Comparing respiratory polygraphy with pulse transit time analysis versus overnight polysomnography in the diagnosis of obstructive sleep apnoea in children

Abstract To evaluate the value of apnoea + hypopnoea index versus self-reported sleepiness at the wheel in anticipating the risk of sleepiness-related accidents in patients referred for obstructive sleep apnoea. A cross-sectional analysis of the French national obstructive sleep apnoea registry. 58,815 subjects referred for a suspicion of obstructive sleep apnoea were investigated by specific items addressing sleepiness at the wheel and sleepiness-related accidents. Apnoea + hypopnoea index was evaluated with a respiratory polygraphy or full polysomnography. Subjects had a median age of 55.6 years [45.3; 64.6], 65% were men, with a median apnoea + hypopnoea index of 22 [8; 39] events/h. Median Epworth sleepiness scale score was 9 [6; 13], 35% of the patients reported sleepiness at the wheel (n = 20,310), 8% (n = 4,588) reported a near-miss accident and 2% (n = 1,313) reported a sleepiness-related accident. Patients reporting sleepiness at the wheel whatever their obstructive sleep apnoea status and severity exhibited a tenfold higher risk of sleepiness-related accidents. In multivariate analysis, other predictors for sleepiness-related accidents were: male gender, ESS, history of previous near-miss accidents, restless leg syndrome/periodic leg movements, complaints of memory dysfunction and nocturnal sweating. Sleep apnoea per se was not an independent contributor. Self-reported sleepiness at the wheel is a better predictor of sleepiness-related traffic accidents than apnoea + hypopnoea index.

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Is there an association between altered baroreceptor sensitivity and obstructive sleep apnoea in the healthy elderly?

ERJ Open Research ◽

10.1183/23120541.00072-2016 ◽

2016 ◽

Vol 2 (3) ◽

pp. 00072-2016 ◽

Cited By ~ 2

Author(s):

Emilia Sforza ◽

Magali Saint Martin ◽

Jean Claude Barthélémy ◽

Frédéric Roche

Keyword(s):

Obstructive Sleep Apnoea ◽

Diastolic Pressure ◽

Sleep Apnoea ◽

Elderly Subjects ◽

Healthy Elderly ◽

Obstructive Sleep ◽

Baroreceptor Reflex Sensitivity ◽

Respiratory Polygraphy ◽

Mild Impairment ◽

Healthy Elderly Subjects

Obstructive sleep apnoea (OSA) is associated with a rise in cardiovascular risk in which increased sympathetic activity and depressed baroreceptor reflex sensitivity (BRS) have been proposed. We examined this association in a sample of healthy elderly subjects with unrecognised OSA.801 healthy elderly (aged ≥65 years) subjects undergoing clinical, respiratory polygraphy and vascular assessment were examined. According to the apnoea–hypopnoea index (AHI), the subjects were stratified into no OSA, mild–moderate OSA and severe OSA cases.OSA was present in 62% of the sample, 62% being mild–moderate and 38% severe. No differences were found for BRS value according to sex and OSA severity. 54% of the group had normal BRS value, 36% mild impairment and 10% severe dysfunction. BRS was negatively associated with body mass index (p=0.006), 24-h systolic (p=0.001) and diastolic pressure (p=0.001), and oxygen desaturation index (ODI) (p=0.03). Regression analyses revealed that subjects with lower BRS were those with hypertension (OR 0.41, 95% CI 0.24–0.81; p=0.002) and overweight (OR 0.42, 95% CI 0.25–0.81; p=0.008), without the effect of AHI and ODI.In the healthy elderly, the presence of a severe BRS dysfunction affects a small amount of severe cases without effect on snorers and mild OSA. Hypertension and obesity seem to play a great role in BRS impairment.

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