scholarly journals Hemostatic alterations in patients with obstructive sleep apnea: an observational study

2019 ◽  
Vol 5 (4) ◽  
pp. 990
Author(s):  
Basavaraj P. Belaldavar ◽  
Tejaswini J. S. ◽  
Samanvaya Soni
Keyword(s):  
Platelet Count ◽  
Observational Study ◽  
Prothrombin Time ◽  
Bleeding Time ◽  
Treatment Options ◽  
Upper Airway ◽  
Sleep Apnoea ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
Level I

<p class="abstract"><strong>Background:</strong> Obstructive sleep apnoea (OSA) is characterized by repetitive partial or complete collapse of the upper airway during sleep, which results in disruptions of normal sleep architecture. It is associated with cardiopulmonary consequences like hypertension, myocardial infarction and stroke. Although the pathogenesis of this association remains unclear, an alteration in coagulability is suspected as a linkage. Hence, the present study aims at the reliability of Bleeding time, platelet count, PT, aPTT and INR to assess the effect on OSA patients’ cardiovascular system.</p><p class="abstract"><strong>Methods:</strong> This is an observational study done on 32 individuals diagnosed with OSA after level I polysomnography from time period of January 01, 2018 to December 31, 2018. The blood coagulation parameters studied for each individual were platelet count, bleeding time (BT), activated partial thromboplastin time (aPTT) and prothrombin time (PT/INR).</p><p class="abstract"><strong>Results:</strong> Out of a total 32 subjects, 17 (53.13%) were male and 15 (46.87%) were female. There is a significant difference in mean prothrombin time (p=0.022). Kruskal-Wallis test showed a significant difference in the median of the PT/INR (p=0.01) and AHI (p&lt;0.001) for different categories of OSA. Prothrombin time is the only factor which is affecting the OSA.</p><p class="abstract"><strong>Conclusions:</strong> Patients with severe OSA may have elevated coagulability levels, particularly in the length of prothrombin time. The potential for anticoagulant and antiplatelet medications to reduce mortality in patients with OSA merits exploration, particularly for patients who are unwilling or unable to achieve full control of OSA with currently available treatment options.</p>

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.

scholarly journals Personalised medicine in sleep respiratory disorders: focus on obstructive sleep apnoea diagnosis and treatment

2017 ◽  
Vol 26 (146) ◽  
pp. 170069 ◽  
Author(s):  
Maria R. Bonsignore ◽  
Monique C. Suarez Giron ◽  
Oreste Marrone ◽  
Alessandra Castrogiovanni ◽  
Josep M. Montserrat
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Treatment Options ◽  
Personalised Medicine ◽  
Upper Airway ◽  
Sleep Apnoea ◽  
Lifestyle Changes ◽  
Mandibular Advancement ◽  
Considerable Proportion ◽  
Special Focus ◽  
Obstructive Sleep

In all fields of medicine, major efforts are currently dedicated to improve the clinical, physiological and therapeutic understanding of disease, and obstructive sleep apnoea (OSA) is no exception. The personalised medicine approach is relevant for OSA, given its complex pathophysiology and variable clinical presentation, the interactions with comorbid conditions and its possible contribution to poor outcomes. Treatment with continuous positive airway pressure (CPAP) is effective, but CPAP is poorly tolerated or not accepted in a considerable proportion of OSA patients. This review summarises the available studies on the physiological phenotypes of upper airway response to obstruction during sleep, and the clinical presentations of OSA (phenotypes and clusters) with a special focus on our changing attitudes towards approaches to treatment. Such major efforts are likely to change and expand treatment options for OSA beyond the most common current choices (i.e. CPAP, mandibular advancement devices, positional treatment, lifestyle changes or upper airway surgery). More importantly, treatment for OSA may become more effective, being tailored to each patient's need.

Short-term results of upper airway stimulation in obstructive sleep apnoea patients: the Amsterdam experience

2020 ◽  
Vol 134 (5) ◽  
pp. 447-452
Author(s):  
P E Vonk ◽  
M J L Ravesloot ◽  
J P van Maanen ◽  
N de Vries
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Upper Airway ◽  
Sleep Apnoea ◽  
Consecutive Series ◽  
Short Term ◽  
Drug Induced ◽  
Upper Airway Stimulation ◽  
Surgical Success ◽  
Obstructive Sleep ◽  
Significant Difference

AbstractObjectivesThis paper aimed to: retrospectively analyse single-centre results in terms of surgical success, respiratory outcomes and adverse events after short-term follow up in obstructive sleep apnoea patients treated with upper airway stimulation; and evaluate the correlation between pre-operative drug-induced sleep endoscopy findings and surgical success.MethodsA retrospective descriptive cohort study was conducted, including a consecutive series of obstructive sleep apnoea patients undergoing implantation of an upper airway stimulation system.ResultsForty-four patients were included. The total median Apnoea–Hypopnea Index and oxygen desaturation index significantly decreased from 37.6 to 8.3 events per hour (p < 0.001) and from 37.1 to 15.9 events per hour (p < 0.001), respectively. The surgical success rate was 88.6 per cent, and did not significantly differ between patients with or without complete collapse at the retropalatal level (p = 0.784). The most common therapy-related adverse event reported was (temporary) stimulation-related discomfort.ConclusionUpper airway stimulation is an effective and safe treatment in obstructive sleep apnoea patients with continuous positive airway pressure intolerance or failure. There was no significant difference in surgical outcome between patients with tongue base collapse with or without complete anteroposterior collapse at the level of the palate.

Aerodynamics Analysis of the Impact of Nasal Surgery on Patients with Obstructive Sleep Apnea and Nasal Obstruction

ORL ◽  
2021 ◽  
pp. 1-8
Author(s):  
Lifeng Li ◽  
Demin Han ◽  
Hongrui Zang ◽  
Nyall R. London
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Nasal Obstruction ◽  
Upper Airway ◽  
Apnea Hypopnea Index ◽  
Nasal Surgery ◽  
Subjective Sleep Quality ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
The Impact

<b><i>Objective:</i></b> The purpose of this study was to evaluate the effects of nasal surgery on airflow characteristics in patients with obstructive sleep apnea (OSA) by comparing the alterations of airflow characteristics within the nasal and palatopharyngeal cavities. <b><i>Methods:</i></b> Thirty patients with OSA and nasal obstruction who underwent nasal surgery were enrolled. A pre- and postoperative 3-dimensional model was constructed, and alterations of airflow characteristics were assessed using the method of computational fluid dynamics. The other subjective and objective clinical indices were also assessed. <b><i>Results:</i></b> By comparison with the preoperative value, all postoperative subjective symptoms statistically improved (<i>p</i> &#x3c; 0.05), while the Apnea-Hypopnea Index (AHI) changed little (<i>p</i> = 0.492); the postoperative airflow velocity and pressure in both nasal and palatopharyngeal cavities, nasal and palatopharyngeal pressure differences, and total upper airway resistance statistically decreased (all <i>p</i> &#x3c; 0.01). A significant difference was derived for correlation between the alteration of simulation metrics with subjective improvements (<i>p</i> &#x3c; 0.05), except with the AHI (<i>p</i> &#x3e; 0.05). <b><i>Conclusion:</i></b> Nasal surgery can decrease the total resistance of the upper airway and increase the nasal airflow volume and subjective sleep quality in patients with OSA and nasal obstruction. The altered airflow characteristics might contribute to the postoperative reduction of pharyngeal collapse in a subset of OSA patients.

scholarly journals The effect of obstructive sleep apnoea on timing of acute coronary syndrome

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M.H Muhmad Hamidi ◽  
H Sani ◽  
M.A Ibrahim ◽  
K.S Ibrahim ◽  
A.B Md Radzi ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
High Risk ◽  
Systolic Function ◽  
Strong Association ◽  
Multiple Logistic Regression Analysis ◽  
Sleep Apnoea ◽  
Neck Circumference ◽  
Coronary Syndrome ◽  
Obstructive Sleep ◽  
Significant Difference

Abstract Background and objective Acute coronary syndrome (ACS) remains the principal cause of death in Malaysia. It is estimated about 20% of ACS occurs at nighttime during sleep between 12am to 6am. Factors associated with nocturnal ACS are unknown. Acute nocturnal pathophysiological response to obstructive sleep apnea (OSA) may increase risk of nocturnal ACS. We hypothesized that OSA risk is associated with timing of ACS onset. Methodology This study included 200 patients with ACS who underwent coronary angiogram for which the time of chest pain onset was clearly identified and divided into 2 groups; nocturnal ACS (12am-5.59am) and non-nocturnal ACS (6am–11.59pm). Two validated questionnaires, STOP-BANG and Epworth Sleepiness Scale (ESS) were self-administered by subjects to determine OSA risk. All subjects timing of ACS onset, OSA risk, demography, anthropometric measurements, comorbidities and echocardiographic characteristics were analyzed. Results Acute coronary syndrome occurs nocturnally in 19% of ACS patients. The prevalence of high risk OSA individuals among ACS patients is 43%. There is significantly higher prevalence of high risk OSA individuals in nocturnal ACS group of 95% compared to 30% of high risk OSA individuals in non-nocturnal ACS group (p=0.001). Nocturnal ACS patients was significantly younger (50.1±8.7yrs, p=0.001), had higher BMI (33.9±4.3kg/m2, p=0.005), waist circumference (106.7±10.3cm, p=0.003) and larger neck circumference (44.6±3.3cm, p=0.001) compared to non-nocturnal ACS group. These groups had similar prevalence of other comorbidities for ACS and showed no significant difference between left and right ventricular systolic function. In multiple logistic regression analysis, the most significant predictors for nocturnal ACS are OSA risk, neck circumference and age. Conclusion There is a strong association between high risk OSA individuals and nocturnal ACS onset. Patient with nocturnal ACS onset should be screened for OSA and prioritized for polysomnography. OSA prevalence according to ACS onset Funding Acknowledgement Type of funding source: None

scholarly journals Is there a relationship between sleep apnoea and microalbuminuria?

2021 ◽  
Author(s):  
Melek Cihanbeylerden ◽  
Melike Bağnu Yüceege
Keyword(s):  
Microvascular Complications ◽  
Sleep Apnoea ◽  
Urinary Albumin ◽  
Control Group ◽  
Creatinine Ratio ◽  
Microvascular Damage ◽  
Metabolic Complications ◽  
Albumin Creatinine Ratio ◽  
Obstructive Sleep ◽  
Significant Difference

Abstract Introduction Obstructive sleep apnoea (OSA) is a cause of hypoxia, and the correlation between hypoxia and microvascular complications is well known. Microalbuminuria (MAU) is a marker for endovascular dysfunction and an indicator of cardiovascular events and all-cause mortality in the general population. The aim of this study was to investigate the relationship between microvascular damage and the metabolic complications of OSA based on the presence of MAU. Material and method Urinary albumin/creatinine ratio (ACR) and microalbumin level were examined in patients with an apnoea-hypopnoea index (AHI) greater than 5/h (study group) and in patients with an AHI less than 5/h (control group). The exclusion criteria were other possible causes of MAU (hypertension, nephropathy, coronary artery disease, and severe thyroid dysfunction). Results Of 103 patients enrolled, 80 formed the group with OSA and 23 served as controls. According to the AHI values, the patients were divided into four groups as normal, mild, moderate and severe. There was no significant difference between the four groups in terms of the microalbumin level and urinary albumin/creatinine ratio. Conclusion In this study, no significant relationship was found between MAU and sleep apnoea.

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