scholarly journals Hospital-Based Polysomnography May Overestimate Obstructive Sleep Apnoea Severity: Comparison of Hospital-Based and Home-Based Measurements with a Single-Lead Electrocardiogram Patch

2021 ◽  
Author(s):  
Wen-Te Liu ◽  
Shang-Yang Lin ◽  
Cheng-Yu Tsai ◽  
Yi-Shin Liu ◽  
Chia-Mo Lin ◽  
...  
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Sleep Time ◽  
Sleep Apnoea ◽  
Health Concern ◽  
Lower Percentage ◽  
Patch Type ◽  
Home Based ◽  
Obstructive Sleep ◽  
Supine Sleep ◽  
Sleep Recording

Abstract Purpose: Obstructive sleep apnoea (OSA) is a global health concern, and polysomnography (PSG) is the gold standard for assessing OSA severity. However, the sleep parameters of home-based and in-laboratory PSG vary because of environmental factors, and the magnitude of these discrepancies remains unclear.Methods: We enrolled 125 Taiwanese patients who underwent PSG while wearing a single-lead electrocardiogram patch (RootiRx). After the PSG, all participants were instructed to continue wearing the RootiRx over the 3 subsequent nights. Scores on OSA indexes, namely the apnoea–hypopnea index, chest effort index (CEI), cyclic variation of heart rate index (CVHRI), and combined CVHRI and CEI (Rx index), were determined. The patients were divided into 3 groups based on PSG-determined OSA severity. The variables (various severity groups and environmental measurements) were subjected to mean comparisons and their correlations were examined by Pearson’s correlation coefficient. Results: The hospital-based CVHRI, CEI, and Rx index differed significantly among the severity groups. All 3 groups exhibited a significantly lower percentage of supine sleep time in the home-based assessment relative to in the hospital-based assessment. Significant positive correlations were noted between the variations in the supine percentage (∆Supine%) and the OSA indexes. For the patients with high sleep efficiency (≥ 80%), significant correlations were observed between the ∆Supine% and ∆Rx index.Conclusion: The high supine percentage of sleep may cause OSA indexes’ overestimation in hospital-based PSG. Sleep recording at home with patch-type wearable devices may aid accurate OSA diagnosis.

scholarly journals Comparison of Hospital-Based and Home-Based Obstructive Sleep Apnoea Severity Measurements with a Single-Lead Electrocardiogram Patch

Sensors ◽  
2021 ◽  
Vol 21 (23) ◽  
pp. 8097
Author(s):  
Wen-Te Liu ◽  
Shang-Yang Lin ◽  
Cheng-Yu Tsai ◽  
Yi-Shin Liu ◽  
Wen-Hua Hsu ◽  
...  
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Sleep Time ◽  
Sleep Apnoea ◽  
Health Concern ◽  
Lower Percentage ◽  
Short Sleep Duration ◽  
Patch Type ◽  
Home Based ◽  
Obstructive Sleep ◽  
Supine Sleep

Obstructive sleep apnoea (OSA) is a global health concern, and polysomnography (PSG) is the gold standard for assessing OSA severity. However, the sleep parameters of home-based and in-laboratory PSG vary because of environmental factors, and the magnitude of these discrepancies remains unclear. We enrolled 125 Taiwanese patients who underwent PSG while wearing a single-lead electrocardiogram patch (RootiRx). After the PSG, all participants were instructed to continue wearing the RootiRx over three subsequent nights. Scores on OSA indices—namely, the apnoea–hypopnea index, chest effort index (CEI), cyclic variation of heart rate index (CVHRI), and combined CVHRI and CEI (Rx index), were determined. The patients were divided into three groups based on PSG-determined OSA severity. The variables (various severity groups and environmental measurements) were subjected to mean comparisons, and their correlations were examined by Pearson’s correlation coefficient. The hospital-based CVHRI, CEI, and Rx index differed significantly among the severity groups. All three groups exhibited a significantly lower percentage of supine sleep time in the home-based assessment, compared with the hospital-based assessment. The percentage of supine sleep time (∆Supine%) exhibited a significant but weak to moderate positive correlation with each of the OSA indices. A significant but weak-to-moderate correlation between the ∆Supine% and ∆Rx index was still observed among the patients with high sleep efficiency (≥80%), who could reduce the effect of short sleep duration, leading to underestimation of the patients’ OSA severity. The high supine percentage of sleep may cause OSA indices’ overestimation in the hospital-based examination. Sleep recording at home with patch-type wearable devices may aid in accurate OSA diagnosis.

scholarly journals The association between beta-blocker therapy and daytime sleepiness in obstructive sleep apnoea

2021 ◽  
Author(s):  
Martina Meszaros ◽  
Alexander G. Mathioudakis ◽  
Maria Xanthoudaki ◽  
Victoria Sircu ◽  
Evangelia Nena ◽  
...  
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Beta Blocker ◽  
Daytime Sleepiness ◽  
Beta Blockers ◽  
Multivariate Logistic Regression Analysis ◽  
Sleep Time ◽  
Sleep Apnoea ◽  
Sensitivity Analyses ◽  
Obstructive Sleep ◽  
Cardinal Symptom

AbstractDaytime sleepiness is a cardinal symptom of obstructive sleep apnoea (OSA) and a well-recognised side effect of beta-blockers, therefore patients with OSA under this treatment may have worse sleepiness. However, the interaction between daytime sleepiness and beta-blockers use has not been thoroughly investigated in patients with OSA before. We analysed the data of 2183 individuals (1852 patients with OSA and 331 snorer controls) from 3 countries (Greece, Hungary and Moldova). Medical history, including medication usage and the Epworth Sleepiness Scale (ESS) were recorded. Patients and controls were divided into somnolent (ESS ≥ 11) and non-somnolent (ESS < 11) groups, and the association between-blocker use with the somnolent group was investigated with multivariate logistic regression analysis adjusted for confounders. Sensitivity analyses were performed in each cohort, in the severity subgroups, in patients who did not take statins and in those who had polysomnography as a diagnostic test. There was no relationship between beta-blocker usage and the somnolent OSA (p = 0.24) or control (p = 0.64) groups. These results were similar in sensitivity analyses (all p > 0.05). ESS was related to BMI (ρ = 0.25), total sleep time (ρ = 0.07), AHI (ρ = 0.32), oxygen desaturation index (ρ = 0.33) and minimum oxygen saturation (ρ =  – 0.32, all p < 0.05) in OSA, and was higher in patients with hypertension, diabetes and cerebro/cardiovascular disease and those who took statins (all p < 0.05). In general, beta-blockers are not associated with increased daytime sleepiness in OSA. Thus, the diagnosis of OSA should not discourage initiation of beta-blocker treatment, if it is clinically indicated.

scholarly journals Triglyceride-Glucose Index in Non-Diabetic, Non-Obese Patients with Obstructive Sleep Apnoea

2021 ◽  
Vol 10 (9) ◽  
pp. 1932
Author(s):  
Andras Bikov ◽  
Stefan M. Frent ◽  
Martina Meszaros ◽  
Laszlo Kunos ◽  
Alexander G. Mathioudakis ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Oxygen Saturation ◽  
Obstructive Sleep Apnoea ◽  
Sleep Time ◽  
Sleep Apnoea ◽  
Obese Patients ◽  
Triglyceride Glucose Index ◽  
Cigarette Pack ◽  
Obstructive Sleep ◽  
And Control

Obstructive sleep apnoea (OSA) is associated with increased insulin resistance. Triglyceride-glucose index (TyG) is a simple marker of insulin resistance; however, it has been investigated only by two studies in OSA. The aim of this study was to evaluate TyG in non-diabetic, non-obese patients with OSA. A total of 132 patients with OSA and 49 non-OSA control subjects were included. Following a diagnostic sleep test, fasting blood was taken for the analysis of the lipid profile and glucose concentrations. TyG was calculated as ln(triglyceride [mg/dL] × glucose [mg/dL]/2). Comparison analyses between OSA and control groups were adjusted for age, gender, body mass index (BMI) and smoking. TyG was higher in men (p < 0.01) and in ever-smokers (p = 0.02) and it was related to BMI (ρ = 0.33), cigarette pack-years (ρ = 0.17), apnoea–hypopnoea index (ρ = 0.38), oxygen desaturation index (ρ = 0.40), percentage of total sleep time spent with oxygen saturation below 90% (ρ = 0.34), and minimal oxygen saturation (ρ = −0.29; all p < 0.05). TyG values were significantly higher in OSA (p = 0.02) following adjustment for covariates. OSA is independently associated with higher TyG values which are related to disease severity in non-obese, non-diabetic subjects. However, the value of TyG in clinical practice should be evaluated in follow-up studies in patients with OSA.

New forehead device in positional obstructive sleep apnoea: a randomised clinical trial

Thorax ◽  
2021 ◽  
pp. thoraxjnl-2020-216167
Author(s):  
Laura Hidalgo Armas ◽  
Sandra Ingles ◽  
Rafaela Vaca ◽  
Jose Cordero-Guevara ◽  
Joaquin Duran Carro ◽  
...  
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Supine Position ◽  
Total Sleep Time ◽  
Controlled Trial ◽  
Randomised Clinical Trial ◽  
Sleep Time ◽  
Sleep Apnoea ◽  
Active Device ◽  
Link Type ◽  
Obstructive Sleep

RationaleApproximately 60% of the patients with obstructive sleep apnoea suffer from a positional effect, and approximately 25% of these patients present events only in the supine position.ObjectiveTo validate a new positional vibrating device and evaluate its efficacy in reducing the Apnoea–Hypopnoea Index and the total sleep time in the supine position without disturbing sleep.MethodsA total of 128 patients were recruited for this multicentre, prospective, parallel, randomised controlled trial and were distributed in three arms (general recommendations, inactive and active device). Full overnight polysomnography was performed at baseline and at 12 weeks. Anthropometric variables and sleep and quality of life questionnaires were collected at 4, 8 and 12 weeks.ResultsThe Apnoea-Hypopnoea Index decreased from 30.6 per hour to 20.4 per hour (p<0.001) in the active device (AD) group. In this group the reduction was 2.3-fold and 3.3-fold than the ones in the general recommendations (GR) and inactive device (ID) groups, respectively (p=0.014). Sleep time in supine position decreased 17.7%±26.3% in GR group (p<0.001), 13.0%±22.4% with ID group (p<0.001) and 21.0%±25.6% in the AD group (p<0.001). Furthermore, total sleep time increased significantly only in the AD group (22.1±57.5 min, p=0.016), with an increased percentage of time in the N3 (deep sleep) and N3+REM (rapid eye movement) stages, without sleep fragmentation.ConclusionThe device was effective in reducing the Apnoea–Hypopnoea Index and time spent in the supine position also in improving sleep architecture. Therefore, the device could be a good option for the management of patients with positional obstructive sleep apnoea.Trial registration detailsThe trial was registered at www.clinicaltrials.gov (NCT03336515).

scholarly journals Sleeping Beauty or the Beast? – The Metabolic Syndrome from an Obstructive Sleep Apnoea Perspective

2010 ◽  
Vol 9 (1) ◽  
pp. 12 ◽  
Author(s):  
Lise Tarnow ◽  
Brigitte Klinkenbijl ◽  
Holger Woehrle ◽  
◽  
◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Obstructive Sleep Apnoea ◽  
Reduce Blood Pressure ◽  
Sleep Apnoea ◽  
Sleeping Beauty ◽  
The Metabolic Syndrome ◽  
Home Based ◽  
Obstructive Sleep

Obstructive sleep apnoea (OSA) is a significant health issue. Patients with cardiovascular disease as well as patients with diabetes have a high prevalence of OSA, and the prevalence of coronary heart disease, heart failure, stroke and diabetes is increased in patients with obstructive sleep apnoea. Physiological responses to OSA include sympathetic activation, neurohumoral changes and inflammation, all of which are precursors for cardiovascular disease and diabetes. International guidelines are starting to recognise the importance of OSA for patients with cardiovascular conditions such as heart failure and hypertension. Diagnosis is important, and home-based sleep testing devices can facilitate this process. Treating OSA with continuous positive airway pressure (CPAP) has been shown to reduce blood pressure (BP) in patients with hypertension, but more research is needed to determine which components of the metabolic syndrome respond best to the addition of CPAP therapy.

scholarly journals The Effect of Change in Posture on Spirometry in Patients with Obstructive Sleep Apnoea Syndrome

2019 ◽  
Vol 19 (4) ◽  
pp. 310
Author(s):  
Redha Al Lawati ◽  
Mohammed A. Al Abri ◽  
Balaji Kuppuswamy ◽  
Amira Al-Kharousi ◽  
Al Yaqdhan Al-Atbi ◽  
...  
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
University Hospital ◽  
Health Concern ◽  
Lower Airway ◽  
Obstructive Sleep Apnoea Syndrome ◽  
Obese Patients ◽  
Sleep Apnoea Syndrome ◽  
Obstructive Sleep ◽  
Significant Difference

Objectives: Obstructive sleep apnoea syndrome (OSAS) is a growing health concern as it is associated with serious comorbidities. OSAS is mainly related to obesity, age, gender and a narrowed upper airway is commonly seen in patients with OSAS. This study aimed to compare spirometry parameters between obese OSAS patients and non-obese OSAS patients when patients moved from sitting to supine. Methods: This cross-sectional study was conducted at Sultan Qaboos University Hospital, Muscat, Oman, between December 2009 and December 2010. Patients with severe OSAS and who were OSAS treatment naïve were recruited. Spirometry was performed in all patients in sitting and supine positions to assess forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), FEV1/FVC, forced expiratory flow (FEF) 50%, FEF 25–75%, maximum forced inspiratory flow and expiratory reserve volume. The mean difference in spirometry parameters between patients in sitting and supine positions was calculated. Results: A total of 27 OSAS patients (19 males and 8 females) were included in this study. There was a significant difference in FEV1/FVC in obese and non-obese patients when changing position (P = 0.03). In addition, there was a significant change between male and female patients’ FVC percentages (P <0.05). Male patients with OSAS had reduced FVC compared to females. There was no significant difference in the remaining spirometry parameters with patients’ change of position. Conclusion: A supine position may cause lower airway obstruction in obese patients with OSAS. The reduced FVC in males possibly contributes to the high prevalence of OSAS in men compared to women.Keywords: Obstructive Sleep Apnea; Obesity; Gender; Spirometry; Posture; Oman.

scholarly journals Reticulocytes in untreated Obstructive Sleep Apnoea

2016 ◽  
Vol 70 (3) ◽  
Author(s):  
O. Marrone ◽  
A. Salvaggio ◽  
M. Gioia ◽  
A. Bonanno ◽  
M. Profita ◽  
...  
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Blood Cells ◽  
Univariate Analysis ◽  
Transferrin Saturation ◽  
Sleep Time ◽  
Sleep Apnoea ◽  
Male Adult ◽  
Obstructive Sleep ◽  
Wide Range ◽  
Nocturnal Polysomnography

Background and Aim. The short, repetitive hypoxaemic episodes observed in obstructive sleep apnoea (OSA) may determine small augmentations in mature red blood cells. It is unknown whether they affect reticulocyte release. This study explored whether the number and degree of maturation of circulating reticulocytes may be altered in OSA, possibly through the effect of erythropoietin. Methods. Fifty male adult patients with suspected OSA, normoxic during wakefulness, were studied. After nocturnal polysomnography, a blood sample was withdrawn for blood cells count, erythropoietin, iron and transferrin determination. Reticulocyte concentration and degree of immaturity [high (H), medium (M), or low (L)] were also determined. Immature reticulocyte fraction (IRF) was calculated as (M+H) percentage of reticulocytes. Results. A wide range of OSA severity was found [apnoea/ hypopnoea index (AHI): 44.3±30.4, range 0.3-105; sleep time spent at oxyhaemoglobin saturation 2% had higher EPO levels (p&lt;0.05), but not worse nocturnal desaturations, than those with values &lt;2%. By contrast, subjects with IRF &lt;15% showed worse desaturations (p&lt;0.05), but similar EPO concentrations, when compared to subjects whose IRF was &lt;10%. At univariate analysis, reticulocyte count correlated to erythropoietin, while IRF to transferrin saturation, BMI and OSA severity. At multiple regression, only lowest nocturnal oxygen saturation remained a significant contributor to IRF (r2 0.223, p&lt;0.05). Conclusions. This data suggests that hypoxaemia due to OSA could influence the release of immature reticulocytes, but this effect is not mediated by erythropoietin.

scholarly journals Adipose tissue as a key player in obstructive sleep apnoea

2019 ◽  
Vol 28 (152) ◽  
pp. 190006 ◽  
Author(s):  
Silke Ryan ◽  
Claire Arnaud ◽  
Susan F. Fitzpatrick ◽  
Jonathan Gaucher ◽  
Renaud Tamisier ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Experimental Models ◽  
Complex Interaction ◽  
Health Concern ◽  
Metabolic Dysfunction ◽  
Major Health ◽  
Multiple Organs ◽  
Obstructive Sleep

Obstructive sleep apnoea (OSA) is a major health concern worldwide and adversely affects multiple organs and systems. OSA is associated with obesity in >60% of cases and is independently linked with the development of numerous comorbidities including hypertension, arrhythmia, stroke, coronary heart disease and metabolic dysfunction. The complex interaction between these conditions has a significant impact on patient care and mortality. The pathophysiology of cardiometabolic complications in OSA is still incompletely understood; however, the particular form of intermittent hypoxia (IH) observed in OSA, with repetitive short cycles of desaturation and re-oxygenation, probably plays a pivotal role. There is fast growing evidence that IH mediates some of its detrimental effects through adipose tissue inflammation and dysfunction. This article aims to summarise the effects of IH on adipose tissue in experimental models in a comprehensive way. Data from well-designed controlled trials are also reported with the final goal of proposing new avenues for improving phenotyping and personalised care in OSA.

scholarly journals Postprandial glucose and HbA1c are associated with severity of obstructive sleep apnoea in non-diabetic obese subjects

2021 ◽  
Author(s):  
A. Cignarelli ◽  
A. Ciavarella ◽  
M. Barbaro ◽  
S. Kounaki ◽  
A. Di Trani ◽  
...  
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Sleep Time ◽  
Postprandial Glucose ◽  
Tolerance Test ◽  
Sleep Apnoea ◽  
Oral Glucose ◽  
Reactive Protein ◽  
Obstructive Sleep ◽  
Obese Subjects ◽  
Main Determinants

Abstract Introduction Obstructive sleep apnoea (OSA) is an underdiagnosed condition frequently associated with glycaemic control impairment in patients with type 2 diabetes. Aim To assess the relationship between glycometabolic parameters and OSA in obese non-diabetic subjects. Methods Ninety consecutive subjects (mean age 44.9 ± 12 years, mean BMI 42.1 ± 9 kg/m2) underwent polysomnography and a 2-h oral glucose tolerance test (OGTT). Results OSA was identified in 75% of subjects, with a higher prevalence of males compared to the group of subjects without OSA (62% vs 32%, p = 0.02). Patients with OSA had comparable BMI (42.8 kg/m2 vs 39.4 kg/m2), a higher average HbA1c (5.8% vs 5.4%, p < 0.001), plasma glucose at 120 min during OGTT (2 h-PG; 123 mg/dl vs 97 mg/dl, p = 0.009) and diastolic blood pressure (81.1 mmHg vs 76.2 mmHg, p = 0.046) than obese subjects without OSA. HbA1c and 2 h-PG were found to be correlated with the apnoea-hypopnoea index (AHI; r = 0.35 and r = 0.42, respectively) and with percent of sleep time with oxyhaemoglobin saturation < 90% (ST90; r = 0.44 and r = 0.39, respectively). Further, in a linear regression model, ST90 and AHI were found to be the main determinants of 2 h-PG (β = 0.81, p < 0.01 and β = 0.75, p = 0.02, respectively) after controlling for age, sex, waist circumference, physical activity, and C-reactive protein. Similarly, ST90 and AHI persisted as independent determinants of HbA1c (β = 0.01, p = 0.01 and β = 0.01, p = 0.01, respectively). Conclusion Beyond the traditional clinical parameters, the presence of a normal-high value of 2 h-PG and HbA1c should raise suspicion of the presence of OSA in obese subjects.

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