Early Major Medical Complications After Surgical Management of Obstructive Sleep Apnea: A Retrospective Cohort Analysis and Case Series

2015 ◽  
Vol 73 (1) ◽  
pp. 123-128 ◽  
Author(s):  
Joseph E. Cillo ◽  
David J. Dattilo
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Surgical Management ◽  
Retrospective Cohort ◽  
Cohort Analysis ◽  
Case Series ◽  
Medical Complications ◽  
Retrospective Cohort Analysis ◽  
Obstructive Sleep

scholarly journals 1150 Obstructive Sleep Apnea-dependent Racial/ethnic And Sex-specific Mechanisms Underlying Alzheimer’s Disease Risk: A Retrospective Cohort Analysis Of In-lab PSG Sleep Study Data

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A438-A438
Author(s):  
O M Bubu ◽  
A D Turner ◽  
A Parekh ◽  
A Mullins ◽  
K Kam ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Duration ◽  
Retrospective Cohort ◽  
Cohort Analysis ◽  
Study Data ◽  
Sleep Fragmentation ◽  
Sleep Study ◽  
Retrospective Cohort Analysis ◽  
Obstructive Sleep

Abstract Introduction We examined race and sex-specific biologic mechanisms of the relationship between obstructive sleep apnea (OSA) and incident AD. Methods Retrospective cohort analysis utilizing in-lab PSG sleep study data conducted among older adults between 2001 and 2005. OSA was defined using AHI4%. Participants had no history of cognitive decline or AD at baseline and included 663 (284 Non-Hispanic White (NHW), 207 Black/African-American (AA) and 172 Hispanic) OSA-patients matched on age, sex, race, BMI, 1:1 ratio to 663 (unexposed cohort I from sleep clinic) and 1:4 ratio to 2652 (unexposed cohort II from non-sleep clinics) non-OSA individuals. Incident AD was assessed annually from 2001-2013 with ICD-9-CM code 331.0. Adjusted cox proportional hazard regression models examined race and sex-specific biologic mechanisms including hypoxia, fragmentation and duration measures of OSA and AD risk. Results Of the 3,978 participants, 2,148 (54%) were women. Mean age at baseline was 72.6 (7.3) years. Over a mean follow-up time of 8.6 (1.4) years, 358 (9%) individuals (212 female) developed AD (119 NHW, 134 AAs, and 105 Hispanics). Relative to non-OSA individuals, OSA-patients had a higher risk of incident AD, with AAs and females showing stronger risk estimates (aHR: 2.24, 1.83, and 1.73, P <.001 for all, for AAs, Hispanics and NHW respectively; and aHR: 2.38, and 1.37, P <.001 for all, for female and male respectively). Measures of hypoxia, sleep fragmentation and sleep duration were associated with increase AD risk (P <.01 for all). Relative to NHW, AAs and Hispanics demonstrated up to 20% stronger effects/estimates on hypoxia and sleep duration measures. Relative to males, females demonstrated up to 25% stronger effects/estimates on sleep fragmentation measures, and 15% weaker effects/estimates on hypoxia measures (P <.01 for all). Conclusion Among OSA-patients, mechanisms related to hypoxia, sleep fragmentation and duration measures increase AD risk and may underlie race/ethnicity and sex disparities in AD. Support NIH/NIA/NHLBI (L30-AG064670, CIRAD P30AG059303 Pilot, T32HL129953, R01HL118624, R21AG049348, R21AG055002, R01AG056031, R01AG022374, R21AG059179, R01AG056682, R01AG056531, K07AG05268503, K23HL125939)

Targeted Multilevel Surgical Management of Obstructive Sleep Apnea: A Case Series of 44 Patients

2014 ◽  
Vol 151 (1_suppl) ◽  
pp. P135-P135
Author(s):  
Melinda Davis-Malesevich ◽  
Iman Naseri ◽  
Whitney B. Salem ◽  
Luis Vega ◽  
Dale Kraemer
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Surgical Management ◽  
Case Series ◽  
Obstructive Sleep

scholarly journals Multilevel Sleep Surgery Including the Palate in Nonsyndromic, Neurologically Intact Children with Obstructive Sleep Apnea

OTO Open ◽  
2019 ◽  
Vol 3 (2) ◽  
pp. 2473974X1985147
Author(s):  
Jason E. Cohn ◽  
George E. Relyea ◽  
Srihari Daggumati ◽  
Brian J. McKinnon
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Tertiary Care ◽  
Case Series ◽  
T Test ◽  
Velopharyngeal Insufficiency ◽  
Apnea Hypopnea Index ◽  
Sleep Surgery ◽  
Obstructive Sleep ◽  
Neurologically Intact

Objective To examine the effects of multilevel sleep surgery, including palate procedures, on obstructive sleep apnea parameters in the pediatric population. Study Design A case series with chart review was conducted to identify nonsyndromic, neurologically intact pediatric patients who underwent either uvulectomy or uvulopalatopharyngoplasty as part of multilevel sleep surgery from 2011 through 2017. Setting A tertiary care, university children’s hospital. Subjects and Methods Unpaired Student t test was used to compare average pre- and postsurgical apnea-hypopnea index (AHI) and oxygen saturation nadir (OSN). Paired Student t test was used to compare the mean pre- and postsurgical AHI and OSN within the same patient for the effects of adenotonsillectomy (T&A) vs multilevel sleep surgery. Results In patients who underwent T&A previously, multilevel sleep surgery, including palate procedures, resulted in improved OSA severity in 6 (86%) patients and worsened OSA in 1 (14%) patient. Multilevel sleep surgery, including palate procedures, significantly decreased mean AHI from 37.98 events/h preoperatively to 8.91 events/h postoperatively ( P = .005). However, it did not significantly decrease OSN. Conclusion This study includes one of the largest populations of children in whom palate procedures as a part of multilevel sleep surgery have been performed safely with no major complications and a low rate of velopharyngeal insufficiency. Therefore, palatal surgery as a part of multilevel sleep surgery is not necessarily the pariah that we have traditional thought it is in pediatric otolaryngology.

scholarly journals 0598 Blurred Binaries: The Clinical Management of Obstructive Sleep Apnea in Transgender Patients

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A229-A229
Author(s):  
B Peters-Mathews ◽  
M Lee ◽  
A Sabzpoushan
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Gender Identity ◽  
Mood Disorders ◽  
Case Series ◽  
Careful Consideration ◽  
Comorbid Conditions ◽  
Loss To Follow Up ◽  
Obstructive Sleep

Abstract Introduction Transgender patients require careful clinical assessment to identify the effects of hormones on their risk of obstructive sleep apnea. Testosterone increases sleep apnea risk and assigned males at birth may develop the condition earlier. Estrogen and progesterone are known to reduce sleep apnea risk. Depending on the use of supplemental hormones and surgical status, the risk of sleep apnea may be altered in a transgender patient. Comorbid conditions, including mood disorders and obesity, may further impact sleep. This topic has not been well-studied, and this pilot project identifies special needs that exist in transgender populations. Methods This retrospective chart review included 25 subjects who identify as transgender who have been managed at an urban sleep disorders center from 2017 to 2019. The case series was assessed to identify characteristics that impact the diagnosis and treatment of obstructive sleep apnea (natural and supplemental hormonal effects, surgical effects, comorbid conditions, etc.). Results The average age of the cohort was 34 years (range 16 to 76). Fourteen subjects were assigned females at birth and identify as men and 11 subjects were assigned males at birth and identify as women. Preferred pronoun usage was concordant with gender identity in 21 subjects, discordant in 1 subject, and gender-neutral (they/them) was used by 3 subjects. Based on 24 subjects, the average BMI was 35.5 (range 23.5 to 53.1). The measured neck circumference was <16 inches in 9 subjects, >17 inches in 6 subjects,and a risk factor for sleep apnea based on birth-assigned sex but not gender identity in 4 subjects. Hormone therapy was used by 24 subjects to enhance their gender identities. When documented, 6 subjects had mastectomies and 2 also had total hysterectomies. Anxiety or depression had been diagnosed in 20 subjects. Testing revealed sleep apnea in 18 subjects. Loss to follow up affected 9 subjects. Conclusion Transgender patients deserve respectful evaluation and careful consideration regarding risk factors for obstructive sleep apnea that may be impacted by gender-affirming hormonal therapy or surgery, and weight gain. Higher rates of mood disorders and loss to follow up may put these patients at long-term risk. Support N/A

Surgical Correction of Anatomic Abnormalities in Obstructive Sleep Apnea Syndrome: Uvulopalatopharyngoplasty

1981 ◽  
Vol 89 (6) ◽  
pp. 923-934 ◽  
Author(s):  
Shiro Fujita ◽  
William Conway ◽  
Frank Zorick ◽  
Thomas Roth
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Surgical Approach ◽  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Sleep Apnea Syndrome ◽  
Medical Complications ◽  
Obstructive Sleep ◽  
Apnea Syndrome ◽  
Objective Improvement

Excessive daytime sleepiness and loud snoring are the major symptoms of obstructive sleep apnea, often leading to serious medical complications if unrecognized and untreated. Tracheostomy has been the only effective treatment in most adult cases. This paper reports on a new surgical approach to treat obstructive sleep apnea by uvulopalatopharyngoplasty designed to enlarge the potential airspace in the oropharynx. Twelve patients underwent this operation. In nine there was relief of symptoms and in eight there was objective improvement in nocturnal respiration and sleep pattern, demonstrated by polysomnography.

Sign in / Sign up

Export Citation Format

Share Document