Obstructive Sleep Apnoea: Fact Not Fiction

1996 ◽  
Vol 23 (4) ◽  
pp. 315-324 ◽  
Author(s):  
Joanna M. Battagel
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Signs And Symptoms ◽  
Active Role ◽  
Sleep Apnoea ◽  
Inspiratory Effort ◽  
Adequate Treatment ◽  
Clinical Disorder ◽  
Obstructive Sleep ◽  
Cardio Vascular

Obstructive sleep apnoea (OSA) is a recognized clinical disorder in which periods of cessation of breathing occur in the presence of inspiratory effort. Because this may have serious cardio-vascular and pulmonary consequences, diagnosis, and adequate treatment are important. Apart from its medical repercussions, OSA adversely affects the quality of life of both the sufferer and his family. This paper aims to give an overview of the complaint, defining and describing the disorder, reporting its signs and symptoms, and discussing its diagnosis and treatment. Particular attention will be given to those areas in which the orthodontist may play an active role.

scholarly journals Adenotonsillectomy for childhood obstructive sleep apnoea reduces thoraco-abdominal asynchrony but spontaneous apnoea−hypopnoea index normalisation does not

2016 ◽  
Vol 49 (1) ◽  
pp. 1601177 ◽  
Author(s):  
Xiao Liu ◽  
Sarah Immanuel ◽  
Yvonne Pamula ◽  
Declan Kennedy ◽  
James Martin ◽  
...  
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Inspiratory Effort ◽  
Obstructive Sleep Apnoea Syndrome ◽  
Quiet Sleep ◽  
Sleep Monitoring ◽  
Post Surgery ◽  
Obstructive Sleep

The efficacy of adenotonsillectomy for treating obstructive sleep apnoea syndrome (OSAS) in children has been established, but its precise effects on inspiratory effort are not well documented.In 353 children enrolled in the Childhood Adenotonsillectomy Trial, randomised to undergo either early adenotonsillectomy (n=182) or a strategy of watchful waiting with supportive care (WWSC) (n=171), thoraco-abdominal asynchrony (TAA) was analysed during quiet, non-apnoeic and non-hypopnoeic breathing during sleep at baseline and at 7 months using overnight polysomnography.Children who underwent early adenotonsillectomy demonstrated a reduction in TAA post-surgery while the WWSC arm showed no change. On assessing TAA with regard to normalisation of clinical polysomnography findings at follow-up, TAA was reduced in children who had surgical resolution of OSAS (based on apnoea–hypopnoea index), but not in children who displayed spontaneous normalisation of apnoea–hypopnoea index. In the latter group, TAA was inversely correlated with quality of life.We conclude that adenotonsillectomy reduces TAA during quiet sleep. Monitoring of instantaneous TAA may yield additional insight in the dynamic changes of inspiratory effort. In combination with traditional indices of obstruction, TAA may more accurately characterise the degree of sleep-disordered breathing in children.

Quality of life of children with sleep-disordered breathing treated with adenotonsillectomy

2010 ◽  
Vol 125 (2) ◽  
pp. 193-198 ◽  
Author(s):  
S M Powell ◽  
M Tremlett ◽  
D A Bosman
Keyword(s):  
Quality Of Life ◽  
Obstructive Sleep Apnoea ◽  
Sleep Disordered Breathing ◽  
Sleep Apnoea ◽  
Life Assessment ◽  
Effect Sizes ◽  
Obstructive Sleep ◽  
Disordered Breathing

AbstractObjective:To assess the quality of life of UK children with sleep-disordered breathing undergoing adenotonsillectomy, by using the Obstructive Sleep Apnoea 18 questionnaire and determining score changes and effect sizes.Design:Prospective, longitudinal study.Setting:The otolaryngology department of a university teaching hospital in Northern England.Participants:Twenty-eight children for whom adenotonsillectomy was planned as treatment for sleep-disordered breathing, and who had either a clinical history consistent with obstructive sleep apnoea or a polysomnographic diagnosis.Main outcome measure:The Obstructive Sleep Apnoea 18 questionnaire, a previously validated, disease-specific quality of life assessment tool; changes in questionnaire scores and effect sizes were assessed.Methods:The Obstructive Sleep Apnoea 18 questionnaire was administered to each child's parent pre-operatively, then again at the follow-up appointment. Questionnaire scores ranged from 1 to 7. Score changes were analysed using the paired t-test; effect sizes were calculated using 95 per cent confidence intervals.Results:Complete data were obtained for 22 children (mean age, 61 months). Ten had undergone pre-operative polysomnography. Twenty-one children underwent adenotonsillectomy (one underwent tonsillectomy). Median follow up was eight weeks (interquartile range, six to 11 weeks). Following surgery, the overall mean score improvement was 2.6 (p < 0.0001) and the mean effect size 2.4 (95 per cent confidence interval 1.9 to 2.8). There were significant improvements in each of the individual questionnaire domains, i.e. sleep disturbance (mean score change 3.9, p < 0.0001), physical suffering (2.2, p < 0.0001), emotional distress (2.0, p = 0.0001), daytime problems (1.8, p = 0.0001) and caregiver concerns (2.6, p < 0.0001).Conclusion:In these children with sleep-disordered breathing treated by adenotonsillectomy, Obstructive Sleep Apnoea 18 questionnaire results indicated significantly improved mean score changes and effect sizes across all questionnaire domains, comparing pre- and post-operative data.

P161 Obstructive sleep apnoea and quality of life in Fabry disease: a parallel cohort study

CHEST Journal ◽  
2017 ◽  
Vol 151 (5) ◽  
pp. A59
Author(s):  
T. Gaisl ◽  
N. Gerard ◽  
N. Sievi ◽  
C.F. Clarenbach ◽  
P.A. Krayenbühl ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cohort Study ◽  
Fabry Disease ◽  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Obstructive Sleep

Adenoidectomy plus tympanostomy tube insertion versus adenoidectomy plus myringotomy in children with obstructive sleep apnoea syndrome

2010 ◽  
Vol 125 (3) ◽  
pp. 274-278 ◽  
Author(s):  
I M Vlastos ◽  
M Houlakis ◽  
D Kandiloros ◽  
L Manolopoulos ◽  
E Ferekidis ◽  
...  
Keyword(s):  
Otitis Media ◽  
Obstructive Sleep Apnoea ◽  
Otitis Media With Effusion ◽  
Sleep Apnoea ◽  
Obstructive Sleep Apnoea Syndrome ◽  
Tympanostomy Tube ◽  
Tube Insertion ◽  
Sleep Apnoea Syndrome ◽  
Obstructive Sleep

AbstractObjective:To determine whether tympanostomy tube insertion has benefit, compared with simple myringotomy, in children with otitis media with effusion who receive concurrent adenoidectomy as treatment for obstructive sleep apnoea syndrome caused by adenoid hypertrophy.Methods:Fifty-two children older than three years with obstructive sleep apnoea syndrome were randomly assigned to receive either adenoidectomy plus tympanostomy tube insertion (group one, n = 25) or adenoidectomy plus myringotomy (group two, n = 27). Pre- and post-operative health-related quality of life was assessed using the otitis media-6 (OM-6) tool, and audiological outcomes were recorded six and 12 months post-operatively.Results:Group one showed better quality of life scores six months post-operatively (score difference −0.38, confidence interval −0.65 to −0.10) but not 12 months post-operatively (score difference −0.23, confidence interval −0.76 to 0.11), compared with pre-operative values. Audiological outcomes did not differ significantly at either time point, compared with pre-operative values.Conclusion:Tympanostomy tube insertion confers a short term benefit, compared with simple myringotomy, in children older than three years with otitis media with effusion who receive concurrent adenoidectomy as treatment for obstructive sleep apnoea syndrome. Further studies are necessary to identify which of these children will receive long-lasting benefit from tympanostomy tube insertion.

scholarly journals A French survey of 3,225 patients treated with CPAP for obstructive sleep apnoea: benefits, tolerance, compliance and quality of life

1998 ◽  
Vol 12 (1) ◽  
pp. 185-192 ◽  
Author(s):  
N. Meslier ◽  
T. Lebrun ◽  
V. Grillier-Lanoir ◽  
N. Rolland ◽  
C. Henderick ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Obstructive Sleep

Quality of sexual life in men with obstructive sleep apnoea

2012 ◽  
Vol 18 (2) ◽  
pp. 245-251 ◽  
Author(s):  
Mehmet Ak ◽  
Adem Balikci ◽  
Bikem Haciomeroglu ◽  
Serkan Zincir ◽  
Alper Cinar ◽  
...  
Keyword(s):  
Sexual Satisfaction ◽  
Obstructive Sleep Apnoea ◽  
Luteinising Hormone ◽  
Sleep Apnoea ◽  
Sexual Life ◽  
Clinical Level ◽  
Obstructive Sleep ◽  
Dsm Iv ◽  
Hormonal Levels

The study investigated the quality of sexual life of male obstructive sleep apnoea patients. Apnoea and non-apnoea participants were assessed with Golombok Rust Inventory of Sexual Satisfaction (GRISS) and Structured Clinical Interview for DSM-IV (SCID) before the sleep test. Folicule Stimulating Hormone (FSH), Luteinising Hormone (LH), prolactin, testosterone and oestrogen levels were also evaluated. The apnoea group had a higher BMI and lower LH and testosterone levels than the non-apnoea group. There were no differences between the apnoea, non-apnoea groups and within the apnoea groups (mild, moderate and high apnoea) in terms of sexual satisfaction. Although there was a change in the hormonal levels of obstructive sleep apnoea patients, the sexual life of apnoea patients was not affected at the clinical level.

scholarly journals Modafinil in the treatment of selected sleep disorders

2021 ◽  
Vol 21 (3) ◽  
pp. 213-218
Author(s):  
Wacław Dyrda ◽  
Daria Smułek ◽  
Adam Wichniak ◽  
Keyword(s):  
Quality Of Life ◽  
Sleep Disorders ◽  
Sleep Disorder ◽  
Shift Work ◽  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Shift Work Sleep Disorder ◽  
Obstructive Sleep ◽  
Idiopathic Hypersomnia

Until 2010, modafinil, which is a wakefulness promoting agent, was approved in Europe for a wider spectrum of indications, such as narcolepsy, idiopathic hypersomnia, obstructive sleep apnoea and shift work sleep disorder. Currently, it is registered by the European Medicines Agency only for the treatment of narcolepsy, and is used as an off-label therapy in other sleep disorders. This paper presents the efficacy of modafinil in selected sleep disorders. Modafinil remains first-choice treatment for narcolepsy. It reduces the frequency of bouts of inadvertent sleep and nap episodes, the duration and intensity of daytime hypersomnolence, and also significantly improves the quality of life of patients. However, it is associated with only a slight improvement in cataplexy and other symptoms. In idiopathic hypersomnia, modafinil reduces the frequency of naps and unintentional sleep episodes, as well as subjective sleepiness measured with the Epworth Sleepiness Scale. Furthermore, the drug is used to treat hypersomnia from obstructive sleep apnoea in the case of lack of improvement despite optimal positive airway pressure therapy. Modafinil is also approved by the U.S. Food and Drug Administration for the treatment of shift work sleep disorder. The drug has been shown to reduce the level of somnolence, but it has not been found to reduce unintentional sleep episodes, reported mistakes or accidents at work. Given the strong negative impact of hypersomnolence on performance at work and school, the risk of accidents and the quality of life, the risk-benefit assessment of modafinil often justifies its use in the treatment of hypersomnolence also outside the approved indications.

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