Association between neck circumference and the severity of obstructive sleep apnea

Introduction: Neck circumference (NC) is one of the parameters to be associated with obstructive sleep apnea (OSA). However, there is lack of research data reflecting our local population with regard to the size of NC in relation to the severity of OSA. Aim: The primary goal of this study was to investigate the association of NC with OSA and to compare NC with other parameters as a predictor of the severity of OSA, among local population. This future reliable parameter can be used in front line clinics as to guide the referral to the tertiary center. Material and methods: This was a prospective study conducted upon 120 OSA patients, aged within 18–55 years, who underwent overnight polysomnography with apnea/hypopnea index more than 5 and met all the inclusion criteria. All patients completed the Epworth sleepiness scale questionnaire while all the parameter measurement including height, weight, body mass index and NC were documented. Results and discussion: A Pearson correlation analysis showed NC was significantly associated with OSA (r = 0.495, P < 0.001) while multiple linear regression model displayed an association between NC and lowest SpO2 desaturation during sleep (LSAT) as predictors of OSA severity (P < 0.001). Mean value of NC also significantly higher among severe OSA compared to mild OSA (42.7 ± 0.9 cm vs. 39.0 ± 1.3 cm; P < 0.001). Conclusions: NC was significantly associated with OSA and both NC and LSAT were significantly correlated as predictors of OSA severity.

Download Full-text

Polysomnographic and clinical characteristics of positional obstructive sleep apnea patients

Egyptian Journal of Bronchology ◽

10.1186/s43168-021-00085-8 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Seda Beyhan Sagmen ◽

Sevda Cömert

Keyword(s):

Body Mass Index ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Body Mass ◽

Severe Disease ◽

Upper Airway ◽

Neck Circumference ◽

Apnea Hypopnea Index ◽

Obstructive Sleep ◽

The Mean

Abstract Background Obstructive sleep apnea is a condition characterized by the complete or partial obstruction of the upper airway during sleep. This study aimed to compare the clinical and polysomnographic characteristics of our obstructive sleep apnea patients according to their positional and non-positional features. Results Two hundred eighty patients were included in the study. One hundred two patients (36.43%) were female, while 178 patients (63.57%) were male. While 88 (31.43%) of these patients were defined as positional patients, 192 (68.57%) were defined as non-positional patients. The mean age of the positional patients (46.78 ± 9.66) was lower than the mean age of the non-positional patients (50.90 ± 10.96) (p 0.001). Similarly, the mean body mass index of the positional patients (29.39 ± 3.80) was lower than the mean body mass index of the non-positional patients (33.30 ± 6.45) (p < 0.001). Neck circumference values of the positional patients (40.36 ± 2.65) were lower compared to the non-positional patients (43.32 ± 2.54) (p < 0.001). Sleep values were compared based on the presence of positional sleep apnea. In the positional patients, sleep duration, sleep efficiency (percentage), duration of stage N3, minimum, and mean saturation values were found to be higher compared to the non-positional patients, while nightlong apnea hypopnea index, apnea index, percentage of sleep time with oxygen saturation below 90%, oxygen desaturation index, mean heart rate, and periodic limb movement index values were found to be lower (p < 0.05). The rate of severe sleep apnea (7.95%) in the positional patients was lower than the non-positional patients (53.65%) (p < 0.001). Conclusion In the light of these data, positional OSA is a very important condition presented in 31.43% of OSA patients and it was determined that these patients were younger, had less body mass index, and shorter neck circumference. The rate of severe disease was found to be lower in positional OSA patients

Download Full-text

Validation of the MediByte®Type 3 Portable Monitor Compared with Polysomnography for Screening of Obstructive Sleep Apnea

Canadian Respiratory Journal ◽

10.1155/2011/760958 ◽

2011 ◽

Vol 18 (3) ◽

pp. 137-143 ◽

Cited By ~ 19

Author(s):

Helen S Driver ◽

Effie J Pereira ◽

Kathryn Bjerring ◽

Fern Toop ◽

Steven C Stewart ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Predictive Value ◽

Pearson Correlation ◽

Apnea Hypopnea Index ◽

Consecutive Series ◽

Recording Time ◽

Obstructive Sleep ◽

Screening Device ◽

Type 3

BACKGROUND: Portable monitors are increasingly being used as a diagnostic screening tool for obstructive sleep apnea (OSA), and in-laboratory validation of these devices with polysomnography (PSG) is required.OBJECTIVE: To assess the reliability of the MediByte (Braebon Medical Corporation, Canada) type 3 screening device compared with overnight PSG.METHODS: To cover a range of OSA severity, a consecutive series of patients wore the screening device while simultaneously undergoing PSG. Data acquired from the screener and PSG were blinded and scored separately. The number of apneas and hypopneas per hour were calculated using recording time (respiratory disturbance index [RDI]) for the MediByte device, and sleep time (apnea-hypopnea index [AHI]) for PSG.RESULTS: Data from 73 patients with a mean age of 53 years and body mass index of 32.2 kg/m2showed high measurement association between the RDI and AHI, with a Pearson correlation of 0.92, accounting for 85% of the variance. Based on Bland-Altman measurement agreement, the mean difference between the RDI and AHI (−5.9±11.2 events/h) indicated screener under-reporting. For an AHI of greater than 15 events/h, the sensitivity and specificity of the screener was 80% and 97%, respectively; for an AHI of greater than 30 events/h, the positive predictive value was 100%, while the negative predictive value was 88%.CONCLUSION: The MediByte device accurately identified patients without OSA and had a high sensitivity for moderate-to-severe OSA.

Download Full-text

Relationship between enuresis and obstructive sleep apnea–hypopnea syndrome in children

Journal of International Medical Research ◽

10.1177/0300060520977407 ◽

2020 ◽

Vol 48 (12) ◽

pp. 030006052097740

Author(s):

Chen Sun ◽

Yingpeng Xu ◽

Chenxi Luo ◽

Qi Li

Keyword(s):

Risk Factors ◽

Obstructive Sleep Apnea ◽

Logistic Regression ◽

Sleep Apnea ◽

Pearson Correlation ◽

Apnea Hypopnea Index ◽

Chi Square ◽

Obstructive Sleep ◽

Chi Square Test ◽

Hypopnea Syndrome

Objective We explored the relationship between enuresis and obstructive sleep apnea–hypopnea syndrome (OSAHS) in children and influencing factors of enuresis with OSAHS. Methods We recruited 196 children ≥5 years old from the otolaryngology outpatient department, who experienced snoring and underwent nasopharynx lateral radiography and in-laboratory polysomnography. We analyzed correlations between the apnea–hypopnea index (AHI) and lowest oxygen saturation (L-SaO2) with age, body mass index (BMI), tonsil size, and adenoidal–nasopharyngeal (A/N) ratio using the Pearson correlation test. Differences in severe OSAHS prevalence, age, AHI, L-SaO2, tonsil size, and A/N ratio between children with and without enuresis were assessed using the chi-square test and t-test. Risk factors of enuresis were analyzed using logistic regression. Follow-up was conducted to assess remission in children with enuresis after adenotonsillectomy. Results BMI, tonsil size, and A/N ratio were correlated with AHI and L-SaO2. Severe OSAHS prevalence, AHI, tonsil size, and A/N ratio were higher and L-SaO2 were lower in children with enuresis. Logistic regression showed that BMI, AHI, tonsil size, and sleep apnea were risk factors for enuresis. Conclusions Our study findings showed that enuresis was associated with OSAHS in children. Adenotonsillectomy may improve the symptoms of enuresis.

Download Full-text

Analyzing Neck Circumference as an Indicator of CPAP Treatment Response in Obstructive Sleep Apnea with Network Medicine

Diagnostics ◽

10.3390/diagnostics11010086 ◽

2021 ◽

Vol 11 (1) ◽

pp. 86

Author(s):

Stefan Mihaicuta ◽

Lucreţia Udrescu ◽

Mihai Udrescu ◽

Izabella-Anita Toth ◽

Alexandru Topîrceanu ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Treatment Response ◽

Area Under The Curve ◽

Positive Likelihood Ratio ◽

Neck Circumference ◽

Apnea Hypopnea Index ◽

Anthropometric Measures ◽

Cpap Treatment ◽

Obstructive Sleep

We explored the relationship between obstructive sleep apnea (OSA) patients’ anthropometric measures and the CPAP treatment response. To that end, we processed three non-overlapping cohorts (D1, D2, D3) with 1046 patients from four sleep laboratories in Western Romania, including 145 subjects (D1) with one-night CPAP therapy. Using D1 data, we created a CPAP-response network of patients, and found neck circumference (NC) as the most significant qualitative indicator for apnea–hypopnea index (AHI) improvement. We also investigated a quantitative NC cutoff value for OSA screening on cohorts D2 (OSA-diagnosed) and D3 (control), using the area under the curve. As such, we confirmed the correlation between NC and AHI (ρ=0.35, p<0.001) and showed that 71% of diagnosed male subjects had bigger NC values than subjects with no OSA (area under the curve is 0.71, with 95% CI 0.63–0.79, p<0.001); the optimal NC cutoff is 41 cm, with a sensitivity of 0.8099, a specificity of 0.5185, positive predicted value (PPV) = 0.9588, negative predicted value (NPV) = 0.1647, and positive likelihood ratio (LR+) = 1.68. Our NC =41 cm threshold classified the D1 patients’ CPAP responses—measured as the difference in AHI prior to and after the one-night use of CPAP—with a sensitivity of 0.913 and a specificity of 0.859.

Download Full-text

HUBUNGAN UKURAN ANTROPOMETRI DENGAN DERAJAT OBSTRUCTIVE SLEEP APNEA

Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia ◽

10.52386/neurona.v35i2.107 ◽

2018 ◽

Vol 35 (2) ◽

Author(s):

Marthin Tori ◽

Herlina Suryawati ◽

Amin Husni

Keyword(s):

Body Mass Index ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Body Mass ◽

Neck Circumference ◽

Anthropometric Measurements ◽

International Organization ◽

Abdominal Circumference ◽

Apnea Hypopnea Index ◽

Obstructive Sleep

CORRELATION BETWEEN ANTHROPOMETRIC MEASUREMENTS AND STAGE OF OBSTRUCTIVE SLEEP APNEAABSTRACKIntroduction: Obstructive sleep apnea (OSA) is estimated to occur 2-10% worldwide and associated with various diseases. OSA severity can be assessed by apnea hypopnea index (AHI). Increased anthropometric measurements indicate increased thickness of fatty tissue in the neck, as well as fatty deposits of the abdomen which can cause constriction of the airways. Other variables suspected to have an effect on AHI are age, sex, smoking habit, and Mallampati score.Aims: To analyze the correlation between anthropometric measurements and OSA severity.Methods: Descriptive analytic studies on OSA patients treated at Dr. Kariadi Hospital, Semarang, January- August 2017. Subjects were included in the study if STOPBANG score was >2. Anthropometric measurements (body mass index, neck circumference, abdominal circumference) was performed on the basis of the International Organization for Standardization (ISO) method while AHI was measured with polysomnography.Results: Bivariate correlation test on 23 subjects showed significant correlation between OSA severity with body mass index (BMI) and neck circumference but no significant correlation with abdominal circumference. Multivariate test showed the most influential variable was BMI.Discussion: There were significant correlations between anthropometric measurements (BMI and neck circumference) with OSA severity.Keywords: Abdominal circumference, apnea hypopnea index, body mass index, neck circumference, obstructive sleep apneaABSTRAKPendahuluan: Obstructive sleep apnea (OSA) diperkirakan terjadi 2-10% di seluruh dunia yang berkaitan dengan berbagai macam penyakit. Derajat OSA dinilai dengan indeks apnea-hypopnea (apnea hypopnea index/AHI). Tingginya nilai antropometri tubuh menandakan tebalnya jaringan lemak pada leher, demikian pula deposit lemak pada abdomen dapat menyebabkan penyempitan pada saluran napas. Variabel lain yang diduga berpengaruh terhadap AHI adalah usia, jenis kelamin, kebiasaan merokok, dan skor Mallampati.Tujuan: Menganalisis hubungan ukuran antropometri dengan derajat OSA.Metode: Studi deskriptif analitik secara potong lintang dilakukan terhadap pasien dengan OSA di RSUP Dr. Kariadi, Semarang, pada bulan Januari-Agustus 2017. Kriteria inklusi adalah pasien yang dicurigai OSA berdasarkan skor STOPBANG >2. Pemeriksaan antropometri (indeks massa tubuh/IMT, lingkar leher, dan lingkar perut) berdasarkan metode dari ISO (the International Organization for Standardization), sedangkan pemeriksaan AHI menggunakan polisomnografi.Hasil: Uji korelasi bivariat terhadap 23 subjek menunjukkan hubungan bermakna antara derajat OSA dengan IMT dan lingkar leher, namun tidak berhubungan dengan lingkar perut. Uji multivariat menunjukkan variabel yang paling berhubungan dengan derajat OSA adalah IMT.Diskusi: Terdapat hubungan bermakna antara ukuran antropometri (IMT dan lingkar leher) dengan derajat OSA.Kata kunci: Apnea hypopnea index, indeks massa tubuh, lingkar leher, lingkar perut, obstructive sleep apnea

Download Full-text

Differences in Anthropometric and Clinical Features among Preschoolers, School-Age Children, and Adolescents with Obstructive Sleep Apnea—A Hospital-Based Study in Taiwan

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17134663 ◽

2020 ◽

Vol 17 (13) ◽

pp. 4663

Author(s):

Hai-Hua Chuang ◽

Jen-Fu Hsu ◽

Li-Pang Chuang ◽

Ning-Hung Chen ◽

Yu-Shu Huang ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Clinical Features ◽

Neck Circumference ◽

School Age Children ◽

Apnea Hypopnea Index ◽

School Age ◽

Z Score ◽

Lymphocyte Ratio ◽

Obstructive Sleep

Pediatric obstructive sleep apnea (OSA) is associated with adverse health outcomes; however, little is known about the diversity of this population. This retrospective study aims to investigate age-related differences in the anthropometric and clinical features of this population. A total of 253 Taiwanese children (70 (27.7%) girls and 183 (72.3%) boys) with OSA were reviewed. Their median age, body mass index (BMI) z-score, and apnea-hypopnea index were 6.9 years, 0.87, and 9.5 events/h, respectively. The cohort was divided into three subgroups: ‘preschoolers’ (≥2 and <6 years), ‘school-age children’ (≥6 and <10 years), and ‘adolescents (≥10 and <18 years)’. The percentage of the male sex, BMI z-score, neck circumference, systolic blood pressure z-score, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio tended to increase with age. Adenoid grades tended to decrease with age. Overall, disease severity was independently correlated with neck circumference, tonsil size, and adenoid grade. Increased neck circumference and tonsillar hypertrophy were the most influential factors for younger children, whereas adenoidal hypertrophy became more important at an older age. In conclusion, gender prevalence ratio, anthropometric measures, and clinical features varied with age, and the pathogenic drivers were not necessarily the same as the aggravating ones.

Download Full-text

Neck circumference as a predictor for the presence and the severity of obstructive sleep apnea in snoring patients

IP Indian Journal of Immunology and Respiratory Medicine ◽

10.18231/j.ijirm.2021.022 ◽

2021 ◽

Vol 6 (2) ◽

pp. 98-104

Author(s):

Safwat A.M. Eldaabousy ◽

Amgad Awad ◽

Saber Abo-AL Hassan ◽

Mohamed Osama Nour

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Sleep Apnea Syndrome ◽

Neck Circumference ◽

Apnea Hypopnea Index ◽

Obstructive Sleep ◽

Sleep Parameters ◽

The Mean ◽

Positive Correlations

To assess if the neck circumference (NC) can be used to predict the presence and the severity of obstructive sleep apnea syndrome (OSA) in a group of patients had snoring and witnessed apnea from Almoosa Hospital, Alhasa, Saudi Arabia. A retrospective study for patients had snoring and witnessed apnea referred to a sleep lab for the diagnosis of obstructive sleep apnea (OSA) by overnight full polysomnogram from August 2016 to August 2020. Apnea-hypopnea index (AHI) was used to categorize the severity of sleep apnea. Age, sex, neck circumference (NC) body mass index (BMI), comorbidities, and sleep parameters were recorded. Receiver-operating characteristic (ROC) curve was used to assess the ability of NC for the diagnosis of the OSA. Sensitivity and specificity were calculated for different cut-off points. The study included 450 patients who met the inclusion criteria with a mean age 52.5 ± 14.6. The mean NC (cm), and BMI were 39.4 ± 3.1, and 35.2 ± 9.0, respectively. OSA was diagnosed in 378 (84.0%) patients. OSA was more detected among males, those with an increased age, NC, BMI, and among patients had hypertension and type 2 diabetes. The mean BMI was significantly higher among females (p=0.031) while NC was significantly higher among males. Significant positive correlations were detected between both NC and BMI with the severity of OSA. Neck circumference can be used to predict the presence as well as the severity of obstructive sleep apnea in snoring patients. BMI, and male gender are independent predictors.

Download Full-text

Improvement in Obstructive Sleep Apnea (OSA) in Super Morbidly Obese Patients After Bariatric Surgery

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2020.08.10650 ◽

2020 ◽

Vol 103 (8) ◽

pp. 725-728

Keyword(s):

Bariatric Surgery ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Lifestyle Modification ◽

Apnea Hypopnea Index ◽

Morbidly Obese ◽

Obese Patients ◽

Obstructive Sleep ◽

Objective Evidence

Background: Lifestyle modification is the mainstay therapy for obese patients with obstructive sleep apnea (OSA). However, most of these patients are unable to lose the necessary weight, and bariatric surgery (BS) has been proven to be an effective modality in selected cases. Objective: To provide objective evidence that BS can improve OSA severity. Materials and Methods: A prospective study was conducted in super morbidly obese patients (body mass index [BMI] greater than 40 kg/m² or BMI greater than 35 kg/m² with uncontrolled comorbidities) scheduled for BS. Polysomnography (PSG) was performed for preoperative assessment and OSA was treated accordingly. After successful surgery, patients were invited to perform follow-up PSG at 3, 6, and 12 months. Results: Twenty-four patients with a mean age of 35.0±14.0 years were enrolled. After a mean follow-up period of 7.8±3.4 months, the mean BMI, Epworth sleepiness scale (ESS), and apnea-hypopnea index (AHI) significantly decreased from 51.6±8.7 to 38.2±6.8 kg/m² (p<0.001), from 8.7±5.9 to 4.7±3.5 (p=0.003), and from 87.6±38.9 to 28.5±21.5 events/hour (p<0.001), respectively. Conclusion: BS was shown to dramatically improve clinical and sleep parameters in super morbidly obese patients. Keywords: Morbid obesity, Bariatric surgery, Obstructive sleep apnea (OSA)

Download Full-text

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

ORL ◽

10.1159/000516243 ◽

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

Objective: 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. Methods: 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. Results: By comparison with the preoperative value, all postoperative subjective symptoms statistically improved (p < 0.05), while the Apnea-Hypopnea Index (AHI) changed little (p = 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 p < 0.01). A significant difference was derived for correlation between the alteration of simulation metrics with subjective improvements (p < 0.05), except with the AHI (p > 0.05). Conclusion: 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.

Download Full-text

High Plasma Cystine Levels Are Associated with Blood Pressure and Reversed by CPAP in Patients with Obstructive Sleep Apnea

Journal of Clinical Medicine ◽

10.3390/jcm10071387 ◽

2021 ◽

Vol 10 (7) ◽

pp. 1387

Author(s):

Raphael Boneberg ◽

Anita Pardun ◽

Lena Hannemann ◽

Olaf Hildebrandt ◽

Ulrich Koehler ◽

...

Keyword(s):

Blood Pressure ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Mononuclear Cells ◽

Vascular Risk Factor ◽

High Plasma ◽

Apnea Hypopnea Index ◽

Hypoxic Stress ◽

Peripheral Blood Mononuclear ◽

Obstructive Sleep

Obstructive sleep apnea (OSA) independent of obesity (OBS) imposes severe cardiovascular risk. To what extent plasma cystine concentration (CySS), a novel pro-oxidative vascular risk factor, is increased in OSA with or without OBS is presently unknown. We therefore studied CySS together with the redox state and precursor amino acids of glutathione (GSH) in peripheral blood mononuclear cells (PBMC) in untreated male patients with OSA (apnea-hypopnea-index (AHI) > 15 h−1, n = 28) compared to healthy male controls (n = 25) stratifying for BMI ≥ or < 30 kg m−2. Fifteen OSA patients were reassessed after 3–5-months CPAP. CySS correlated with cumulative time at an O2-saturation <90% (Tu90%) (r = 0.34, p < 0.05) beside BMI (r = 0.58, p < 0.001) and was higher in subjects with “hypoxic stress” (59.4 ± 2.0 vs. 50.1 ± 2.7 µM, p < 0.01) defined as Tu90% ≥ 15.2 min (corresponding to AHI ≥ 15 h−1). Moreover, CySS significantly correlated with systolic (r = 0.32, p < 0.05) and diastolic (r = 0.31, p < 0.05) blood pressure. CPAP significantly lowered CySS along with blood pressure at unchanged BMI. Unexpectedly, GSH antioxidant capacity in PBMC was increased with OSA and reversed with CPAP. Plasma CySS levels are increased with OSA-related hypoxic stress and associated with higher blood pressure. CPAP decreases both CySS and blood pressure. The role of CySS in OSA-related vascular endpoints and their prevention by CPAP warrants further studies.

Download Full-text