Frequency of Prosthetic Complications Related to Implant-Borne Prosthesis in a Sleep Disorder Unit

2017 ◽  
Vol 43 (1) ◽  
pp. 19-23
Author(s):  
Eduardo Anitua ◽  
Juan Saracho ◽  
Gabriela Zamora Almeida ◽  
Joaquin Duran-Cantolla ◽  
Mohammad Hamdan Alkhraisat
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Bruxism ◽  
Apnea Hypopnea Index ◽  
Sleep Study ◽  
Obstructive Sleep ◽  
The Mean ◽  
Fracture Complication ◽  
Prosthetic Complications

Sleep bruxism and higher clench index have been associated with obstructive sleep apnea (OSA). However, there is no study that reports on the prosthetic complications in patients with OSA. Records of patients who had performed a sleep study to diagnose OSA were examined for the occurrence of prosthetic complications in implant-borne reconstructions. The primary outcome was the frequency of prosthetic complications. The secondary outcomes were anthropometric data, type of complication, type of prosthesis, type of retention, number of supporting implants, number of prosthetic units, and the presence of obstructive sleep apnea. Of the 172 patients, 67 had an implant-supported prosthesis, and all were included in the study. The mean age was 61 ± 10 years, and 36 were female. Thirty complications in 22 prostheses were identified in 16 patients. The complications were porcelain fracture (14 events), screw/implant fracture (8 events), screw loosening (3 events), and decementation (5 events). The follow-up time was 117 ± 90 months after placement of the prosthesis. The average time for complications to occur was 73 ± 65 months after the placement of the prosthesis. According to the apnea-hypopnea index (AHI), 49 patients had OSA. Thirteen of the 16 patients having a prosthetic complication also had OSA. The highest AHI and thus the severity of OSA was identified in patients with a fracture complication related to an implant, a screw, or a porcelain. The frequency of prosthetic complications has been higher in patients with obstructive sleep apnea.

scholarly journals Validity and Reliability of the Thai Version of the Pediatric Obstructive Sleep Apnea Screening Tool

2021 ◽  
Author(s):  
Archwin Tanphaichitr ◽  
Pitchayanan Chuenchod ◽  
Kitirat Ungkanont ◽  
Wish Banhiran ◽  
Vannipa Vathanophas ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Internal Consistency ◽  
Screening Tool ◽  
Apnea Hypopnea Index ◽  
Sleep Study ◽  
Retest Reliability ◽  
Obstructive Sleep ◽  
The Mean ◽  
Test Retest Reliability

Objective: Obstructive sleep apnea (OSA) is highly prevalent in children and requires an expensive and relatively unavailable sleep study for diagnosis. This study was undertaken to translate the previously validated OSA screening tool (POSAST) to the Thai language and assess its accuracy and test-retest reliability in at-risk symptomatic children. Study design: Prospective cross-sectional cohort study Methods: Pediatric patients clinically referred for suspected OSA who underwent overnight polysomnography (PSG) were recruited, and caregivers completed the Thai version of the POSAST. The same questionnaire was completed again after 2-4 weeks. Results: One hundred and ten subjects completed the study. The mean age was 8.4±2.9 years. The mean apnea-hypopnea index (AHI) was 10.9±11.9 events/hour. Test-retest reliability (Pearson correlation coefficient = 0.96, P<0.001) and internal consistency (Cronbach’s alpha coefficient = 0.82, P<0.001) between each question were excellent. A cumulative equation-derived score cut-off of 1.9 yielded 78.4% sensitivity and 50.0% specificity, while a numerical additive score cut-off of 8 corresponded to 81.1% sensitivity and 52.8% specificity for diagnosing moderate and severe OSA (AHI ≥5 events per hour) Conclusion: The internal consistency and reproducibility of the Thai version of the POSAST are satisfactory, display acceptable validity, and the instrument can be used for screening symptomatic Thai children for OSA.

scholarly journals 0709 Using The Sleep Adjusted Residual Apnea Hypopnea Index In The Real-World Monitoring Of Obstructive Sleep Apnea

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A270-A270
Author(s):  
E Viteri ◽  
V McGhee ◽  
J V Tackett ◽  
A X Freire
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Time ◽  
Small Sample ◽  
Apnea Hypopnea Index ◽  
Sleep Study ◽  
Convenience Sample ◽  
Obstructive Sleep ◽  
Adjusted Residual

Abstract Introduction Treatment efficacy of obstructive sleep apnea (OSA) depends on controlling respiratory events for the majority of sleep time. Apnea-hypopnea index (AHI) and adherence are frequently used to determine efficacy of continuous positive airway (CPAP) therapy, but fail to capture the effect of residual events during untreated sleep-time. The Sleep Adjusted Residual AHI (SARAHI) consolidates treated and untreated AHI and CPAP use into a single number: SARAHI = [(Untreated AHI × Hours Untreated) + (Treated AHI × Hours Treated)] / (Total Sleep Hours). We attempted to determine the clinical applicability of this index as a determinant of OSA control and its relation with sleepiness improvement. Methods As part of a quality assessment project, a convenience sample was haphazardly collected from a database of patients initiated on CPAP in a Veteran’s Affairs Hospital. Patients initiating treatment after OSA diagnosis by polysomnogram or portable sleep study were included. Information from a CPAP-download within a year of diagnosis and Epworth Sleepiness Scale (ESS) at diagnosis and follow-up were collected. SARAHI was calculated using two different measures of “total sleep hours”: 8 hours (SARAHI-8hrs) or recorded sleep time during sleep study (SARAHI-PSG). Results Thirteen patients (12 male) with a mean age of 53.3 years were included. At diagnosis, mean AHI was 26.0 events/hour and ESS was 14.6. At follow-up, CPAP mean adherence was 338 min and average use was 61.8% of days; mean residual AHI was 4.4 events/hour and mean ESS 13.7. SARAHI-8hrs was 16.0 events/hour and SARAHI-PSG was 13.8 events/hr. Simple linear regression did not show a significant correlation between ESS improvement and either of these indexes or with improvement in AHI. Conclusion SARAHI showed no correlation with ESS in this small sample. We recommend further research as SARAHI is simple to use and provides more information than currently used parameters. Support None

Adjustable Tongue Advancement for Obstructive Sleep Apnea: A Pilot Study

2008 ◽  
Vol 117 (11) ◽  
pp. 815-823 ◽  
Author(s):  
Evert Hamans ◽  
An Boudewyns ◽  
Boris A. Stuck ◽  
Alexander Baisch ◽  
Marc Willemen ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Positive Airway Pressure ◽  
Upper Airway ◽  
Apnea Hypopnea Index ◽  
Obstructive Sleep ◽  
Clinical Adverse Event ◽  
The Mean ◽  
Substantial Morbidity

Objectives: Surgical treatment of obstructive sleep apnea (OSA) caused by hypopharyngeal collapse of the upper airway can be considered in patients who are intolerant to continuous positive airway pressure (CPAP). The present procedures addressing the hypopharynx are invasive and have substantial morbidity and limited efficacy. Methods: Ten patients (mean age, 44 years) with moderate to severe OSA, ie, an apnea-hypopnea index (AHI) between 15 and 50, with CPAP intolerance were included in a prospective, nonrandomized, multicenter study to evaluate the feasibility, safety, and efficacy of a novel tongue advancement procedure. The procedure consists of the implantation of a tissue anchor in the tongue base and an adjustment spool at the mandible. Titration of this tissue anchor results in advancement of the tongue and a patent upper airway. Results: The mean AHI decreased from 22.8 at baseline to 11.8 at the 6-month follow-up (p = 0.007). The Epworth Sleepiness Scale score decreased from 11.4 at baseline to 7.7 at the 6-month follow-up (p = 0.094), and the snoring score decreased from 7.5 at baseline to 3.9 at the 6-month follow-up (p = 0.005). Four technical adverse events were noted, and 1 clinical adverse event occurred. Conclusions: Adjustable tongue advancement is a feasible and relatively safe way to reduce the AHI and snoring in selected patients with moderate to severe OSA and CPAP intolerance. Technical improvements and refinements to the procedure are ongoing.

scholarly journals Partial intracapsular tonsillectomy in the treatment of pediatric obstructive sleep apnea/hypopnea syndrome: a prospective study with 5-year follow-up

2021 ◽  
Author(s):  
Matteo Cavaliere ◽  
Pietro De Luca ◽  
Egidio De Bonis ◽  
Riccardo Maurizi ◽  
Claudia Cassandro ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Apnea Hypopnea Index ◽  
Sleep Study ◽  
Obstructive Sleep ◽  
Operative Evaluation ◽  
A Prospective Study ◽  
Hypopnea Syndrome ◽  
Intracapsular Tonsillectomy

Abstract Objective To assess efficacy and safety of tonsil reduction with bipolar forceps electrocautery as treatment of paediatric obstructive sleep apnea/hypopnea syndrome (OSAHS). Study design Prospective interventional study. Methods Two hundred and sixty-three children aged 4–10 years with OSAHS and an apnea hypopnea index (AHI) > 3 were enrolled from March 2013 to January 2016. Pre-operative evaluation included oropharyngeal clinical examination with fiberoptic nasopharyngoscopy, OSA-18 questionnaire and overnight sleep study. All children were treated with adenoidectomy and tonsillotomy with bipolar forceps. OSA-18 questionnaire and overnight sleep study were performed 30 days after surgery. Results Pre-operative average of the OSA-18 questionnaires was of 70.3 (SD = 9.7); 30-day post-operative score was 23.15 (SD = 8.2; p = 0.045). Pre-operative average Apnea Hypopnea Index (AHI) score was 9.41 (SD = 4.1); 30-day post-operative average of AHI score was of 1.75 (SD = 0.8; p = 0.012). Oxygen Desaturation Index (ODI) rate changed from 7.39 (SD = 4) to 1.34 (30-day post-operative) (SD = 4.7; p = 0.085). NADIR rate changed from 79% (SD = 6.32) to 90% (30-day post-operative) (SD = 5.18; p = 0.00012). Peri- and post-operative complications in our sample were mainly pain (average 75 doses of paracetamol), while bleeding did not occur (0%). All patients received a follow-up examination 5 years after surgery to evaluate tonsil size; at this time-point, a reduction in tonsil size from 3.6 (3–4; SD = 4.2) to 1.3 (1–2; SD = 5.5) was found, while tonsil regrowth was observed in five children (2%). Conclusion This study showed that partial tonsillotomy with bipolar forceps electrocautery associated to adenoidectomy is an effective technique in treating OSAHS symptoms in children and ensures less complications in terms of hemorrhage, postoperative pain and infections compared to traditional adenotonsillectomy. The very low tonsillar regrowth rate reported in this study may support the routine use of this technique.

Improvement in Obstructive Sleep Apnea (OSA) in Super Morbidly Obese Patients After Bariatric Surgery

2020 ◽  
Vol 103 (8) ◽  
pp. 725-728
Keyword(s):  
Bariatric Surgery ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Lifestyle Modification ◽  
Apnea Hypopnea Index ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Obstructive Sleep ◽  
Objective Evidence

Background: Lifestyle modification is the mainstay therapy for obese patients with obstructive sleep apnea (OSA). However, most of these patients are unable to lose the necessary weight, and bariatric surgery (BS) has been proven to be an effective modality in selected cases. Objective: To provide objective evidence that BS can improve OSA severity. Materials and Methods: A prospective study was conducted in super morbidly obese patients (body mass index [BMI] greater than 40 kg/m² or BMI greater than 35 kg/m² with uncontrolled comorbidities) scheduled for BS. Polysomnography (PSG) was performed for preoperative assessment and OSA was treated accordingly. After successful surgery, patients were invited to perform follow-up PSG at 3, 6, and 12 months. Results: Twenty-four patients with a mean age of 35.0±14.0 years were enrolled. After a mean follow-up period of 7.8±3.4 months, the mean BMI, Epworth sleepiness scale (ESS), and apnea-hypopnea index (AHI) significantly decreased from 51.6±8.7 to 38.2±6.8 kg/m² (p<0.001), from 8.7±5.9 to 4.7±3.5 (p=0.003), and from 87.6±38.9 to 28.5±21.5 events/hour (p<0.001), respectively. Conclusion: BS was shown to dramatically improve clinical and sleep parameters in super morbidly obese patients. Keywords: Morbid obesity, Bariatric surgery, Obstructive sleep apnea (OSA)

scholarly journals Subjective and Objective Appraisal of Activity in Adults with Obstructive Sleep Apnea

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Eileen R. Chasens ◽  
Susan M. Sereika ◽  
Martin P. Houze ◽  
Patrick J. Strollo
Keyword(s):  
Physical Activity ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Epworth Sleepiness Scale ◽  
Functional Outcomes ◽  
Apnea Hypopnea Index ◽  
Sleep Study ◽  
Obstructive Sleep ◽  
Subjective Sleepiness ◽  
Aging Adults

Objective.This study examined the association between obstructive sleep apnea (OSA), daytime sleepiness, functional activity, and objective physical activity.Setting.Subjects (N=37) being evaluated for OSA were recruited from a sleep clinic.Participants. The sample was balanced by gender (53% male), middle-aged, primarily White, and overweight or obese with a mean BMI of 33.98 (SD=7.35;median BMI=32.30). Over 40% reported subjective sleepiness (Epworth Sleepiness Scale (ESS) ≥10) and had OSA (78% with apnea + hypopnea index (AHI) ≥5/hr).Measurements.Evaluation included questionnaires to evaluate subjective sleepiness (Epworth Sleepiness Scale (ESS)) and functional outcomes (Functional Outcomes of Sleep Questionnaire (FOSQ)), an activity monitor, and an overnight sleep study to determine OSA severity.Results.Increased subjective sleepiness was significantly associated with lower scores on the FOSQ but not with average number of steps walked per day. A multiple regression analysis showed that higher AHI values were significantly associated with lower average number of steps walked per day after controlling patient's age, sex, and ESS.Conclusion.Subjective sleepiness was associated with perceived difficulty in activity but not with objectively measured activity. However, OSA severity was associated with decreased objective physical activity in aging adults.

S296 – Thyroidectomy for Goiter Improves Obstructive Sleep Apnea

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P173-P174
Author(s):  
Mark T Agrama
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Total Thyroidectomy ◽  
Community Hospital ◽  
Apnea Hypopnea Index ◽  
Tracheal Compression ◽  
Obstructive Sleep ◽  
The Mean ◽  
Postoperative Improvement ◽  
Symptomatic Control

Objectives Evaluate the effects of total thyroidectomy for euthyroid goiter causing tracheal compression on the apnea hypopnea index (AHI) in patients with obstructive sleep apnea (OSA). Demonstrate a relationship between tracheal compression and OSA. Methods A retrospective study of 8 patients with euthyroid goiter causing tracheal compression who had moderate or severe OSA. Between January 2004 and December 2007, 8 patients with these conditions were treated in a community hospital by the author. At least 1 compressive symptom (dysphagia, dyspnea, and/or orthopnea) was reported by all patients. Computed tomography of the neck and chest was used to confirm the extent of goiter and tracheal compression. OSA was confirmed with preoperative polysomnography. Total thyroidectomy was performed. Postoperative polysomnography was obtained after 90 days. Outcome measures were changes in compressive symptoms and AHI using paired t test. Results All 8 patients reported symptomatic control of compressive symptoms after thyroidectomy. 7 of 8 patients demonstrated postoperative improvement of AHI. The mean postoperative AHI decreased significantly from 52.1 to 36.6 (P < 0.05). Conclusions Total thyroidectomy for goiter causing tracheal compression can significantly improve symptoms and AHI in those patients who have OSA. Evaluation of patients with OSA should include screening for tracheal compression from goiter.

scholarly journals Detection of obstructive sleep apnea using Belun Sleep Platform wearable with neural network-based algorithm and its combined use with STOP-Bang questionnaire

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0258040
Author(s):  
Eric Yeh ◽  
Eileen Wong ◽  
Chih-Wei Tsai ◽  
Wenbo Gu ◽  
Pai-Lien Chen ◽  
...  
Keyword(s):  
Neural Network ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Physiological Data ◽  
Apnea Hypopnea Index ◽  
Clinical Practices ◽  
Sleep Study ◽  
Link Type ◽  
Obstructive Sleep ◽  
Sensitivity Specificity

Many wearables allow physiological data acquisition in sleep and enable clinicians to assess sleep outside of sleep labs. Belun Sleep Platform (BSP) is a novel neural network-based home sleep apnea testing system utilizing a wearable ring device to detect obstructive sleep apnea (OSA). The objective of the study is to assess the performance of BSP for the evaluation of OSA. Subjects who take heart rate-affecting medications and those with non-arrhythmic comorbidities were included in this cohort. Polysomnography (PSG) studies were performed simultaneously with the Belun Ring in individuals who were referred to the sleep lab for an overnight sleep study. The sleep studies were manually scored using the American Academy of Sleep Medicine Scoring Manual (version 2.4) with 4% desaturation hypopnea criteria. A total of 78 subjects were recruited. Of these, 45% had AHI < 5; 18% had AHI 5–15; 19% had AHI 15–30; 18% had AHI ≥ 30. The Belun apnea-hypopnea index (bAHI) correlated well with the PSG-AHI (r = 0.888, P < 0.001). The Belun total sleep time (bTST) and PSG-TST had a high correlation coefficient (r = 0.967, P < 0.001). The accuracy, sensitivity, specificity in categorizing AHI ≥ 15 were 0.808 [95% CI, 0.703–0.888], 0.931 [95% CI, 0.772–0.992], and 0.735 [95% CI, 0.589–0.850], respectively. The use of beta-blocker/calcium-receptor antagonist and the presence of comorbidities did not negatively affect the sensitivity and specificity of BSP in predicting OSA. A diagnostic algorithm combining STOP-Bang cutoff of 5 and bAHI cutoff of 15 events/h demonstrated an accuracy, sensitivity, specificity of 0.938 [95% CI, 0.828–0.987], 0.944 [95% CI, 0.727–0.999], and 0.933 [95% CI, 0.779–0.992], respectively, for the diagnosis of moderate to severe OSA. BSP is a promising testing tool for OSA assessment and can potentially be incorporated into clinical practices for the identification of OSA. Trial registration: ClinicalTrial.org NCT03997916 https://clinicaltrials.gov/ct2/show/NCT03997916?term=belun+ring&draw=2&rank=1

scholarly journals Clinical and Polysomnographic Characteristics of Patients with Extreme Obstructive Sleep Apnea, AHI > 100: A Case-Control Study

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Forogh Soltaninejad ◽  
Negarsadat Neshat ◽  
Mehrzad Salmasi ◽  
Babak Amra
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Apnea Hypopnea Index ◽  
Obstructive Sleep ◽  
Study Results ◽  
Significant Difference ◽  
Severe Manifestation ◽  
The Mean ◽  
Nocturnal Polysomnography ◽  
Control Study

Background: Severe obstructive sleep apnea (OSA), defined by apnea-hypopnea index (AHI) as more than 30 events per hour, was previously related to more comorbidity. However, limited studies separated the patients with AHI > 100 from those with a less severe manifestation of the disease. Objectives: The current study aimed at describing the characteristics of this subgroup and comparing them with less severe conditions. Methods: A retrospective analysis was conducted on 114 patients with OSA. Nocturnal polysomnography was used to diagnose severe OSA. Patients were categorized into two groups: (1) 60 < AHI < 100 (very severe OSA), (2) AHI ≥ 100 (extreme OSA). Demographic, medical history, and polysomnographic variables were evaluated and compared between the two groups. Results: Extreme OSA was diagnosed in 19 patients, the mean body mass index (BMI) was significantly higher in this group (39.26 ± 5.93 vs. 35.68 ± 6.45 kg/m2, P = 0.025). They also had lower minimal O2 saturation (65.68 ± 10.16 vs. 74.10 ± 8.74, P = 0.003) and more time with < 90% O2 saturation (T < 90%) (81.78 ± 22.57 vs. 58.87 ± 33.14, P = 0.01). OHS prevalence was significantly higher in the group with extreme OSA (P = 0.04). The most frequent comorbidity was hypertension, with an incidence of 60.5%, for the extreme group, although there was no significant difference between the two groups in terms of clinical associations. Conclusions: The current study results suggested that greater BMI and lower minimal O2 saturation, as well as increased T < 90%, were associated with extreme OSA, although no differences were observed in the associated diseases between the compared groups.

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