scholarly journals Nightly Hypoxia Does Not Seem to Lead to Otolith Dysfunction in Patients With Obstructive Sleep Apnea

2020 ◽  
pp. 014556132092212
Author(s):  
Richard Birk ◽  
Miriam Dietz ◽  
Jörg Ulrich Sommer ◽  
Boris A. Stuck ◽  
Karl Hörmann ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Vestibular Function ◽  
Oxygen Desaturation ◽  
Vestibular Evoked Myogenic Potentials ◽  
Head Impulse Test ◽  
Apnea Hypopnea Index ◽  
Horizontal Semicircular Canal ◽  
Respiratory Parameters ◽  
Obstructive Sleep

Objectives: Obstructive sleep apnea (OSA) is a common sleep disorder, which is associated with recurrent oxygen desaturation during sleep. It has already been shown that nocturnal hypoxia may lead to cochlear dysfunction in patients with OSA. Less is known whether hypoxia during sleep also impacts vestibular function in those patients. Thus, the aim of the presented study was to assess a potential vestibulotoxic effect of nightly desaturations with hypoxia in patients with OSA by investigating a possible correlation between respiratory parameters and vestibular function tests. Methods: A total of 56 patients were included in the study and underwent a fully attended cardiorespiratory polysomnography (PSG). Vestibular function was assessed using video head impulse test to evaluate horizontal semicircular canal function and cervical vestibular evoked myogenic potentials (cVEMPs) and ocular vestibular evoked myogenic potentials (oVEMPs) to measure otolith function. Descriptive data analysis was conducted and correlation analysis between selected PSG parameters and the results of vestibular testing was performed using Kendall τ coefficient. Results: A significant correlation between vestibular function and respiratory polysomnographic parameters could not be demonstrated in the study ( P > .05) but cVEMP and oVEMP results showed a trend toward a correlation with oxygen desaturation indices and apnea–hypopnea index. Additionally, otolith hypofunction was more prevalent in patients with hypertension as well as OSA. Conclusion: The results of our study show that there is no significant correlation between vestibular function and sleep apnea parameters, although otolith dysfunction might be more prevalent in patients with OSA and hypertension.

scholarly journals 0610 Prevalence of Positional Obstructive Sleep Apnea Based on 3% Vs 4% Oxygen Desaturation Using Home Sleep Apnea Testing

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A233-A234
Author(s):  
M Mandal ◽  
R Rengan ◽  
S Rani ◽  
J Ramzy ◽  
M Vega Sanchez ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Oxygen Desaturation ◽  
Apnea Hypopnea Index ◽  
Apnea Test ◽  
Positional Obstructive Sleep Apnea ◽  
Obstructive Sleep ◽  
Respiratory Event ◽  
Home Sleep Apnea Testing ◽  
Definition Of

Abstract Introduction Approximately 30% of patient with obstructive sleep apnea (OSA) have positional OSA [non-supine apnea-hypopnea index (AHI) < 5 events/hr]. However, the prevalence is based on variable definitions for hypopneas related to the degree of oxygen desaturation. In addition, use of a home sleep apnea test (HSAT) to identify positional OSA is limited. We hypothesized that in patients evaluated with an HSAT, using a definition for hypopneas based on 4% compared to 3% oxygen desaturation will significantly decrease the percentage diagnosed with positional OSA. Methods Fourteen patients with positional OSA based on a non-supine respiratory event index (REI) < 5 events/hr were included. The initial diagnosis was determined based on a hypopnea definition of ≥ 3% oxygen desaturation. The studies were reanalyzed using a hypopnea definition of ≥ 4% oxygen desaturation. Results Fourteen patients [9 (64%) males, 46±14 yrs, BMI 31±6 kg/m2, ESS 7±5, REI 9±3 events/hr, mean SaO2 94±2%, lowest SaO2 81±6%, %TST SaO2 < 90% 4±6%] were identified with positional OSA (supine REI 16±7 events/hr, non-supine REI 3±1 events/hr) using a hypopneas definition of ≥ 3% oxygen desaturation. When reanalyzed using a hypopnea ≥ 4% oxygen desaturation there was a significant decrease in the REI to 7±2 events/hr (p<0.001). Three patients (21%) no longer were considered to have OSA. These patients were younger (32±14 vs. 50±11yrs, p=0.03) and had less severe OSA (REI 6±1 vs. 9±3 events/hr (p=0.04), but there was no difference in BMI (32±11 vs. 31±5 kg/m2, p=0.9) or mean and lowest SaO2 (96±0.4 vs. 94±2%, p=0.13, and 82±8 vs. 81±6%, p=0.9, respectively). Conclusion In patients with mild positional OSA, using a hypopnea definition of at least 4% vs. 3% oxygen desaturation on a HSAT will have a significant effect on the overall REI and often exclude patients who would otherwise be treated for OSA. Support None.

Agreement Between Oxygen Desaturation Index and Apnea-Hypopnea Index in Adults With Suspected Obstructive Sleep Apnea at an Altitude of 2240 m

2007 ◽  
Vol 43 (12) ◽  
pp. 649-654 ◽  
Author(s):  
Luis Torre-Bouscoulet ◽  
Armando Castorena-Maldonado ◽  
Rocío Baños-Flores ◽  
Juan Carlos Vázquez-García ◽  
María Sonia Meza-Vargas ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Oxygen Desaturation ◽  
Apnea Hypopnea Index ◽  
Desaturation Index ◽  
Oxygen Desaturation Index ◽  
Obstructive Sleep

Observational Study of Obstructive Sleep Apnea in Wake-Up Stroke: The SLEEP TIGHT Study

2016 ◽  
Vol 41 (5-6) ◽  
pp. 233-241 ◽  
Author(s):  
Brian B. Koo ◽  
Daawn M. Bravata ◽  
Lauren A. Tobias ◽  
Jason S. Mackey ◽  
Edward J. Miech ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Ambulatory Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Oxygen Desaturation ◽  
Apnea Hypopnea Index ◽  
Obstructive Sleep ◽  
Nighttime Blood Pressure ◽  
The Mean

Background: Wake-up stroke (WUS) accounts for a quarter of all ischemic strokes. Its conspicuous occurrence during sleep suggests that WUS may be associated with obstructive sleep apnea (OSA). We investigated the potential association among WUS, OSA, and measures of sympathetic hyperactivity. Methods: This is a cross-sectional analysis of data from the Sleep Apnea in Transient Ischemic Attack and Stroke (SLEEP TIGHT) study. Ischemic stroke patients were divided into WUS and non-WUS groups. Participants underwent polysomnography and ambulatory blood pressure monitoring. Collected data included demographic, medical, stroke characteristics (including severity by National Institutes of Health Stroke Scale), cholesterol, serum catecholamines, C-reactive protein, interleukin-6, B-type natriuretic peptide, blood pressure, and polysomnographic (apnea-hypopnea index (AHI); measures of hypoxia). Because both stroke and OSA affect men and women to varying degrees, the cohort was considered as a whole and by gender stratification. Results: Among 164 participants, 30.3% had WUS. The mean age was 62.0 ± 11.3 and the mean body mass index was 30.2 ± 7.9 kg/m2. One-hundred-and-five participants (63.6%) were males and 92 participants (56.8%) were Caucasian. Neither AHI nor OSA (AHI ≥5) frequency differed between WUS and non-WUS groups. Men tended to be more likely than women to have WUS (74.0 vs. 59.6%; p = 0.08), but this was not statistically significant. In gender-stratified analyses, men with WUS compared to men with non-WUS had significantly higher rates of severe OSA (AHI >30: 45.0 vs. 17.6%; p = 0.03) and tended toward more 3% oxygen desaturation events (57.0 ± 63.9 vs. 31.8 ± 22.9; p = 0.06). These differences were not seen in women. WUS patients tended to be of the male gender (74.0 vs. 59.6%; p = 0.08). History of stroke, hypertension, diabetes, dyslipidemia, or atrial fibrillation, serum catecholamines, and inflammatory biomarkers was no different between the groups. Low-density lipoprotein (LDL) was significantly higher in WUS (114.5 ± 36.3 vs. 101.4 ± 37.6; p = 0.04). Baseline diastolic blood pressure (DBP) was significantly greater in the WUS group. There was no difference in systolic or ambulatory blood pressure (including nighttime blood pressure) between WUS and non-WUS groups. Conclusions: WUS may be associated with severe OSA with more oxygen desaturation in men but not in women. WUS may be associated with high DBP and increased LDL cholesterol.

S248 – Supraglottoplasty for Laryngomalacia with Sleep Apnea

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P158-P158
Author(s):  
Mark E Zafereo ◽  
Rodney J Taylor ◽  
Kevin D Pereira
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Arterial Oxygen Saturation ◽  
Arterial Oxygen ◽  
Apnea Hypopnea Index ◽  
Obstructive Apnea ◽  
Respiratory Parameters ◽  
Obstructive Sleep ◽  
Respiratory Disturbance ◽  
Student’S T

Objectives To determine if supraglottoplasty is effective in reversing abnormal respiratory parameters in children with laryngomalacia and obstructive sleep apnea. Methods 10 patients with laryngomalacia and obstructive sleep apnea as documented by polysomnography underwent supraglottoplasty at a tertiary referral children's hospital between 2005 and 2007. Retrospective data collection included age, findings on flexible and rigid endoscopy, type of procedure performed, and postoperative course. The postoperative polysomnographies were reviewed to identify changes in obstructive apnea index (OAI), obstructive apnea/hypopnea index (OAHI), respiratory disturbance index (RDI), and low arterial oxygen saturation (O2 nadir) after supraglottoplasty. Pre- and postoperative mean data were calculated, and comparisons were made with a Student's T-test. Results All 10 patients were successfully extubated following supraglottoplasty. There were no perioperative or postoperative complications, and no patient required a subsequent airway procedure. Each patient had a postoperative nocturnal polysomnography performed following supraglottoplasty at 11 weeks (range 2–29 weeks). Caregivers reported mild improvement (10%), significant improvement (70%), and complete resolution (20%) of stridor and nocturnal snoring at a follow-up visit 4 weeks after hospital discharge. Marked improvements were observed in OAI, OAHI, RDI and O2 nadir, all of which were statistically significant (p<0.05). Conclusions Polysomnography should be included in the initial evaluation of infants with laryngomalacia to rule out obstructive sleep apnea. Supraglottoplasty is an effective treatment for infants with laryngomalacia and obstructive sleep apnea. The significant benefits of the procedure outweigh the low morbidity. Improvement after surgery can be reliably confirmed by polysomnography.

Association of Respiratory Mechanic Instability and Respiratory Parameters among Adults with Obstructive Sleep Apnea

2019 ◽  
Vol 160 (5) ◽  
pp. 928-934
Author(s):  
Ji Ho Choi ◽  
Bora Lee ◽  
Se-Hwan Hwang
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Oxygen Saturation ◽  
Respiratory Mechanic ◽  
Oxygen Desaturation ◽  
Desaturation Index ◽  
Arousal Index ◽  
Oxygen Desaturation Index ◽  
Respiratory Parameters ◽  
Obstructive Sleep

Objectives Respiratory mechanic instability (RMI) is derived from analysis of paradoxical thoracoabdominal movements during airway obstruction. This study aimed to evaluate RMI parameters in obstructive sleep apnea (OSA) and the correlation between RMI parameters and other parameters in polysomnography. Study Design Retrospective review. Setting A university hospital. Methods A retrospective chart review was performed, and data from 189 adult patients who underwent an in-laboratory sleep study and were seen in our clinic during the past 8 months. The RMI parameters were measured from thoracoabdominal bands during polysomnography. Results Subjects were divided into 2 groups: control (n = 67, apnea-hypopnea index [AHI] <5) and OSA (n = 122, AHI ≥5). The OSA group was divided into 3 subgroups according to AHI: mild, 5 ≤ AHI < 15; moderate, 15 ≤ AHI < 30; severe, AHI ≥30. As AHI increased, all RMI parameters showed a significant rising pattern and difference between control and subgroups. Arousal index, lowest oxygen saturation, and oxygen desaturation index ≥3% were significantly correlated with all RMI parameters. Based on cutoff values, areas under the curves of the RMI index for predicting mild, moderate, and severe OSA were >0.85. Conclusion All RMI parameters were well related to respiratory parameters of polysomnography, such as arousal index, lowest oxygen saturation, and oxygen desaturation index ≥3%. The areas under the curves of all RMI parameters for predicting OSA and subgroups showed significant diagnostic performance. These parameters may be useful to identify OSA cases from control.

scholarly journals Evaluation of Erectile Dysfunction in Nonobese, Nondiabetic Men with Obstructive Sleep Apnea

2021 ◽  
Vol 14 (1) ◽  
pp. 4-12
Author(s):  
Ana Carolina D. Scoralick ◽  
Alonço da C. Viana Júnior ◽  
André L. Cavalcanti ◽  
Ana Paula C. dos Santos ◽  
Denise D. Neves ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Erectile Dysfunction ◽  
Sleep Apnea ◽  
Sleep Apnea Syndrome ◽  
Laboratory Diagnosis ◽  
Oxygen Desaturation ◽  
Apnea Hypopnea Index ◽  
Total Testosterone ◽  
Cross Sectional ◽  
Obstructive Sleep

Background: Erectile Dysfunction (ED) has affected people suffering from Obstructive Sleep Apnea Syndrome (OSAS) and multiple studies have confirmed this correlation. Objective: The objective of the is to identify the association between ED and Obstructive Sleep Apnea (OSA) in nonobese, nondiabetic men based on the International Index of Erectile Function (IIEF). Methods: This retrospective cross-sectional study included 143 nonobese, nondiabetic men with OSA (age, ≥20 years) who visited the Sleep Outpatient Clinic of the Otorhinolaryngology Department at Hospital Naval Marcílio Dias from May 2017 to August 2018. Patient age, body mass index (BMI), drinking, smoking, laboratory diagnosis of hypogonadism based on total testosterone levels, and sleep parameters (e.g., apnea–hypopnea index, rapid eye movement density, and minimum Oxygen Saturation [SatO2]) were considered. Analysis of variance was used to evaluate means. The chi-squared test and Fisher’s exact test were used to compare variables and Person’s correlation coefficient was used to analyze numerical variables. Results: The mean minimum SatO2 was 78.89%, and 46% of patients exhibited minimum SatO2 <80%. Moreover, minimum SatO2 of <80% and increasing age were associated with ED complaints based on IIEF scores,. A laboratory diagnosis of hypogonadism was associated with increased BMI, and aging was associated with SatO2. Conclusion: The results of the study revealed that oxygen desaturation of <80% was related to complaints of ED from the IIEF. Moreover, a relationship between laboratory hypogonadism and increased BMI values, aging, and oxygen desaturation has been demonstrated. Therefore, we recommend polysomnography in patients with ED complaints.

Outcome of Adenotonsillectomy for Obstructive Sleep Apnea in Obese and Normal-Weight Children

2007 ◽  
Vol 137 (1) ◽  
pp. 43-48 ◽  
Author(s):  
Ron B. Mitchell ◽  
James Kelly
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Controlled Trial ◽  
Normal Weight ◽  
Apnea Hypopnea Index ◽  
Dramatic Improvement ◽  
Obese Children ◽  
Respiratory Parameters ◽  
Obstructive Sleep ◽  
Study Participants

OBJECTIVES: 1) To evaluate the relative severity of obstructive sleep apnea (OSA) in obese and normal-weight children; 2) to compare changes in respiratory parameters after adenotonsillectomy in obese and normal-weight children. STUDY DESIGN AND SETTING: Prospective controlled trial that included children aged 3 to 18 years. All study participants underwent pre- and postoperative polysomnography. RESULTS: The study population included 33 obese children and 39 normal-weight controls. Preoperatively, the median obstructive apnea-hypopnea index (AHI) was 23.4 (range 3.7-135.1) for obese and 17.1 (range 3.9-36.5) for controls ( P < 0.001). Postoperatively, the AHI was 3.1 (range 0-33.1) for obese and 1.9 (range 0.1-7.0) for controls ( P < 0.01). Twenty-five obese children (76%) and 11 controls (28%) had persistent OSA. CONCLUSION AND SIGNIFICANCE: AHI scores are higher in obese than in normal-weight children with OSA. Both groups show a dramatic improvement in AHI after adenotonsillectomy, but persistent OSA is more common in obese children.

scholarly journals Prediction of obstructive sleep apnea: comparative performance of three screening instruments on the apnea-hypopnea index and the oxygen desaturation index

2020 ◽  
Author(s):  
Christianne C. A. F. M. Veugen ◽  
Emma M. Teunissen ◽  
Leontine A. S. den Otter ◽  
Martijn P. Kos ◽  
Robert J. Stokroos ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Oxygen Desaturation ◽  
Screening Tools ◽  
Apnea Hypopnea Index ◽  
Screening Instruments ◽  
Comparative Performance ◽  
Desaturation Index ◽  
Oxygen Desaturation Index ◽  
Obstructive Sleep

Abstract Purpose To evaluate the performance of the NoSAS (neck, obesity, snoring, age, sex) score, the STOP-Bang (snoring, tiredness, observed apneas, blood pressure, body mass index, age, neck circumference, gender) questionnaire, and the Epworth sleepiness score (ESS) as a screening tool for obstructive sleep apnea (OSA) severity based on the apnea-hypopnea index (AHI) and the oxygen desaturation index (ODI). Methods Data from 235 patients who were monitored by ambulant polysomnography (PSG) were retrospectively analyzed. OSA severity was classified based on the AHI; similar classification categories were made based on the ODI. Discrimination was assessed by the area under the curve (AUC), while predictive parameters were calculated by four-grid contingency tables. Results The NoSAS score and the STOP-Bang questionnaire were both equally adequate screening tools for the AHI and the ODI with AUC ranging from 0.695 to 0.767 and 0.684 to 0.767, respectively. Both questionnaires perform better when used as a continuous variable. The ESS did not show adequate discrimination for screening for OSA (AUC ranging from 0.450 to 0.525). Male gender, age, and BMI proved to be the strongest individual predictors in this cohort. Conclusion This is the first study to evaluate the predictive performance of three different screening instruments with respect to both the AHI and the ODI. This is important, due to increasing evidence that the ODI may have a higher reproducibility in the clinical setting. The NoSAS score and the STOP-Bang questionnaire proved to be equally adequate to predict OSA severity based on both the AHI and the ODI.

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