Demographic characteristics of 3,659 Japanese patients with obstructive sleep apnea–hypopnea syndrome diagnosed by full polysomnography: associations with apnea–hypopnea index

2007 ◽  
Vol 11 (2) ◽  
pp. 93-101 ◽  
Author(s):  
Fumi Ohdaira ◽  
Kazutoshi Nakamura ◽  
Hideaki Nakayama ◽  
Makoto Satoh ◽  
Tetsuro Ohdaira ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Japanese Patients ◽  
Demographic Characteristics ◽  
Apnea Hypopnea Index ◽  
Obstructive Sleep ◽  
Hypopnea Syndrome

Predictors of Surgical Outcomes of Uvulopalatopharyngoplasty for Obstructive Sleep Apnea Hypopnea Syndrome

2011 ◽  
Vol 145 (6) ◽  
pp. 1049-1054 ◽  
Author(s):  
Yuan Ping Xiong ◽  
Hong Liang Yi ◽  
Shan Kai Yin ◽  
Li Li Meng ◽  
Xu Lan Tang ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Lipid Metabolism ◽  
Sleep Apnea ◽  
Oxygen Saturation ◽  
Success Rate ◽  
Surgical Outcomes ◽  
Apnea Hypopnea Index ◽  
Glucose And Lipid Metabolism ◽  
Obstructive Sleep ◽  
Hypopnea Syndrome

Objectives. To investigate predictors of surgical outcomes of uvulopalatopharyngoplasty (UPPP) for obstructive sleep apnea hypopnea syndrome (OSAHS). Study Design. Case series with planned data collection. Setting. A university medical center. Subjects and Methods. Thirty-nine patients with OSAHS received Z-palatopharyngoplasty (ZPPP) or Han-uvulopalatopharyngoplasty (H-UPPP). All patients were evaluated within 3 months before surgery and at 6 to 12 months after surgery. Statistical analyses were conducted on preoperative parameters that could have affected surgical efficacy and outcome. Success was defined as an apnea–hypopnea index (AHI) fewer than 20 times per hour and a decrease of more than 50%. Results. The success rate was 56.4% (22/39 patients). There were statistically significant differences in AHI, lowest oxygen saturation (L-Sao2), time with oxygen saturation less than 90% (CT90), percentage of time with oxygen saturation less than 90% (CT90%), microarousal index (MI), apolipoprotein E (ApoE), high-density lipoprotein (HDL), fasting blood glucose (FBG), and Friedman OSA stage between the treatment success and failure groups. Higher success rate was predicted by lower severity, as indicated by lower AHI, CT90, CT90%, and MI; higher L-Sao2; and fewer glucose and lipid metabolism abnormalities, shown by lower ApoE and FBG and higher HDL. Conclusions. Disease severity, glucose and lipid metabolism, and Friedman OSA stage may be important predictors of surgical outcome of UPPP for OSAHS.

scholarly journals Uvulopalatopharyngoplasty and barbed reposition pharyngoplasty with and without hyoid suspension for obstructive sleep apnea hypopnea syndrome: A comparison of long-term functional results

2020 ◽  
Author(s):  
Antonio Minni ◽  
Fabrizio Cialente ◽  
Massimo Ralli ◽  
Andrea Colizza ◽  
Quirino Lai ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Protective Factor ◽  
Surgical Techniques ◽  
Functional Results ◽  
Apnea Hypopnea Index ◽  
Obstructive Sleep ◽  
Hyoid Suspension ◽  
Hypopnea Syndrome

Obstructive sleep apnea hypopnea syndrome (OSAHS) is a common condition; when conservative approaches are not effective, surgical techniques aimed at reducing the airway obstruction effect are used. This retrospective study aimed at comparing the functional outcomes in patients with OSAHS undergoing uvulopalatopharyngoplasty (UPPP) according to Fairbanks and barbed reposition pharyngoplasty (BRP) according to Mantovani, with or without hyoid suspension (HS). One-hundred twenty-two consecutive OSAHS patients who underwent surgical treatment were included in the study. Patients were divided into 4 groups; all patients underwent preoperative and postoperative polysomnography (PSG) with apnea/hypopnea index (AHI) and oxygen desaturation index (ODI) evaluation, and Epworth Sleepiness Scale (ESS) evaluation. The results were analyzed according to the different surgical procedures, in relation to the preoperative PSG and anthropometric data. A significant reduction was observed at 18-month follow-up for patients in BRP group for BMI (p = 0.004), ESS (p < 0.0001), ODI (p < 0.0001), and AHI (p < 0.0001). Risk factors for poor postoperative AHI reduction were evaluated; preoperative AHI was the strongest independent protective factor, while preoperative ODI was the strongest risk factor. The association of HS with UPPP or BRP showed significant results in terms of higher postoperative AHI reduction only when associated to UPPP (p < 0.0001). This study showed that the BRP technique was more effective compared to UPPP for patients with OSAHS. The association of HS showed greater benefits in UPPP compared to BRP.  Randomized prospective trials with longer follow-up are necessary to confirm our results and formulate a more accurate indication of the optimal therapeutic strategy.

scholarly journals Application of IoT-based medical diagnosis and treatment in patients with obstructive sleep apnea/hypopnea syndrome in primary hospitals: A preliminary study

2018 ◽  
Vol 01 (03) ◽  
pp. 207-212
Author(s):  
Yuhua Wu ◽  
Jian Zhou ◽  
Jing Li ◽  
Jie Liu ◽  
Shanqun Li ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Medical Technology ◽  
Diagnosis And Treatment ◽  
Apnea Hypopnea Index ◽  
Medical Monitoring ◽  
Obstructive Sleep ◽  
Before And After ◽  
Preliminary Study ◽  
Hypopnea Syndrome

Objective: To conduct a preliminary study of the hierarchical diagnosis and treatment of patients with obstructive sleep apnea/hypopnea syndrome (OSAHS) using the Internet of Things (IoT) medical technology and to explore the feasibility of the hierarchical diagnosis, treatment, and management of OSAHS patients using IoT medicine in primary hospitals. Methods: The IoT technology and a remote medical monitoring system were used to observe and compare the respiratory and sleep parameters before and after a three-month intervention in 47 patients with OSAHS who met the diagnostic criteria and were selected in the Kashgar region. All parameters were compared based on the severity (mild, moderate, and severe) of OSAHS. Results: The Epworth Sleepiness Scale (ESS) score, apnea–hypopnea index (AHI), and nighttime minimum oxygen saturation (lowest SaO2min) improved in patients with OSAHS from before to after treatment ([Formula: see text]). The improvements were more profound in OSAHS patients with cardiovascular disease such as hypertension. Conclusion: The IoT medical technology can help to hierarchically diagnose, treat, and manage patients with OSAHS. It is feasible for primary hospitals in rural regions to use the IoT technology for the hierarchical diagnosis and treatment of OSAHS patients.

scholarly journals Dysfunction of Nrf2-ARE Signaling Pathway: Potential Pathogenesis in the Development of Neurocognitive Impairment in Patients with Moderate to Severe Obstructive Sleep Apnea-Hypopnea Syndrome

2018 ◽  
Vol 2018 ◽  
pp. 1-15 ◽  
Author(s):  
Li Zhou ◽  
Ruoyun Ouyang ◽  
Hong Luo ◽  
Yating Peng ◽  
Ping Chen ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Signaling Pathway ◽  
Neurocognitive Impairment ◽  
Apnea Hypopnea Index ◽  
Heme Oxygenase 1 ◽  
Severe Obstructive Sleep Apnea ◽  
Obstructive Sleep ◽  
Hypopnea Syndrome ◽  
Nrf2 Protein

The present study investigated the nuclear factor erythroid 2-related factor 2- (Nrf2-) antioxidant response element (ARE) signaling pathway in patients with moderate to severe obstructive sleep apnea-hypopnea syndrome (OSAHS). Their correlation with neurocognitive impairment metrics was investigated to explore potential pathogenesis in OSAHS. Forty-eight patients with OSAHS and 28 controls underwent testing with the Epworth Sleep Scale (ESS), MATRICS Consensus Cognitive Battery (MCCB), Stroop Color and Word Test, polysomnography (PSG), and measurements of the concentration of plasma superoxide dismutase (SOD) and thioredoxin (Trx). Further, 20 pairs of matched patients with OSAHS and controls were selected for measurement of the expression (protein and mRNA) of Nrf2 and of its downstream antioxidase, heme oxygenase-1 (HO-1), in peripheral mononuclear cells (PBMCs). Finally, correlations between neurocognitive impairment and the above metrics were analyzed. Expression of Nrf2 and HO-1 mRNA and protein in the PBMCs, as well as plasma SOD and Trx levels, were significantly reduced in patients with OSAHS. After adjusting for education, sex, age, and smoking index, the expression of Nrf2-ARE signaling pathway proteins (or mRNA) was closely correlated with sleep respiratory parameters. An inverse relationship was demonstrated between the expression of nuclear Nrf2 in PBMCs, concentration of plasma SOD and Trx, and apnea-hypopnea index (AHI) in patients with OSAHS. Trx, nuclear Nrf2 protein, and HO-1 protein were also negatively correlated with the percent of time that SaO2 was less than 90% (TSat90). Total Nrf2 protein level was positively correlated with AHI and TSat90 and negatively correlated with minimum SaO2 (LSaO2), while nuclear Nrf2 protein and HO-1 protein were positively correlated with LSaO2. Moreover, significant positive correlations were found between maze scores and expression of nuclear Nrf2 protein, HO-1 protein, and SOD and Trx levels. Furthermore, inverse relationships between total Nrf2 protein in PBMCs and HVLT-R and maze scores were found. Multiple linear regression showed plasma Trx concentration as a potential predictor of maze and BVMT-R scores. In conclusion, the expression of Nrf2-ARE molecules and related antioxidases is significantly decreased in patients with OSAHS and is correlated with neurocognitive dysfunction. The Nrf2-ARE signaling pathway may play a crucial role in neurocognitive impairment in patients with moderate to severe OSAHS. Further studies are needed to explore the exact mechanisms and potential treatment interventions.

Z-palatopharyngoplasty for obstructive sleep apnea/hypopnea syndrome

2009 ◽  
Vol 140 (5) ◽  
pp. 640-645 ◽  
Author(s):  
Hong L. Yi ◽  
Shan K. Yin ◽  
Yu J. Zhang ◽  
Bin Chen ◽  
Wen Y. Lu ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Body Length ◽  
Clinical Stage ◽  
Case Series ◽  
Apnea Hypopnea Index ◽  
Factors Affecting ◽  
Obstructive Sleep ◽  
Mandibular Body ◽  
Hypopnea Syndrome

Objective: To explore the feasibility, outcomes, and factors affecting the outcome of Z-palatopharyngoplasty (ZP3) in the treatment of severe obstructive sleep apnea/hypopnea syndrome (OSAHS). Study Design: Case series with chart review. Methods: ZP3 was performed on 34 Friedman stage II/III OSAHS patients with a posterior airway space (PAS) ≥ 11 mm. Postoperative follow-up was at least 6 months, and the differences between responders and nonresponders were analyzed. Results: On the basis of success criteria, defined as an apnea-hypopnea index < 20 and a decrease > 50 percent, the success rate was 64.7 percent. The lowest oxygen saturation (LSaO2), percentage of time with an oxyhemoglobin saturation below 90 percent (CT90), mandibular plane angle (MPA), mandibular body length, position of the tongue, and Friedman clinical stage differed significantly between responders and nonresponders. The logistic regression analysis showed that MPA and Friedman stage were the key predictors of ZP3 surgical success. The best cutoff points for LSaO2, CT90, and MPA were 72 percent, 22.80 percent, and 29.40°, respectively. Conclusions: Factors affecting the outcome of ZP3 included LSaO2, CT90, MPA, mandibular body length, position of the tongue, and Friedman clinical stage. Of these, the MPA and Friedman clinical stage were most influential.

scholarly journals Efficacy of Somnodent® Appliance Therapy in Moderate to Severe Obstructive Sleep Apnea Patients Somnodent® OAs for Moderate to Severe OSAHS

2021 ◽  
Vol 3 (3) ◽  
pp. 01-07
Author(s):  
Guillaume Buiret ◽  
Frederic Chidiac
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Reduction Rate ◽  
Oral Appliance ◽  
Dropout Rate ◽  
Apnea Hypopnea Index ◽  
Severe Obstructive Sleep Apnea ◽  
Oral Appliances ◽  
Obstructive Sleep ◽  
Hypopnea Syndrome

Objective: Oral appliances are one of the treatments of obstructive sleep apnea hypopnea syndrome. The main objective of the study was to determine the efficacy of the Somnodent® oral appliance on Apnea-Hypopnea Index. The secondary objective was to measure the efficacy on other oxymetric parameters and to determine its tolerance and dropout rate. Methods: Efficacy results of the oral appliances based on the apnea hypopnea index, the oxygen desaturation index and the lower oxygen saturation reduction, appliance complications and dropout rates were retrospectively collected from 25 patients with a moderate to severe obstructive sleep apnea hypopnea syndrome treated by a Somnodent® oral appliance. The procedure was entirely performed by otolaryngologists. Results: The AHI with OA was more significantly reduced in patients with a higher initial apnea hypopnea index and a higher initial body mass index but reduction was not related to age and not proportional to degree of mandibular advancement. The 50%-AHI reduction rate after OA was 55.6%, the AHI ≤5/h rate after OA was 22.2%. The OA significantly reduced the mean apnea-hypopnea index (-14.3/h, p<10-5). No patient had his AHI increased with oral appliance. One patient stopped using OA mainly because of nausea. Conclusions: Somnodent® is an effective and well-tolerated treatment for moderate to severe obstructive sleep apnea hypopnea syndrome.

scholarly journals Partial intracapsular tonsillectomy in the treatment of pediatric obstructive sleep apnea/hypopnea syndrome: a prospective study with 5-year follow-up

2021 ◽  
Author(s):  
Matteo Cavaliere ◽  
Pietro De Luca ◽  
Egidio De Bonis ◽  
Riccardo Maurizi ◽  
Claudia Cassandro ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Apnea Hypopnea Index ◽  
Sleep Study ◽  
Obstructive Sleep ◽  
Operative Evaluation ◽  
A Prospective Study ◽  
Hypopnea Syndrome ◽  
Intracapsular Tonsillectomy

Abstract Objective To assess efficacy and safety of tonsil reduction with bipolar forceps electrocautery as treatment of paediatric obstructive sleep apnea/hypopnea syndrome (OSAHS). Study design Prospective interventional study. Methods Two hundred and sixty-three children aged 4–10 years with OSAHS and an apnea hypopnea index (AHI) > 3 were enrolled from March 2013 to January 2016. Pre-operative evaluation included oropharyngeal clinical examination with fiberoptic nasopharyngoscopy, OSA-18 questionnaire and overnight sleep study. All children were treated with adenoidectomy and tonsillotomy with bipolar forceps. OSA-18 questionnaire and overnight sleep study were performed 30 days after surgery. Results Pre-operative average of the OSA-18 questionnaires was of 70.3 (SD = 9.7); 30-day post-operative score was 23.15 (SD = 8.2; p = 0.045). Pre-operative average Apnea Hypopnea Index (AHI) score was 9.41 (SD = 4.1); 30-day post-operative average of AHI score was of 1.75 (SD = 0.8; p = 0.012). Oxygen Desaturation Index (ODI) rate changed from 7.39 (SD = 4) to 1.34 (30-day post-operative) (SD = 4.7; p = 0.085). NADIR rate changed from 79% (SD = 6.32) to 90% (30-day post-operative) (SD = 5.18; p = 0.00012). Peri- and post-operative complications in our sample were mainly pain (average 75 doses of paracetamol), while bleeding did not occur (0%). All patients received a follow-up examination 5 years after surgery to evaluate tonsil size; at this time-point, a reduction in tonsil size from 3.6 (3–4; SD = 4.2) to 1.3 (1–2; SD = 5.5) was found, while tonsil regrowth was observed in five children (2%). Conclusion This study showed that partial tonsillotomy with bipolar forceps electrocautery associated to adenoidectomy is an effective technique in treating OSAHS symptoms in children and ensures less complications in terms of hemorrhage, postoperative pain and infections compared to traditional adenotonsillectomy. The very low tonsillar regrowth rate reported in this study may support the routine use of this technique.

scholarly journals Serum Uric Acid Is Independently Associated with Risk of Obstructive Sleep Apnea-Hypopnea Syndrome in Chinese Patients with Type 2 Diabetes

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Caiyu Zheng ◽  
Haiqu Song ◽  
Shunhua Wang ◽  
Jing Liu ◽  
Tingting Lin ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Obstructive Sleep Apnea ◽  
Uric Acid ◽  
Sleep Apnea ◽  
Serum Uric Acid ◽  
Control Group ◽  
Apnea Hypopnea Index ◽  
Obstructive Sleep ◽  
Hypopnea Syndrome

Purpose. We aimed to investigate the association between serum uric acid (SUA) levels and obstructive sleep apnea-hypopnea syndrome (OSAHS) in patients with type 2 diabetes. Methods. A cross-sectional study of 212 type 2 diabetes mellitus (T2DM) patients was conducted in Xiamen, China. All patients underwent polysomnography (PSG) recordings for OSAHS diagnosis. Patients were grouped according to the apnea-hypopnea index (AHI) as mild (5-14.9), moderate (15-29.9), and severe (≧30) OSAHS. Patients with AHI≤4.9 served as the control group. Weight, body mass index (BMI), SUA, liver function, renal function, blood pressure, lipid profiles, and glycemic parameters were measured. Results. A total of 158 patients (101 men and 57 women) with complete data were analyzed in this study. 127 patients were identified as OSAHS. Among the 127 patients with OSAHS, 56 (44.1%), 37 (29.1%), and 34 (26.8%) had mild, moderate, and severe OSAHS, respectively. Correlation analyses showed that the SUA level was significantly related to the apnea-hypopnea index (AHI) (r=0.194, p=0.016). The level of SUA was significantly higher among OSAHS patients compared to the control group (control group: 333.14±80.52 μmol/L, mild group: 345.50±90.27 μmol/L, moderate group: 363.59±134.26 μmol/L, and severe group: 428.37±123.58 μmol/L and p=0.029). Multivariable logistic regression analyses showed that SUA was the independent risk factor for OSAHS (OR: 1.006, 95% CI: 1.001-1.011, p=0.020). Conclusions. The SUA level is significantly associated with the severity of OSAHS and should be controlled when managing OSAHS.

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