scholarly journals Obstructive sleep apnoea in the general population: highly prevalent but minimal symptoms

2015 ◽  
Vol 47 (1) ◽  
pp. 194-202 ◽  
Author(s):  
Erna S. Arnardottir ◽  
Erla Bjornsdottir ◽  
Kristin A. Olafsdottir ◽  
Bryndis Benediktsdottir ◽  
Thorarinn Gislason
Keyword(s):  
General Population ◽  
Obstructive Sleep Apnoea ◽  
Clinical Symptoms ◽  
Population Sample ◽  
Sleep Apnoea ◽  
Middle Aged ◽  
Sleep Study ◽  
Psychomotor Vigilance Test ◽  
Obstructive Sleep ◽  
Osa Treatment

The aim was to assess the prevalence of obstructive sleep apnoea (OSA) as defined by an apnoea–hypopnea index (AHI) ≥15 in the middle-aged general population, and the interrelationship between OSA, sleep-related symptoms, sleepiness and vigilance.A general population sample of 40–65-year-old Icelanders was invited to participate in a study protocol that included a type 3 sleep study, questionnaire and a psychomotor vigilance test (PVT).Among the 415 subjects included in the study, 56.9% had no OSA (AHI <5), 24.1% had mild OSA (AHI 5–14.9), 12.5% had moderate OSA (AHI 15–29.9), 2.9% had severe OSA (AHI ≥30) and 3.6% were already diagnosed and receiving OSA treatment. However, no significant relationship was found between AHI and subjective sleepiness or clinical symptoms. A relationship with objective vigilance assessed by PVT was only found for those with AHI ≥30. Subjects already on OSA treatment and those accepting OSA treatment after participating in the study were more symptomatic and sleepier than others with similar OSA severity, as assessed by the AHI.In a middle-aged general population, approximately one in five subjects had moderate-to-severe OSA, but the majority of them were neither symptomatic nor sleepy and did not have impaired vigilance.

Pierre Robin sequence causes position-dependent obstructive sleep apnoea in infants

2021 ◽  
pp. archdischild-2020-320527
Author(s):  
Hanna-Leena Kristiina Kukkola ◽  
Pia Vuola ◽  
Maija Seppä-Moilanen ◽  
Päivi Salminen ◽  
Turkka Kirjavainen
Keyword(s):  
Eye Movement ◽  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Sleep Position ◽  
Pierre Robin Sequence ◽  
Rapid Eye Movement ◽  
Obstructive Sleep ◽  
Osa Treatment ◽  
Sleep Positioning ◽  
Pierre Robin

IntroductionObstructive sleep apnoea (OSA) and feeding difficulties are key problems for Pierre Robin sequence (PRS) infants. OSA management varies between treatment centres. Sleep positioning represents the traditional OSA treatment, although its effectiveness remains insufficiently evaluated.DesignTo complete a polysomnographic (PSG) evaluation of effect of sleep position on OSA in PRS infants less than 3 months of age. We analysed a 10-year national reference centre dataset of 76 PRS infants. PSG was performed as daytime recordings for 67 in the supine, side and prone sleeping position when possible. In most cases, recording included one cycle of non-rapid eye movement (NREM) and rapid eye movement (REM) sleep in each position.ResultsOne-third of infants (9/76, 12%) had severe OSA needing treatment intervention prior to PSG. During PSG, OSA with an obstructive apnoea and hypopnoea index (OAHI) >5 per hour was noted in 82% (55/67) of infants. OSA was most severe in the supine and mildest in the side or in the prone positions. The median OAHI in the supine, side and prone positions were 31, 16 and 19 per hour of sleep (p=0.003). For 68% (52/67) of the infants, either no treatment or positional treatment alone was considered sufficient.ConclusionsThe incidence of OSA was 84% (64/76) including the nine infants with severe OSA diagnosed prior to PSG. For the most infants, the OSA was sleep position dependent. Our study results support the use of PSG in the evaluation of OSA and the use of sleep positioning as a part of OSA treatment.

Effect of a 1-week intense myofunctional training on obstructive sleep apnoea in children with Down syndrome

2018 ◽  
Vol 104 (3) ◽  
pp. 275-279 ◽  
Author(s):  
Magnus von Lukowicz ◽  
Nina Herzog ◽  
Sebastian Ruthardt ◽  
Mirja Quante ◽  
Gabriele Iven ◽  
...  
Keyword(s):  
Down Syndrome ◽  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Marginal Effect ◽  
Sleep Study ◽  
Desaturation Index ◽  
Intensive Training ◽  
Children With Down Syndrome ◽  
Training Camp ◽  
Obstructive Sleep

BackgroundObstructive sleep apnoea (OSA) is common in children with Down syndrome (DS), yet difficult to treat. As muscular hypotonia of the upper airway may cause OSA and is also common in DS, we tested whether intense myofunctional therapy improves OSA in children with DS.Patients and methodsForty-two children underwent cardiorespiratory sleep studies immediately before and after a 1-week intensive training camp consisting of three daily 45 min sessions of myofunctional exercises according to Padovan. Primary outcome was the mixed-obstructive-apnoea/hypopnoea index (MOAHI), secondary outcomes the ≤3% oxygen desaturation index (DI3), the ≤90% desaturation index (DI90) and the lowest pulse oximeter saturation (SpO2nadir).ResultsEighteen recordings had ≥3 hours of artefact-free recording in both the pretreatment and post-treatment sleep study and were therefore included in the analysis. Mean age was 6.3 years (SD 2.5); 83% had OSA prior to intervention. Mean MOAHI was 6.4 (SD 8.6) before and 6.4 (SD 10.8) after the intervention (p>0.05); the DI3 and SpO2nadir also did not change. Only the DI90 decreased significantly from 2.7 (SD 4.5) to 2.1 (SD 3.7) (p<0.05).ConclusionThe 1-week intense myofunctional training camp evaluated here in children with DS had only a marginal effect on OSA. Whether a longer follow-up period or duration of intervention would yield stronger effects remains to be determined.

scholarly journals Predicting response to oxygen therapy in obstructive sleep apnoea patients using a 10-minute daytime test

2018 ◽  
Vol 51 (1) ◽  
pp. 1701587 ◽  
Author(s):  
David Wang ◽  
Keith K. Wong ◽  
Luke Rowsell ◽  
Garrick W. Don ◽  
Brendon J. Yee ◽  
...  
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Oxygen Therapy ◽  
Characteristic Curve ◽  
Personalised Medicine ◽  
Sleep Apnoea ◽  
Low Flow ◽  
Response Threshold ◽  
Clinical Tool ◽  
Obstructive Sleep ◽  
Osa Treatment

There is no satisfactory treatment for obstructive sleep apnoea (OSA). Supplemental low-flow oxygen therapy (LFO2) has been shown to reduce hypoxaemia and is well tolerated by patients with OSA. However, oxygen therapy may be beneficial only to certain subsets of patients with OSA. In this study, we evaluated a 10-min awake ventilatory chemoreflex test in predicting individual OSA response to 2 months of LFO2therapy.At baseline, patients with OSA underwent ventilatory chemoreflex testing in the afternoon, prior to the overnight polysomnography. Subjects were reassessed with polysomnography after 2 months of nocturnal oxygen treatment.20 patients with OSA completed the study. After 2 months of O2treatment, changes in the apnoea–hypopnoea index (AHI) were significantly correlated with baseline CO2ventilatory response threshold (VRT) and chemosensitivity (p<0.05). In predicting a fall in AHI, the area under the receiver operating characteristic curve (AUC) was 0.79 for VRT and 0.89 for chemosensitivity. When these two variables were combined in a logistic regression model, the prediction effect became stronger with an AUC of 0.97, sensitivity of 0.92 and specificity of 0.83.Our awake ventilatory chemoreflex test could be considered a simple potential clinical tool to predict individual OSA response to oxygen therapy. It could provide a novel personalised medicine approach to OSA treatment.

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 and schizophrenia: a primer for psychiatrists

2011 ◽  
Vol 23 (5) ◽  
pp. 201-209 ◽  
Author(s):  
Abdulkader Alam ◽  
Kadiamada Nanaiah Roy Chengappa
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Daytime Sleepiness ◽  
Treatment Options ◽  
Clinical Manifestations ◽  
Sleep Apnoea ◽  
Diagnosis And Treatment ◽  
Adverse Health Outcomes ◽  
Ovid Medline ◽  
Obstructive Sleep ◽  
Osa Treatment

Alam A, Chengappa KNR. Obstructive sleep apnoea and schizophrenia: a primer for psychiatristsObjective:The main objective of this review is to improve psychiatric clinician awareness of obstructive sleep apnoea (OSA) and its potential consequences in patients with schizophrenia. This article will also discuss the diagnosis and treatment options for OSA while considering the significant role psychiatrists can play in facilitating the diagnosis and treatment of OSA.Data sources:Ovid, Medline and PsychInfo databases were searched for articles between 1960 and 2010. Search terms used wereSleep apnoeaorapnoeaandschizophreniaorpsychosis. The number of articles retrieved was 38. Articles were carefully reviewed for any data pertinent to OSA in patients with schizophrenia.Conclusions:OSA is a common disorder that is frequently unrecognised. As a chronic breathing condition, OSA is associated with adverse health outcomes and high mortality. OSA may co-occur with schizophrenia or evolve over time, especially with weight gain. The diagnosis should be considered whenever a patient presents with risk factors or clinical manifestations that are highly suggestive of OSA. Those who report snoring, daytime sleepiness and are obese or have a large neck circumference should be considered for an OSA diagnosis. Appropriate diagnosis and treatment of OSA can reduce daytime sleepiness, improve cardiovascular and other medical conditions, as well as reduce mortality. Psychiatrists can play very important role in suspecting OSA in their patients and making the initial referral. Furthermore, behavioural management, especially promoting weight loss and smoking cessation, are effective components of OSA treatment that psychiatrists are positioned to facilitate with their patients.

scholarly journals Oral Appliance Therapy for Obstructive Sleep Apnoea: State of the Art

2019 ◽  
Vol 8 (12) ◽  
pp. 2121 ◽  
Author(s):  
Kate Sutherland ◽  
Peter A. Cistulli
Keyword(s):  
Health Outcomes ◽  
Obstructive Sleep Apnoea ◽  
Productivity Loss ◽  
Sleep Apnoea ◽  
World Health ◽  
Cardiometabolic Health ◽  
Accident Risk ◽  
Sleep Study ◽  
Pharyngeal Airway ◽  
Obstructive Sleep

Obstructive sleep apnoea (OSA) represents a significant global health burden, with impact on cardiometabolic health, chronic disease, productivity loss and accident risk. Oral appliances (OA) are an effective therapy for OSA and work by enlarging and stabilising the pharyngeal airway to prevent breathing obstructions during sleep. Although recommended in clinical guidelines for OSA therapy, they are often considered only as second-line therapy following positive airway pressure (PAP) therapy failure. There has been a long-standing barrier to selecting OA over PAP therapy due to the inability to be certain about the level of efficacy in individual OSA patients. A range of methods to select OSA patients for OA therapy, based on the outcome of a single sleep study night, have been proposed, although none has been widely validated for clinical use. Emergent health outcome data suggest that equivalent apnoea–hypopnea index reduction may not be necessary to produce the same health benefits of PAP. This may be related to the more favourable adherence to OA therapy, which can now be objectively verified. Data on longer term health outcomes are needed, and there are additional opportunities for device improvement and combination therapy approaches. OAs have an important role in precision care of OSA as a chronic disorder through a multi-disciplinary care team. Future studies on real-world health outcomes following OA therapy are needed.

scholarly journals Screening for obstructive sleep apnoea in professional drivers

Breathe ◽  
2020 ◽  
Vol 16 (1) ◽  
pp. 29364 ◽  
Author(s):  
Sophia E. Schiza ◽  
Izolde Bouloukaki
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Early Identification ◽  
Sleep Apnoea ◽  
Screening Tools ◽  
List Type ◽  
Objective Data ◽  
Sleep Study ◽  
Professional Drivers ◽  
Obstructive Sleep ◽  
Increased Risk

Professional drivers show a higher prevalence of obstructive sleep apnoea (OSA) compared with the general population. Furthermore, there is concern about the association between OSA and car crash risk given that drivers with OSA show an increased risk for car accidents. Despite this risk, OSA is often underdiagnosed and undertreated in this population, mainly due to lack of appropriate screening and sleep study referrals. Polysomnography (PSG), the gold standard test, is inappropriate for systematic screening because of its high expense, complexity and relative inaccessibility in this population. Therefore, there is a strong demand for good screening tools, including both subjective and objective data that may assist in early identification of possible OSA among professional drivers and, thus, aid in PSG examination referral and OSA management in an accredited sleep centre. However, there is considerable disagreement over screening methods and criteria for triggering a sleep study referral in different countries. There is also a strong need for further research in the area of OSA screening of commercial drivers in order to improve the diagnostic accuracy of screening tools and ensure that patients with OSA are accurately identified.Key pointsObstructive sleep apnoea (OSA) is often undiagnosed and undertreated in professional drivers.Professional drivers often under-report and are reluctant to report OSA symptoms.Barriers to OSA diagnosis include appropriate screening and sleep study referrals.Screening tools including both subjective and objective data may assist in early identification of possible OSA among professional drivers.Educational aimsTo evaluate screening instruments currently used to identify OSA risk in professional drivers.To provide guidance for developing an assessment strategy for OSA by professional driver medical examiners.

scholarly journals A rare instance of retrosternal goitre presenting with obstructive sleep apnoea in a middle-aged person

2013 ◽  
Vol 4 (12) ◽  
pp. 1064-1066 ◽  
Author(s):  
Jude Rodrigues ◽  
Renny Furtado ◽  
Anant Ramani ◽  
Nivedita Mitta ◽  
Shantata Kudchadkar ◽  
...  
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Middle Aged ◽  
Middle Aged Person ◽  
Aged Person ◽  
Obstructive Sleep ◽  
Rare Instance

Night-to-night variability of respiratory events in obstructive sleep apnoea: a systematic review and meta-analysis

Thorax ◽  
2020 ◽  
Vol 75 (12) ◽  
pp. 1095-1102 ◽  
Author(s):  
Maurice Roeder ◽  
Matteo Bradicich ◽  
Esther Irene Schwarz ◽  
Sira Thiel ◽  
Thomas Gaisl ◽  
...  
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Evidence Synthesis ◽  
Meta Analysis ◽  
Sleep Apnoea ◽  
Study Data ◽  
Sleep Study ◽  
Diagnostic Threshold ◽  
Respiratory Events ◽  
Obstructive Sleep ◽  
Significant Difference

BackgroundIt is current practice to use a single diagnostic sleep study in the diagnostic workup of obstructive sleep apnoea (OSA). However, a relevant night-to-night variability (NtNV) of respiratory events has been reported.MethodsWe evaluated the NtNV of respiratory events in adults with suspected or already diagnosed OSA who underwent more than one diagnostic sleep study. Data sources were PubMed, Cochrane and Embase up to 23 January 2019. Random-effects models were used for evidence synthesis. For moderator analysis, mixed-effects regression analysis was performed. The study was registered with PROSPERO (CRD42019135277).ResultsOf 2143 identified papers, 24 studies, comprising 3250 participants, were included. The mean Apnoea-Hypopnoea Index (AHI) difference between the first and second night was −1.70/hour (95% CI −3.61 to 0.02). REM time differences (first to second night) were significantly positive associated with differences in mean AHI (β coefficient 0.262 (95% CI 0.096 to 0.428). On average, 41% (95% CI 27% to 57%) of all participants showed changes of respiratory events >10/hour from night to night. Furthermore, 49% (95% CI 32% to 65%) of participants changed OSA severity class (severity thresholds at 5/hour, 15/hour and 30/hour) at least once in sequential sleep studies. Depending on the diagnostic threshold (5/hour, 10/hour or 15/hour), on average 12% (95% CI 9% to 15%), 12% (95% CI 8% to 19%) and 10% (95% CI 8% to 13%) of patients would have been missed during the first night due to single night testing.ConclusionWhile there was no significant difference between mean AHI in two sequential study nights on a group level, there was a remarkable intraindividual NtNV of respiratory events, leading to misdiagnosis and misclassification of patients with suspected OSA.

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