The utility of neck/thyromental ratio in defining low-risk patients with obstructive sleep apnea in sleep clinics

2014 ◽  
Vol 271 (9) ◽  
pp. 2575-2581
Author(s):  
Melike Yuceege ◽  
Hikmet Firat ◽  
Nejat Altintas ◽  
Murad Mutlu ◽  
Sadik Ardic
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Low Risk ◽  
Obstructive Sleep ◽  
Risk Patients

Abstract P195: Lack of Association between Sleep Duration and ECG Arrhythmia Risk Measures: Chicago Area Sleep Study

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Jason Ng ◽  
Phyllis C Zee ◽  
Jeffrey J Goldberger ◽  
Kristen L Knutson ◽  
Kiang Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Duration ◽  
Low Risk ◽  
Qtc Interval ◽  
Sleep Study ◽  
Chicago Area ◽  
Obstructive Sleep ◽  
Pr Interval

Introduction Sleep duration is significantly associated with cardiovascular disease risk factors such as hypertension, diabetes, and obesity in adults at low risk for obstructive sleep apnea. Although it is known that apnea increases the risk for sudden cardiac death, it is not known whether adults with short sleep duration independent of apnea have a higher risk for cardiac arrhythmias Hypothesis We tested the hypothesis that sleep duration in adults at low risk for obstructive sleep apnea would be associated with ECG measures that are known risk factors for ventricular arrhythmias. Methods The Chicago Area Sleep Study recruited 610 participants via commercially available telephone listings. Participants were screened using in-home apnea detection equipment (ApneaLinkTM) for one night to exclude subjects with apnea/hypopnea index ≥ 15. Participants wore wrist actigraphs for 7 days to objectively determine sleep duration. A 10-minute 12-lead ECG was recorded for each subject. Standard measures of heart rate, PR interval, and QTc interval were obtained along with markers of ventricular repolarization, Tpeak to Tend interval (Tpe) and spatial QRS-T angle. Signal-averaged ECG analysis was performed to measure filtered QRS duration (fQRSd), RMS voltage of terminal 40 ms (RMS), and duration of terminal QRS signals <40μV (LAS). Participants with atrial fibrillation, >20% ectopic beats and those using antihypertensive and sleep medications were excluded from analysis. The effect of sleep duration on the ECG parameters was estimated using a multiple linear regression model adjusting for demographics (sex, age, and race) and cardiovascular risk factors (BMI, hypertension, coronary heart disease, and diabetes). Results ECGs from a total of 504 participants (200 male, 48±8 years old) were analyzed. Mean sleep duration was 7±1 hrs, heart rate was 64±9 bpm, PR interval was 165±18 ms, and QTc interval was 424±23 ms. Mean Tpe interval was 83±14 ms and spatial QRS-T angle was 29±26 deg. The signal-averaged ECG measures of fQRSd, RMS, and LAS had mean values of 78±12 ms, 58±34 μV, and 24±9 ms, respectively. In an unadjusted model, there was a borderline association between sleep duration and QTc (β=0.004 ms/hr, SE=0.0023, p=0.08). However, that association was no longer significant following adjustment with demographics and cardiovascular risk factors. No other ECG measures were associated with sleep duration. Conclusions In a population at low risk of obstructive sleep apnea, ECG-based measures of cardiovascular risks were not associated with sleep duration. Previously reported associations between short sleep and cardiovascular events may not be arrhythmic in origin.

scholarly journals Factors predictive of obstructive sleep apnea in patients undergoing pre-operative evaluation for bariatric surgery and referred to a sleep laboratory for polysomnography

2015 ◽  
Vol 41 (5) ◽  
pp. 440-448 ◽  
Author(s):  
Ricardo Luiz de Menezes Duarte ◽  
Flavio José Magalhães-da-Silveira
Keyword(s):  
Bariatric Surgery ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Good Accuracy ◽  
Apnea Hypopnea Index ◽  
Roc Curve Analysis ◽  
Obstructive Sleep ◽  
High Prevalence ◽  
Risk Patients ◽  
Operative Evaluation

Objective: To identify the main predictive factors for obtaining a diagnosis of obstructive sleep apnea (OSA) in patients awaiting bariatric surgery. Methods: Retrospective study of consecutive patients undergoing pre-operative evaluation for bariatric surgery and referred for in-laboratory polysomnography. Eight variables were evaluated: sex, age, neck circumference (NC), BMI, Epworth Sleepiness Scale (ESS) score, snoring, observed apnea, and hypertension. We employed ROC curve analysis to determine the best cut-off value for each variable and multiple linear regression to identify independent predictors of OSA severity. Results: We evaluated 1,089 patients, of whom 781 (71.7%) were female. The overall prevalence of OSA-defined as an apnea/hypopnea index (AHI) ≥ 5.0 events/h-was 74.8%. The best cut-off values for NC, BMI, age, and ESS score were 42 cm, 42 kg/m2, 37 years, and 10 points, respectively. All eight variables were found to be independent predictors of a diagnosis of OSA in general, and all but one were found to be independent predictors of a diagnosis of moderate/severe OSA (AHI ≥ 15.0 events/h), the exception being hypertension. We devised a 6-item model, designated the NO-OSAS model (NC, Obesity, Observed apnea, Snoring, Age, and Sex), with a cut-off value of ≥ 3 for identifying high-risk patients. For a diagnosis of moderate/severe OSA, the model showed 70.8% accuracy, 82.8% sensitivity, and 57.9% specificity. Conclusions: In our sample of patients awaiting bariatric surgery, there was a high prevalence of OSA. At a cut-off value of ≥ 3, the proposed 6-item model showed good accuracy for a diagnosis of moderate/severe OSA.

scholarly journals Short term cognitive function after sevoflurane anesthesia in patients suspect to obstructive sleep apnea syndrome: an observational study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Soeren Wagner ◽  
Lorenz Sutter ◽  
Fabian Wagenblast ◽  
Andreas Walther ◽  
Jan-Henrik Schiff
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Cognitive Function ◽  
High Risk ◽  
Observational Study ◽  
Risk Group ◽  
Sleep Apnea Syndrome ◽  
Obstructive Sleep ◽  
Risk Patients ◽  
Apnea Syndrome

Abstract Background The obstructive sleep apnea syndrome (OSAS) is characterized by intermittent cerebral hypoxia which can cause cognitive alterations. Likewise, hypoxia induced neurocognitive deficits are detectable after general anesthesia using volatile anesthetics. The objective of this study was to evaluate the association between a moderate to high risk patients of OSAS and postoperative cognitive dysfunction after volatile anesthesia. Methods In this single center prospective, observational study between May 2013 and September 2013, 46 patients aged 55 to 80 years with an estimated hospital stay of at least 3 days undergoing surgery were enrolled. Patients were screened using the STOP-BANG test with score of 3 or higher indicating moderate to high risk of OSAS. The cognitive function was assessed using a neuropsychological assessment battery, including the DemTect test for cognitive impairment among other tests e.g. SKT memory, the day before surgery and within 2 days after extubation. Results Twenty-three of the 46 analyzed patients were identified with a moderate to high risk of OSAS. When comparing post- to preoperative phase a significant better performance for the SKT was found for both groups (p <  0.001). While the moderate to high risk group scores increased postoperative in the DemTect test, they decreased in the low risk group (p <  0.003). When comparing the changes between groups, the moderate to high risk patients showed significant better test result for DemTect testing after anaesthesia. This effect remained robust when adjusting for potential confounding variables using a two-factor ANOVA. Conclusion Compared to low risk, a moderate to high risk of OSAS based on the STOP-BANG score was associated with improved postoperative cognitive function measured by the DemTect test. Trial registration The study was approved by the local Ethics committee (Ethikkommission der Medizinischen Fakultät der Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany) (reference number: 87_12 B) on 19.04.2012.

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

397 Health Insurance Status in Subjects at High Risk for Obstructive Sleep Apnea

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A158-A158
Author(s):  
Adnan Abbasi ◽  
Sameepya Thatipelli
Keyword(s):  
Health Care ◽  
Obstructive Sleep Apnea ◽  
Health Insurance ◽  
Sleep Apnea ◽  
High Risk ◽  
Low Risk ◽  
Insurance Status ◽  
Health Insurance Status ◽  
Obstructive Sleep ◽  
Increased Risk

Abstract Introduction Undiagnosed obstructive sleep apnea (OSA) is a major public health problem. Undiagnosed OSA can result in decreased productivity due to absenteeism, increased risk of comorbidities (cardiovascular disease, diabetes, and depression), and increased motor vehicle as well as workplace accidents. Lack of health insurance coverage can lead to undiagnosed and therefore untreated OSA. The objective of this study is to evaluate health insurance status in subjects at high-risk for OSA. Methods This is a cross-sectional, population-based study of adults 18 years and older who participated in the 2017–2018 National Health and Nutrition Examination Survey (NHANES). A modified STOP-Bang score was used to calculate OSA risk. This score included all the variables from the standard STOP-Bang questionnaire, except neck circumference, since it was not reported in the NHANES survey. Subjects were divided into two groups: those at low-risk for OSA with a modified STOP-Bang score of ≤ 3 and those at high-risk for OSA with a modified STOP-Bang score of &gt;4. Results A total of 4,847 adult subjects were included, which represented 223,385,241 of the U.S. non-institutionalized population. Using the modified STOP-Bang score cutoff of &gt;4, 20.9% of the sample were classified as high-risk for OSA, while 79.1% were classified as low-risk for OSA. 90% of the high-risk OSA group and 85.1% of the low-risk OSA group reported having health insurance. Sociodemographic data will also be analyzed and included. Conclusion Approximately 10% of subjects who are at high-risk for OSA reported not having health insurance. This represents over 4.6 million Americans in the non-institutionalized population. Health insurance can improve access to health care. Timely diagnosis and treatment of OSA not only can reduce morbidity and mortality, but can also reduce health care costs. Support (if any) CDC for NHANES Data.

Placenta-secreted circulating markers in pregnant women with obstructive sleep apnea

2015 ◽  
Vol 43 (1) ◽  
Author(s):  
Ghada Bourjeily ◽  
Patrizia Curran ◽  
Kristen Butterfield ◽  
Hasina Maredia ◽  
Marshall Carpenter ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Growth Factor ◽  
Pregnant Women ◽  
Protein A ◽  
Growth Factor Receptor ◽  
Low Risk ◽  
Chronic Hypertension ◽  
Second Trimester ◽  
Obstructive Sleep

AbstractObstructive sleep apnea (OSA) is associated with placenta-mediated adverse clinical outcomes. We aimed at comparing placenta-secreted proteins, such as first and second trimester Down syndrome screening markers which have been linked to preeclampsia, and markers of angiogenesis in pregnant women with OSA, and pregnant controls at low risk for OSA.A case-control study of pregnant women with OSA and controls at low risk for OSA was performed. Levels of first and second trimester markers were reported as multiple of median (MoM), and adjusted for body mass index (BMI). Stored samples were tested for markers of angiogenesis and adjusted for gestational age, BMI, and chronic hypertension.A total of 24 women with OSA and 166 controls had screening markers. BMI was higher in cases compared to controls, P=0.01. MoM levels of placenta associated plasma protein-A (PAPP-A) were significantly lower in cases versus controls, even after adjusting for BMI (0.52 IQR 0.48 vs. 1.01 IQR 0.63, P=0.009). The ratio of soluble vascular endothelial growth factor receptor 1 to placental growth factor was significantly higher in cases than controls, even after adjusting for confounders (4.42 IQR 2.52 vs. 2.93 IQR 2.01, P=0.009).Circulating placenta-secreted glycoproteins and markers of angiogenesis are altered in pregnant women with OSA.

scholarly journals Obstructive Sleep Apnea in General Surgery Patients: Is Screening Required Preoperatively?

2021 ◽  
Vol 5 (3) ◽  
pp. 94-98
Author(s):  
Osama Ahmed ◽  
◽  
Zahid Habib ◽  
Sheeraz Ur Rahman ◽  
Arshad Beg ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
High Risk ◽  
General Surgery ◽  
Risk Group ◽  
Cross Sectional Study ◽  
High Risk Group ◽  
Low Risk ◽  
Cross Sectional ◽  
Obstructive Sleep

Abstract: Aim: To screen cases who are at high risk and low risk for obstructive sleep apnea in general surgery patients. Materials & Methods: It is a cross-sectional study. It was done in Liaquat National Hospital from January 2019 to June 2019. After institutional approval, 335 patients were included in this study, who presented to general surgery OPD. STOP-BANG questionnaire was used to screen cases who are at high risk and low risk for obstructive sleep apnea in general surgery patients. Results: 335 patients were screened and 38.5% of individuals in population had age of more than 50 years. In this population 149(44.5%) of patients were male. Out of 335 patients, 135(40.3%) of them were found to have high risk of obstructive sleep apnea while the remaining 199(59.7%) were classified in low risk group. All of the parameters of STOP-bang questionnaire including age (p<0.001), gender (p=0.026), BMI (p<0.001), snoring (p<0.001), tiredness (p<0.001), sleep apnea (p=0.001), diastolic blood pressure (p<0.001) and neck circumference (p<0.001) were significantly different between high risk and low risk patients. Conclusion: This study can provide a catalyst for more meticulous screening for OSA preoperatively to diagnose high risk group. Keywords: Sleep Apnea, Obstructive, Care, Preoperative, Surgery, General, Operative Procedures.

scholarly journals Correlation between Obstructive Sleep Apnea Syndrome and Cardiac Disease Severity

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Hamid Reza Javadi ◽  
Shabnam Jalilolghadr ◽  
Zohreh Yazdi ◽  
Zeinab Rezaie Majd
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
High Risk ◽  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Epworth Sleepiness Scale ◽  
Berlin Questionnaire ◽  
High Risk Patients ◽  
Obstructive Sleep ◽  
Risk Patients

Background. Obstructive sleep apnea (OSA) syndrome is one of the most common respiratory disorders in humans. There is emerging evidence linking OSA to vascular disease, particularly hypertension. The underlying pathophysiological mechanisms that link OSA to cardiovascular diseases such as hypertension, congestive heart failure, and atrial fibrillation are not entirely understood. The aim of this study was to investigate the association of obstructive sleep apnea hypopnea syndrome (OSAHS) with coronary atherosclerotic disease (CAD). Methods. A questionnaire survey based on Berlin questionnaire and Epworth Sleepiness Scale (ESS) was conducted among 406 patients to assess demographic data and the symptoms, such as excessive daytime sleepiness and snoring. Epworth Sleepiness Scale and Berlin questionnaire were completed by all of the patients. Venous blood samples were obtained for biochemical tests. Characteristics of coronary arteries were collected from angiographies’ reports. All patients were divided into two groups based on results from Berlin questionnaire: low risk patients for OSA and high risk patients for OSA. Data were analyzed by SPSS software version 13. Results. Mean age of patients was 61.8±10.5. 212 (52.2%) patients were categorized as high risk group for apnea. Also, excessive daytime sleepiness was reported in 186 patients (45.8%). The severity of coronary artery involvement, daytime sleepiness, and electrocardiogram abnormalities was significantly higher in high risk patients for OSA compared with low risk patients. High risk patients had higher level of FBS and LDL and lower level of HDL cholesterol P<0.05. Conclusion. Our study found a strong correlation between the number of stenotic vessels and OSA. Based on our findings, OSA can be a predisposing factor for cardiac diseases.

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