Epidemiologic Profile of Patients with Snoring and Obstructive Sleep Apnea in a University Hospital

Aim: Our study was done to evaluate the role of Endoscopic posterior midline partial glossectomy as a surgical modality for the hypopharyngeal collapse in obstructive sleep apnea patients. Study design: Prospective case series study. Place and Duration of Study: Tanta university hospital, otolaryngology department, from October 2017 till March 2019. Methodology: This was a prospective case series study, conducted on 10 patients from 2017 -2019 with tongue base collapse and normal craniofacial angles, the patients were evaluated preoperative and 6 months postoperative subjectively by Epworth sleepiness scale (ESS) and objectively by polysomnography and lateral cephalometry. Results: Our study included 10 patients with age (mean ± SD48.70±4.08), BMI( mean ±SD24.45±1.56), 5 patients showed a significant reduction in AHI with a success rate of 50% with a significant change in ESS and the non-significant changes in cephalometric parameters. Conclusion: Transoral endoscopic posterior midline partial glossectomy can improve the surgical outcomes of obstructive sleep apnea patients.

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Obstructive sleep apnea is an independent risk factor for severe COVID-19: a population-based study

SLEEP ◽

10.1093/sleep/zsab272 ◽

2021 ◽

Author(s):

Kristján Godsk Rögnvaldsson ◽

Elías Sæbjörn Eyþórsson ◽

Össur Ingi Emilsson ◽

Björg Eysteinsdóttir ◽

Runólfur Pálsson ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Risk Factor ◽

Sleep Apnea ◽

Population Based ◽

Community Dwelling ◽

University Hospital ◽

Logistic Regression Models ◽

Icelandic Population ◽

Obstructive Sleep ◽

National University

Abstract Study Objectives Obstructive sleep apnea (OSA) has been proposed as a risk factor for severe COVID-19. Confounding is an important consideration as OSA is associated with several known risk factors for severe COVID-19. Our aim was to assess the association of OSA with hospitalization due to COVID-19 using a population-based cohort with detailed information on OSA and comorbidities. Methods Included were all community-dwelling Icelandic citizens 18 years of age and older diagnosed with SARS-CoV-2 infection in 2020. Data on demographics, comorbidities, and outcomes of COVID-19 was obtained from centralized national registries. Diagnosis of OSA was retrieved from the centralized Sleep Department Registry at Landspitali–The National University Hospital. Severe COVID-19 was defined as the composite outcome of hospitalization and death. The associations between OSA and the outcome were expressed as odds ratios (OR) with 95% confidence intervals (95% CI), calculated using logistic regression models and inverse probability weighting. Results A total of 4,756 individuals diagnosed with SARS-CoV-2 infection in Iceland were included in the study (1.3% of the Icelandic population), of whom 185 had a diagnosis of OSA. In total, 238 were hospitalized or died, 38 of whom had OSA. Adjusted for age, sex, and BMI, OSA was associated with poor outcome (OR 2.2, 95% CI 1.4 -3.5). This association was slightly attenuated (OR 2.0, 95% CI 2.0, 1.2-3.2) when adjusted for demographic characteristics and various comorbidities. Conclusions OSA was associated with twofold increase in risk of severe COVID-19, and the association was not explained by obesity or other comorbidities.

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IDENTIFICATION OF OBSTRUCTIVE SLEEP APNEA USING ARTIFICIAL NEURAL NETWORKS AND WAVELET PACKET DECOMPOSITION OF THE HRV SIGNAL

The Journal of Engineering Research [TJER] ◽

10.24200/tjer.vol17iss1pp24-33 ◽

2020 ◽

Vol 17 (1) ◽

pp. 24

Author(s):

Abdulnasir Hossen ◽

Sarah Qasim

Keyword(s):

Neural Network ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Probabilistic Neural Network ◽

Wavelet Packet ◽

Back Propagation ◽

Normal Subjects ◽

University Hospital ◽

Feedforward Network ◽

Obstructive Sleep

The advancement of telecommunication technologies has provided us with new promising alternatives for remote diagnosis and possible treatment suggestions for patients of diverse health disorders, among which is the ability to identify Obstructive Sleep Apnea (OSA) syndrome by means of Electrocardiograph (ECG) signal analysis. In this paper, the standard spectral bands’ powers and statistical interval-based parameters of the Heart Rate Variability (HRV) signal were considered as a form of features for classifying the Sultan Qaboos University Hospital (SQUH) database for OSA syndrome into 4 different levels. Wavelet packet analysis was applied to obtain and estimate the standard frequency bands of the HRV signal. Further, the single perceptron neural network, the feedforward with back-propagation neural network and the probabilistic neural network have been implemented in the classification task. The classification between normal subjects versus severe OSA patients achieved 95% accuracy with the probabilistic neural network. While the classification between normal subjects versus mild OSA subjects reached accuracy of 95% also. When grouping mild, moderate and severe OSA subjects in one group compared to normal subjects as a second group, the classification with the feedforward network achieved an accuracy of 87.5%. Finally, when classifying subjects directly into one of the four classes (normal or mild or moderate or severe), a 77.5% accuracy was achieved with the feedforward network.

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Comparative Study of Clinical and Polysomnographic Characteristics of Obstructive Sleep Apnea Among Obese and Non-Obese Patients at Chiang Mai University Hospital

Biomedical Journal of Scientific & Technical Research ◽

10.26717/bjstr.2019.14.002608 ◽

2019 ◽

Vol 14 (5) ◽

Author(s):

Theerakorn Theerakittikul

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Comparative Study ◽

University Hospital ◽

Obese Patients ◽

Chiang Mai ◽

Obstructive Sleep

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Interrelationship among Obstructive Sleep Apnea, Renal Function and Survival: A Cohort Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17144922 ◽

2020 ◽

Vol 17 (14) ◽

pp. 4922

Author(s):

Patrizia Pochetti ◽

Danila Azzolina ◽

Beatrice Ragnoli ◽

Paolo Amedeo Tillio ◽

Vincenzo Cantaluppi ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Renal Function ◽

Cohort Study ◽

Sleep Apnea ◽

University Hospital ◽

Rank Test ◽

P Value ◽

Renal Function Decline ◽

Obstructive Sleep

Previous studies showed a bidirectional relationship between renal function decline and obstructive sleep apnea (OSA) syndrome. Continuous Positive Airway Pressure (C-PAP) treatment was shown to preserve the kidney function in OSA patients. This study aims to investigate the progression of long-term renal function in OSA patients treated with different PAP strategies (patients were divided into two groups, fixed C-PAP or other PAP—automatic and bilevel pressure). Comorbidities and 10-years survival were also evaluated. We performed a retrospective, observational, single-center, cohort study, including the first 40 consecutive patients enrolled from 2009 in the Respiratory disease Unit at the Vercelli University Hospital database. The patient inclusion criteria were: age ≥ 18 years with OSA syndrome according to AASM (American Academy of Sleep Medicine) guidelines. Creatinine serum levels (mg/dL) and the estimated Glomerular Filtration Rate (eGFR, mL/min calculated by CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration equation)) were measured at 3 different time points: at baseline, 3 years and 8 years after PAP treatment. The Kaplan–Meier survival curves stratified according to PAP treatment and compliance have been reported together with log-rank test estimation. In our study, we found a significant creatinine serum level reduction after 3 years of fixed C-PAP treatment (p value = 0.006) when compared to baseline values. However, we observed that the long-term C-PAP benefit was not significant (p value = 0.060). Our data confirmed the progressive renal function decline in OSA patients, especially in those using other-PAP treatments; nevertheless, OSA treatment with a fixed C-PAP device has shown, in the short term, a significant improvement in renal function. By contrast, in our study, long-term benefits after 8 years are not been demonstrated probably because of the lack of compliance of the patients and the aging effect.

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Predictors of obstructive sleep apnea misclassification using total bed time versus total sleep time: an evaluation using polysomnography data

10.21203/rs.3.rs-219251/v1 ◽

2021 ◽

Author(s):

Wei Yang Lim ◽

Kay Choong See

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Total Sleep Time ◽

Significant Risk ◽

Sleep Time ◽

Tertiary Hospital ◽

University Hospital ◽

Obstructive Sleep ◽

National University ◽

Using Data

Abstract Background and Objective Obstructive sleep apnea (OSA) is a highly prevalent condition worldwide. Untreated, it is associated with multiple medical complications as well as a reduced quality of life. Home sleep apnea tests are increasingly used for its diagnosis and evaluation of severity, but using total bed time rather than total sleep time may underestimate OSA severity. We aim to uncover the extent and predictors of OSA misclassification when using total bed time. Methods A retrospective observational study was conducted using data from the sleep laboratory of the National University Hospital, Singapore, a tertiary hospital with 1200 beds. Misclassification of OSA was defined as any OSA severity that was less severe using total bed time versus total sleep time. Logistic regression was used to identify predictors of OSA misclassification.Results A total of 1621 patients were studied (mean age 45.6 + 15.9 years; 73.4% male). 300 (18.5%) patients were misclassified. Risk factors for OSA misclassification included age (OR 1.02, 95% CI 1.01-1.03, P=0.001) and body-mass index (BMI) (OR 0.97,95% CI 0.95-0.99, P=0.015). Risk for misclassification was significant in patients aged>57 years old, with BMI<32.3 kg/m2. Conclusion Using total bed time rather than total sleep time to quantify OSA severity was associated with a significant risk of misclassification, particularly in patients aged >57 years old, with BMI <32.3 kg/m2. This was a novel finding that has not been previously reported.

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Assessment of the Effectiveness of Obstructive Sleep Apnea Treatment Using Optical Coherence Tomography to Evaluate Retinal Findings

10.20944/preprints202112.0284.v1 ◽

2021 ◽

Author(s):

Gloria Tejero-Garcés ◽

Francisco J Ascaso ◽

Paula Casas ◽

Maria I Adiego ◽

Peter Baptista ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Optical Coherence Tomography ◽

Sleep Apnea ◽

Retinal Thickness ◽

Sleep Apnea Syndrome ◽

University Hospital ◽

Optical Coherence ◽

Fiber Layer ◽

Obstructive Sleep ◽

Prospective Comparative Study

Retinal findings may change in patients with obstructive sleep apnea syndrome (OSAS). The present study aims to evaluate several retinal findings such as macula layer thickness, peripapillary retinal nerve fiber layer, and the optic nerve head in patients with OSAS using optical coherence tomography (OCT) and monitor the result of several types of treatment of OSAS with OCT. A prospective comparative study was designed. Patients were recruited at a Sleep Unit of a University Hospital and underwent comprehensive ophthalmological examinations. Following exclusion criteria, fifty-two patients with OSAS were finally included. Patients were examined by OCT twice: first, before treatment; secondly, after six months of treatment. In mild-moderate patients, where retinal swelling has been demonstrated, retinal thicknesses decreased [fovea (p=0.026), as well as inner ring macula (p=0.007), outer ring macula (p=0.015), and macular volume (p=0.015)]. In severe patients, where retinal atrophy had been observed, retinal thickness increased [fovea (p&lt;0.001)]. No statistically significant differences in efficacy between treatments were demonstrated. In conclusion, OCT can evaluate the retina in patients with OSAS and help monitor results after treatment. In severe OSAS, retinal thickness increased six months after treatment.

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Decreased maxillary sinus volume is a potential predictor of obstructive sleep apnea

The Angle Orthodontist ◽

10.2319/080819-520.1 ◽

2020 ◽

Vol 90 (4) ◽

pp. 556-563

Author(s):

Yoon-Ji Kim ◽

Hyung-Kyun Shin ◽

Dong-Yul Lee ◽

Jae-Jun Ryu ◽

Tae Hoon Kim

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Maxillary Sinus ◽

High Body Mass Index ◽

Normal Subjects ◽

University Hospital ◽

Nasal Airway ◽

Maxillary Sinus Volume ◽

Obstructive Sleep ◽

Maxillary Sinuses

ABSTRACT Objectives To investigate the associations between nasal airway volume and the presence and severity of obstructive sleep apnea (OSA) in adults. Materials and Methods The medical records of adult patients who visited the sleep clinic at University Hospital between June 2013 and April 2017 and underwent overnight polysomnography for the diagnosis of obstructive sleep apnea were reviewed retrospectively. Using computed tomography, the volumes of the nasal airways and maxillary sinuses were measured, and associations with the presence and severity of OSA were analyzed while controlling for the effects of possible confounders such as lateral cephalometric variables, maxillary widths, tongue/hyoid position, and soft palate dimensions. Results Comparison between normal subjects and patients with OSA revealed that the latter had decreased ratios of maxillary sinus volume to whole nasal airway volume (P = .029) than normal subjects. OSA severity was greater in those with inferior positions of the hyoid (P = .010), in older patients (P = .011), and in those with high body mass index (P = .001). The volume of the total nasal airway or maxillary sinuses were not associated with OSA severity. Conclusions A decreased ratio of maxillary sinus volume to whole nasal airway volume is associated with adult OSA. However, OSA severity is not associated with either maxillary sinus volume or whole nasal airway volume.

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