scholarly journals Five-Minute Awake Snoring Test for Determining CPAP Pressures (Five-Minute CPAP Test): A Pilot Study

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Macario Camacho ◽  
Chad M. Ruoff ◽  
Makoto Kawai ◽  
Rahul Modi ◽  
Jabri Arbee ◽  
...  
Keyword(s):  
Pilot Study ◽  
Positive Relationship ◽  
Water Pressure ◽  
Negative Relationship ◽  
Case Series ◽  
Apnea Hypopnea Index ◽  
Nasal Cpap ◽  
Strong Positive Relationship ◽  
Bedside Test ◽  
Obstructive Sleep

Objective. To develop a quick, simple, bedside test for determining continuous positive airway pressures (CPAP) for obstructive sleep apnea (OSA) patients.Study Design. Prospective case series at a tertiary medical center.Methods. The Five-Minute Awake Snoring Test for Determining CPAP (Five-Minute CPAP Test) was developed and tested. Patients wear a soft-gel nasal triangle mask while holding a tongue depressor with the wide section (1.75 cm) between the teeth. Fixed pressure nasal CPAP is applied while the patient simulates snoring at 4 centimeters of water pressure. The pressure is incrementally titrated up and then down to determine the lowest pressure at which the patient cannot snore (Quiet Pressure).Results. Overall, thirty-eight patients participated. All could simulate snoring. Correlation coefficients were statistically significant between Quiet Pressures and body mass index (rs=0.60[strong positive relationship],p=0.0088), apnea-hypopnea index (rs=0.49[moderate positive relationship],p=0.039), lowest oxygen saturation (rs=-0.47[moderate negative relationship],p=0.048), and oxygen desaturation index (rs=0.62[strong positive relationship],p=0.0057).Conclusion. This pilot study introduces a new concept, which is the final product of over one year of exploration, development, and testing. Five-Minute CPAP Test is a quick, inexpensive, and safe bedside test based on supine awake simulated snoring with nasal CPAP.

Drug-Induced Sleep Computed Tomography–Directed Upper Airway Surgery for Obstructive Sleep Apnea: A Pilot Study

2018 ◽  
Vol 160 (1) ◽  
pp. 172-181 ◽  
Author(s):  
Li-Ang Lee ◽  
Chao-Jan Wang ◽  
Yu-Lun Lo ◽  
Chung-Guei Huang ◽  
I-Chun Kuo ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Pilot Study ◽  
Case Series ◽  
Upper Airway ◽  
Lateral Wall ◽  
Apnea Hypopnea Index ◽  
Drug Induced ◽  
Obstructive Sleep

Objective A surgical response to upper airway (UA) surgery for obstructive sleep apnea (OSA) depends on adequate correction of collapsible sites in the UA. This pilot study aimed to examine the surgical response to UA surgery directed by drug-induced sleep computed tomography (DI-SCT) for OSA. Study Design Prospective case series. Setting Tertiary referral center. Subjects and Methods This study recruited 29 OSA patients (median age, 41 years; median body mass index, 26.9 kg/m2) who underwent single-stage DI-SCT-directed UA surgery between October 2012 and September 2014. DI-SCT was performed with propofol for light sedation with a bispectral monitor before and after UA surgery. Nonresponders were defined as those with a reduction in apnea-hypopnea index <50% after 6 months following UA surgery. Results DI-SCT showed that 28 (97%) patients had collapses at multiple sites, all of whom underwent multilevel UA surgery accordingly. The apnea-hypopnea index decreased from 53.6 to 26.8 ( P < .001). There were 18 (62%) nonresponders and 11 (38%) responders. Multiple-site collapses could not predict surgical response ( P > .99). The nonresponders had significant improvements in velopharyngeal, oropharyngeal lateral wall, and tongue collapses (all P < .05), whereas the responders had significant improvements in velopharyngeal and oropharyngeal lateral wall collapses (both P ≤ .05). Conclusion Despite multilevel OSA surgery, residual UA obstruction in nonresponders likely occurs due to multiple mechanisms. DI-SCT may help to elucidate the reasons for a nonresponse.

scholarly journals Multilevel Sleep Surgery Including the Palate in Nonsyndromic, Neurologically Intact Children with Obstructive Sleep Apnea

OTO Open ◽  
2019 ◽  
Vol 3 (2) ◽  
pp. 2473974X1985147
Author(s):  
Jason E. Cohn ◽  
George E. Relyea ◽  
Srihari Daggumati ◽  
Brian J. McKinnon
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Tertiary Care ◽  
Case Series ◽  
T Test ◽  
Velopharyngeal Insufficiency ◽  
Apnea Hypopnea Index ◽  
Sleep Surgery ◽  
Obstructive Sleep ◽  
Neurologically Intact

Objective To examine the effects of multilevel sleep surgery, including palate procedures, on obstructive sleep apnea parameters in the pediatric population. Study Design A case series with chart review was conducted to identify nonsyndromic, neurologically intact pediatric patients who underwent either uvulectomy or uvulopalatopharyngoplasty as part of multilevel sleep surgery from 2011 through 2017. Setting A tertiary care, university children’s hospital. Subjects and Methods Unpaired Student t test was used to compare average pre- and postsurgical apnea-hypopnea index (AHI) and oxygen saturation nadir (OSN). Paired Student t test was used to compare the mean pre- and postsurgical AHI and OSN within the same patient for the effects of adenotonsillectomy (T&A) vs multilevel sleep surgery. Results In patients who underwent T&A previously, multilevel sleep surgery, including palate procedures, resulted in improved OSA severity in 6 (86%) patients and worsened OSA in 1 (14%) patient. Multilevel sleep surgery, including palate procedures, significantly decreased mean AHI from 37.98 events/h preoperatively to 8.91 events/h postoperatively ( P = .005). However, it did not significantly decrease OSN. Conclusion This study includes one of the largest populations of children in whom palate procedures as a part of multilevel sleep surgery have been performed safely with no major complications and a low rate of velopharyngeal insufficiency. Therefore, palatal surgery as a part of multilevel sleep surgery is not necessarily the pariah that we have traditional thought it is in pediatric otolaryngology.

Polysomnography Outcomes after Supraglottoplasty in Children with Obstructive Sleep Apnea

2019 ◽  
Vol 161 (4) ◽  
pp. 694-698 ◽  
Author(s):  
Bharat Bhushan ◽  
James W. Schroeder ◽  
Kathleen R. Billings ◽  
Nicholas Giancola ◽  
Dana M. Thompson
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Tertiary Care ◽  
Case Series ◽  
Apnea Hypopnea Index ◽  
Historical Cohort ◽  
Tertiary Care Medical Center ◽  
Obstructive Sleep ◽  
The Mean ◽  
The Impact

ObjectiveLaryngomalacia has been reported to contribute to the severity of obstructive sleep apnea (OSA) in children. It is unclear if surgical treatment of laryngomalacia improves polysomnography (PSG) outcomes in these patients. The objective of this study is to report the impact of supraglottoplasty on PSG parameters in children with laryngomalacia-related OSA.Study DesignRetrospective case series.SettingTertiary care medical center.Subjects and MethodsHistorical cohort study of consecutive children with laryngomalacia who underwent supraglottoplasty and who had undergone overnight PSG before and after surgery.ResultsForty-one patients were included in the final analysis: 22 (53.6%) were male, and 19 (46.3%) were female. The mean ± SEM age of patients at preoperative PSG was 1.3 ± 0.89 years (range, 0.003-2.9). In entire cohort, the mean obstructive apnea-hypopnea index score was reduced from 26.6 events/h before supraglottoplasty to 7.3 events/h after surgery ( P = .003). Respiratory disturbance index was reduced from 27.3 events/h before supraglottoplasty to 7.8 events/h after surgery ( P = .003). The percentage of REM sleep decreased from 30.1% ± 2.4 to 24.8% ± 1.3 ( P = .04). Sleep efficiency was improved ( P = .05).ConclusionOverall, supraglottoplasty significantly improved several PSG outcomes in children with laryngomalacia. However, mild to moderate OSA was still present postoperatively in most children. This suggested a multifactorial cause for OSA in this population.

Antecedents of Online Game Dependency

2010 ◽  
Vol 21 (2) ◽  
pp. 69-99 ◽  
Author(s):  
Kaunchin Chen ◽  
Jengchung V. Chen ◽  
William H. Ross
Keyword(s):  
Predictive Models ◽  
Positive Relationship ◽  
Aesthetic Experience ◽  
Negative Relationship ◽  
Virtual Community ◽  
Online Games ◽  
Online Game ◽  
Massively Multiplayer Online Game ◽  
Mediating Factors ◽  
Strong Positive Relationship

Massively Multiplayer Online Game (MMOG) dependency has been widely studied but research results suggest inconclusive antecedent causes. This study proposes and empirically tests three predictive models of MMOG dependency using a survey of online gaming participants. It finds multimedia realism for social interaction serves as an original antecedent factor affecting other mediating factors to cause MMOG dependency. These mediating factors derive from Uses and Gratifications theory and include: (1) participation in a virtual community, (2) diversion from everyday life, and (3) a pleasant aesthetic experience. Of these, participation in a virtual community has a strong positive relationship with MMOG dependency, and aesthetics has a modest negative relationship. Moderator analyses suggest neither gender nor “frequency of game playing” are significant but experience playing online games is a significant moderating factor of MMOG dependency.

scholarly journals Design and Evaluation of a Non-Contact Bed-Mounted Sensing Device for Automated In-Home Detection of Obstructive Sleep Apnea: A Pilot Study

Biosensors ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. 90 ◽  
Author(s):  
Mosquera-Lopez ◽  
Leitschuh ◽  
Condon ◽  
Hagen ◽  
Rajhbeharrysingh ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Pilot Study ◽  
Pressure Sensors ◽  
Diagnostic System ◽  
High Sensitivity ◽  
Apnea Hypopnea Index ◽  
P Value ◽  
Apnea Test ◽  
Obstructive Sleep

We conducted a pilot study to evaluate the accuracy of a custom built non-contactpressure-sensitive device in diagnosing obstructive sleep apnea (OSA) severity as an alternative toin-laboratory polysomnography (PSG) and a Type 3 in-home sleep apnea test (HSAT). Fourteenpatients completed PSG sleep studies for one night with simultaneous recording from ourload-cell-based sensing device in the bed. Subjects subsequently installed pressure sensors in theirbed at home and recorded signals for up to four nights. Machine learning models were optimized toclassify sleep apnea severity using a standardized American Academy of Sleep Medicine (AASM)scoring of the gold standard studies as reference. On a per-night basis, our model reached a correctOSA detection rate of 82.9% (sensitivity = 88.9%, specificity = 76.5%), and OSA severity classificationaccuracy of 74.3% (61.5% and 81.8% correctly classified in-clinic and in-home tests, respectively).There was no difference in Apnea Hypopnea Index (AHI) estimation when subjects wore HSATsensors versus load cells (LCs) only (p-value = 0.62). Our in-home diagnostic system providesan unobtrusive method for detecting OSA with high sensitivity and may potentially be used forlong-term monitoring of breathing during sleep. Further research is needed to address the lowerspecificity resulting from using the highest AHI from repeated samples.

scholarly journals Liquidity, Growth and Profitability of Non-financial Public Listed Malaysia: A Malaysian Evidence

2019 ◽  
Vol 10 (3) ◽  
pp. 194
Author(s):  
Mazurina Mohd Ali ◽  
Nik Noor Ayu Nik Hussin ◽  
Erlane K Ghani
Keyword(s):  
Firm Growth ◽  
Positive Relationship ◽  
Negative Relationship ◽  
Sustainable Growth ◽  
Return On Equity ◽  
Listed Firms ◽  
Financial Firms ◽  
Strong Positive Relationship ◽  
Sustainable Growth Rate ◽  
The Relationship

This study examines the relationship between liquidity, growth and profitability of non-financial firms listed on the Bursa Malaysia. Specifically, this study examines the relationship between liquidity and growth on profitability for 50 non-financial public listed firms in Malaysia. Using panel data technique on 250 observations across a five-year period, this study shows that liquidity has a strong positive relationship with profitability in terms of return on asset of the firms. However, liquidity in terms of quick ratio has no impact on profitability. This study also shows that firm growth in terms of sales growth has a negative relationship with profitability. However, this study shows that liquidity and growth in general do not influence profitability in terms of return on equity, although the result shows that sustainable growth rate has a positive relationship on profitability. This study highlights the importance of these measures in measuring performance. The findings in this study provide guidelines to the firms on the measures that best to be used in evaluating performance so that appropriate strategies can be adopted to increase performance.

Eficácia polissonográfica de um aparelho intraoral semiflexível em pacientes apneicos resistentes ao CPAP – estudo preliminar

2020 ◽  
Vol 13 (52) ◽  
pp. 88-95
Author(s):  
Marcelo de Melo Quintela ◽  
Leticia Cristina Cidreira Boaro ◽  
William Cunha Brandt ◽  
Márcia Hiromi Tanaka ◽  
Caio Vinicius Gonçalvez Roman Torres ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Pilot Study ◽  
Sleep Apnea Syndrome ◽  
Therapeutic Benefit ◽  
Apnea Hypopnea Index ◽  
Similar Reduction ◽  
Inappropriate Use ◽  
Obstructive Sleep ◽  
Apnea Syndrome ◽  
Post Hoc

INTRODUCTION: Intraoral appliances (IOA) are indicated for treatment of Obstructive Sleep Apnea Syndrome (OSAS) even in patients with poor adherence to CPAP. Polysomnography with IOA may confirm therapeutic benefit. METHODS: Polysomnographic results of a semiflexible IOA in patients under inadequate use of CPAP were compared by a retrospective pilot study including 17 patients (11 men and 6 women) aged 53.7 +- 7.8 years, BMI of 27.05 +- 4.1kg/m2 and basal apnea-hypopnea index (AHI) of 35.0 +- 19.8/h. Confirmed the inappropriate use or refusal of CPAP, the patients received a semiflexible propulsion device (AQUALITY) and, after complete titration, new polysomnographies were compared to baseline and CPAP registers. ANOVA was used for repeated and post-hoc Bonferroni measurements (p <0.05). RESULTS: There was a similar reduction in AHI with OA (7.7 +- 1.7/h) and CPAP (6.1 +- 1.6/h), both compared to baseline (p <0.001). The O2 desaturation index was reduced with IOA (2.4 +- 0.6 h) and CPAP (1.3 +- 0.6/h), both compared to baseline (15.7 +- 3.8) (p <0.001). Awakening rates were also minimized with IOA (7.2 +- 1.9/h) and CPAP (4.2 +- 0.7/h), both compared to baseline (18.9 +- 5.3) (p <0.001). Sleep efficiency was higher with IOA compared to CPAP (87,2 +- 2,1 x 75,6 +- 3,9) (p <0.05). CONCLUSION: Treatment with the selected device resulted in improved polysomnographic records in this sample and may be indicated as an alternative to CPAP in undertreated patients.

Role of Microfinance for Entrepreneurial Success

2021 ◽  
Vol 11 (1) ◽  
pp. 1-16
Author(s):  
Mufaro Dzingirai ◽  
Neeta Baporikar
Keyword(s):  
Regression Analysis ◽  
Positive Relationship ◽  
Negative Relationship ◽  
Business Owners ◽  
Entrepreneurial Success ◽  
Scale Type ◽  
Correlation And Regression Analysis ◽  
Strong Positive Relationship ◽  
Spearman’S Correlation

The main objective of the paper is to analyze the influence of microfinance on entrepreneurial success of Zimbabwean SMEs. Adopting explanatory research design with a sample that constitutes 120 business owners of SMEs in Gweru district data collection was through questionnaire administering that used Likert scale-type questions. The hypotheses are analyzed using Spearman's correlation and regression analysis in order to empirically establish the influence of microfinance on entrepreneurial success. The main regression results show a strong positive relationship between microfinance and entrepreneurial success, a weak negative relationship between the business owner's age and entrepreneurial success, and a positive relationship between the level of studies and entrepreneurial success of Zimbabwean SMEs.

Upper Airway Stimulation for OSA

2016 ◽  
Vol 155 (1) ◽  
pp. 188-193 ◽  
Author(s):  
David T. Kent ◽  
Jake J. Lee ◽  
Patrick J. Strollo ◽  
Ryan J. Soose
Keyword(s):  
Outcome Measures ◽  
Case Series ◽  
Upper Airway ◽  
Positive Pressure ◽  
Apnea Hypopnea Index ◽  
Upper Airway Stimulation ◽  
Pressure Therapy ◽  
Early Results ◽  
Obstructive Sleep ◽  
Adherence Monitoring

Objective To review outcome measures and objective adherence data for patients treated with hypoglossal nerve stimulation (HNS) therapy for moderate to severe obstructive sleep apnea (OSA). Study Design Case series with chart review. Setting Academic sleep medicine center. Subjects and Methods The first 20 implanted patients to complete postoperative sleep laboratory testing were assessed. All patients had moderate to severe OSA, were unable to adhere to positive pressure therapy, and met previously published inclusion criteria for the commercially available implantable HNS system. Data included demographics, body mass index (BMI), apnea-hypopnea index (AHI), Epworth Sleepiness Score (ESS), nightly hours of device usage, and procedure- and therapy-related complications. Results Mean age was 64.8 ± 12.0 years, with 50% female. Mean BMI was unchanged postoperatively (26.5 ± 4.2 to 26.8 ± 4.5 kg/m2; P > .05). Mean AHI (33.3 ± 13.0 to 5.1 ± 4.3; P < .0001) and mean ESS (10.3 ± 5.2 to 6.0 ± 4.4; P < .01) decreased significantly. Seventy percent (14/20) of patients achieved a treatment AHI <5, 85% (17/20) an AHI <10, and 95% (19/20) an AHI <15. Average stimulation amplitude was 1.89 ± 0.50 V after titration. Adherence monitoring via device interrogation showed high rates of voluntary device use (mean 7.0 ± 2.2 h/night). Conclusion For a clinical and anatomical subset of patients with OSA, HNS therapy is associated with good objective adherence, low morbidity, and improved OSA outcome measures. Early results at one institution suggest that HNS therapy can be implemented successfully into routine clinical practice, outside of a trial setting.

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