Obstructive sleep apnoea is more prevalent in men with schizophrenia compared to general population controls: results of a matched cohort study

2018 ◽  
Vol 26 (6) ◽  
pp. 600-603 ◽  
Author(s):  
Hannah Myles ◽  
Andrew Vincent ◽  
Nicholas Myles ◽  
Robert Adams ◽  
Madhu Chandratilleke ◽  
...  
Keyword(s):  
Relative Risk ◽  
General Population ◽  
Obstructive Sleep Apnoea ◽  
Population Group ◽  
Sleep Apnoea ◽  
General Population Study ◽  
Obstructive Sleep ◽  
General Population Group ◽  
Relative Prevalence ◽  
Population Controls

Objectives: Obstructive sleep apnoea (OSA) may be more common in people with schizophrenia compared to the general population, but the relative prevalence is unknown. Here, we determine the relative prevalence of severe OSA in a cohort of men with schizophrenia compared to representative general population controls, and investigate the contribution of age and body mass index (BMI) to differences in prevalence. Methods: Rates of severe OSA (apnoea–hypopnoea index > 30) were compared between male patients with schizophrenia and controls from a representative general population study of OSA. Results: The prevalence of severe OSA was 25% in the schizophrenia group and 12.3% in the general population group. In subgroups matched by age, the relative risk of severe OSA was 2.9 ( p = 0.05) in the schizophrenia subjects, but when adjusted for age and BMI, the relative risk dropped to 1.7 and became non-significant ( p = 0.17). Conclusions: OSA is prevalent in men with schizophrenia. Obesity may be an important contributing factor to the increased rate of OSA.

Obstructive Sleep Apnoea, Atrial Fibrillation and Erectile Dysfunction – The OSAFED Syndrome – Is there More than Meets the Eye?

2015 ◽  
Vol 01 (01) ◽  
pp. 19
Author(s):  
Filip M Szymanski ◽  
Anna E Platek ◽  
Krzysztof J Filipiak ◽  
◽  
◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Erectile Dysfunction ◽  
Clinical Practice ◽  
Cardiovascular Risk ◽  
General Population ◽  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Clinical Syndromes ◽  
Obstructive Sleep

Obstructive sleep apnoea, atrial fibrillation and erectile dysfunction (OSAFED) syndrome is a new clinical entity recently introduced into clinical practice. The acronym consists of the first letters of the three clinical entities that comprise the disease, namely obstructive sleep apnoea (OSA), atrial fibrillation (AF) and erectile dysfunction (ED). As with many other clinical syndromes, OSAFED syndrome groups several clinical entities, which seemingly concern various organs and have different symptoms, but are closely associated by sharing risk factors and phenotype, and effecting cardiovascular risk in the same manner. OSA, AF and ED are also highly prevalent in the general population and tend to coexist. OSAFED syndrome was named as such to show how important diagnosis is of all these components in specific groups of patient. It is crucial for clinicians to improve the diagnosis and early treatment of all – OSA, AF and ED – and the incorporation of all these factors into one syndrome might help to facilitate this process.

scholarly journals Polysomnographic Evaluation of OSA in Patients of Bronchial Asthma

2020 ◽  
Vol 5 (12) ◽  
pp. 595-598
Author(s):  
Dar Mohd Yousoof ◽  
Jamal Mohammad ◽  
Mir Shahnawaz ◽  
Shah Naveed Nazir ◽  
Dar Khursheed ◽  
...  
Keyword(s):  
General Population ◽  
Bronchial Asthma ◽  
Obstructive Sleep Apnoea ◽  
Risk Group ◽  
Communicable Disease ◽  
Sleep Apnoea ◽  
High Risk Group ◽  
North India ◽  
Obstructive Sleep ◽  
Asthma Patients

Introduction: Bronchial asthma a common non-communicable disease affecting more than 300 million people world-wide. Compared to general population quality of sleep is poor in asthma patients due to various factors like poor control of asthma, co-morbidities like allergic rhinitis and oesophageal reflex disease but little is known about the potential role of obstructive sleep apnoea. Aims and objectives: This study was conducted is to evaluate the association between Asthma and risk of developing Obstructive Sleep Apnoea. Materials and methods: This was a prospective design study conducted on 137 patients of diagnosed bronchial asthma attending out-patient department of a referral chest from north India after ethical clearance. These patients underwent Berlin score assessment first and later level-1 polysomnography to evaluate for OSA. Results: prevalence of PSG documented OSA observed was 53.3% which is significantly higher than the general population and there was significant association with increasing age as 54.7% of patients were in middle aged population (40-60 years) and obesity with 67.1% patients having OSA with BMI >30 compared to 37.5% prevalence only with BMI <30, as well as with severity of asthma. Besides OSA was seen in 91.9% of Berlin high risk group patients, while it was found in only 21.3 % of Berlin low-risk group. Conclusion: prevalence of OSA in asthma patients is significantly higher as compared to general population and there is significant positive co-relation between severity of asthma, BMI, increasing age and higher Berlin score with the overall prevalence of OSA.

scholarly journals Obstructive sleep apnoea as a risk factor for incident metabolic syndrome: a joined Episono and HypnoLaus prospective cohorts study

2018 ◽  
Vol 52 (5) ◽  
pp. 1801150 ◽  
Author(s):  
Camila Hirotsu ◽  
Jose Haba-Rubio ◽  
Sonia M. Togeiro ◽  
Pedro Marques-Vidal ◽  
Luciano F. Drager ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Risk Factor ◽  
General Population ◽  
Obstructive Sleep Apnoea ◽  
Arterial Oxygen Saturation ◽  
Sleep Apnoea ◽  
Arterial Oxygen ◽  
Obstructive Sleep ◽  
Increased Risk

Cross-sectional studies have demonstrated that obstructive sleep apnoea (OSA) and metabolic syndrome (MetS) are often associated, but whether a temporal relationship exists is unknown. We aimed to investigate the effect of OSA on the risk of developing MetS in the general population.A prospective study was conducted combining two population-based samples: Episono (Brazil) and HypnoLaus (Switzerland). MetS was assessed according to unified criteria. Polysomnography (PSG) was performed at baseline and follow-up in Episono, and at baseline in HypnoLaus. OSA was defined according to the apnoea–hypopnoea index as mild (≥5– <15 events h−1) and moderate-to-severe (≥15 events·h−1). We included 1853 participants (mean±sd age 52±13 years, 56% female) without MetS at baseline.After mean±sd 6±1 years, 318 (17.2%) participants developed MetS. Moderate-to-severe OSA was independently associated with incident MetS (OR 2.58, 95% CI 1.61–4.11) and increased the number of MetS components from baseline to follow-up through mediation of the percentage of time with arterial oxygen saturation <90%. Subset analysis in Episono confirmed that the increase in this parameter between baseline and follow-up PSGs represented a risk factor for incident MetS (OR 1.42, 95% CI 1.04–1.95, for each 10% increase).OSA is independently associated with an increased risk of developing MetS through mediation of nocturnal hypoxaemia in the general population.

scholarly journals Clinical effectiveness and cost-effectiveness results from the randomised controlled Trial of Oral Mandibular Advancement Devices for Obstructive sleep apnoea–hypopnoea (TOMADO) and long-term economic analysis of oral devices and continuous positive airway pressure

2014 ◽  
Vol 18 (67) ◽  
pp. 1-296 ◽  
Author(s):  
Linda Sharples ◽  
Matthew Glover ◽  
Abigail Clutterbuck-James ◽  
Maxine Bennett ◽  
Jake Jordan ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Relative Risk ◽  
Obstructive Sleep Apnoea ◽  
Clinical Effectiveness ◽  
Cost Effective ◽  
Sleep Apnoea ◽  
Mandibular Advancement ◽  
Obstructive Sleep ◽  
Mandibular Advancement Devices

BackgroundObstructive sleep apnoea–hypopnoea (OSAH) causes excessive daytime sleepiness (EDS), impairs quality of life (QoL) and increases cardiovascular disease and road traffic accident risks. Continuous positive airway pressure (CPAP) treatment is clinically effective but undermined by intolerance, and its cost-effectiveness is borderline in milder cases. Mandibular advancement devices (MADs) are another option, but evidence is lacking regarding their clinical effectiveness and cost-effectiveness in milder disease.Objectives(1) Conduct a randomised controlled trial (RCT) examining the clinical effectiveness and cost-effectiveness of MADs against no treatment in mild to moderate OSAH. (2) Update systematic reviews and an existing health economic decision model with data from the Trial of Oral Mandibular Advancement Devices for Obstructive sleep apnoea–hypopnoea (TOMADO) and newly published results to better inform long-term clinical effectiveness and cost-effectiveness of MADs and CPAP in mild to moderate OSAH.TOMADOA crossover RCT comparing clinical effectiveness and cost-effectiveness of three MADs: self-moulded [SleepPro 1™ (SP1); Meditas Ltd, Winchester, UK]; semibespoke [SleepPro 2™ (SP2); Meditas Ltd, Winchester, UK]; and fully bespoke [bespoke MAD (bMAD); NHS Oral-Maxillofacial Laboratory, Addenbrooke’s Hospital, Cambridge, UK] against no treatment, in 90 adults with mild to moderate OSAH. All devices improved primary outcome [apnoea–hypopnoea index (AHI)] compared with no treatment: relative risk 0.74 [95% confidence interval (CI) 0.62 to 0.89] for SP1; relative risk 0.67 (95% CI 0.59 to 0.76) for SP2; and relative risk 0.64 (95% CI 0.55 to 0.76) for bMAD (p < 0.001). Differences between MADs were not significant. Sleepiness [as measured by the Epworth Sleepiness Scale (ESS)] was scored 1.51 [95% CI 0.73 to 2.29 (SP1)] to 2.37 [95% CI 1.53 to 3.22 (bMAD)] lower than no treatment (p < 0.001), with SP2 and bMAD significantly better than SP1. All MADs improved disease-specific QoL. Compliance was lower for SP1, which was unpopular at trial exit. At 4 weeks, all devices were cost-effective at £20,000/quality-adjusted life-year (QALY), with SP2 the best value below £39,800/QALY.Meta-analysisA MEDLINE, EMBASE and Science Citation Index search updating two existing systematic reviews (one from November 2006 and the other from June 2008) to August 2013 identified 77 RCTs in adult OSAH patients comparing MAD with conservative management (CM), MADs with CPAP or CPAP with CM. MADs and CPAP significantly improved AHI [MAD −9.3/hour (p < 0.001); CPAP −25.4/hour (p < 0.001)]. Effect difference between CPAP and MADs was 7.0/hour (p < 0.001), favouring CPAP. No trials compared CPAP with MADs in mild OSAH. MAD and CPAP reduced the ESS score similarly [MAD 1.6 (p < 0.001); CPAP 1.6 (p < 0.001)].Long-term cost-effectivenessAn existing model assessed lifetime cost–utility of MAD and CPAP in mild to moderate OSAH, using the revised meta-analysis to update input values. The TOMADO provided utility estimates, mapping ESS score to European Quality of Life-5 Dimensions three-level version for device cost–utility. Using SP2 as the standard device, MADs produced higher mean costs and mean QALYs than CM [incremental cost-effectiveness ratio (ICER) £6687/QALY]. From a willingness to pay (WTP) of £15,367/QALY, CPAP is cost-effective, although the likelihood of MADs (p = 0.48) and CPAP (p = 0.49) being cost-effective is very similar. Both were better than CM, but there was much uncertainty in the choice between CPAP and MAD (at a WTP £20,000/QALY, the probability of being the most cost-effective was 47% for MAD and 52% for CPAP). When SP2 lifespan increased to 18 months, the ICER for CPAP compared with MAD became £44,066. The ICER for SP1 compared with CM was £1552, and for bMAD compared with CM the ICER was £13,836. The ICER for CPAP compared with SP1 was £89,182, but CPAP produced lower mean costs and higher mean QALYs than bMAD. Differential compliance rates for CPAP reduces cost-effectiveness so MADs become less costly and more clinically effective with CPAP compliance 90% of SP2.ConclusionsMandibular advancement devices are clinically effective and cost-effective in mild to moderate OSAH. A semi-bespoke MAD is the appropriate first choice in most patients in the short term. Future work should explore whether or not adjustable MADs give additional clinical and cost benefits. Further data on longer-term cardiovascular risk and its risk factors would reduce uncertainty in the health economic model and improve precision of effectiveness estimates.Trial registrationThis trial is registered as ISRCTN02309506.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 18, No. 67. See the NIHR Journals Library website for further project information.

Associations between obstructive lung disease and symptoms of obstructive sleep apnoea in a general population

2016 ◽  
Vol 12 (1) ◽  
pp. 31-39 ◽  
Author(s):  
Trygve Müller Jonassen ◽  
Tomas Mikal Eagan ◽  
Bjørn Bjorvatn ◽  
Sverre Lehmann
Keyword(s):  
General Population ◽  
Lung Disease ◽  
Obstructive Sleep Apnoea ◽  
Obstructive Lung Disease ◽  
Sleep Apnoea ◽  
Obstructive Sleep

scholarly journals Predicted relative prevalence estimates for obstructive sleep apnoea and the associated healthcare provision across the UK

Thorax ◽  
2013 ◽  
Vol 69 (4) ◽  
pp. 390-392 ◽  
Author(s):  
Joerg Steier ◽  
Alistair Martin ◽  
Judy Harris ◽  
Ian Jarrold ◽  
Darien Pugh ◽  
...  
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Healthcare Provision ◽  
Obstructive Sleep ◽  
Prevalence Estimates ◽  
Relative Prevalence ◽  
The Uk

scholarly journals Mortality and morbidity in obstructive sleep apnoea–hypopnoea syndrome: results from a 30-year prospective cohort study

2020 ◽  
Vol 6 (3) ◽  
pp. 00057-2020 ◽  
Author(s):  
Sophie Dodds ◽  
Linda J. Williams ◽  
Amber Roguski ◽  
Marjorie Vennelle ◽  
Neil J. Douglas ◽  
...  
Keyword(s):  
Cohort Study ◽  
General Population ◽  
Prospective Cohort Study ◽  
Obstructive Sleep Apnoea ◽  
Prospective Cohort ◽  
Sleep Apnoea ◽  
Mortality And Morbidity ◽  
Obstructive Sleep

BackgroundObstructive sleep apnoea–hypopnoea syndrome (OSAHS) carries substantial negative health consequences. This study examines factors affecting mortality and morbidity according to continuous positive airway pressure (CPAP) use and predictors affecting CPAP adherence in a longitudinal cohort of OSAHS patients.Materials and methodsThis prospective, cohort study comprised 4502 patients who were diagnosed with OSAHS at a tertiary sleep disorders centre between 1982 and 2003. Of these, 1174 patients completed follow-up in 2012. Data collected included anthropometric, sleep and demographic characteristics, including comorbidities, ongoing medications and CPAP adherence. Patients were followed up for an average of 14.8±3.7 years.ResultsImputation analysis showed that long-term CPAP users (>5 years) were 5.63 times more likely to be alive at study end than non-CPAP users (95% CI: 4.83–6.58, p<0.001) and 1.74-times more likely than short-term CPAP users (≤5 years) (95% CI: 1.49–2.02, p<0.001). Females had a significantly higher mortality rate during the follow-up period (26.8% versus 19.6%, p<0.001). Respiratory mortality was more common in patients with OSAHS, in particular those who did not use CPAP, compared to the general population (17.2% versus 12.2%, p=0.002 respectively), whereas deaths from cancer were less common compared to the general population (16.2% versus 25.6%, p<0.001). Compared to CPAP users, non-CPAP-users had a significantly increased incidence of type II diabetes mellitus (DMII) (27.9% versus 18.7%, p=0.003), ischaemic heart disease (IHD) (25.5% versus 12.7%, p<0.001) and myocardial infarction (MI) (14.7% versus 4.2%, p<0.001) at long-term follow-up.ConclusionsLong-term CPAP use in men and women with OSAHS reduces mortality and decreases the incidence of DMII and cardiovascular disease.

High prevalence of undiagnosed obstructive sleep apnoea in the general population and methods for screening for representative controls

2012 ◽  
Vol 17 (3) ◽  
pp. 967-973 ◽  
Author(s):  
Laila Simpson ◽  
David R. Hillman ◽  
Matthew N. Cooper ◽  
Kim L. Ward ◽  
Michael Hunter ◽  
...  
Keyword(s):  
General Population ◽  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Obstructive Sleep ◽  
High Prevalence

The role of dry mouth in screening sleep apnea

2020 ◽  
pp. postgradmedj-2020-137619
Author(s):  
Cheng Zhang ◽  
Yane Shen ◽  
Feng Liping ◽  
Jing Ma ◽  
guang-fa wang
Keyword(s):  
Sleep Apnea ◽  
General Population ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Population Group ◽  
Dry Mouth ◽  
Clinical Population ◽  
Diagnostic Efficacy ◽  
Obstructive Sleep ◽  
General Population Group

Purpose of the studyEffective screening questionnaires are essential for early detection of obstructive sleep apnea (OSA). The STOP-Bang questionnaire has high sensitivity but low specificity. Dry mouth is a typical clinical sign of OSA. We hypothesised that adding dry mouth in the STOP-Bang questionnaire would improve its specificity.Study designA survey of the incidence of dry mouth was performed in a general population group and suspected sleep apnea clinical population group. Patients with suspected OSA were assessed by laboratory polysomnography and STOP-Bang questionnaire was performed. Adding the option of dry mouth to the OSA screening questionnaire resulted in a new quesionnaire, where cut-off value, diagnostic efficacy and the predictive parameters (sensitivity, specificity, positive predictive value and negative predictive value) were explored.Results(In the 912 general population group, the incidence of dry mouth in the snoring group (54.0%) was much higher than that in the non-snoring group (30.5%) (p<0.05). In 207 patients with suspected OSA, the incidence of dry mouth in the OSA group was much higher than that in the non-OSA group (p<0.05). The sensitivity and specificity of the STOP-Bang questionnaire were 88.8% and 23.7% for identifying OSA, and 92.2% and 23.1% for identifying moderate and severe OSA, respectively. Adding the option of dry mouth (dry mouth every morning) to the STOP-Bang questionare resulted in a new questionnaire (STOP-Bang-dry-mouth questionnarie) with 9 items. Its sensitivity and specificity were 81.70% and 42.10% for identifying OSA, and 89.10% and 42.30% for identifying moderate and severe OSA, respectively.ConclusionsThe dry mouth symptom correlated with snoring and sleep apnea. The specificity of the STOP-Bang questionnaire can be improved by integrating dry mouth. The diagnostic accuracy of the STOP-Bang-dry mouth questionnaire is yet to be further verified in prospective studies.

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