Obstructive sleep apnea and chronic kidney disease: open questions on a potential public health problem

Abstract Over the last thirty years, the pathogenesis of obstructive sleep apnea syndrome (OSAS) has begun to be elucidated worldwide due to the presence of standardized diagnostic and treatment. In adults, the clinical diagnosis may be suggestive of OSAS when symptoms like fatigue, lack of concentration, poor work performance, absenteeism, daytime sleepiness, insomnia, snoring, nocturnal respiratory distress or apnea episodes witnessed by others are present. Some medical conditions found in employees’ personal history such as craniofacial abnormalities, some endocrine diseases, arterial hypertension, especially resistant arterial hypertension, coronary artery disease, atrial fibrillation, congestive heart failure, stroke, obesity, diabetes mellitus, cognitive dysfunction or mental disorders may be the alarm signal for OSAS. The assessment of all risk factors, clinical presentation and diagnosis must become an important part of occupational medical examinations and performed in all workers due to its major public health potential and impact on survival. The early identification of OSAS among workers performed by the occupational physician can potentially reduce the risk of work injuries and fatalities. In conclusion, OSAS is a complex entity and an important public health problem. The delay in diagnosis and treatment contributes to the increase of healthcare services demand and implicitly to general mortality.

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Obstructive sleep apnea and non-sustained ventricular tachycardia in patients with advanced chronic kidney disease and mild left ventricular dysfunction

Cardiothoracic and Vascular Sciences ◽

10.15761/cvs.1000101 ◽

2017 ◽

Vol 1 (1) ◽

Author(s):

Márcio Galindo Kiuchi ◽

Shaojie Chen

Keyword(s):

Chronic Kidney Disease ◽

Obstructive Sleep Apnea ◽

Ventricular Tachycardia ◽

Sleep Apnea ◽

Kidney Disease ◽

Left Ventricular Dysfunction ◽

Ventricular Dysfunction ◽

Left Ventricular ◽

Advanced Chronic Kidney Disease ◽

Obstructive Sleep

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Predictors of chronic kidney disease in obstructive sleep apnea patients

Multidisciplinary Respiratory Medicine ◽

10.4081/mrm.2020.470 ◽

2020 ◽

Vol 15 ◽

Author(s):

Phunphai Somkearti ◽

Paiboon Chattakul ◽

Sittichai Khamsai ◽

Panita Limpawattana ◽

Jarin Chindaprasirt ◽

...

Keyword(s):

Blood Pressure ◽

Body Mass Index ◽

Chronic Kidney Disease ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Kidney Disease ◽

Systolic Blood Pressure ◽

High Systolic Blood Pressure ◽

Mallampati Score ◽

Obstructive Sleep

Introduction: Obstructive sleep apnea (OSA) is a common condition in patients with chronic kidney disease (CKD). It may worsen renal function in CKD patients and is associated with uncontrolled blood pressure. Although OSA is found in up to 80% of CKD patients, there are limited data available on its clinical features in patients with and without CKD. Objective: This study aimed to identify the differences in the clinical characteristics of OSA between CKD and non-CKD OSA patients and determine the clinical predictors for CKD in OSA patients. Methods: This was a retrospective study conducted at Khon Kaen University's Srinagarind Hospital in Thailand between July and December 2018. The inclusion criteria were diagnosis with OSA via polysomnography and having undergone laboratory tests for CKD. Obstructive sleep apnea is diagnosed according to the apnea-hypopnea index (AHI) as experiencing >5 events/hour, while CKD diagnosed based on the KDOQI guidelines. Eligible patients were divided into two groups: OSA with CKD and OSA without CKD. Predictors of CKD in OSA patients were analyzed using multivariate logistic regression analysis. Results: During the study period, there were 178 OSA patients who met the study criteria, 88 (49.44%) of whom were in the OSA with CKD group. Both age and body mass index were comparable between OSA patients with CKD and those without (age: 59 and 57 years, respectively; body mass index: 30 and 29 kg/m2, respectively. There were three significant factors that differed between those with and without CKD group including systolic blood pressure (147 vs 135 mmHg), proportion of patients with diabetes (55% vs 34%), and proportion of patients with Mallampati scores of 3-4 (73% vs 39%). There were three independent predictors for OSA in patients with CKD: female sex, high systolic blood pressure, and Mallampati score of 3 or 4, with adjusted odds ratios (95% confidence interval) of 4.624 (1.554, 13.757), 1.060 (1.020, 1.101), and 2.816 (1.356, 5.849), respectively. The Hosmer-Lemeshow chi square statistic of the predictive model was 6.06 (p 0.640). Systolic blood pressure of more than 130 and 150 mmHg resulted in sensitivity of 84.21% and specificity of 81.40%, respectively. Conclusions: Female sex, high systolic blood pressure, and Mallampati score of 3-4 were suggestive of OSA with CKD. Obstructive sleep apnea patients with one or more of these predictors may have a high risk of CKD.

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OBESITY AND SLEEP-RELATED PATHOLOGY IN CHILDREN

Romanian Journal of Pediatrics ◽

10.37897/rjp.2015.1.2 ◽

2015 ◽

Vol 64 (1) ◽

pp. 10-13

Author(s):

Oana Iaru ◽

◽

Mihaela Oros ◽

D. Oraseanu ◽

◽

...

Keyword(s):

Public Health ◽

Quality Of Life ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Pediatric Population ◽

Public Health Problem ◽

Systemic Complications ◽

Obstructive Sleep ◽

Respiratory Pathology

Obesity is a public health problem, with an important increase in prevalence in the last decades, pediatric population also fits these characteristics. Among the systemic complications of obesity is included the sleep – related respiratory pathology. The association obstructive sleep apnea – obesity is suspected in a child who snores, has sleep fragmentation and breathing pauses, but the diagnosis is confirmed using polysomnography. Obstructive sleep apnea has many kinds of complications (increased by the association with obesity) – cardiac, metabolic, neurocognitive, all of them affecting the quality of life. The treatment of obstructive sleep apnea includes weight loss, adenotonsillectomy and CPAP ventilation.

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