422 Influence of Sex-Specific Differences in Inpatient Sleep Testing Approach for Diagnosis of Obstructive Sleep Apnea

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A167-A167
Author(s):  
Cinthya Pena Orbea ◽  
Cody McIntire ◽  
Lu Wang ◽  
Reena Mehra
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Cleveland Clinic ◽  
Development Program ◽  
Apnea Hypopnea Index ◽  
Chronic Obstructive ◽  
P Value ◽  
Sleep Study ◽  
Lower Odds ◽  
Obstructive Sleep

Abstract Introduction Increased attention has been focused on sex-specific differences in approaches to diagnostic testing for obstructive sleep apnea (OSA) given differences in hypoxia, arousal thresholds and sleep state dependent influences, but with sparse data available for inpatient testing. We postulate that women are more likely to have a lesser degree of sleep apnea on inpatient home sleep apnea testing (HSAT) versus polysomnography (PSG). Methods The Cleveland Clinic Sleep Laboratory registry was queried for inpatient sleep testing (HSAT or PSG conducted over the last 15 years. Demographics, comorbidities, and sleep study (Nihon Kohden®) data were collated. Logistic regression was used to examine sleep study type predictive of OSA at various severity thresholds (apnea hypopnea index (AHI, 3 or 4% hypopnea rule)>5,>15 and >30 and hypoxia (11% (median) time spent with SaO2<90%) adjusted for age, race and body mass index and comorbidities (hypertension, coronary artery disease, arrhythmias, heart failure, diabetes, stroke, chronic obstructive pulmonary disease, mood disorders, respiratory failure and epilepsy with a sex interaction term) (OR, 95%CI presented). Results The analytic sample was comprised of 639 patients: age:55.8±16.3 years, 45% female, 73% Caucasian, BMI:37.5 ± 13.3kg/m2, 74% had OSA and 51% HSAT. Men had higher AHI:16.2 [5.9, 42.3] vs 8.2 [2.9, 20.7]p<0.001, higher arousal index:33.1[18.9,.54] vs 25.3 [15.6, 39.2]p=0.003. Women had higher BMI:40.2 ±14.7, vs 36 ±11.7kg/m2,p<0.001. Unlike AHI>5, at AHI>15, men had lower odds of OSA: OR=0.51:0.32–0.80,p=0.004 for HSAT versus PSG compared to women: OR=1.03:0.61–1.72,p=0.92; interaction p-value=0.046. Men had lower odds of OSA (AHI >30): OR=0.57(0.35,0.92,p=0.022) in HSAT vs PSG; albeit sex-interaction was not statistically significant. Men versus women had 2-versus 3-fold higher hypoxia ie. OR=2.04:1.22–3.41,p=0.006 in men undergoing HSAT versus PSG with strength of association higher in women: OR=3.03:1.68–5.46,p=0.001, interaction p-value=0.32 Conclusion We unexpectedly observe sex-specific differences in inpatient sleep testing such that men had an overall lower odds of detection of moderate to severe and OSA and nocturnal hypoxia relative to women with HSAT versus PSG. Future investigation focused on concurrent inpatient PSG and HSAT should verify these sex-specific findings and clarify potential biophysiologic rationale Support (if any) Transformative Neuroscience Research Development Program: Multimodal Neurocardiorespiratory Physiologic Sleep Signal Repository Transformative Resource Facilitating Transdisciplinary Research Opportunities

scholarly journals Subjective and Objective Appraisal of Activity in Adults with Obstructive Sleep Apnea

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Eileen R. Chasens ◽  
Susan M. Sereika ◽  
Martin P. Houze ◽  
Patrick J. Strollo
Keyword(s):  
Physical Activity ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Epworth Sleepiness Scale ◽  
Functional Outcomes ◽  
Apnea Hypopnea Index ◽  
Sleep Study ◽  
Obstructive Sleep ◽  
Subjective Sleepiness ◽  
Aging Adults

Objective.This study examined the association between obstructive sleep apnea (OSA), daytime sleepiness, functional activity, and objective physical activity.Setting.Subjects (N=37) being evaluated for OSA were recruited from a sleep clinic.Participants. The sample was balanced by gender (53% male), middle-aged, primarily White, and overweight or obese with a mean BMI of 33.98 (SD=7.35;median BMI=32.30). Over 40% reported subjective sleepiness (Epworth Sleepiness Scale (ESS) ≥10) and had OSA (78% with apnea + hypopnea index (AHI) ≥5/hr).Measurements.Evaluation included questionnaires to evaluate subjective sleepiness (Epworth Sleepiness Scale (ESS)) and functional outcomes (Functional Outcomes of Sleep Questionnaire (FOSQ)), an activity monitor, and an overnight sleep study to determine OSA severity.Results.Increased subjective sleepiness was significantly associated with lower scores on the FOSQ but not with average number of steps walked per day. A multiple regression analysis showed that higher AHI values were significantly associated with lower average number of steps walked per day after controlling patient's age, sex, and ESS.Conclusion.Subjective sleepiness was associated with perceived difficulty in activity but not with objectively measured activity. However, OSA severity was associated with decreased objective physical activity in aging adults.

393 Comparison of Oxygenation Abnormalities Between Obstructive Sleep Apnea and Central Sleep Apnea

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A156-A157
Author(s):  
Sikawat Thanaviratananich ◽  
Hao Cheng ◽  
Maria Pino ◽  
Krishna Sundar
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Demographic Data ◽  
Central Sleep Apnea ◽  
Nrem Sleep ◽  
Rate Of Change ◽  
Apnea Hypopnea Index ◽  
P Value ◽  
Obstructive Sleep ◽  
Cheyne Stokes Breathing

Abstract Introduction The apnea-hypopnea index (AHI) is used as a generic index to quantify both central sleep apnea (CSA) and obstructive sleep apnea (OSA) syndromes. Patterns of oxygenation abnormalities seen in CSA and OSA may be key to understanding differing clinical impacts of these disorders. Oxygen desaturation and resaturation slopes and durations in OSA and CSA were compared between OSA and CSA patients. Methods Polysomnographic data of patients aged 18 years or older with diagnosis of OSA and CSA, at University of Iowa Hospitals and Clinics, were analyzed and demographic data were collected. Oximetric changes during hypopneas and apneas were studied for desaturation/resaturation durations and desaturation/resaturation slopes. Desaturation and resaturation slopes were calculated as rate of change in oxygen saturation (ΔSpO2/Δtime). Comparison of hypoxemia-based parameters between patients with OSA and CSA was performed using unpaired t-test. Results 32 patients with OSA with median AHI of 15.4 (IQR 5.1 to 30.55) and median ODI of 15.47 (IQR 9.50 to 29.33) were compared to 15 patients with CSA with a median AHI of 20.4 (IQR 12.6 to 47.8) and median ODI of 27.56 (IQR 17.99 to 29.57). The mean number of desaturation and resaturation events was not significantly different between patients with OSA and CSA (OSA - 106.81±87.93; CSA - 130.67±76.88 with a p-value 0.1472). 4/15 CSA patients had Cheyne-Stokes breathing, 2/15 had treatment emergent central sleep apnea, 1/15 had methadone-associated CSA and for 8/15, no etiologies for CSA were found. Mean desaturation durations was significantly longer in OSA (20.84 s ± 5.67) compared to CSA (15.94 s ± 4.54) (p=0.0053) and consequently the desaturation slopes were steeper in CSA than OSA (-0.35%/sec ±0.180 vs. -0.243 ± 0.073; p=0.0064). The resaturation duration was not significantly longer in OSA (9.76 s ± 2.02) than CSA (9.057 s ± 2.17) (p=0.2857). Differences between desaturation duration and slopes between CSA and OSA persisted during REM and NREM sleep, and in supine sleep. Conclusion As compared to OSA, patients with CSA have different patterns of desaturations and resaturations with lesser hypoxic burden with CSA. This may have implications on the clinical outcomes seen between these two disorders. Support (if any):

scholarly journals Detection of obstructive sleep apnea using Belun Sleep Platform wearable with neural network-based algorithm and its combined use with STOP-Bang questionnaire

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0258040
Author(s):  
Eric Yeh ◽  
Eileen Wong ◽  
Chih-Wei Tsai ◽  
Wenbo Gu ◽  
Pai-Lien Chen ◽  
...  
Keyword(s):  
Neural Network ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Physiological Data ◽  
Apnea Hypopnea Index ◽  
Clinical Practices ◽  
Sleep Study ◽  
Link Type ◽  
Obstructive Sleep ◽  
Sensitivity Specificity

Many wearables allow physiological data acquisition in sleep and enable clinicians to assess sleep outside of sleep labs. Belun Sleep Platform (BSP) is a novel neural network-based home sleep apnea testing system utilizing a wearable ring device to detect obstructive sleep apnea (OSA). The objective of the study is to assess the performance of BSP for the evaluation of OSA. Subjects who take heart rate-affecting medications and those with non-arrhythmic comorbidities were included in this cohort. Polysomnography (PSG) studies were performed simultaneously with the Belun Ring in individuals who were referred to the sleep lab for an overnight sleep study. The sleep studies were manually scored using the American Academy of Sleep Medicine Scoring Manual (version 2.4) with 4% desaturation hypopnea criteria. A total of 78 subjects were recruited. Of these, 45% had AHI < 5; 18% had AHI 5–15; 19% had AHI 15–30; 18% had AHI ≥ 30. The Belun apnea-hypopnea index (bAHI) correlated well with the PSG-AHI (r = 0.888, P < 0.001). The Belun total sleep time (bTST) and PSG-TST had a high correlation coefficient (r = 0.967, P < 0.001). The accuracy, sensitivity, specificity in categorizing AHI ≥ 15 were 0.808 [95% CI, 0.703–0.888], 0.931 [95% CI, 0.772–0.992], and 0.735 [95% CI, 0.589–0.850], respectively. The use of beta-blocker/calcium-receptor antagonist and the presence of comorbidities did not negatively affect the sensitivity and specificity of BSP in predicting OSA. A diagnostic algorithm combining STOP-Bang cutoff of 5 and bAHI cutoff of 15 events/h demonstrated an accuracy, sensitivity, specificity of 0.938 [95% CI, 0.828–0.987], 0.944 [95% CI, 0.727–0.999], and 0.933 [95% CI, 0.779–0.992], respectively, for the diagnosis of moderate to severe OSA. BSP is a promising testing tool for OSA assessment and can potentially be incorporated into clinical practices for the identification of OSA. Trial registration: ClinicalTrial.org NCT03997916 https://clinicaltrials.gov/ct2/show/NCT03997916?term=belun+ring&draw=2&rank=1

scholarly journals 0879 Outcomes of Adenotonsillectomy in Children with Down Syndrome and Obstructive Sleep Apnea

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A335-A335
Author(s):  
A Morello Gearhart ◽  
B Gunaratnam ◽  
E Senthilvel
Keyword(s):  
Obstructive Sleep Apnea ◽  
Down Syndrome ◽  
Sleep Apnea ◽  
Sleep Onset ◽  
Sleep Efficiency ◽  
Apnea Hypopnea Index ◽  
P Value ◽  
Children With Down Syndrome ◽  
Arousal Index ◽  
Obstructive Sleep

Abstract Introduction Obstructive sleep apnea (OSA) is highly prevalent in children with Down Syndrome (DS). The aim of this study was to assess the effectiveness of adenotonsillectomy (T&A) on polysomnographic parameters of children with DS. Methods Retrospective chart review of children with DS who underwent T&A between 2012-2019 was performed. Preoperative OSA severity was categorized by obstructive apnea-hypopnea index (OAHI): mild = 1-4.9 events/h; moderate = 5-9.9 events/h; severe ≥ 10 events/h. Results We identified 43 DS children with pre and post T&A polysomnographic data in a population of 162 DS patients. A total of 25 were male, mean age 5.1 years (± 3.8 years) and 56% Caucasians. Preoperative data showed 19% mild OSA, 30% moderate and 51% severe. Postoperatively, apnea-hypopnea index (AHI) normalized in 9.3%, 37.2% had mild OSA, 18.6% moderate and 34.9% severe. Overall, T&A resulted in significant improvement (p-value &lt;0.05) in mean AHI, (18.51 ± 28.05 vs 11.72 ± 16.43), SaO2 nadir (80.00 ± 14.82 vs 85.51 ± 5.94), sleep efficiency (81.97 ± 11.15 vs 85.9 ± 8.28), arousal index (16.14 ± 10.23 vs 14.45 ± 12.34), and wake after sleep onset (67.19 ± 46.89 vs 50.55 ± 40.83) and no statistical difference (p-value &gt;0.05) in end-tidal carbon dioxide (43.86 ± 9.56 vs 44.17 ± 3.78), Rapid Eye Movement (REM)% (15.86 ± 7.75 vs 15.92 ± 7.41), sleep latency (24.03 ± 34.39 vs 22.55 ± 21.11), and central apnea index (0.86 ± 1.38 vs 0.66 ± 0.82) in pre and post T&A data. There was no statistically significant difference in pre and post T&A polysomnographic parameters between 17 DS and 17 age and gender-matched non-DS control subjects. Conclusion Adenotonsillectomy resulted in improvement in AHI, oxygen desaturation nadir, sleep efficiency, arousal index and wake after sleep onset. However, a significant portion of children with DS continued to have moderate to severe OSA after T&A. Support None.

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 Examination of Pulse Oximetry Tracings to Detect Obstructive Sleep Apnea in Patients with Advanced Chronic Obstructive Pulmonary Disease

2014 ◽  
Vol 21 (3) ◽  
pp. 171-175 ◽  
Author(s):  
Adrienne S Scott ◽  
Marcel A Baltzan ◽  
Norman Wolkove
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Pulse Oximetry ◽  
Pulmonary Disease ◽  
Time Scale ◽  
Apnea Hypopnea Index ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Obstructive Sleep

Nocturnal hypoxemia and obstructive sleep apnea (OSA) are common comorbidities in patients with chronic obstructive pulmonary disease (COPD). The authors sought to develop a strategy to interpret nocturnal pulse oximetry and assess its capacity for detection of OSA in patients with stage 3 to stage 4 COPD. A review of consecutive patients with COPD who were clinically prescribed oximetry and polysomnography was conducted. OSA was diagnosed if the polysomnographic apnea-hypopnea index was >15 events/h. Comprehensive criteria were developed for interpretation of pulse oximetry tracings through iterative validation and interscorer concordance of ≥80%. Criteria consisted of visually identified desaturation ‘events’ (sustained desaturation ≥4%, 1 h time scale), ‘patterns’ (≥3 similar desaturation/saturation cycles, 15 min time scale) and the automated oxygen desaturation index. The area under the curve (AUC), sensitivity, specificity and accuracy were calculated. Of 59 patients (27 male), 31 had OSA (53%). The mean forced expiratory volume in 1 s was 46% of predicted (range 21% to 74% of predicted) and 52% of patients were on long-term oxygen therapy. Among 59 patients, 35 were correctly identified as having OSA or not having OSA, corresponding to an accuracy of 59%, with a sensitivity and specificity of 59% and 60%, respectively. The AUC was 0.57 (95% CI 0.55 to 0.59). Using software-computed desaturation events (hypoxemia ≥4% for ≥10 s) indexed at ≥15 events/h of sleep as diagnostic criteria, sensitivity was 60%, specificity was 63% and the AUC was 0.64 (95%CI 0.62 to 0.66). No single criterion demonstrated important diagnostic utility. Pulse oximetry tracing interpretation had a modest diagnostic value in identifying OSA in patients with moderate to severe COPD.

scholarly journals Obstructive Sleep Apnea, Sleep Duration, and Associated Mediators With Carotid Intima-Media Thickness

2021 ◽  
Author(s):  
Silvana P. Souza ◽  
Ronaldo B. Santos ◽  
Itamar S. Santos ◽  
Barbara K. Parise ◽  
Soraya Giatti ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Duration ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
R Package ◽  
Apnea Hypopnea Index ◽  
Sleep Study ◽  
Media Thickness ◽  
Obstructive Sleep

Objective: To elucidate the independent associations of obstructive sleep apnea (OSA) and sleep duration (SD) as well as the potential inflammatory and metabolic mediators on carotid intima-media thickness (CIMT) in a large cohort of adults. Approach and Results: Consecutive participants from the ELSA-Brasil performed a clinical evaluation, sleep study, 1-week actigraphy for defining SD and CIMT using standard techniques. Gamma regression models were used to explore the association between OSA and SD with CIMT. Mediation analysis was performed using the mediation R package. A total of 2009 participants were included in the main analysis. As compared with no OSA (apnea-hypopnea index [AHI] <5 events/hour; n=613), patients with mild (AHI, 5–14.9; n=741), moderate (AHI, 15–29.9; n=389), and severe OSA (AHI ≥30 events/hour; n=266) presented a progressive CIMT increase (0.690 [0.610–0.790], 0.760 [0.650–0.890], 0.810 [0.700–0.940], and 0.820 [0.720–0.958] mm; P <0.001). In contrast, CIMTs were similar for those with SD <6 hours (0.760 [0.650–0.888]), 6 to 8 hours (0.750 [0.640–0.880]) and >8 hours (0.740 [0.670–0.900]). All forms of OSA were independently associated with CIMT (mild: β: 0.019, SE 0.008; P =0.022; moderate: β: 0.025, SE 0.011; P =0.022; severe OSA: β: 0.040, SE 0.013; P =0.002). Moreover, the association of AHI with CIMT was mediated by increased C-reactive protein and triglycerides ( P <0.01). SD did not interact with OSA in the association with CIMT. Conclusions: OSA is independently associated with increased CIMT in a dose-response relationship. This association is partially mediated by inflammation and dyslipidemia. In contrast, SD is not associated nor interacted with OSA to increase CIMT.

scholarly journals Prospective Screening for Primary Aldosteronism in Patients With Suspected Obstructive Sleep Apnea

Hypertension ◽  
2021 ◽  
Author(s):  
Min Ru Chee ◽  
Jesse Hoo ◽  
Renata Libianto ◽  
Stella M. Gwini ◽  
Garun Hamilton ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Primary Aldosteronism ◽  
Blood Pressure Monitoring ◽  
Apnea Hypopnea Index ◽  
Hypertension Status ◽  
Antihypertensive Medications ◽  
Sleep Study ◽  
Obstructive Sleep

Several studies have demonstrated a bidirectional relationship between obstructive sleep apnea and primary aldosteronism (PA); however, many of these studies are limited to patients with known obstructive sleep apnea, hypertension, or PA. We evaluated the role of screening for PA in all patients referred for a diagnostic sleep study without selecting for prior diagnoses with these conditions. Plasma aldosterone and renin concentration were measured after an overnight polysomnography. Blood pressure was measured at the sleep center for all patients, while a proportion underwent 24-hour blood pressure monitoring. Of the 85 participating patients, 2 (2.4%) were identified to have likely PA based on an elevated aldosterone:renin ratio and/or clinical characteristics. Another 10 (11.8%) were identified to have possible PA based on their low or normal plasma renin concentration despite taking antihypertensive medications that are known to elevate renin. In participants with both obstructive sleep apnea and hypertension (n=40), the prevalence of likely or possible PA was 30%. However, there was no correlation between aldosterone, rennin, or aldosterone:renin ratio and the apnea-hypopnea index using multiple regression analysis adjusted for interfering medications and hypertension status. The observed high prevalence of possible PA among those with both hypertension and obstructive sleep apnea suggests that they should be routinely screened for PA.

scholarly journals Validity and Reliability of the Thai Version of the Pediatric Obstructive Sleep Apnea Screening Tool

2021 ◽  
Author(s):  
Archwin Tanphaichitr ◽  
Pitchayanan Chuenchod ◽  
Kitirat Ungkanont ◽  
Wish Banhiran ◽  
Vannipa Vathanophas ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Internal Consistency ◽  
Screening Tool ◽  
Apnea Hypopnea Index ◽  
Sleep Study ◽  
Retest Reliability ◽  
Obstructive Sleep ◽  
The Mean ◽  
Test Retest Reliability

Objective: Obstructive sleep apnea (OSA) is highly prevalent in children and requires an expensive and relatively unavailable sleep study for diagnosis. This study was undertaken to translate the previously validated OSA screening tool (POSAST) to the Thai language and assess its accuracy and test-retest reliability in at-risk symptomatic children. Study design: Prospective cross-sectional cohort study Methods: Pediatric patients clinically referred for suspected OSA who underwent overnight polysomnography (PSG) were recruited, and caregivers completed the Thai version of the POSAST. The same questionnaire was completed again after 2-4 weeks. Results: One hundred and ten subjects completed the study. The mean age was 8.4±2.9 years. The mean apnea-hypopnea index (AHI) was 10.9±11.9 events/hour. Test-retest reliability (Pearson correlation coefficient = 0.96, P<0.001) and internal consistency (Cronbach’s alpha coefficient = 0.82, P<0.001) between each question were excellent. A cumulative equation-derived score cut-off of 1.9 yielded 78.4% sensitivity and 50.0% specificity, while a numerical additive score cut-off of 8 corresponded to 81.1% sensitivity and 52.8% specificity for diagnosing moderate and severe OSA (AHI ≥5 events per hour) Conclusion: The internal consistency and reproducibility of the Thai version of the POSAST are satisfactory, display acceptable validity, and the instrument can be used for screening symptomatic Thai children for OSA.

scholarly journals A Pharyngoplasty with a Dorsal Palatal Flap Expansion: The Evaluation of a Modified Surgical Treatment Method for Obstructive Sleep Apnea Syndrome—A Preliminary Report

2021 ◽  
Vol 10 (16) ◽  
pp. 3746
Author(s):  
Ewa Olszewska ◽  
Piotr Fiedorczuk ◽  
Adam Stróżyński ◽  
Agnieszka Polecka ◽  
Ewa Roszkowska ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Oxygen Saturation ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Apnea Hypopnea Index ◽  
Upper Airways ◽  
Sleep Study ◽  
Obstructive Sleep ◽  
Apnea Syndrome

Surgical techniques for obstructive sleep apnea syndrome (OSAS) constantly evolve. This study aims to assess the effectiveness and safety of a new surgical approach for an OSAS pharyngoplasty with a dorsal palatal flap expansion (PDPFEx). A total of 21 participants (mean age 49.9; mean BMI 32.5) underwent a type III sleep study, an endoscopy of the upper airways, a filled medical history, a visual analog scale for snoring loudness, an Epworth Sleepiness Scale, and a Short Form Health Survey-36 questionnaire. A follow-up re-evaluation was performed 11 ± 4.9 months post-operatively. The study group (4 with moderate, 17 with severe OSAS) showed an improvement in all measured sleep study characteristics (p < 0.05), apnea-hypopnea index (pre-median 45.7 to 29.3 post-operatively, p = 0.009, r = 0.394), oxygen desaturation index (pre-median 47.7 and 23.3 post-operatively, p = 0.0005, r = 0.812), mean oxygen saturation (median 92% pre-operatively and median 94% post-operatively, p = 0.0002, r = 0.812), lowest oxygen saturation (p = 0.0001, r = 0.540) and time of sleep spent with blood oxygen saturation less than 90% (p = 0.0001, r = 0.485). The most commonly reported complications were throat dryness (11 patients) and minor difficulties in swallowing (5 patients transient, 3 patients constant). We conclude that a PDPFEx is a promising new surgical method; however, further controlled studies are needed to demonstrate its safety and efficacy for OSAS treatment in adults.

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