S295 – Palate Length, Tonsil Size, and Sleep Apnea Severity

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P173-P173
Author(s):  
Neil Bhattacharyya
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Soft Tissue ◽  
Soft Palate ◽  
Free Edge ◽  
Obstructive Sleep Apnea Severity ◽  
Obstructive Sleep ◽  
Lateral Posterior ◽  
The Mean ◽  
Respiratory Disturbance

Objectives Determine the relationships between soft tissue oropharyngeal measurements and obstructive sleep apnea severity. Methods A prospective series of adult patients undergoing surgical theraphy for obstructive sleep apnea (OSA) was studied. Tonsil size (graded 0 to 4+) and median (palatal spineuvula tip) and lateral (posterior hard palate-free edge soft palate) dimensions of the soft palate were directly measured transorally at the time of surgery. From the preoperative polysomnographic and the medical record, respiratory disturbance index (RDI), lowest oxygen saturation (LSat) and body mass index (BMI) were determined. The relationships between both RDI and LSat and tonsil size and palatal dimensions was determined with multivariate linear regression adjusted for BMI. Results 88 patients were enrolled. The mean (±)95% confidence interval values for the median and lateral soft palate lengths were 4.71 (±) 0.14 cm and 3.73 (±) 0.12 cm, respectively; the mean tonsil size was 1.8 (±) 0.3. The mean RDI and LSat were 44.0 (±) 5.6 events/hour and 84.7 (±) 2.4%, respectively. On multivariate regression, only BMI significantly predicted RDI (p=0.003); median (p=0.210) and lateral (p=0.507) palate lengths and tonsil size (p=0.860) did not. For the LSat, both BMI and tonsil size were significant predictors (p<0.001 and p=0.017, respectively); median and lateral lengths were not (p=0.251 and p=.376, respectively). Conclusions Adjusted for BMI, soft palate length does not consistently predict sleep apnea severity. Adjusted for BMI, tonsil size predicts the LSat but not the RDI. These results highlight difficulties associated with correlating soft tissue anatomy with sleep apnea severity.

scholarly journals Correlation between short-time and whole-night obstruction level tests for patients with obstructive sleep apnea

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jeong-Whun Kim ◽  
Jae-Cheul Ahn ◽  
Young-Seok Choi ◽  
Chae-Seo Rhee ◽  
Hahn Jin Jung
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Short Duration ◽  
Soft Palate ◽  
Surgical Outcomes ◽  
Drug Induced ◽  
Obstructive Sleep ◽  
Average Proportion ◽  
The Mean ◽  
Short Time

AbstractIdentification of obstructive level is crucial for successful surgical outcomes in patients with obstructive sleep apnea (OSA). Unfortunately, most of the dynamic airway evaluations are performed for a short duration under drug-induced sleep; therefore, it is uncertain whether they represent airway events that occur during a whole night of sleep. This study was aimed to evaluate the correlation between obstructive levels that were identified by a short-time and a whole-night test in patients with OSA. Total 101 patients with OSA underwent drug-induced sleep fluoroscopy (DISF) and pressure manometry (PM). For DISF, the obstructive pattern was classified into one of three groups: soft palate, tongue-based, and a combined obstruction. PM was used to measure the proportion of retroglossal events out of total whole-night obstructive events in each patient. The mean age of the patients was 43.8 years. The obstructive pattern was identified as soft palate in 56 patients, combined in 38 patients, and tongue-based in 7 patients following DISF. Results from PM showed that the mean percentage of retroglossal obstructive events was 31.2 ± 30.7%. The average proportion of retroglossal obstructive events that were identified by PM in patients with soft palate, combined, and tongue-based obstruction was 27.2%, 32.1%, and 59.0%, respectively (p = 0.033). There are limitations of evaluating obstructive events that occur during a whole night with short-time tests. Surgeons should be aware the possibility of disagreement in the obstructive level between short-time and whole-night tests.

1337-P: Metabolomic Profile Associated with Obstructive Sleep Apnea Severity in Obese Pregnant Women with Gestational Diabetes

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 1337-P
Author(s):  
SIRIMON REUTRAKUL ◽  
NARICHA CHIRAKALWASAN ◽  
SURANUT CHAROENSRI ◽  
SOMVANG AMNAKKITTIKUL ◽  
SUNEE SAETUNG ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Gestational Diabetes ◽  
Pregnant Women ◽  
Metabolomic Profile ◽  
Obstructive Sleep Apnea Severity ◽  
Obstructive Sleep

scholarly journals Continuous Positive Airway Pressure-Mandibular Advancement Device Combination Therapy for Moderate-to-Severe Obstructive Sleep Apnea: A Preliminary Study

2021 ◽  
Author(s):  
Thyagaseely Sheela Premaraj ◽  
Jacob Stadiem ◽  
Shyamaly Arya Premaraj ◽  
Charles R. Davies ◽  
Matthew Dennis ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Daytime Sleepiness ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Mandibular Advancement Device ◽  
Mandibular Advancement ◽  
Severe Obstructive Sleep Apnea ◽  
Obstructive Sleep ◽  
The Mean

Abstract Objectives The purpose of this pilot study was to determine whether compliance to auto-adjusting positive airway pressure (APAP) improves with the addition of a mandibular advancement device (MAD). Secondary outcome measures included were APAP pressure, subjective daytime sleepiness, apnea–hypopnea index (AHI), and mask leaks. Setting and Sample Population Participants included were diagnosed with moderate-to-severe obstructive sleep apnea (OSA) and became noncompliant to prescribed APAP. Thirteen participants with a mean age of 61.6 years were recruited for this study. Materials and Methods All participants were given a MAD to use with their APAP. Parameters measured included APAP pressure, AHI, mask leak reported via ResMed AirViewTM software, and self-reported daytime sleepiness (Epworth Sleepiness Scale [ESS]). A paired two-sample for mean t-test was performed to determine significance. Results The mean difference of pre- and postintervention APAP compliance was 23.1%, which was statistically significant (p = 0.015). The mean APAP air pressures were unchanged. The difference between pre- and postintervention mean ESS scores was 1.4 and was statistically significant (p = 0.027). The mean difference between pre- and postintervention AHI values and mask leak showed no significant difference. Conclusion This study showed that combination of APAP-MAD therapy, for patients with moderate-to-severe OSA who were noncompliant to APAP use, significantly increased compliance with APAP therapy, and significantly decreased the daytime sleepiness of participants.

Association between obstructive sleep apnea and persistent-postural perceptual dizziness

2021 ◽  
pp. 1-6
Author(s):  
Anand K. Bery ◽  
Jayson Lee Azzi ◽  
Andre Le ◽  
Naomi S. Spitale ◽  
Judith Leech ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sensitivity And Specificity ◽  
Berlin Questionnaire ◽  
Future Studies ◽  
Obstructive Sleep ◽  
Chronic Dizziness ◽  
Patients At Risk ◽  
The Mean ◽  
The Relationship

BACKGROUND: Obstructive sleep apnea (OSA) has been linked to vestibular dysfunction, but no prior studies have investigated the relationship between Persistent Postural Perceptual Dizziness (PPPD), a common cause of chronic dizziness, and OSA. OBJECTIVE AND METHODS: We determined the frequency of OSA in an uncontrolled group of PPPD patients from a tertiary dizziness clinic based on polysomnogram (PSG). We then assessed the sensitivity and specificity of common OSA questionnaires in this population. RESULTS: Twenty-five patients with PPPD underwent PSG (mean age 47, 60% female, mean BMI 29.5). A majority, or 56%, of patients were diagnosed with OSA, and in most, the OSA was severe. OSA patients were older (56 years versus 40 years, p = 0.0006) and had higher BMI (32 versus 26, p = 0.0078), but there was no clear gender bias (56% versus 64% female, p = 1.00). The mean sensitivity and specificity of the STOP BANG questionnaire for detecting OSA was 86% and 55%, respectively. Sensitivity and specificity of the Berlin Questionnaire was 79% and 45%, respectively. CONCLUSIONS: The prevalence of OSA was much higher in our small PPPD group than in the general population. Screening questionnaires appear to demonstrate good sensitivity to detect PPPD patients at risk of OSA in this small study. Future studies should confirm these findings and determine whether treatment of OSA improves symptoms in PPPD.

scholarly journals A deep cascaded segmentation of obstructive sleep apnea-relevant organs from sagittal spine MRI

2021 ◽  
Vol 16 (4) ◽  
pp. 579-588
Author(s):  
Tatyana Ivanovska ◽  
Amro Daboul ◽  
Oleksandr Kalentev ◽  
Norbert Hosten ◽  
Reiner Biffar ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Soft Palate ◽  
High Speed ◽  
Sleep Apnea Syndrome ◽  
Epidemiological Data ◽  
Epidemiological Studies ◽  
Obstructive Sleep ◽  
Validation Set ◽  
Spine Mri

Abstract Purpose The main purpose of this work was to develop an efficient approach for segmentation of structures that are relevant for diagnosis and treatment of obstructive sleep apnea syndrome (OSAS), namely pharynx, tongue, and soft palate, from mid-sagittal magnetic resonance imaging (MR) data. This framework will be applied to big data acquired within an on-going epidemiological study from a general population. Methods A deep cascaded framework for subsequent segmentation of pharynx, tongue, and soft palate is presented. The pharyngeal structure was segmented first, since the airway was clearly visible in the T1-weighted sequence. Thereafter, it was used as an anatomical landmark for tongue location. Finally, the soft palate region was extracted using segmented tongue and pharynx structures and used as input for a deep network. In each segmentation step, a UNet-like architecture was applied. Results The result assessment was performed qualitatively by comparing the region boundaries obtained from the expert to the framework results and quantitatively using the standard Dice coefficient metric. Additionally, cross-validation was applied to ensure that the framework performance did not depend on the specific selection of the validation set. The average Dice coefficients on the test set were $$0.89\pm 0.03$$ 0.89 ± 0.03 , $$0.87\pm 0.02$$ 0.87 ± 0.02 , and $$0.79\pm 0.08$$ 0.79 ± 0.08 for tongue, pharynx, and soft palate tissues, respectively. The results were similar to other approaches and consistent with expert readings. Conclusion Due to high speed and efficiency, the framework will be applied for big epidemiological data with thousands of participants acquired within the Study of Health in Pomerania as well as other epidemiological studies to provide information on the anatomical structures and aspects that constitute important risk factors to the OSAS development.

S296 – Thyroidectomy for Goiter Improves Obstructive Sleep Apnea

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P173-P174
Author(s):  
Mark T Agrama
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Total Thyroidectomy ◽  
Community Hospital ◽  
Apnea Hypopnea Index ◽  
Tracheal Compression ◽  
Obstructive Sleep ◽  
The Mean ◽  
Postoperative Improvement ◽  
Symptomatic Control

Objectives Evaluate the effects of total thyroidectomy for euthyroid goiter causing tracheal compression on the apnea hypopnea index (AHI) in patients with obstructive sleep apnea (OSA). Demonstrate a relationship between tracheal compression and OSA. Methods A retrospective study of 8 patients with euthyroid goiter causing tracheal compression who had moderate or severe OSA. Between January 2004 and December 2007, 8 patients with these conditions were treated in a community hospital by the author. At least 1 compressive symptom (dysphagia, dyspnea, and/or orthopnea) was reported by all patients. Computed tomography of the neck and chest was used to confirm the extent of goiter and tracheal compression. OSA was confirmed with preoperative polysomnography. Total thyroidectomy was performed. Postoperative polysomnography was obtained after 90 days. Outcome measures were changes in compressive symptoms and AHI using paired t test. Results All 8 patients reported symptomatic control of compressive symptoms after thyroidectomy. 7 of 8 patients demonstrated postoperative improvement of AHI. The mean postoperative AHI decreased significantly from 52.1 to 36.6 (P < 0.05). Conclusions Total thyroidectomy for goiter causing tracheal compression can significantly improve symptoms and AHI in those patients who have OSA. Evaluation of patients with OSA should include screening for tracheal compression from goiter.

scholarly journals Compared to Individuals with Mild to Moderate Obstructive Sleep Apnea (OSA), Individuals with Severe OSA Had Higher BMI and Respiratory-Disturbance Scores

Life ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 368
Author(s):  
Leeba Rezaie ◽  
Soroush Maazinezhad ◽  
Donald J. Fogelberg ◽  
Habibolah Khazaie ◽  
Dena Sadeghi-Bahmani ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Multiple Regression ◽  
Daytime Sleepiness ◽  
Respiratory Disturbance Index ◽  
Disturbance Index ◽  
Related Data ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
Respiratory Disturbance

Objective: Individuals with obstructive sleep apnea (OSA) are at increased risk to suffer from further somatic and sleep-related complaints. To assess OSA, demographic, anthropometric, and subjective/objective sleep parameters are taken into consideration, but often separately. Here, we entered demographic, anthropometric, subjective, and objective sleep- and breathing-related dimensions in one model. Methods: We reviewed the demographic, anthropometric, subjective and objective sleep- and breathing-related data, and polysomnographic records of 251 individuals with diagnosed OSA. OSA was considered as a continuous and as categorical variable (mild, moderate, and severe OSA). A series of correlational computations, X2-tests, F-tests, and a multiple regression model were performed to investigate which demographic, anthropometric, and subjective and objective sleep dimensions were associated with and predicted dimensions of OSA. Results: Higher apnea/hypopnea index (AHI) scores were associated with higher BMI, higher daytime sleepiness, a higher respiratory disturbance index, and higher snoring. Compared to individuals with mild to moderate OSA, individuals with severe OSA had a higher BMI, a higher respiratory disturbance index (RDI) and a higher snoring index, while subjective sleep quality and daytime sleepiness did not differ. Results from the multiple regression analysis showed that an objectively shorter sleep duration, more N2 sleep, and a higher RDI predicted AHI scores. Conclusion: The pattern of results suggests that blending demographic, anthropometric, and subjective/objective sleep- and breathing-related data enabled more effective discrimination of individuals at higher risk for OSA. The results are of practical and clinical importance: demographic, anthropometric, and breathing-related issues derived from self-rating scales provide a quick and reliable identification of individuals at risk of OSA; objective assessments provide further certainty and reliability.

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