Delivery outcomes as a result of snoring as determined by standard sleep surveys

2021 ◽  
pp. 1753495X2110641
Author(s):  
A Robertson ◽  
A Makris ◽  
P Johnson ◽  
S Middleton ◽  
M Norman ◽  
...  

Background Sleep-disordered breathing (SDB), is an umbrella term that encompasses obstructive sleep apnea (OSA), central sleep apnea (CSA) and hypoventilation. is common but studies in the pregnant population are limited. Data suggests relationships between OSA and preeclampsia, but the relationship between snoring and pregnancy outcomes is unknown. Methods A prospective study of 2224 singleton pregnancies was undertaken. Women were questioned using the Berlin Questionnaire (BQ- 2 or more categories where the score is positive.) and the Epworth Sleepiness Scale (ESS >10/24), the results compared with pregnancy outcomes with regard to hypertension in pregnancy. Results Women having symptoms raising the possibility of OSA defined by the BQ with a score >7 was 45.5%, and using ESS with a score >10, was 36%. The birth and neonatal outcomes for self-reported snoring and increased daytime sleepiness showed increased adverse outcomes notably increased caesarean section rates and low APGAR scores but not birth before 37 weeks of gestation. Conclusion Using questionnaires designed for the general population, the prevalence of possible undiagnosed OSA is high in the pregnant population. The increased adverse delivery and neonatal outcomes for self-reported snoring and increased daytime sleepiness with these tools indicated the need for further investigation of the links between snoring SDB and pregnancy outcomes.

2021 ◽  
pp. 1-6
Author(s):  
Anand K. Bery ◽  
Jayson Lee Azzi ◽  
Andre Le ◽  
Naomi S. Spitale ◽  
Judith Leech ◽  
...  

BACKGROUND: Obstructive sleep apnea (OSA) has been linked to vestibular dysfunction, but no prior studies have investigated the relationship between Persistent Postural Perceptual Dizziness (PPPD), a common cause of chronic dizziness, and OSA. OBJECTIVE AND METHODS: We determined the frequency of OSA in an uncontrolled group of PPPD patients from a tertiary dizziness clinic based on polysomnogram (PSG). We then assessed the sensitivity and specificity of common OSA questionnaires in this population. RESULTS: Twenty-five patients with PPPD underwent PSG (mean age 47, 60% female, mean BMI 29.5). A majority, or 56%, of patients were diagnosed with OSA, and in most, the OSA was severe. OSA patients were older (56 years versus 40 years, p = 0.0006) and had higher BMI (32 versus 26, p = 0.0078), but there was no clear gender bias (56% versus 64% female, p = 1.00). The mean sensitivity and specificity of the STOP BANG questionnaire for detecting OSA was 86% and 55%, respectively. Sensitivity and specificity of the Berlin Questionnaire was 79% and 45%, respectively. CONCLUSIONS: The prevalence of OSA was much higher in our small PPPD group than in the general population. Screening questionnaires appear to demonstrate good sensitivity to detect PPPD patients at risk of OSA in this small study. Future studies should confirm these findings and determine whether treatment of OSA improves symptoms in PPPD.


2021 ◽  
Vol 12 ◽  
Author(s):  
Danwei Zhang ◽  
Zhen Zhang ◽  
Huihua Li ◽  
Kaimo Ding

Excessive daytime sleepiness (EDS) is a significant public health concern, with obstructive sleep apnea (OSA) being a common cause, and a particular relationship exists with the severity of depression. A literature search on OSA, depression, and EDS was performed in PubMed. The chosen evidence was limited to human studies. Available evidence was systematically reviewed to ascertain the association of EDS with depression and OSA according to the general population and some specific population subgroups. In addition, effectiveness of continuous positive airway pressure (CPAP) was analyzed as a standard therapy for improving EDS and depression in patients with OSA. In the general population, patients with OSA, and some other subpopulations, the review contributed to: (1) delineating the prevalence of EDS; (2) substantiating the relationship of EDS and depression; (3) presenting the relationship between EDS and OSA; and (4) revealing that the duration of CPAP is crucial for its therapeutic effects in improving EDS and depressive symptoms in patients with OSA.


2017 ◽  
Vol 2 (1) ◽  

Introduction: Obstructive sleep apnea syndrome (OSAS) is the most common sleep-related respiratory disorder. With the purpose of assisting in the screening or evaluation of OSAS patients, some scales and questionnaires were proposed. Objective: To evaluate and critically compare the relationship of excessive daytime sleepiness with the presence or absence of OSAS, in addition to other polysomnographic data. Material and method: Systematic review of the literature. Results: Six studies were included, with a total of 4258 patients; four studies demonstrate association between the Epworth sleepiness scale and the hypopnea apnea index (AIH); of those, two studies showed significant differences between ESS score and OSAS severity. Five studies (4233 patients) demonstrated lower minimum oxygen saturation in the group with excessive daytime sleepiness. There was an increase in sleep efficiency in in patients with excessive daytime sleepiness, as per the results of 3 studies (3002 patients). Discussion: The relationship between the presence of excessive daytime sleepiness and OSAS is still questioned, and its pathophysiological mechanism uncertain. Excessive daytime sleepiness secondary to OSAS seems to be an independent event, related to nocturnal hypoxemia and sleep fragmentation. Conclusion: The confidence intervals obtained from these studies do not provide clinical safety to use the Epworth sleepiness scale for screening or stratifying the risk of patients suspected of having sleep apnea.


Medicina ◽  
2019 ◽  
Vol 55 (8) ◽  
pp. 468 ◽  
Author(s):  
Alexia Alexandropoulou ◽  
Georgios D. Vavougios ◽  
Chrissi Hatzoglou ◽  
Konstantinos I. Gourgoulianis ◽  
Sotirios G. Zarogiannis

Background and objectives: The risk assessment of Obstructive Sleep Apnea (OSA) and Excessive Daytime Sleepiness (EDS) in specific occupational populations is important due to its association with morbidity. The aim of the present study was to identify the risk of OSA development and EDS in a Greek nursing staff population. Materials and Methods: In this cross-sectional study a total of 444 nurses, 56 males (age = 42.91 ± 5.76 years/BMI = 27.17 ± 4.32) and 388 females (age = 41.41 ± 5.92 years/BMI = 25.08 ± 4.43) working in a Greek secondary and tertiary hospital participated during the period from 18 January 2015 to 10 February 2015. The participants completed the Berlin Questionnaire (BQ), concerning the risk for OSA and the Epworth Sleepiness Scale (ESS), concerning the EDS. The work and lifestyle habits of the participants were correlated with the results of the questionnaires. Results: According to the BQ results 20.5% (n = 91) of the nursing staff was at high risk for OSA. Increased daytime sleepiness affected 27.7% (n = 123) of the nurses according to ESS results. Nurses at risk for Obstructive Sleep Apnea Syndrome (OSAS), positive for both BQ and ESS, were 7.66% (n = 34). Out of the nurses that participated 77% (n = 342) were working in shifts status and had significant meal instability (breakfast p < 0.0001, lunch p < 0.0001, dinner p = 0.0008). Conclusions: The population at high risk for OSA and EDS in the nursing staff was found to be 20% and 28% respectively. High risk for OSAS was detected in 7.66% of the participants. The high risk for OSA and EDS was the same irrespective of working in shift status. In specific, nursing population age was an independent predictor for high risk for OSA and skipping lunch an independent predictor of daytime sleepiness.


2017 ◽  
Vol 142 (12) ◽  
pp. 912-923
Author(s):  
Benedikt Linz ◽  
Michael Böhm ◽  
Dominik Linz

AbstractThe prevalence of sleep-disordered breathing (SDB) is high in patients with cardiovascular diseases. Typical symptoms like daytime sleepiness can be absent and those patients may report unspecific, therapy-resistant symptoms related to their underlying disease. Particularly sleep-related symptoms like nocturia, nocturnal dyspnea and pectangina can be present. Based on the results of recently published studies, the treatment of central sleep apnea in patients with symptomatic, systolic heart failure by adaptive servo-ventilation is no longer recommended. Although the treatment of obstructive sleep apnea did not prevent cardiovascular events, it improved snoring, daytime sleepiness and health-related quality of life. Furthermore, studies imply that treatment of SDB should be considered as an adjunct treatment modality in patients with hypertension and atrial fibrillation. Due to the high prevalence, screening for SDB can help to identify patients at high cardiovascular risk.


2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Mohammed Adam Ahmed Elnour ◽  
Abdulmoneim Ahmed Saleh ◽  
Mowffaq Mohammed Kalantan ◽  
Hyder Osman Mirghani

Abstract Objectives The study aimed to assess the relationship between coffee intake, obstructive sleep apnea risk (OSA), and glycemic control among patients with diabetes mellitus. Results There were 110 patients with diabetes and 96 healthy control subjects (matched for age and sex) attending a diabetes center زinTabuk, Saudi Arabia during the period from June 2018–October 2019. Stop-Bang questionnaire was used to assess OSA risk, and Epworth Sleepiness Scale to investigate daytime sleepiness. OSA risk and daytime sleepiness were higher among patients with diabetes compared to controls (4.34 ± 1.61 vs. 2.86 ± 1.24, and 8.31 ± 4.40 vs. 6.39 ± 3.70 respectively, P < 0.5), while coffee consumption was not (4.64 ± 3.95 vs. 3.45 ± 3.06, P > 0.05). Women with diabetes were younger with short duration since the diagnosis of diabetes and consumed less coffee compared to men, P < 0.5. A negative correlation was found between coffee consumption and the duration of diabetes, while no correlation was found between coffee intake, the glycated hemoglobin, OSA risk, sex, and daytime sleepiness. Daytime sleepiness and OSA risk were commoners among patients with diabetes, they were not correlated with coffee consumption which was negatively correlated with the duration since diabetes diagnosis. Further larger multi-center studies investigating coffee intake among patients newly diagnosed with diabetes are recommended.


2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Hamid Reza Javadi ◽  
Shabnam Jalilolghadr ◽  
Zohreh Yazdi ◽  
Zeinab Rezaie Majd

Background. Obstructive sleep apnea (OSA) syndrome is one of the most common respiratory disorders in humans. There is emerging evidence linking OSA to vascular disease, particularly hypertension. The underlying pathophysiological mechanisms that link OSA to cardiovascular diseases such as hypertension, congestive heart failure, and atrial fibrillation are not entirely understood. The aim of this study was to investigate the association of obstructive sleep apnea hypopnea syndrome (OSAHS) with coronary atherosclerotic disease (CAD). Methods. A questionnaire survey based on Berlin questionnaire and Epworth Sleepiness Scale (ESS) was conducted among 406 patients to assess demographic data and the symptoms, such as excessive daytime sleepiness and snoring. Epworth Sleepiness Scale and Berlin questionnaire were completed by all of the patients. Venous blood samples were obtained for biochemical tests. Characteristics of coronary arteries were collected from angiographies’ reports. All patients were divided into two groups based on results from Berlin questionnaire: low risk patients for OSA and high risk patients for OSA. Data were analyzed by SPSS software version 13. Results. Mean age of patients was 61.8±10.5. 212 (52.2%) patients were categorized as high risk group for apnea. Also, excessive daytime sleepiness was reported in 186 patients (45.8%). The severity of coronary artery involvement, daytime sleepiness, and electrocardiogram abnormalities was significantly higher in high risk patients for OSA compared with low risk patients. High risk patients had higher level of FBS and LDL and lower level of HDL cholesterol P<0.05. Conclusion. Our study found a strong correlation between the number of stenotic vessels and OSA. Based on our findings, OSA can be a predisposing factor for cardiac diseases.


SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A328-A328
Author(s):  
Ugorji Okorie ◽  
Rupa Koothirezhi ◽  
Pratibha Anne ◽  
Oleg Chernyshev ◽  
Cesar Liendo ◽  
...  

Abstract Introduction Introduction/Background: A new protocol and standard of care was created amidst the COVID-19 Pandemic that began in 2020. Traditional split night studies fell out of favor and were replaced by solely diagnostic studies with placement on Auto-PAP therapy if treatment of sleep disordered breathing was required. Some patients, however, required a more tailored approach if diagnostic polysomnogram (PSG) was particularly concerning. Our case report describes the treatment of a patient with severe Mixed Apnea Predominant Obstructive Sleep Apnea (OSA) with accompanying Central Sleep Apnea (CSA) using COVID-19 Precautions. Report of case(s) Case Description: A 48 year old AAM patient with a PMH of HTN, pre-diabetes, GERD, obesity and tobacco abuse initially presented to Sleep Medicine in late January 2020 with complaints of snoring, witnessed apneas, waking up gasping, excessive daytime sleepiness, fatigue, and non-restorative sleep for many years with ESS 24 and FSS 48 on initial evaluation. Diagnostic PSG showed AHI 76.9 with O2 desaturation to 59% and demonstrated the presence of severe Mixed Apnea predominant OSA and CSA with worsening during REM sleep. Because of the severity, he underwent a PAP titration in August 2020 using the AASM COVID-19 sleep study precautions which included use of a negative pressure room. Optimal control of snoring, apneic respiratory events and oxygen desaturations was achieved at 14 cm H2O in the supine body position during REM sleep. Follow up with Sleep Medicine in October and December 2020 showed objective compliance over a 30 day period not completely at goal due to issues with mask desensitization and sleep hygiene, however the patient subjectively reported that he noticed great improvement in snoring, excessive daytime sleepiness and fatigue. Conclusion: Discussion/Conclusion With a diagnosis of Severe Mixed Apnea Predominant OSA as well as CSA noted during the study, the differential diagnosis included CHF, Chiari malformation, opioid abuse and idiopathic CSA as the cause. Despite a dangerous pandemic, appropriate therapy for certain patients must still be attained. Special protocols developed during the COVID-19 Pandemic allowed for our patient to receive adequate treatment, while ensuring the safety of all involved. Support (if any) References COVID 19: FAQs for Sleep Clinicians. AASM official website. https://aasm.org/covid-19-resources/covid-19-faq/


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