scholarly journals The association between obstructive sleep apnea and sleep spindles in middle-aged and older men: A community-based cohort study

SLEEP ◽  
2021 ◽  
Author(s):  
Jesse L Parker ◽  
Yohannes Adama Melaku ◽  
Angela L D’Rozario ◽  
Gary A Wittert ◽  
Sean A Martin ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Morphological Changes ◽  
Large Population ◽  
Population Based ◽  
Community Dwelling ◽  
Apnea Hypopnea Index ◽  
Sleep Spindles ◽  
Cross Sectional ◽  
Obstructive Sleep

Abstract Study objectives Sleep spindles show morphological changes in obstructive sleep apnea (OSA). However, previous small studies have limited generalisability, leaving associations between OSA severity measures and spindle metrics uncertain. This study examined cross-sectional associations between OSA severity measures and spindle metrics among a large population-based sample of men. Methods Community-dwelling men with no previous OSA diagnosis underwent home-based polysomnography. All-night EEG (F4-M1) recordings were processed for artefacts and spindle events identified using previously validated algorithms. Spindle metrics of interest included frequency (Hz), amplitude (µV 2), overall density (11–16 Hz), slow density (11–13 Hz), and fast density (13–16 Hz) (number/minute). Multivariable linear regression models controlling for demographic, biomedical, and behavioural confounders were used to examine cross-sectional associations between OSA severity measures and spindle metrics. Results In adjusted analyses, higher apnea-hypopnea index (AHI/h, as a continuous variable) and percentage total sleep time with oxygen saturation <90% (TST90) were associated with decreased slow spindle density (AHI, B= -0.003, p=0.032; TST90, B= -0.004, p=0.047) but increased frequency (AHI, B=0.002, p=0.009; TST90, B=0.002, p=0.043). Higher TST90 was also associated with greater spindle amplitude (N2 sleep, B=0.04, p=0.011; N3 sleep, B=0.11, p<0.001). Furthermore, higher arousal index was associated with greater spindle amplitude during N2 sleep (B=0.31, p<0.001) but decreased overall density (B= -1.27, p=0.030) and fast density (B= -4.36, p=0.028) during N3 sleep. Conclusions Among this large population-based sample of men, OSA severity measures were independently associated with spindle abnormalities. Further population studies are needed to determine associations between spindle metrics and functional outcomes.

scholarly journals Obstructive Sleep Apnea among the Lebanese general population: Prevalence, associated factors and knowledge

2020 ◽  
Author(s):  
Aurélie Choucair ◽  
Diana Malaeb ◽  
Souheil Hallit ◽  
Elissar Dagher
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Daytime Sleepiness ◽  
Associated Factors ◽  
Public Awareness ◽  
Large Population ◽  
Population Based ◽  
Cross Sectional ◽  
Obstructive Sleep ◽  
Study Results

Abstract Background : To date, there has been no large population-based study associated with public awareness in Lebanon about sleep apnea. Our study investigated the prevalence of, associated factors and knowledge of Obstructive Sleep Apnea (OSA) among a representative sample of Lebanese adults. Methods: A cross-sectional study, conducted between June and August 2019, enrolled 472 people aged above 18 years. A proportionate random sample from all Lebanese Mohafazat was applied. Results: The study results showed that a higher number of cigarettes per day, having diabetes mellitus, myocardial infarction, hypertension and arrhythmia were associated with higher daytime sleepiness. Participants living in the North had less daytime sleepiness, whereas those living in Beqaa had higher daytime sleepiness compared to those living in Beirut. Concerning knowledge, having heard about sleep apnea and having a university level of education were associated with a higher score, whereas having cerebrovascular accidents was associated with lower knowledge scores. Conclusion Complications of OSA are still poorly known, as are certain suggestive symptoms. Given the local relevance of OSA, ongoing health campaigns and innovative educational programs should be assigned to target the general community.

scholarly journals Obstructive sleep apnea in Norwegian adults with achondroplasia: a population-based study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Svein O. Fredwall ◽  
Britt Øverland ◽  
Hanne Berdal ◽  
Søren Berg ◽  
Harald Weedon-Fekjær ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Clinical Symptoms ◽  
Population Based ◽  
Cross Sectional Study ◽  
Apnea Hypopnea Index ◽  
Berlin Questionnaire ◽  
Cross Sectional ◽  
Obstructive Sleep ◽  
Sleep Registration

Abstract Background Previous studies have found a high prevalence of obstructive sleep apnea (OSA) in children with achondroplasia, but clinical studies on this complication in adults with achondroplasia are lacking. Objectives This population-based, cross-sectional study investigated the prevalence, severity, and predictive factors of OSA in Norwegian adults with achondroplasia. Methods We collected clinical data on 49 participants. Participants without a preexisting diagnosis of OSA had an overnight sleep registration. OSA was defined as an apnea–hypopnea index (AHI) ≥ 5 plus characteristic clinical symptoms, or AHI ≥ 15. We used the Berlin Questionnaire to assess clinical symptoms of OSA. Results OSA was found in 59% (29/49) of the participants (95% confidence interval 44 to 73%), of whom 59% (17/29) had moderate to severe OSA (AHI ≥ 15), and 48% (14/29) were previously undiagnosed. Variables predictive of OSA were: excessive daytime sleepiness; unrested sleep; loud snoring; observed nocturnal breathing stops; hypertension; age > 40 years; and BMI > 30 kg/m2. Conclusion OSA was highly prevalent in Norwegian adults with achondroplasia, which we believe is representative of this population worldwide. Follow-up of adults with achondroplasia should include assessment of symptoms and signs of OSA, with a low threshold for conducting an overnight sleep registration if findings suggestive of OSA are present.

Abstract TMP55: Polysomnographic and Sleep-related Variables Associated to Leukoaraiosis in Patients with Obstructive Sleep Apnea

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Kevin R Duque ◽  
Brian Villafuerte ◽  
Fiorella Adrianzen ◽  
Rodrigo Zamudio ◽  
Andrea Mendiola ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Logistic Regression ◽  
Sleep Apnea ◽  
Multinomial Logistic Regression ◽  
Sleep Time ◽  
Cross Sectional Study ◽  
Apnea Hypopnea Index ◽  
Cross Sectional ◽  
Obstructive Sleep ◽  
Medical Histories

Introduction: Obstructive sleep apnea (OSA) is a biological plausible risk factor for leukoaraiosis (LA). We tested the hypothesis that polysomnographic (PSG) and sleep-related variables are associated to LA in OSA patients. Methods: Cross-sectional study in which PSG records, medical histories and brain 1.5T MRI were collected from all consecutive patients who had attended a Sleep Medicine Center between 2009-2014. LA was graded from 0 to 9 with the ’Atherosclerosis Risk In Communities’ study scale. OSA was defined by The International Classification of Sleep Disorders, 2014, and its severity categorizing according to apnea-hypopnea index (AHI, <15 mild, 15 to <30 moderate, 30 to <45 severe and ≥45 very severe). A multinomial logistic regression was performed to describe the association between OSA severity and LA (divided into 2 groups: mild-to-moderate LA and non-to-minimal LA). The covariates for all regression models were age, gender, BMI, hypertension, ischemic stroke, myocardial infarction, diabetes and pack-year of smoking. Results: From 82 OSA patients (77% male; mean age 58±9 years, range 19-91), 54 (66%) had LA. Mild-to-moderate LA was found in 13 patients (8 mild and 5 moderate LA) and non-to-minimal LA in 69 (41 minimal and 28 non LA). Spearman’s correlation coefficient between AHI and LA grade was 0.41 (p<0.001). Furthermore, the higher OSA severity, the higher LA severity (p<0.001, for Jonckheere-Terpstra test for ordered alternatives). In the multinomial logistic regression model adjusted for cofounders, severe OSA patients had higher risk for mild or moderate LA (HR 12.8, 95% IC 1.2-141) compared to mild-to-moderate OSA patients. Additionally, self-reported habitual sleep duration from 7 to 9 hours (HR 0.36, 90% IC 0.14-0.90) and proportion of time in apnea/hypopnea over total sleep time (HR 1.04 for one unit increase, 90% IC 1.01-1.08) could be associated with the presence of LA (adjusted only for age and gender). In a multiple regression analysis with all the aforementioned variables, age (p=0.002), diabetes (p=0.003), and OSA severity (p=0.04) were predictors of the presence of LA. Conclusion: Patients with severe OSA had higher risk for mild to moderate LA when compared to patients with mild or moderate OSA.

Utility of Neck, Height, and Tonsillar Size to Screen for Obstructive Sleep Apnea among Obese Youth

2017 ◽  
Vol 158 (4) ◽  
pp. 745-751 ◽  
Author(s):  
Indra Narang ◽  
Suhail Al-Saleh ◽  
Reshma Amin ◽  
Evan J. Propst ◽  
Saadoun Bin-Hasan ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Predictive Ability ◽  
Ambulatory Setting ◽  
Apnea Hypopnea Index ◽  
Predictive Tool ◽  
Anthropometric Measures ◽  
Cross Sectional ◽  
Obese Youth ◽  
Obstructive Sleep

Objectives To determine whether neck:height ratio combined with adenoid and tonsillar size is a good predictive tool for obstructive sleep apnea in obese youth. Study Design Cross-sectional study. Setting Sleep clinics at the Hospital for Sick Children, Toronto, Canada. Subjects and Methods Consented obese individuals aged 8 to 18 years were recruited between 2013 and 2015. Anthropometric measures were obtained by a trained research coordinator in a standardized manner. Otolaryngologists evaluated adenoid and tonsil sizes. Obstructive sleep apnea was diagnosed with an overnight polysomnogram as an obstructive apnea-hypopnea index ≥2. Multivariable logistic regressions investigated the relationship between potential predictors and obstructive sleep apnea. The C-statistic measured the predictive ability. Results Of the 53 subjects (median age, 13 years; 55% males), 28 (53%) were diagnosed with obstructive sleep apnea, with a median index of 10.6 per hour. In a logistic regression controlling for adenoid size, enlarged tonsils were significantly associated with the presence of obstructive sleep apnea ( P < .01). Adding neck:height ratio into the model improved the model predictive ability (C-index increased from 0.73 to 0.84). Controlling for tonsil and adenoid sizes, an increase in neck:height ratio was significantly associated with the presence of obstructive sleep apnea ( P = .01). Conclusion Our study suggests that neck:height ratio combined with tonsillar hypertrophy may have a strong predictive ability for obstructive sleep apnea and may be useful in an ambulatory setting to screen obese youth at high risk. These findings should be confirmed in a larger study.

Obstructive Sleep Apnea in Acromegaly and the Effect of Treatment: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 105 (3) ◽  
pp. e23-e31 ◽  
Author(s):  
Matteo Parolin ◽  
Francesca Dassie ◽  
Luigi Alessio ◽  
Alexandra Wennberg ◽  
Marco Rossato ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Meta Analysis ◽  
Upper Airway ◽  
Apnea Hypopnea Index ◽  
Cross Sectional ◽  
Obstructive Sleep ◽  
Before And After ◽  
The Difference

Abstract Background Obstructive sleep apnea (OSA) is a common disorder characterized by upper airway collapse requiring nocturnal ventilatory assistance. Multiple studies have investigated the relationship between acromegaly and OSA, reporting discordant results. Aim To conduct a meta-analysis on the risk for OSA in acromegaly, and in particular to assess the role of disease activity and the effect of treatments. Methods and Study Selection A search through literature databases retrieved 21 articles for a total of 24 studies (n = 734). Selected outcomes were OSA prevalence and apnea-hypopnea index (AHI) in studies comparing acromegalic patients with active (ACT) vs inactive (INACT) disease and pretreatment and posttreatment measures. Factors used for moderator and meta-regression analysis included the percentage of patients with severe OSA, patient sex, age, body mass index, levels of insulin-like growth factor 1, disease duration and follow-up, and therapy. Results OSA prevalence was similar in patients with acromegaly who had ACT and INACT disease (ES = −0.16; 95% CI, −0.47 to 0.15; number of studies [k] = 10; P = 0.32). In addition, AHI was similar in ACT and INACT acromegaly patients (ES = −0.03; 95% CI, −0.49 to 0.43; k = 6; P = 0.89). When AHI was compared before and after treatment in patients with acromegaly (median follow-up of 6 months), a significant improvement was observed after treatment (ES = −0.36; 95% CI, −0.49 to −0.23; k = 10; P &lt; 0.0001). In moderator analysis, the percentage of patients with severe OSA in the populations significantly influenced the difference in OSA prevalence (P = 0.038) and AHI (P = 0.04) in ACT vs INACT patients. Conclusion Prevalence of OSA and AHI is similar in ACT and INACT patients in cross-sectional studies. However, when AHI was measured longitudinally before and after treatment, a significant improvement was observed after treatment.

scholarly journals 0722 The Association Between Obstructive Sleep Apnea and Neurobehavioural Function in Men: A Large, Population-Based Cohort Study

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A274-A275
Author(s):  
J L Parker ◽  
R J Adams ◽  
S L Appleton ◽  
Y A Melaku ◽  
A Vakulin
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Total Sleep Time ◽  
Sleep Time ◽  
Inspection Time ◽  
Sleep Disruption ◽  
Clinical Samples ◽  
Apnea Hypopnea Index ◽  
Cross Sectional ◽  
Obstructive Sleep

Abstract Introduction Obstructive sleep apnea (OSA) is linked with impaired vigilance, attention, memory and executive function. However, this evidence largely comes from small experimental studies or larger studies in clinical samples and therefore the scope and magnitude of OSA driven neurobehavioural dysfunction in the general population remains unclear. This study aimed to examine the cross-sectional association between OSA and neurobehavioural function in a large community sample of men. Methods A total of 837 participants from the Men Androgen Inflammation Lifestyle Environment and Stress (MAILES) study, a longitudinal cohort of men 40+ years, underwent full overnight polysomnography. Participants completed the inspection time (IT) test, mini-mental state examination (MMSE), Fuld object memory evaluation (FOME), and trail-making test (TMT) part A (TMT-A) and part B (TMT-B). Using regression models adjusted for multiple important covariates, we examined the association between neurobehavioural function scores, clinical metrics of OSA severity (Apnea-Hypopnea Index (AHI); percentage total sleep time with oxygen saturation &lt;90% (TST90), and measures of sleep disruption (duration of rapid eye movement (REM) and non-REM (NREM) sleep; and total sleep time (TST). Results In multivariable linear regressions, greater TST was associated with worse IT scores (B=13.688, 95% CI [0.134, 27.241], P=0.048) and TMT-B scores (B=19.255, 95% CI [0.931, 37.578], P=0.040). In logistic regressions, greater TST was associated with better MMSE scores (Odds ratio [OR]=0.440, 95% CI [0.194, 0.997], P=0.049); and higher AHI was strongly associated with worse FOME scores in fully adjusted models (OR=1.358, 95% CI [1.252, 1.472], P&lt;0.001). Conclusion The AHI and TST were positively, significantly associated with neurobehavioural function across different domains. This cross-sectional data shows that neurobehavioural function deficits in OSA are directly related to sleep and breathing disruptions. Future large prospective studies are needed to determine if OSA and sleep disruption predict future onset of neurobehavioural dysfunction and cognitive decline. Support National Health and Medical Research Council and the Adelaide Institute for Sleep Health.

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

SLEEP ◽  
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.

scholarly journals Increased prevalence of obstructive sleep apnea in women diagnosed with endometrial or breast cancer

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249099
Author(s):  
Ayey Madut ◽  
Veronika Fuchsova ◽  
Hong Man ◽  
Shabeel Askar ◽  
Ritu Trivedi ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Endometrial Cancer ◽  
Sleep Apnea ◽  
Small Sample Size ◽  
Small Sample ◽  
Apnea Hypopnea Index ◽  
Cross Sectional ◽  
Obstructive Sleep ◽  
Incidence And Mortality ◽  
High Prevalence

Background Epidemiological studies demonstrate associations between obstructive sleep apnea (OSA) and cancer incidence and mortality. The aim of this study was to measure OSA in women with breast (BC) or endometrial cancer (EC) and associations with clinico-pathological tumor variables. Methods and findings In a cross sectional study, women with BC (12 months) or EC (3 months) post-diagnosis were recruited from cancer clinics. We collected demographic, anthropometric data, cancer stage, grade, histopathology and history of cancer treatment and all subjects had in-laboratory polysomnography. Sleepiness was assessed with the Epworth Sleepiness Scale (ESS). We compared anthropometric and polysomnographic data between cancer groups (unpaired t-tests), and assessed relationships between cancer characteristics and OSA variables (Fishers exact test). There were no significant differences between average age (BC:59.6±8.7 years(n = 50); EC:60.3±7.7 years(n = 37)), or ESS score (BC:6.4±4.4; EC 6.8±4.7; mean±SD; all p>0.2), however, BMI was higher in EC (BC: 29.7±7.9kgm-2; EC: 34.2±8.0 kgm-2; p<0.05). BC had longer sleep latency (BC:31.8±32minutes; EC:19.3±17.9 minutes), less Stage 3 sleep (BC:20.0±5.2%; EC:23.6±8.2%) and more REM sleep (BC:21.1±6.9%; EC: 16.6±5.7%), all p<0.05. EC had lower average awake and asleep oxygen saturation levels (BC: 95.6±1.3%; EC: 94.6±1.9% [awake]: BC: 94.8±2.1%; EC: 93.3±2.4% [asleep]; both p<0.05). Apnea-Hypopnea Index (AHI) (BC: 21.2(7.3–36.9) events/hr; EC: 15.7 (10–33.5) events/hour (median (interquartile range)) was not different p = 0.7), however, 58% and 57% of women with BC and EC respectively, had an AHI>15 events/hour. In this small sample size group, no significant associations (all p>0.1) were detected between OSA metrics and clinico-pathological tumor variables. Conclusion In postmenopausal women with breast or endometrial cancer there is high prevalence of OSA, with no association with specific tumor characteristics detected. Recognition of the high prevalence of OSA in women with cancer is important to recognise as it may impact on surgical risk and quality of life.

Association between Flexible Nasal Endoscopy, Polysonography Findins and Obstructive Sleep Apnea Severety

2021 ◽  
Vol 9 (3) ◽  
pp. 01-06
Author(s):  
Zappelini CEM ◽  
Jeremias LA ◽  
Borba IN ◽  
Machado LZ ◽  
Nicoladelli SJ ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Rem Sleep ◽  
Sleep Stage ◽  
Upper Airway ◽  
Inverse Correlation ◽  
Apnea Hypopnea Index ◽  
Upper Airways ◽  
Cross Sectional ◽  
Obstructive Sleep

Introduction: Obstructive Sleep Apnea (OSA) is a condition with recurrent collapses of the pharyngeal region that result in partial or total reduction in airflow. Its diagnosis and severity depends on the Apnea-Hypopnea Index (AHI), data from the polysomnography exam (PSG). Its pathophysiology includes anatomical disorders of the upper airways that can be assessed through Flexible Nasofibroscopy (FN). Objective: To identify the alterations present in the tests of FN and PSG in patients with OSA and correlate with the AHI. Methods: Cross-sectional study, with data collected from reports of the FN and PSG exams of 81 patients with OSA, seen at an otorhinolaryngology clinic in Tubarão - SC. It was verified the association between the outcome –AHI- and other exposure variables - sociodemographic and clinical. Results: Among the 81 patients, 75.31% were male, 41.98% had mild apnea, 30.86% moderate and 27.16% severe apnea. There was no correlation between FN findings and AHI (p> 0.05). There was a difference between the mean age, number of obstructive episodes per hour of sleep and minimum saturation between the groups with severe and mild apnea (p <0.05). Patients with severe apnea had a higher percentage of sleep phase one and a shorter REM sleep time compared to the mild apnea group (p <0.05). A positive correlation was obtained between: obstructive episodes with sleep stage 1 (p <0.01) and age (p <0.05); between minimum saturation and sleep stage 3 (p <0.05). There was an inverse correlation between obstructive episodes with minimal saturation (p <0.001), with sleep stage 3 (p <0.01) and with REM sleep (p <0.01); between age and minimum saturation (p <0.01). Conclusion: OSA directly interferes with sleep architecture. The present study did not find association between upper airway alterations and OSA severity.

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