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

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.

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

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.

Polysomnography Outcomes after Supraglottoplasty in Children with Obstructive Sleep Apnea

2019 ◽  
Vol 161 (4) ◽  
pp. 694-698 ◽  
Author(s):  
Bharat Bhushan ◽  
James W. Schroeder ◽  
Kathleen R. Billings ◽  
Nicholas Giancola ◽  
Dana M. Thompson
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Tertiary Care ◽  
Case Series ◽  
Apnea Hypopnea Index ◽  
Historical Cohort ◽  
Tertiary Care Medical Center ◽  
Obstructive Sleep ◽  
The Mean ◽  
The Impact

ObjectiveLaryngomalacia has been reported to contribute to the severity of obstructive sleep apnea (OSA) in children. It is unclear if surgical treatment of laryngomalacia improves polysomnography (PSG) outcomes in these patients. The objective of this study is to report the impact of supraglottoplasty on PSG parameters in children with laryngomalacia-related OSA.Study DesignRetrospective case series.SettingTertiary care medical center.Subjects and MethodsHistorical cohort study of consecutive children with laryngomalacia who underwent supraglottoplasty and who had undergone overnight PSG before and after surgery.ResultsForty-one patients were included in the final analysis: 22 (53.6%) were male, and 19 (46.3%) were female. The mean ± SEM age of patients at preoperative PSG was 1.3 ± 0.89 years (range, 0.003-2.9). In entire cohort, the mean obstructive apnea-hypopnea index score was reduced from 26.6 events/h before supraglottoplasty to 7.3 events/h after surgery ( P = .003). Respiratory disturbance index was reduced from 27.3 events/h before supraglottoplasty to 7.8 events/h after surgery ( P = .003). The percentage of REM sleep decreased from 30.1% ± 2.4 to 24.8% ± 1.3 ( P = .04). Sleep efficiency was improved ( P = .05).ConclusionOverall, supraglottoplasty significantly improved several PSG outcomes in children with laryngomalacia. However, mild to moderate OSA was still present postoperatively in most children. This suggested a multifactorial cause for OSA in this population.

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

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.

Abstract WP153: Severe Obstructive Sleep Apnea is Associated With Presence of Intracranial Cerebral Atherosclerosis

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Tae-Jin Song ◽  
Yoonkyung Chang ◽  
Yong-Jae Kim ◽  
Hyang Woon Lee
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Cerebrovascular Diseases ◽  
Apnea Hypopnea Index ◽  
Regression Analyses ◽  
Arousal Index ◽  
Asian Populations ◽  
Cerebral Atherosclerosis ◽  
Obstructive Sleep ◽  
The Mean

Background and significance: Intracranial cerebral atherosclerosis (ICAS) is closely associated with risk of cerebrovascular diseases, especially in Asian populations. Obstructive sleep apnea (OSA) is associated with systemic atherosclerosis, but it is not clear whether OSA is an independent risk factor of ICAS. We aimed to investigate the association between ICAS and apnea-hypopnea index (AHI), representing severity of OSA, in suspected OSA patients. Methods: We included 142 patients who suspected OSA from Ewha Sleep Center who underwent brain MR angiography (MRA) and polysomnography (PSG). We also investigated the presence and burden of ICAS on MRA and AHI on PSG. Results: The mean patient age was 59.7 ± 13.1 years, and 54.2% (77/142) were male. The mean AHI was 19.8 ± 20.9, and 17 patients (12.0%) had ICAS. Higher AHI was noted in patients with ICAS compared to those without ICAS (38.2 ± 27.1 vs. 17.3 ± 18.7, p = 0.023). The burden of ICAS was positively correlated with severity of OSA (p for trend = 0.013)(Figure 1). In multivariable binary logistic analyses, after adjusting for age, sex, hypertension, hyperlipidemia, smoking, arousal index and minimum SaO 2 , severe OSA was independently related with presence of ICAS (odds ratio (OR): 14.05, 95% confidence interval (CI): 1.28 - 153.64, p = 0.030). Likewise, in multivariable ordinal logistic regression analyses, severe OSA was marginally associated with burden of ICAS (OR: 8.47, 95% CI: 0.74 - 95.77, p = 0.084). Conclusion: Our findings suggest that severe OSA is associated with presence of ICAS in patients with suspected OSA.

scholarly journals Characteristics of patients with rapid eye movement-related obstructive sleep apnea: a retrospective review of 52 patients at a tertiary care center

2020 ◽  
Vol 8 (1) ◽  
pp. 42
Author(s):  
Muhannad Hawari ◽  
Mohamad Gayath Jamil ◽  
Sanaa Hemideh ◽  
Ayman Alharbi
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Eye Movement ◽  
Retrospective Review ◽  
Care Center ◽  
Tertiary Care ◽  
Rapid Eye Movement ◽  
Sleep Study ◽  
Obstructive Sleep ◽  
Tertiary Center

Background: The term “rapid eye movement (REM)-related obstructive sleep apnea (OSA)” is commonly used to describe sleep disordered breathing that occurs exclusively in REM sleep. The prevalence of REM-related OSA ranges from 10% to 36%. Despite the presence of reports describing the features of REM-related OSA, there is still much more to be known about it.Methods: In this study we did retrospective review of 734 patients who had a diagnostic sleep study in a sleep lab at a tertiary center between January 2014 and August 2016 were reviewed.Results: We found that hypertension was found in the charts of 50 patients, 36 of them were diagnosed with hypertension and on medical therapy (72%), 11 patients (out of 50) had diabetes (22%) and 9 (out of 49) had dyslipidemia. 2 patients (out of 49) had Ischemic heart disease (4%), 1 patient (out of 49) had stroke (2%) and 3 patients (out of 49) had arrhythmias (6%). 8 patients (out of 49) had thyroid disease (16%).Conclusions: In conclusion Most patients had mild REM related OSA and most did not have subjective EDS. Hypertension was the most common comorbidity among our patients.

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