Beyond the apnea hypopnea index (AHI): importance of sleep quality management of obstructive sleep apnea (OSA) and related mortality in patients with cardiovascular disease

2019 ◽  
Vol 64 ◽  
pp. S155
Author(s):  
H. Hilmisson ◽  
S. Magnusdottir
Keyword(s):  
Cardiovascular Disease ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Quality Management ◽  
Sleep Quality ◽  
Apnea Hypopnea Index ◽  
Obstructive Sleep ◽  
Related Mortality

scholarly journals 0936 Sleep Disturbances in Wolfram Syndrome

SLEEP ◽  
2019 ◽  
Vol 42 (Supplement_1) ◽  
pp. A376-A377
Author(s):  
Amy K Licis ◽  
Gabriel Davis ◽  
Sarah Eisenstein ◽  
Heather Lugar ◽  
Tamara Hershey
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Quality ◽  
Rating Scale ◽  
Wolfram Syndrome ◽  
High Rate ◽  
Apnea Hypopnea Index ◽  
Diabetes Research ◽  
Sleep Study ◽  
Obstructive Sleep

Abstract Introduction Wolfram syndrome is a rare disorder associated with diabetes mellitus, diabetes insipidus, optic nerve atrophy, hearing and vision loss, and neurodegeneration. Sleep complaints are common but have not been studied with objective measures. Our goal was to assess rates of sleep apnea and objective and self-reported measures of sleep quality, and to determine the relationship of sleep pathology to other clinical variables in Wolfram syndrome patients. Methods Genetically confirmed Wolfram syndrome patients were evaluated at the 2015 and 2016 Washington University Wolfram Syndrome Research Clinics. Patients wore an actigraphy device and a type III ambulatory sleep study device and completed the Epworth Sleepiness Scale (ESS), the Pittsburgh Sleep Quality Index (PSQI) and/or the Pediatric Sleep Questionnaire (PSQ). PSQI and PSQ questionnaire data were compared to a previously collected group of controls. Patients were characterized clinically with the Wolfram Unified Rating Scale (WURS) and a subset underwent magnetic resonance imaging (MRI) for brain volume measurements. Results Twenty-one patients were evaluated ranging from age 8.9 - 29.7 years. Five of 17 (29%) adult patients fit the criteria for obstructive sleep apnea (OSA; apnea-hypopnea index [AHI] ≥ 5) and all 4 of 4 (100%) children aged 12 years or younger fit the criteria for obstructive sleep apnea (AHI’s ≥1). Higher AHI was related to greater disease severity (higher WURS Physical scores). Higher mixed apnea scores were related to lower brainstem and cerebellar volumes. Patients’ scores on the PSQ were higher than those of controls, indicating greater severity of childhood obstructive sleep-related breathing disorders. Conclusion Wolfram syndrome patients had a high rate of OSA. Further study would be needed to assess how these symptoms change over time. Addressing sleep disorders in Wolfram syndrome patients would likely improve their overall health and quality of life. Support (If Any) This work was supported by the NICHD (HD070855; Hershey, PI) and supported by CTSA (UL1 RR024992) and Diabetes Research Center (DK 020579).

scholarly journals Identifying Obstructive Sleep Apnea Subtypes and Its Correlation With Mood States

2021 ◽  
Vol 3 (3) ◽  
pp. 120-125
Author(s):  
Hyo Jin Kim ◽  
Jae-Won Choi ◽  
Eun-Jeong Joo ◽  
Kyu Young Lee ◽  
Soo-Young Bhang ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Quality ◽  
Medical Center ◽  
Optimal Number ◽  
Mood States ◽  
Self Report ◽  
Apnea Hypopnea Index ◽  
Obstructive Sleep ◽  
Cluster 2

Objective: It has been difficult to establish specific subtypes of obstructive sleep apnea (OSA) due to the heterogeneous nature of the disor- der. Previous studies have attempted to exact clinical subgroups or phenotypes of the disorder. However, the psychiatric impact of OSA has been often overlooked, and thus, this study used cluster analysis to examine subgroups of OSA incorporating mood states.Methods: This study is comprised of 346 adult OSA patients (apnea-hypopnea index, AHI≥5) who underwent polysomnography at Nowon Eulji Medical Center from January 2003 to November 2012. Their data also included validated self-report questionnaires that evaluate daytime sleepi- ness, sleep quality, morningness-eveningness, and mood states: Epworth Sleepiness Scale, Korean version of the Pittsburgh Sleep Quality In- dex (PSQI-K), Horne and Östberg Questionnaire, and Korean edition of Profile of Mood States (K-POMS), respectively. A K-means cluster analy- sis was performed to determine the optimal number of clusters and characteristics.Results: We identified three clusters: cluster 1, moderately symptomatic OSA with the least disturbed mood (n=166); cluster 2, severely symptomatic OSA not so disturbed mood (n=90); cluster 3, moderately symptomatic with highest disturbed mood (n=90). Cluster 1 had the lowest AHI and the lowest K-POMS total scores. Cluster 2, despite having the most severe OSA parameters, did not show mood disturbances. Cluster 3 had the highest K-POMS total scores and PSQI-K scores.Conclusion: Certain individuals with OSA are more likely to suffer from disturbed mood states without serious OSA indices. Psychiat- ric manifestations should also be considered when determining the severity of the disorder.

scholarly journals Treatment Success with Titratable Thermoplastic Mandibular Advancement Devices for Obstructive Sleep Apnea: A Comparison of Patient Characteristics

2017 ◽  
Vol 96 (3) ◽  
pp. E25-E32 ◽  
Author(s):  
Tang-Chuan Wang ◽  
Yung-An Tsou ◽  
Yi-Fan Wu ◽  
Chia-Chang Huang ◽  
Wesley Wen-Yang Lin ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Visual Analogue Scale ◽  
Sleep Quality ◽  
Analogue Scale ◽  
Treatment Success ◽  
Mandibular Advancement ◽  
Apnea Hypopnea Index ◽  
Obstructive Sleep ◽  
Mandibular Advancement Devices

A titratable thermoplastic mandibular advancement devices (MAD) is clearly an effective treatment option in some patients with obstructive sleep apnea (OSA). Determining which patients may be more likely to respond to treatment with thermoplastic MADs and to adhere to treatment would be of obvious clinical relevance. This was an experimental descriptive study (N = 60). Patients with OSA were instructed to wear a titratable thermoplastic MAD for 3 months. Treatment success was defined as a ≥50% reduction from baseline in the apnea-hypopnea index (AHI) or AHI <10 when wearing MAD. Adherence was defined as MAD use ≥5 nights/week. Treatment was successful in 66.7% of patients and 60.0% were adherent. All Polysomnographic parameters and visual analogue scale scores (sleep quality, snoring, waking refreshed) were significantly improved after treatment. The patients in whom treatment failed had significantly higher neck circumferences (39.3 cm vs. 37.5 cm, p = 0.014), higher baseline AHI values (26.6 vs. 18.0, p = 0.016), and smaller AHI reduction (-31.8 vs -53.1, p < 0.001) than those in the group in whom treatment succeeded. There were no significant differences in Polysomnographic, cephalometric, or visual analogue scale measures between patients for whom treatment was and was not successful, regardless of baseline values or the change rates after the MAD was placed. Titratable thermoplastic MADs can improve indicators of sleep quality, even in patients in whom treatment is considered to have failed.

scholarly journals Obstructive Sleep Apnea in a Clinical Population: Prevalence, Predictive Factors and Clinical Characteristics of Patients Referred to a Sleep Center in Mongolia

2021 ◽  
Vol 18 (22) ◽  
pp. 12032
Author(s):  
Shuren Dashzeveg ◽  
Yasunori Oka ◽  
Munkhjin Purevtogtokh ◽  
Enkhnaran Tumurbaatar ◽  
Battuvshin Lkhagvasuren ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Waist Circumference ◽  
Sleep Quality ◽  
Clinical Population ◽  
Apnea Hypopnea Index ◽  
Assessment Data ◽  
Cross Sectional ◽  
Population Prevalence ◽  
Obstructive Sleep

Obstructive sleep apnea (OSA) disrupts sleep. This study examined factors related to OSA severity. A cross-sectional, prospective, hospital-based study was conducted with 205 patients who underwent polysomnography (PSG). Demographic, anthropometric, clinical, PSG, and sleep quality assessment data were analyzed. Participants (N = 205) were classified into four groups based on apnea–hypopnea index (AHI); no OSA (AHI <5/h; N = 14), mild (mOSA, 5< AHI <15/h; N = 50), moderate (modOSA, 15 <AHI <30/h; N = 41), severe (sOSA, 30 <AHI <60/h; N = 50), and very severe (vsOSA, AHI ≥ 60; N = 50). Men had more severe OSA than women (p < 0.001). Anthropometric characteristics differed with OSA severity (p < 0.001). OSA patients had decreased sleep quality and increased excessive daytime sleepiness (EDS). Body mass index (BMI), neck/waist circumference, and blood pressure (BP) differed between groups (p < 0.001). Patients with vsOSA had the highest Mallampati grades (p < 0.001). Multiple linear regression indicated that OSA severity was related to gender and sleep quality. PSG parameters (oxygen saturation, systolic BP, and arousal/respiratory arousal) were strongly related to OSA severity. In conclusion, about half of study-referred patients had severe/very severe OSA; these groups were predominantly obese men with high BP. OSA severity associated with high BP, BMI, waist circumference, and neck circumference.

scholarly journals Sleep Disturbance and Depressive Tendency in Bed Partners of Patients With Obstructive Sleep Apnea

2021 ◽  
Author(s):  
Chien-Ming Chu ◽  
Shao-Yun Wu ◽  
Chung-Chieh Yu ◽  
Chih-Yu Huang
Keyword(s):  
Obstructive Sleep Apnea ◽  
Chronic Disease ◽  
Sleep Apnea ◽  
Sleep Quality ◽  
Sleep Disturbance ◽  
Apnea Hypopnea Index ◽  
Poor Sleep ◽  
Obstructive Sleep ◽  
The Mean ◽  
Depressive Tendency

Abstract Snoring, apnea, and arousal are commonly observed during sleep in patients with obstructive sleep apnea (OSA), and these nocturnal symptoms frequently disturb their bed partners. We aimed to evaluate the sleep disturbance and depressive tendency in the bed partners of patients with OSA. A cross-sectional, prospective study was conducted. A total of 136 patients with OSA and their bed partners were recruited. We analyzed the demographic data of both patients with OSA and bed partners and the polysomnography parameters of patients with OSA. The sleep quality of bed partners was assessed using the Chinese version of the Pittsburgh Sleep Quality Index (PSQI), and depressive symptoms were evaluated using the Center for Epidemiologic Studies Depression Scale (CES-D). The mean apnea–hypopnea index (AHI) was 43.5/h among all participants (76.5% male). Among bed partners, the mean PSQI score was 7.8 and the mean CES-D score was 15.4. The prevalence of chronic disease was significantly higher in bed partners with sleep disturbance (PSQI > 5) and depressive tendency (CES-D ≥ 16). The AHI and snore index of patients with OSA were not associated with bed partners’ sleep disturbance and depressive tendency, which were stratified according to PSQI (> 5 and ≤ 5) and CES-D (≥ 16 and < 16), respectively. The CES-D score was positively correlated with the PSQI score in the bed partners of patients with OSA (r = 0.426, p < 0.001). Bed partners tended to have sleep disturbance, which was unrelated to the severity of AHI and snoring in patients with OSA. Poor sleep quality may cause depressive tendency and chronic disease in the bed partners of patients with OSA.

Improvement in Obstructive Sleep Apnea (OSA) in Super Morbidly Obese Patients After Bariatric Surgery

2020 ◽  
Vol 103 (8) ◽  
pp. 725-728
Keyword(s):  
Bariatric Surgery ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Lifestyle Modification ◽  
Apnea Hypopnea Index ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Obstructive Sleep ◽  
Objective Evidence

Background: Lifestyle modification is the mainstay therapy for obese patients with obstructive sleep apnea (OSA). However, most of these patients are unable to lose the necessary weight, and bariatric surgery (BS) has been proven to be an effective modality in selected cases. Objective: To provide objective evidence that BS can improve OSA severity. Materials and Methods: A prospective study was conducted in super morbidly obese patients (body mass index [BMI] greater than 40 kg/m² or BMI greater than 35 kg/m² with uncontrolled comorbidities) scheduled for BS. Polysomnography (PSG) was performed for preoperative assessment and OSA was treated accordingly. After successful surgery, patients were invited to perform follow-up PSG at 3, 6, and 12 months. Results: Twenty-four patients with a mean age of 35.0±14.0 years were enrolled. After a mean follow-up period of 7.8±3.4 months, the mean BMI, Epworth sleepiness scale (ESS), and apnea-hypopnea index (AHI) significantly decreased from 51.6±8.7 to 38.2±6.8 kg/m² (p<0.001), from 8.7±5.9 to 4.7±3.5 (p=0.003), and from 87.6±38.9 to 28.5±21.5 events/hour (p<0.001), respectively. Conclusion: BS was shown to dramatically improve clinical and sleep parameters in super morbidly obese patients. Keywords: Morbid obesity, Bariatric surgery, Obstructive sleep apnea (OSA)

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