scholarly journals Comparing Cognitive Performance in Patients with Obstructive Sleep Apnea and healthy Subjects

2018 ◽  
Author(s):  
Maryam Maghsoudipour ◽  
Shoaleh Memari ◽  
Khosro Sadeghniiat Haghighi ◽  
Pourya Rezasoltani
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Cognitive Performance ◽  
Healthy Subjects ◽  
Pearson Correlation ◽  
Direct Consequence ◽  
Control Group ◽  
Case Group ◽  
Obstructive Sleep ◽  
Significant Difference

Introduction::   Daily performance deficits are inevitable results of a large group of sleep disorders. Cognition and cognitive performance might be defected as a direct consequence of sleep disorder assessed by subjective or objective measures. So, this survey was performed in order to compare cognitive performance of obstructive sleep apnea patients and healthy subjects in Baharloo hospital of Tehran.   Method:  In this case control study, the samples were chosen by  convenience sampling, from Baharloo hospital patients and were assigned to case group (apnea patients) and control group (healthy subjects), based on AHI score. Also, we used a demographic questionnaire, ESS, Berlin, and STOP BANG. Appropriate tool was used to assess cognitive performance in two groups. In order to analyze data we used SPSS (version 19).  Independent T test, Chi square, Fisher test, Kruskal-wallis Test, and Pearson correlation test were used. Results:   Results demonstrated a significant difference of sleepiness and cognitive performance between healthy subjects and OSA (Obstructive Sleep Apnea) patients.  Conclusion:   Screening and diagnosis of OSA patients, and considering the deficient cognitive performance is crucial. Also, education about the importance of OSA Syndrome and the treatment is necessary.     Keywords:  Obstructive sleep apnea, Cognitive performance, Excessive daytime sleepiness

scholarly journals Effect of Cooling Irrigating Saline in Tongue Base Ablation in Obstructive Sleep Apnea

OTO Open ◽  
2021 ◽  
Vol 5 (1) ◽  
pp. 2473974X2198959
Author(s):  
Ahmed Yassin Bahgat
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Controlled Trial ◽  
Tongue Base ◽  
Control Group ◽  
University Hospitals ◽  
Energy Field ◽  
Obstructive Sleep ◽  
Prospective Randomized Controlled Trial ◽  
Significant Difference

Objective Plasma is formed by creating a high-density energy field within an electrically conductive fluid such as saline. Sometimes ablated bits of tissue get stuck between the electrodes of the wand, obstructing the suction channel. The purpose of this study is to investigate the effect of cooling the irrigating saline during ablation of the hypertrophied tongue base in patients with obstructive sleep apnea. Study Design Prospective randomized controlled trial. Setting An otorhinolaryngology department in Main University hospitals. Methods Sixty adult patients with obstructive sleep apnea and tongue base hypertrophy underwent tongue base ablation surgery. Patients were randomly divided into 2 groups of 30 patients each: cooled saline and room temperature saline. The Coblation wand used was the EVac 70 Xtra HP (Smith & Nephew). Results In this study, a significant difference in operative time (mean ± SD) was seen between groups: 21.2 ± 5.5 minutes in the cold group and 47 ± 9.5 minutes in the control group ( P = .001). The wands in the cold group did not obstruct, while all the wands in the control group were obstructed by tissue clogs with variable degrees, hence wasting more time to clean the wands’ tips. Conclusion Cooling the irrigating saline overcame the problem of wand clogs, and the wand tip did not occlude at all during the procedures, thus saving time lost in wand cleaning and demonstrating a faster and safer surgical procedure. Further studies are needed to identify the hemostatic effect of the cooled saline over the regular one.

scholarly journals The Effect of Vitamin C Therapy Towards Malondialdehyde Plasma Content on Chronic Tonsillitis Patients With Risk of Obstructive Sleep Apnea Syndrome

2018 ◽  
Vol 10 (9) ◽  
pp. 97
Author(s):  
Sutji Pratiwi Rahardjo Hiro ◽  
Hiro Salomo Mangape ◽  
Abdul Qadar Punagi ◽  
Andi Nilawati Usman
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Vitamin C ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Chronic Tonsillitis ◽  
Control Group ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
Apnea Syndrome

INTRODUCTION: Sleep Apnea Syndrome is a syndrome with an episode of apnea or hypopnea during sleep. The objective of this study was to investigate the effect of the vitamin C therapy to plasma Malondialdehyde (MDA) level in patients with chronic tonsillitis who have a risk factor of Obstructive Sleep Apnea Syndrome (OSAS), measured pre and post-therapy.METHODS: The design of this study was a clinical trial with pre-test and post-test control group. This study was conducted in Dr. Wahidin Sudirohusodo Hospital and Hasanuddin University Teaching Hospital in Makassar and 30 subjects was enrolled (20 subjects were patients with chronic tonsillitis and OSAS, and 10 subjects were control). The measurement of plasma MDA level was obtained using ELISA method. The data were analyzed using the Mann-Whitney test and Chi-square test.RESULTS: The results of this study showed a decreasing level of plasma MDA in patients with chronic tonsillitis and OSAS after the vitamin C therapy. However, there was no significant difference between patients who had not received vitamin C therapy.CONCLUSION: The intervention of vitamin C in chronic tonsillitis patients and can reduce levels of plasma MDA.

scholarly journals Creatinine Clearance in Patients with Obstructive Sleep Apnea

2021 ◽  
Vol 7 (1) ◽  
pp. 59
Author(s):  
Seda Beyhan Sagmen ◽  
Nesrin Kiral ◽  
Ali Fidan ◽  
Elif Torun Parmaksiz ◽  
Coskun Dogan ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Endothelial Dysfunction ◽  
Creatinine Clearance ◽  
Control Group ◽  
Apnea Hypopnea Index ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

During an apnea, hemodynamic complications such as hypoxemia, a rise in systemic and pulmonary arterial pressure, and changes in heart rate occur in patients with obstructive sleep apnea (OSA). Potential mechanisms of OSA-associated renal dysfunction include renal hypoxia, hypertension, endothelial dysfunction. Hypertension is common in patients with OSA. This study aims to assess OSA patients' renal functions and investigate the creatinine clearance (CC) values across OSA patients with and without hypertension. The study included 530 individuals with OSA and 60 individuals with an apnea-hypopnea index (AHI) of <5. CC calculated with the Cockcroft-Gault Equation. Patients with OSA divide into two groups as the group of patients with hypertension (HT) (group 1) and without HT (group 2). The study included 339 (64%) male and 191 (36%) female patients. It found that 32.4% of OSA patients had HT (Group 1). There was a significant difference in CC and urea levels between groups 1 and 2 (p<0.001; p=0.005). While CC was low in the OSA group, CC values were not statistically significantly different between the OSA patients and the control group (p>0.05). A statistically significant difference was detected in urea and creatinine levels between the OSA and control groups (p=0.005; p=0.012). Creatinine clearance decreases in patients with OSA in the presence of HT. Patients with OSA often experience cardiovascular disorders, and glomerular endothelial dysfunction occurs in OSA patients.

scholarly journals The signal axis GATA2-EDN1-AGT induced hypertension from obstructive sleep apnea-hypopnea syndrome with the clinical and animal study

2022 ◽  
Vol 67 (4) ◽  
pp. 91-96
Author(s):  
Li Zhang ◽  
Shaokun Xu ◽  
Ning Zhou ◽  
Juanqin Shen ◽  
Jiaqing Huang ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Systolic Pressure ◽  
Strong Relationship ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Case Group ◽  
Obstructive Sleep ◽  
Induced Hypertension ◽  
Hypopnea Syndrome

Hypertension occurred in 50% obstructive sleep apnea-hypopnea syndrome (OSAHS) patients meanwhile OSAHS occurred in 30% hypertension patients. The present study aimed to explore the molecular mechanism of GATA2-EDN1-AGT induced hypertension in the development of obstructive sleep apnea-hypopnea syndrome. OSAHS patients (56 cases: 36 cases of male, 20 cases of female, 42~60 years old) were divided into two groups (case group: patients with hypertension monitored by 24 h ambulatory blood pressure and polysomnography; control group: patients without hypertension). Wistar rats were used to establish the OSAHS model (narrow pharyngeal cavity). PaO2 and PaCO2 of patients and rats were measured by an automatic blood gas analyzer. The profile of total protein in the OSAHS group and normal group was evaluated. Protein-protein-interaction (PPI) was carried out to show all matter proteins related. The levels of EDN-1, AGTII and atrial natriuretic peptide (ANP) in blood samples of patients and rats were analyzed by enzyme-linked immunosorbent assay (ELISA). The expression of GATA2, EDN1, endothelin-converting enzyme 1 (ECE-1) and AGTⅡ was measured. The results showed that SaO2 and AHI were positively associated with systolic pressure (P<0.05) in OSAHS patients. There was no correlation among other indexes (P>0.05). It was also observed that GATA2 had a strong relationship with AGTⅡ and EDN1. The results of ELISA presented that the levels of EDN1, AGTⅡ and ANP in the OSAHS group of human and animal models were significantly increased (P<0.05). The results of immunochemistry showed that the expression of GATA2 and AGTⅡ in the vascular of OSAHS group was upregulated manifestly (P<0.05). It was concluded that OSAHS can induce AHI, which increases hypertension via the GATA2-EDN1-AGT Ⅱ axis.

2 The association between obstructive sleep apnea severity and cognition in older people

2020 ◽  
Vol 91 (8) ◽  
pp. e9.1-e9
Author(s):  
Yu-Jun Luo ◽  
Chen-Chen Lo ◽  
Cheng-Yu Tsai ◽  
Yin-Tzu Lin ◽  
Hsin-Mei Hsu ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Apnea Syndrome ◽  
Sleep Efficiency ◽  
Lower Score ◽  
Control Group ◽  
Case Group ◽  
Time In Bed ◽  
Obstructive Sleep ◽  
Four Levels

Relationship between obstructive sleep apnea syndrome (OSAS) and dementia has been investigated in recent years. However, the effects of hypoxia during sleep timeon dementia remain unclear. The objective of this study is to associate the score of mini-mental state examination (MMSE) with OSAS. In this study, 67 patients whom were more than 50 years old and have been done for MMSE test and diagnosed with OSAS in sleep center in Taipei from 2015 to 2018. Four levels of OSAS severity were classified by the apnea and hypopnea index (AHI), according to the American Academy of Sleep Medicine (AASM) guideline. Subjects with MMSE scores above 25 and below 25 were served respectively as case group and control group. Logistic regression analyses were used to examine the associations. The average AHI were 28.48 times per hour for case group and 17.93 times per hour for control group. The AHI had a 1.03 fold higher odds ratio (95% CI=0.99 ~ 1.07, p=0.06) for lower score group compared with higher score group. The mean sleep efficiency were 57.8% in lower score group, while higher score group had an average sleep efficiency of 70.3%. Furthermore, sleep efficiency, total sleep time, the ratio of wake to total time in bed as well as the ratio of wake to sleep period time in case group were significant lower than the control group. We observe the associations between MMSE score and some parameters of polysomnography. The subjects with high severity OSAS, insufficient sleep efficacy, longer awake duration and shorter sleep duration could lead to cognitive impairment.

scholarly journals P060 Hypoxia-induced overexpression of Rev-Erb-alpha and NPAS2 proteins in obstructive sleep apnea patients - possible mechanism of DM2 development

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A41-A41
Author(s):  
F Karuga ◽  
S Turkiewicz ◽  
M Ditmer ◽  
M Sochal ◽  
P Białasiewicz ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Serum Protein ◽  
Protein Level ◽  
Control Group ◽  
Apnea Hypopnea Index ◽  
Orphan Nuclear Receptor ◽  
Protein Levels ◽  
Obstructive Sleep ◽  
Significant Difference

Abstract Circadian clocks are endogenous coordinators of 24-hour behavioral and molecular rhythms, which disruption may be caused by obstructive sleep apnea (OSA). It is composed of a set of genes, function as activators (CLOCK, BMAL) or repressors (PER, CRY). Neuronal PAS Domain Protein 2 (NPAS2) can substitute CLOCK in its function. Orphan nuclear receptor (Rev-Erb-α) is another protein supporting the CLOCK-BMAL1 complex, forming the loop which helps to regulate their expression. There are studies suggesting the significant influence of circadian disruption mediated via NPAS2 and Rev-Erb-α on DM2 development. The aim of the study was to determine the role of NPAS2 and Rev-Erb-α in DM2 for OSA patients. All participants underwent polysomnography (PSG) examination. Based on apnea-hypopnea index accompanied by clinical data the recruited individuals (n=40) were assigned to one from 3 groups: OSA (severe OSA, no DM2; n=17), DM2 (severe OSA + DM2; n=7) and control group (no OSA, no DM2; n=16). Serum protein levels of Rev-Erb-α and NPAS2 were assessed with ELISA immunoassay. Analysis between the groups revealed the statistically significant difference only in NPAS2 protein level (p=0.037). Further post-hoc analysis revealed significant differences between OSA and the control group (p=0.017). Moreover, a statistically significant correlation between AHI and NPAS2 serum protein level was observed (r=-0.478, p=0.002). NPAS2 protein levels are associated with a number of apneas and hypopneas during the REM phase of sleep and might have a significant role in the development of OSA complications. However, further studies are needed to understand its role.

Postoperative monitoring of children with obstructive sleep apnea syndrome

2014 ◽  
Vol 155 (18) ◽  
pp. 703-707 ◽  
Author(s):  
Pálma Benedek ◽  
Gabriella Kiss ◽  
Eszter Csábi ◽  
Gábor Katona
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Preoperative Evaluation ◽  
Sleep Apnea Syndrome ◽  
Study Patient ◽  
Severe Obstructive Sleep Apnea ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
Apnea Syndrome

Introduction: Treatment of pediatric obstructive sleep apnea syndrome is surgical. The incidence of postoperative respiratory complications in this population is 5–25%. Aim: The aim of the authors was to present the preoperative evaluation and monitoring procedure elaborated in Heim Pál Children Hospital, Budapest. Method: 142 patients were involved in the study. Patient history was obtained and physical examination was performed in all cases. Thereafter, polysomnography was carried out, the severity of the obstructive sleep apnea syndrome was determined, and the patients underwent tonsilloadenotomy. Results: 45 patients with mild, 50 patients with moderate and 47 patients with severe obstructive sleep apnea syndrome were diagnosed. There was no complication in patients with mild disease, while complications were observed in 6 patients in the moderate group and 24 patients in the severe group (desaturation, apnea, stridor, stop breathing) (p<0.000). In patients with severe obstructive sleep apnea syndrome, no significant difference was noted in preoperative apnoea-hypapnea index (p = 0.23) and in nadir oxygen saturation values (p = 0.73) between patients with and without complication. Conclusions: Patients with severe obstructive sleep apnea syndrome should be treated in hospital where pediatric intensive care unit is available. Orv. Hetil., 2014, 155(18), 703–707.

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.

Evaluation of corneal endothelium using specular microscopy in patients with obstructive sleep apnea syndrome

2021 ◽  
pp. 112067212110065
Author(s):  
Murat Serkan Songur ◽  
Yavuz Selim İntepe ◽  
Seray Aslan Bayhan ◽  
Hasan Ali Bayhan ◽  
Ender Şahin ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Coefficient Of Variation ◽  
Corneal Endothelium ◽  
Corneal Thickness ◽  
Sleep Apnea Syndrome ◽  
Control Group ◽  
Specular Microscopy ◽  
Obstructive Sleep ◽  
Apnea Syndrome

Purpose: In the present study we evaluate the corneal endothelium using specular microscopy in patients with obstructive sleep apnea syndrome (OSAS). Methods: The study included a total of 100 patients including 35 patients with mild OSAS, 34 patients with moderate OSAS and 31 patients with severe OSAS, and the right eyes of 30 patients as a control group. Patients were examined to exclude the possibility of ocular diseases. Cellular density in the cornea epithelium (cell/mm2), corneal thickness (µ), percentage of hexagonal cells (%) and the coefficient of variation were evaluated using a specular microscope. Results: Corneal thickness was significantly decreased in all OSAS groups when compared to the control group ( p = 0.002), while no significant difference was identified among the OSAS groups. The corneal endothelial cell density, percentage of hexagonal cells and coefficient of variation were significantly different between the OSAS groups and the control group ( p < 0.001). Conclusion: More significant impairments were noted in the corneal endothelium of the patients in the OSAS group than in the control group, and specular microscopy is in valuable in the follow-up and treatment of such patients.

scholarly journals Initiation of therapy for obstructive sleep apnea syndrome: a randomized comparison of outcomes of telemetry-supported home-based vs. sleep lab-based therapy initiation

2021 ◽  
Author(s):  
Ingo Fietze ◽  
Sebastian Herberger ◽  
Gina Wewer ◽  
Holger Woehrle ◽  
Katharina Lederer ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Control Group ◽  
Sleep Laboratory ◽  
Home Therapy ◽  
Home Management ◽  
Therapy Initiation ◽  
Home Based ◽  
Obstructive Sleep ◽  
At Home

Abstract Purpose Diagnosis and treatment of obstructive sleep apnea are traditionally performed in sleep laboratories with polysomnography (PSG) and are associated with significant waiting times for patients and high cost. We investigated if initiation of auto-titrating CPAP (APAP) treatment at home in patients with obstructive sleep apnea (OSA) and subsequent telemonitoring by a homecare provider would be non-inferior to in-lab management with diagnostic PSG, subsequent in-lab APAP initiation, and standard follow-up regarding compliance and disease-specific quality of life. Methods This randomized, open-label, single-center study was conducted in Germany. Screening occurred between December 2013 and November 2015. Eligible patients with moderate-to-severe OSA documented by polygraphy (PG) were randomized to home management or standard care. All patients were managed by certified sleep physicians. The home management group received APAP therapy at home, followed by telemonitoring. The control group received a diagnostic PSG, followed by therapy initiation in the sleep laboratory. The primary endpoint was therapy compliance, measured as average APAP usage after 6 months. Results The intention-to-treat population (ITT) included 224 patients (110 home therapy, 114 controls); the per-protocol population (PP) included 182 patients with 6-month device usage data (89 home therapy, 93 controls). In the PP analysis, mean APAP usage at 6 months was not different in the home therapy and control groups (4.38 ± 2.04 vs. 4.32 ± 2.28, p = 0.845). The pre-specified non-inferiority margin (NIM) of 0.3 h/day was not achieved (p = 0.130); statistical significance was achieved in a post hoc analysis when NIM was set at 0.5 h/day (p < 0.05). Time to APAP initiation was significantly shorter in the home therapy group (7.6 ± 7.2 vs. 46.1 ± 23.8 days; p < 0.0001). Conclusion Use of a home-based telemonitoring strategy for initiation of APAP in selected patients with OSA managed by sleep physicians is feasible, appears to be non-inferior to standard sleep laboratory procedures, and facilitates faster access to therapy.

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