclusion in a multivariate linear mixed model with country, age, and sex included a priori and site as a random effect. Results Significant univariate predictors of adherence at 24 months in 1,121 participants included: early adherence measures, improvement in daytime sleepiness at 1 month, fixed CPAP pressure, some measures of OSA severity, cardiovascular disease history, breathing pauses, and very loud snoring. While observed adherence varied between countries, adherence during sham screening, initial titration, and the first month of treatment retained independent predictive value in the multivariate model along with fixed CPAP pressure and very loud snoring. Conclusions Early CPAP adherence had the greatest predictive value for identifying those at highest risk of non-adherence to long-term CPAP therapy. Clinical Trial Registration SAVE is registered with clinicaltrials.gov (NCT00738179).

Diagnostic Accuracy of Stop-Bang Questionnaire in Diagnosing High Risk Patients of Obstructive Sleep Apnea Considering Polysomnography as a Gold Standard

2021 ◽  
Vol 15 (10) ◽  
pp. 2823-2825
Author(s):  
Masood uz Zaman Babar ◽  
Rizwan Ali Tunio ◽  
Sunil Dat Maheshwari ◽  
Ali Hassan ◽  
Hasham Masood Qureshi
Keyword(s):  
Obstructive Sleep Apnea ◽  
Standard Deviation ◽  
Sleep Apnea ◽  
High Risk ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Gold Standard ◽  
High Risk Patients ◽  
Obstructive Sleep ◽  
Risk Patients

Objective: To determine the diagnostic accuracy of stop-bang questionnaire to diagnose high risk patients of obstructive sleep apnea taking polysomnography as gold standard. Methodology: This cross-sectional descriptive study was conducted at Isra University Hospital Hyderabad and help taken from Sleep Disorder Laboratory, The Aga Khan Hospital, Karachi. Patients with age of 18 to 70 years, presenting with symptoms of OSA of either gender were included. History was taken from patients. STOP- BANG Questionnaire was filled out for each patient consenting to participate in the study. All information was noted and entered in the Proforma. Results: Mean age of patients was 40.1 with standard deviation 17.6, mean AHI score was 20 with standard deviation 6 and stop bang score showed average 6.8 with standard deviation 2.7. Distribution of gender showed that most of the patients were male. Diagnostic accuracy calculated for stop bang questionnaire, sensitivity 77.2%, Specificity 65.5%, Positive Predictive Value 75.4%, Negative Predictive Value 67.8%, Diagnostic Accuracy 72.3% of stop bang questionnaire as follows. Conclusion: This study confirms the STOP-Bang questionnaire's high performance in screening for Obstructive sleep apnea (OSA) in the surgical population and sleep clinic. The likelihood of OSA severity increases from moderate to severe with the increasing STOP-Bang score. Keywords: Obstructive sleep apnea, stop-bang questionnaire, apnea-hypopnea index, polysomnogram

scholarly journals 1202 Validation Of A Novel Wearable Home Sleep Testing Device For Assessment Of Obstructive Sleep Apnea

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A459-A460
Author(s):  
E Yeh ◽  
E Wong ◽  
K Strohl ◽  
W Gu ◽  
C Tsai ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Likelihood Ratio ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Left Ventricular ◽  
Clinical Practices ◽  
Obstructive Sleep

Abstract Introduction There is a substantial need for an accurate and easy-to-use tool for obstructive sleep apnea (OSA) assessment. Belun Ring Platform (BRP), a novel photoplethysmography (PPG)-based home sleep apnea testing system with a proprietary deep learning algorithm, has been shown to have good sensitivity and specificity in predicting OSA in subjects without significant comorbidities and medications known to affect heart rate (HR). In this study, we further tested its performance in subjects referred for in-lab polysomnography (PSG) assessment of sleep disorders without excluding those with non-arrhythmia comorbidities or the subjects on HR-affecting medications. Methods PSG was recorded simultaneously with the Ring in the sleep lab and the studies were manually scored by certified sleep technicians according to the AASM Scoring manual version 2.4. Exclusion criteria include age &lt;18, unstable cardiopulmonary status, recent hospitalization within 30 days, significant arrhythmias, baseline HR &lt;50 or &gt;100, home oxygen use, pacemaker/defibrillator, post-cardiac transplantation or Left ventricular assist device. Results A cohort of 78 individuals (26 males and 52 females, age 50.5) were studied with 26 taking HR-affecting medications. Of these, 35 (45%) had AHI &lt; 5; 14 (18%) had AHI 5-15; 15 (19%) had AHI 15-30; 14 (18%) had AHI &gt; 30. The Ring-REI correlated well with the PSG-AHI (r =0.83, P &lt;0.001). The accuracy, sensitivity, specificity in categorizing AHI &gt;15 were 0.808, 0.931, and 0.735 respectively. The positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio were 0.675, 0.947, 3.509, and 0.094 respectively. The use of HR-affecting medications did not significantly affect the sensitivity and specificity of BRP in predicting OSA (P =0.16 and 0.44 respectively). Conclusion BRP is promising as a reasonable tool for OSA assessment and can potentially be incorporated into a broad spectrum of clinical practices for identification of patients with OSA. Support This study is supported by a Grant from Belun Technology Company Limited.

Predictive value of craniofacial and anthropometric measures in obstructive sleep apnea (OSA)

CRANIO® ◽  
2016 ◽  
Vol 35 (3) ◽  
pp. 162-167 ◽  
Author(s):  
Krishnan Jyothi Remya ◽  
Krishnakumar Mathangi ◽  
Damal Chandrasekhar Mathangi ◽  
Yerlagadda Sriteja ◽  
Ramamoorthy Srihari ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Predictive Value ◽  
Anthropometric Measures ◽  
Obstructive Sleep

scholarly journals EK Sign: A Wrinkling of Uvula and the Base of Uvula in Obstructive Sleep Apnea-Hypopnea Syndrome

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Venkata Koka ◽  
Sandrine Baron ◽  
Darius Abedipour ◽  
Vincent Latournerie ◽  
Pierre El Chater
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Positive Predictive Value ◽  
Clinical Sign ◽  
Clinical Data ◽  
Predictive Value ◽  
Strong Predictor ◽  
Obstructive Sleep ◽  
Maxilla And Mandible ◽  
Hypopnea Syndrome

Introduction. Diagnosis of obstructive sleep apnea-hypopnea syndrome (OSAHS) is suspected in the presence of symptoms and/or pharyngeal alterations and skeletal abnormalities of maxilla and mandible. Our aim is to find a new clinical sign that leads to suspicion of OSAHS in snorers.Methods. We reviewed the clinical data of 69 snoring patients with or without OSAHS. We defined EK sign as the presence of horizontal wrinkling of uvula and the base of uvula and tried to correlate its presence with OSAHS.Results. EK sign was present in 25 of 69 patients. The positive predictive value of EK sign is 100%. The presence of EK sign significantly correlated with OSAHS (44% if AHI ≥ 5 and 0% if AHI < 5;p= 0.01) and severity of OSAHS (7% if AHI < 15 and 58% with AHI ≥ 15;p< 0.001).Conclusions. The EK sign is a strong predictor of OSAHS with a specificity of 100%. We recommend performing sleep tests in presence of EK sign in snorers even in the absence of other abnormalities or symptoms.

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