Clinical features and outcome in obese patients with undiagnosed obstructive sleep apnea admitted with respiratory failure in a tertiary care center

Introduction: Atrial fibrillation is the most common sustained arrhythmias.Recently there has been evidence of higher prevalence of atrial fibrillation in obstructive sleep apnea patients compared to the general population. The aim of this study was to find the prevalence of atrial fibrillation in patients of obstructive sleep apnea in a tertiary care center. Methods: This descriptive cross-sectional study was done in Om Hospital and Research Centre from January 2016 to 2018 March after ethical clearance. Convenience sampling was done. Data was collected and entry was done in microsoft excel, point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: The prevalence of atrial fibrillation in patients with obstructive sleep apnea is 7 (10.44%) at 95% Confidence Interval (6.70-14.17%). Apnoea–Hypopnoea Index of more than 30was present in 3 (42.8%) patients of atrial fibrillation. Atrial fibrillation was seen highest, 3 (42.8%) in patients with BMI more than 30 and lowest, 1 (14.28%) patients with BMI less than 23.5. Prevalence of atrial fibrillation was seen 5 (71.4%) in male patients and 2 (28.57%) in female patients. Sixty seven (75.28%) patients had obstructive sleep apnea in which male patients was predominant 48 (71.64%). Conclusions: Prevalence ofatrial fibrillation in patients of obstructive sleep apnea was found to higher than the similar studies done. It is important to obtain detail cardiac history in any patients with obstructive sleep apnea and look for arrhythmias speciallyatrial fibrillation.

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Obstructive sleep apnea is an important predictor of hepatic fibrosis in patients with nonalcoholic fatty liver disease in a tertiary care center

Hepatology International ◽

10.1007/s12072-015-9615-3 ◽

2015 ◽

Vol 9 (2) ◽

pp. 283-291 ◽

Cited By ~ 15

Author(s):

Swastik Agrawal ◽

Ajay Duseja ◽

Ashutosh Aggarwal ◽

Ashim Das ◽

Manu Mehta ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Liver Disease ◽

Sleep Apnea ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Care Center ◽

Tertiary Care ◽

Tertiary Care Center ◽

Nonalcoholic Fatty Liver ◽

Obstructive Sleep

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Screening for obstructive sleep apnea in a diabetic retinopathy clinic in a tertiary care center

Indian Journal of Ophthalmology ◽

10.4103/ijo.ijo_3633_20 ◽

2021 ◽

Vol 69 (11) ◽

pp. 3349

Author(s):

Sandeep Bansal ◽

Rakesh Kaswan ◽

Reema Bansal ◽

Deeksha Katoch ◽

Mohit Dogra ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Diabetic Retinopathy ◽

Sleep Apnea ◽

Care Center ◽

Tertiary Care ◽

Tertiary Care Center ◽

Obstructive Sleep

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Prediction of obstructive sleep apnea in patients presenting to a tertiary care center

Sleep And Breathing ◽

10.1007/s11325-006-0062-1 ◽

2006 ◽

Vol 10 (3) ◽

pp. 147-154 ◽

Cited By ~ 20

Author(s):

S.K. Sharma ◽

V. Malik ◽

C. Vasudev ◽

Amit Banga ◽

Alladi Mohan ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Care Center ◽

Tertiary Care ◽

Tertiary Care Center ◽

Obstructive Sleep

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Polysomnographic Outcomes After Observation for Mild Obstructive Sleep Apnea in Children Younger Than 3 Years

Otolaryngology ◽

10.1177/0194599820954383 ◽

2020 ◽

pp. 019459982095438

Author(s):

Kathleen M. Sarber ◽

Douglas C. von Allmen ◽

Raisa Tikhtman ◽

Javier Howard ◽

Narong Simakajornboon ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Care Center ◽

Tertiary Care ◽

Apnea Hypopnea Index ◽

Optimal Timing ◽

Obstructive Apnea ◽

Obstructive Sleep ◽

Mild Obstructive Sleep Apnea ◽

The Impact

Objective Mild obstructive sleep apnea (OSA), particularly in young children, is often treated with observation. However, there is little evidence regarding the outcomes with this approach. Our aim was to assess the impact of observation on sleep for children aged <3 years with mild OSA. Study Design Case-control study. Setting Pediatric tertiary care center. Methods We reviewed cases of children (<3 years old) diagnosed with mild OSA (obstructive apnea-hypopnea index, 1-5 events/h) who were treated with observation between 2012 and 2017 and had at least 2 polysomnograms performed 3 to 12 months apart. Demographic data and comorbid diagnoses were collected. Results Twenty-six children met inclusion criteria; their median age was 7.2 months (95% CI, 1.2-22.8). Nine (35%) were female and 24 (92%) were White. Their median body mass index percentile was 39 (95% CI, 1-76). Comorbidities included cardiac disease (42.3%), laryngomalacia (42.3%), allergies (34.6%), reactive airway disease (23.1%), and prematurity (7.7%). The obstructive apnea-hypopnea index significantly decreased from 2.7 events/h (95% CI, 1-4.5) to 1.3 (95% CI, 0-4.5; P = .013). There was no significant improvement in median saturation nadir (baseline, 86%; P = .76) or median time with end-tidal carbon dioxide >50 mm Hg (baseline, 0 minutes; P = .34). OSA resolved in 8 patients (31%) and worsened in 1 (3.8%). Only race was a significant predictor of resolution per regression analysis; however, only 2 non-White children were included. Conclusion In our cohort, resolution of mild OSA occurred in 31% of patients treated with 3 to 12 months of observation. The presence of laryngomalacia, asthma, and allergies did not affect resolution. Larger studies are needed to better identify factors (including race) associated with persistent OSA and optimal timing of intervention for these children. Level of Evidence 4.

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Prevalence of hypothyroidism among patients with obstructive sleep apnea: A study in a tertiary care center

IP Indian Journal of Immunology and Respiratory Medicine ◽

10.18231/j.ijirm.2021.035 ◽

2021 ◽

Vol 6 (3) ◽

pp. 161-164

Author(s):

D.S Sowjanya ◽

M Ravindranath

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Epworth Sleepiness Scale ◽

Care Center ◽

Tertiary Care ◽

Arousal Index ◽

Obstructive Sleep ◽

The Mean ◽

Saturated Oxygen

Obstructive sleep apnea is a common disorder wherein there are recurrent episodes of sleep disordered breathing resulting in disrupted sleep and other sequelae. The symptoms of hypothyroidism are very similar to OSA, a number of studies have been performed to analyze their association with conflicting results. A questionnaire based on the Wisconsin Sleep Apnea questionnaire for quality of sleep, sleep pattern, symptoms during sleep, snoring were asked to 118 patients included in the study. The day time sleep patterns were assessed by the Epworth Sleepiness scale. Polysomnography testing, Saturated oxygen levels, sleep efficiency and arousal index were also done for all the patients. Blood was collected for the detection of thyroid hormones. There were 82 (69.5%) males and 36 (30.5%) females on the present study out of 118 patients. The mean age of the patients under study was 53.91 ± 4.69 years, the weight was 89.48 ± 12.83 kgs and the BMI was 34.86 ± 6.11. Amongst the patients with OSA and hypothyroid, the apnea hypoapnea index was 66.22 ± 18.31 episodes per hour, and Epworth sleepiness scale was 15.18 ± 5.26 while in patients with OSA and without hypothyroid, it was 24.17 ± 6.29 and 8.25 ± 5.82 respectively. Our study shows a significant association between OSA and hypothyroidism among patients, thus having a considerable implications in managing the thyroid condition of the patients.

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Sleep Endoscopy Findings in Children With Obstructive Sleep Apnea and Small Tonsils

Annals of Otology Rhinology & Laryngology ◽

10.1177/00034894211045645 ◽

2021 ◽

pp. 000348942110456

Author(s):

Adrian Williamson ◽

Steven W. Coutras ◽

Michele M. Carr

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Airway Obstruction ◽

Care Center ◽

Tertiary Care ◽

Tongue Base ◽

Sleep Endoscopy ◽

Sleep Study ◽

Palatine Tonsils ◽

Obstructive Sleep

Objective: Obstructive Sleep Apnea (OSA) in children is treated primarily with adenotonsillectomy (AT). When clinical exam demonstrates small tonsils, the success of AT in resolving OSA is uncertain. The purpose of this study is to determine the utility of Drug induced Sleep Endoscopy (DISE) for children with OSA and small tonsils (Brodsky scale 1+) and to identify what obstructive trends exist in this subset of patients and to determine the utility of DISE-directed surgical intervention in patients with small tonsils. Methods: A retrospective chart review was performed for patients who underwent DISE at a tertiary care center over a 2-year period. Inclusion criteria were 1+ tonsils and a positive sleep study. Data collected included DISE findings, BMI, comorbid conditions, and pre-op PSG data. Results: Forty children were included with a mean age of 5.0 years (range 8 months-16 years). Mean preoperative AHI was 5.46 and mean oxygen saturation nadir was 87.1%. The most common contributor to airway obstruction was the adenoid (29 patients, 72.5%), followed by the tongue base or lingual tonsil (21 patients, 52.5%). The palatine tonsils (10 patients, 25.0%), epiglottis (10.0%), or obstruction intrinsic to the larynx (10.0%) were significantly less frequently identified as contributors to OSA when compared to the adenoid ( P < .001). The majority of patients had multilevel obstruction (25 patients, 62.5%). Adenoidectomy (27 patients, 67.5%) was the most commonly performed procedure, followed by tonsillectomy (10 patients, 25.0%, P < .001) and tongue base surgery (9 patient 22.5%, P < .001). Conclusion: In this group, small palatine tonsils were infrequently identified as a contributor to airway obstruction and tonsillectomy was avoided in most cases. This study illustrates the utility of DISE as a tool to personalize the surgical management of pediatric patients with OSA and small tonsils on physical exam.

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