Acromegaly and Obstructive Sleep Apnea: Identifying the High-Risk Group

Abstract: Aim: To screen cases who are at high risk and low risk for obstructive sleep apnea in general surgery patients. Materials & Methods: It is a cross-sectional study. It was done in Liaquat National Hospital from January 2019 to June 2019. After institutional approval, 335 patients were included in this study, who presented to general surgery OPD. STOP-BANG questionnaire was used to screen cases who are at high risk and low risk for obstructive sleep apnea in general surgery patients. Results: 335 patients were screened and 38.5% of individuals in population had age of more than 50 years. In this population 149(44.5%) of patients were male. Out of 335 patients, 135(40.3%) of them were found to have high risk of obstructive sleep apnea while the remaining 199(59.7%) were classified in low risk group. All of the parameters of STOP-bang questionnaire including age (p<0.001), gender (p=0.026), BMI (p<0.001), snoring (p<0.001), tiredness (p<0.001), sleep apnea (p=0.001), diastolic blood pressure (p<0.001) and neck circumference (p<0.001) were significantly different between high risk and low risk patients. Conclusion: This study can provide a catalyst for more meticulous screening for OSA preoperatively to diagnose high risk group. Keywords: Sleep Apnea, Obstructive, Care, Preoperative, Surgery, General, Operative Procedures.

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Preeclampsia and Baby Complications Correlated to High-Risk Score for Obstructive Sleep Apnea Screen by STOPBang Questionnaire

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2021.06.11400 ◽

2021 ◽

Vol 104 (6) ◽

pp. 927-933

Keyword(s):

At Risk ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

High Risk ◽

Risk Group ◽

High Risk Group ◽

Low Risk ◽

Maternal Complications ◽

Neonatal Complications ◽

Obstructive Sleep

Background: Obstructive sleep apnea (OSA) has been postulated as a risk factor for adverse maternal-fetal outcomes, especially preeclampsia. The physiological changes during pregnancy predispose a woman “at risk” towards developing OSA. Therefore, incidence of OSA may increase among pregnant population. STOP-Bang has been postulated as an acceptable screening tool for OSA in obstetric population. Objective: To identify the correlation between preeclampsia and patients who were at risk of OSA, based on STOP-Bang, Berlin, and Epworth sleepiness scale. Materials and Methods: A diagnostic prediction research was conducted using cross-sectional approach. Patients, who have STOP-Bang score of 3 or more and less than 3, were categorized as high-risk and low-risk for OSA, respectively. The relationship between high-risk OSA patients and preeclampsia were evaluated using logistic regression. Results: Seven hundred and three patients were included, and 47 patients (6.7%) were diagnosed preeclampsia. Six hundred fifty and 53 patients were classified as low-risk and high-risk for OSA, respectively. Fifty percent of the high-risk group were complicated with preeclampsia compared with 2.8% in low-risk group. The odd ratio (OR) of having preeclampsia in high-risk group was 32.6 (95% CI 16.1 to 66.1). The pregnant women, classified as high-risk, were associated with neonatal complications by OR 3.4 (95% CI 1.4 to 8.2) but not maternal complications. Conclusion: Among pregnant population, a STOP-Bang score of 3 or more is associated with the occurrence of preeclampsia and neonatal complications. Keywords: STOP-Bang questionnaire; Obstructive sleep apnea; Pregnancy; Preeclampsia

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Short term cognitive function after sevoflurane anesthesia in patients suspect to obstructive sleep apnea syndrome: an observational study

BMC Anesthesiology ◽

10.1186/s12871-021-01363-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Soeren Wagner ◽

Lorenz Sutter ◽

Fabian Wagenblast ◽

Andreas Walther ◽

Jan-Henrik Schiff

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Cognitive Function ◽

High Risk ◽

Observational Study ◽

Risk Group ◽

Sleep Apnea Syndrome ◽

Obstructive Sleep ◽

Risk Patients ◽

Apnea Syndrome

Abstract Background The obstructive sleep apnea syndrome (OSAS) is characterized by intermittent cerebral hypoxia which can cause cognitive alterations. Likewise, hypoxia induced neurocognitive deficits are detectable after general anesthesia using volatile anesthetics. The objective of this study was to evaluate the association between a moderate to high risk patients of OSAS and postoperative cognitive dysfunction after volatile anesthesia. Methods In this single center prospective, observational study between May 2013 and September 2013, 46 patients aged 55 to 80 years with an estimated hospital stay of at least 3 days undergoing surgery were enrolled. Patients were screened using the STOP-BANG test with score of 3 or higher indicating moderate to high risk of OSAS. The cognitive function was assessed using a neuropsychological assessment battery, including the DemTect test for cognitive impairment among other tests e.g. SKT memory, the day before surgery and within 2 days after extubation. Results Twenty-three of the 46 analyzed patients were identified with a moderate to high risk of OSAS. When comparing post- to preoperative phase a significant better performance for the SKT was found for both groups (p < 0.001). While the moderate to high risk group scores increased postoperative in the DemTect test, they decreased in the low risk group (p < 0.003). When comparing the changes between groups, the moderate to high risk patients showed significant better test result for DemTect testing after anaesthesia. This effect remained robust when adjusting for potential confounding variables using a two-factor ANOVA. Conclusion Compared to low risk, a moderate to high risk of OSAS based on the STOP-BANG score was associated with improved postoperative cognitive function measured by the DemTect test. Trial registration The study was approved by the local Ethics committee (Ethikkommission der Medizinischen Fakultät der Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany) (reference number: 87_12 B) on 19.04.2012.

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420 Evaluating the Rate of Referral for Obstructive Sleep Apnea in a Pre-Doctoral Dental Clinic Using the STOP-Bang Questionnaire

SLEEP ◽

10.1093/sleep/zsab072.419 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A166-A166

Author(s):

Nathan Guess ◽

Henry Fischbach ◽

Andy Ni ◽

Allen Firestone

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

High Risk ◽

Electronic Health Record ◽

Health Record ◽

Dental Clinic ◽

Neck Size ◽

Previous Diagnosis ◽

Obstructive Sleep ◽

Electronic Health

Abstract Introduction The STOP-Bang Questionnaire is a validated instrument to assess an individual’s risk for obstructive sleep apnea (OSA). The prevalence of OSA is estimated at 20% in the US with only 20% of those individuals properly diagnosed. Dentists are being asked to screen and refer patients at high risk for OSA for definitive diagnosis and treatment. The aim of this study was to determine whether patients in a dental school student clinic who were identified as high-risk for OSA, were referred for evaluation of OSA. Methods All new patients over the age of 18 admitted to The Ohio State University - College of Dentistry complete an “Adult Medical History Form”. Included in this study were 21,312 patients admitted between July 2017 and March 2020. Data were extracted from the history form to determine the STOP-Bang Score for all patients: age, sex, BMI, self-reported snoring-, stopped breathing/choking/gasping while sleeping-, high blood pressure-, neck size over 17” (males) or 16” (females)-, and tiredness. Each positive response is a point, for a maximum of 8 points possible. Additionally, any previous diagnosis of sleep apnea, and the patient’s history of referrals were extracted from the health record. According to clinic policy, if the patient did not have a previous diagnosis for OSA noted in the health history, and scored 5 or more on the STOP-Bang Questionnaire, they should receive a referral for an evaluation for OSA. Notes and referral forms were reviewed to determine if the appropriate referrals occurred for patients at high risk without a previous diagnosis. Results Of the 21,312 patients screened; 1098 (5.2%) screened high-risk for OSA, of which 398 had no previous diagnosis of OSA. Of these 398 patients, none (0%) had referrals for further evaluation for OSA. Conclusion The rate of appropriate referrals from a student dental clinic with an electronic health record was unacceptably low. Continued education and changes to the electronic health record are needed to ensure those at high-risk for OSA are appropriately referred and managed. Support (if any):

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480 Cardiovascular and metabolic risk in patients with suspected comorbid insomnia and obstructive sleep apnea (COMISA)

SLEEP ◽

10.1093/sleep/zsab072.479 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A189-A190

Author(s):

Miguel Meira e Cruz ◽

Luana Seixas ◽

Augusto Santos ◽

João Garrido ◽

Yuri Lopes ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

High Risk ◽

Arterial Hypertension ◽

Sleep Time ◽

Comorbid Condition ◽

Therapeutic Success ◽

Comorbid Insomnia ◽

Systemic Arterial Hypertension ◽

Obstructive Sleep

Abstract Introduction Only few studies looked for a possible association of cardiovascular disorders (CVD), in comorbid insomnia with obstructive sleep apnea (COMISA) even though this is a relevant topic in order to prevent one of the major causes of morbimortality. The present study aimed to investigate the association of insomnia symptoms in patients at risk for obstructive sleep apnea in terms of prevalence and clinical interactions and to evaluate the risk of CVD in patients with a risk for COMISA. Methods This is a cross-sectional study. All medical records with data such as age, sex, height, weight and BMI, time to sleep, time to wake up, total sleep time, the Epworth Sleepiness Scale (ESS), STOP-BANG Questionnaires were studied. Insomnia and comorbidities were also investigated, and the patientsanswered yes or no to systemic arterial hypertension, diabetes, CVD. Results 685 patients were enrolled on the present study. We observed that the mild, moderate, and high risk for COMISA presented progressively increasing levels for the frequency of hypertension, diabetes, and CVD. A binary logistic regression was performed to assess whether risk for COMISA could be a predictor for CVD, and it was found that the model containing risk for COMISA was statistically significant: [x2(1)=5.273;p<0.021, R2 Negelkerke=0.014]. Risk for COMISA presented itself as a significant predictor for CVD (OR=1.672; 95% CI=1.079–2.592). Conclusion There was an increased frequency of associated comorbidities such as CVD, systemic arterial hypertension, and diabetes, according to the mild, moderate, or high risk. These findings highlight the need for a cardiometabolic evaluation in patients with this comorbid condition which may impact prognosis and therapeutic success. Support (if any):

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