Omission of polysomnography in treatment of snoring: common reasons and medico-legal implications

2000 ◽  
Vol 114 (7) ◽  
pp. 519-521 ◽  
Author(s):  
Y. H. Goh ◽  
D. K. S. Choy
Keyword(s):  
Upper Airway ◽  
Clinical History ◽  
Tertiary Hospital ◽  
Sleep Apnoea ◽  
Obstructive Sleep Apnoea Syndrome ◽  
Upper Airway Resistance Syndrome ◽  
Asian Patients ◽  
Legal Implications ◽  
Obstructive Sleep ◽  
Number Of Patients

Although polysomnography (PSG) is an important investigation in the treatment of snorers, it was observed that a large number of patients did not have pre-operative PSG assessment in a tertiary hospital in Singapore. Of the 118 Asian patients who underwent surgery for snoring from January 1997 to December 1998, 36 (30.5 per cent) of patients did not have pre-operative PSG and only 21 (17.8 per cent) of patients had post-operative PSG. In this cohort, 43 (36.4 per cent) patients presented with snoring as their only complaint and not associated with symptoms indicative of obstructive sleep apnoea syndrome (OSAS). Thirty-one of these ‘simple snorers’ underwent sleep studies with the following outcome: two (6.5 per cent) true simple snorers, two (6.5 per cent) upper airway resistance syndrome, nine (29 per cent) mild OSAS, seven (22.6 per cent) moderate OSAS and 11 (35.5 per cent) severe OSAS. Our study showed that without the aid of PSG, it would be difficult to predict the severity of sleep apnoea based on clinical history alone. In an increasingly litigation-conscious society such as Singapore, there is therefore little justification in omitting PSG in the treatment of snoring. The common reasons for omission of preoperative PSG and the medico-legal implications are also discussed.

scholarly journals A frequent phenotype for paediatric sleep apnoea: short lingual frenulum

2016 ◽  
Vol 2 (3) ◽  
pp. 00043-2016 ◽  
Author(s):  
Christian Guilleminault ◽  
Shehlanoor Huseni ◽  
Lauren Lo
Keyword(s):  
Clinical Investigation ◽  
Upper Airway ◽  
Sleep Apnoea ◽  
Obstructive Sleep Apnoea Syndrome ◽  
Systematic Screening ◽  
Obstructive Sleep ◽  
Airway Collapsibility ◽  
Upper Airway Collapsibility ◽  
Oral Anatomy ◽  
Symptoms And Signs

A short lingual frenulum has been associated with difficulties in sucking, swallowing and speech. The oral dysfunction induced by a short lingual frenulum can lead to oral-facial dysmorphosis, which decreases the size of upper airway support. Such progressive change increases the risk of upper airway collapsibility during sleep.Clinical investigation of the oral cavity was conducted as a part of a clinical evaluation of children suspected of having sleep disordered breathing (SDB) based on complaints, symptoms and signs. Systematic polysomnographic evaluation followed the clinical examination. A retrospective analysis of 150 successively seen children suspected of having SDB was performed, in addition to a comparison of the findings between children with and without short lingual frenula.Among the children, two groups of obstructive sleep apnoea syndrome (OSAS) were found: 1) absence of adenotonsils enlargement and short frenula (n=63); and 2) normal frenula and enlarged adenotonsils (n=87). Children in the first group had significantly more abnormal oral anatomy findings, and a positive family of short frenulum and SDB was documented in at least one direct family member in 60 cases.A short lingual frenulum left untreated at birth is associated with OSAS at later age, and a systematic screening for the syndrome should be conducted when this anatomical abnormality is recognised.

Investigation of smell and taste function in patients with obstructive sleep apnoea syndrome

2019 ◽  
Vol 133 (05) ◽  
pp. 376-379 ◽  
Author(s):  
A Yenigun ◽  
N Degirmenci ◽  
S S Goktas ◽  
R Dogan ◽  
O Ozturan
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Upper Airway ◽  
Sleep Apnoea ◽  
Obstructive Sleep Apnoea Syndrome ◽  
Upper Respiratory Tract ◽  
Taste Test ◽  
Sleep Apnoea Syndrome ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
Taste And Smell

AbstractObjectiveThis study investigated the relationship between disease severity and taste and smell functions in patients with obstructive sleep apnoea syndrome.MethodsA total of 65 patients with recurrent upper airway obstruction during sleep were included. Participants were divided into four groups according to apnoea-hypopnoea index, obtained on polysomnography. Smell and taste tests were performed on these patients.ResultsA significant difference was observed between the smell thresholds of the groups for the identification test (p = 0.016). In the taste test, significant differences were observed between the groups in terms of sweet, sour, salty and bitter taste test thresholds (p = 0.029, p = 0.0005, p = 0.001 and p = 0.017, respectively).ConclusionAs sleep apnoea severity increased (according to the apnoea-hypopnoea index) in obstructive sleep apnoea syndrome patients, the taste and smell thresholds decreased due to the effect of neuropathy and inflammation in the upper respiratory tract.

Inspiratory flow limitation in obstructive sleep apnoea patients

2004 ◽  
Vol 106 (6) ◽  
pp. 563-565 ◽  
Author(s):  
Ramon FARRÉ
Keyword(s):  
Pilot Study ◽  
Airway Obstruction ◽  
Sleep Disorder ◽  
Obstructive Sleep Apnoea ◽  
Upper Airway ◽  
Sleep Apnoea ◽  
Obstructive Sleep Apnoea Syndrome ◽  
Bench Test ◽  
Flow Limitation ◽  
Obstructive Sleep

Patients suffering from the obstructive sleep apnoea syndrome (OSAS) experience nocturnal episodes of upper airway obstruction resulting in recurrent oxygen desaturations and arousals. Methods to quantify the nocturnal obstructive events are of interest for characterizing this prevalent sleep disorder. In a study published in this issue of Clinical Science, Bloch and co-workers propose the computation of a new index for objectively quantifying the degree of flow limitation in patients with OSAS. The results obtained in a bench test and in a pilot study in patients suggest that the flow limitation index proposed may help to better characterize the disturbed breathing events undergone by patients with OSAS.

scholarly journals Obstructive Sleep Apnoea Syndrome and Weight Loss: Review

2012 ◽  
Vol 2012 ◽  
pp. 1-11 ◽  
Author(s):  
Douglas C. Cowan ◽  
Eric Livingston
Keyword(s):  
Weight Loss ◽  
Obstructive Sleep Apnoea ◽  
Dietary Intervention ◽  
Therapeutic Option ◽  
Upper Airway ◽  
Sleep Apnoea ◽  
Surgical Approaches ◽  
Obstructive Sleep Apnoea Syndrome ◽  
Central Adiposity ◽  
Obstructive Sleep

Obstructive sleep apnoea (OSA) syndrome is common, and obesity is a major risk factor. Increased peripharyngeal and central adiposity result in increased pharyngeal collapsibility, through increased mechanical loading around the upper airway, reduced tracheal traction on the pharynx, and reduced neuromuscular activity, particularly during sleep. Significant and sustained weight loss, if achieved, is likely to be a useful therapeutic option in the management of OSA and may be attempted by behavioural, pharmacological, and surgical approaches. Behavioural therapy programs that focus on aspects such as dietary intervention, exercise prescription patients and general lifestyle counselling have been tested. Bariatric surgery is an option in the severely obese when nonsurgical measures have failed, and laparoscopic adjustable gastric banding and Roux-en-Y gastric bypass are the most commonly employed techniques in the United Kingdom. Most evidence for efficacy of surgery comes from cohort studies. The role of sibutramine in OSA in the obese patients has been investigated, however, there are concerns regarding associated cardiovascular risk. In this paper the links between obesity and OSA are discussed, and the recent studies evaluating the behavioural, pharmacological and surgical approaches to weight loss in OSA are reviewed.

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