scholarly journals Obstructive Sleep Apnea Is Associated With Low Testosterone Levels in Severely Obese Men

2021 ◽  
Vol 12 ◽  
Author(s):  
Milina Tančić-Gajić ◽  
Miodrag Vukčević ◽  
Miomira Ivović ◽  
Ljiljana V. Marina ◽  
Zorana Arizanović ◽  
...  

BackgroundDisrupted sleep affects cardio-metabolic and reproductive health. Obstructive sleep apnea syndrome represents a major complication of obesity and has been associated with gonadal axis activity changes and lower serum testosterone concentration in men. However, there is no consistent opinion on the effect of obstructive sleep apnea on testosterone levels in men.ObjectiveThe aim of this study was to determine the influence of obstructive sleep apnea on total and free testosterone levels in severely obese men.Materials and methodsThe study included 104 severely obese (Body Mass Index (BMI) ≥ 35 kg/m2) men, aged 20 to 60, who underwent anthropometric, blood pressure, fasting plasma glucose, lipid profile, and sex hormone measurements. All participants were subjected to polysomnography. According to apnea-hypopnea index (AHI) patients were divided into 3 groups: <15 (n = 20), 15 - 29.9 (n = 17) and ≥ 30 (n = 67).ResultsThere was a significant difference between AHI groups in age (29.1 ± 7.2, 43.2 ± 13.2, 45.2 ± 10.2 years; p < 0.001), BMI (42.8 ± 5.9, 43.2 ± 5.9, 47.1 ± 7.8 kg/m2; p = 0.023), the prevalence of metabolic syndrome (MetS) (55%, 82.4%, 83.6%, p = 0.017), continuous metabolic syndrome score (siMS) (4.01 ± 1.21, 3.42 ± 0.80, 3.94 ± 1.81, 4.20 ± 1.07; p = 0.038), total testosterone (TT) (16.6 ± 6.1, 15.2 ± 5.3, 11.3 ± 4.44 nmol/l; p < 0.001) and free testosterone (FT) levels (440.4 ± 160.8, 389.6 ± 162.5, 294.5 ± 107.0 pmol/l; p < 0.001). TT level was in a significant negative correlation with AHI, oxygen desaturation index (ODI), BMI, MetS and siMS. Also, FT was in a significant negative correlation with AHI, ODI, BMI, age, MetS and siMS. The multiple regression analysis revealed that both AHI and ODI were in significant correlation with TT and FT after adjustment for age, BMI, siMS score and MetS components.ConclusionObstructive sleep apnea is associated with low TT and FT levels in severely obese men.

2014 ◽  
Vol 155 (18) ◽  
pp. 703-707 ◽  
Author(s):  
Pálma Benedek ◽  
Gabriella Kiss ◽  
Eszter Csábi ◽  
Gábor Katona

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.


ORL ◽  
2021 ◽  
pp. 1-8
Author(s):  
Lifeng Li ◽  
Demin Han ◽  
Hongrui Zang ◽  
Nyall R. London

<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.


OTO Open ◽  
2021 ◽  
Vol 5 (1) ◽  
pp. 2473974X2198959
Author(s):  
Ahmed Yassin Bahgat

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.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Behnam Kargar ◽  
Zahra Zamanian ◽  
Majid Bagheri Hosseinabadi ◽  
Vahid Gharibi ◽  
Mohammad Sanyar Moradi ◽  
...  

Abstract Background Understanding the causes and risk factors of metabolic syndrome is important for promoting population health. Oxidative stress has been associated with metabolic syndrome, and also obstructive sleep apnea. These are two diseases which have common prognostic characteristics for heart disease. The aim of this study was to examine the role of oxidative stress in the concurrent presence of metabolic syndrome and obstructive sleep apnea in a working population. Methods Participants were 163 artisan bakers in Shahroud, Iran, routinely exposed to significant heat stress and other oxidative stress indicators on a daily basis as part of their work. Using a cross-sectional design, data relevant to determining metabolic syndrome status according to International Diabetes Federation criteria, and the presence of obstructive sleep apnea according to the STOP-Bang score, was collected. Analyses included hierarchical binary logistic regression to yield predictors of the two diseases. Results Hierarchical binary logistic regression showed that oxidative stress – alongside obesity, no regular exercise, and smoking – was an independent predictor of metabolic syndrome, but not obstructive sleep apnea. Participants who were obese were 28 times more likely to have metabolic syndrome (OR 28.59, 95% CI 4.91–63.02) and 44 times more likely to have obstructive sleep apnea (OR 44.48, 95% CI 4.91–403.28). Participants meeting metabolic syndrome criteria had significantly higher levels of malondialdehyde (p <  0.05) than those who did not. No difference in oxidative stress index levels were found according to obstructive sleep apnea status. Conclusions Our findings suggest that oxidative stress contributes to the onset of metabolic syndrome, and that obstructive sleep apnea is involved in oxidative stress. Whilst obesity, exercise, and smoking remain important targets for reducing the incidence of metabolic syndrome and obstructive sleep apnea, policies to control risks of prolonged exposure to oxidative stress are also relevant in occupations where such environmental conditions exist.


CHEST Journal ◽  
2007 ◽  
Vol 131 (5) ◽  
pp. 1387-1392 ◽  
Author(s):  
Masakazu Kono ◽  
Koichiro Tatsumi ◽  
Toshiji Saibara ◽  
Akira Nakamura ◽  
Nobuhiro Tanabe ◽  
...  

CHEST Journal ◽  
2009 ◽  
Vol 136 (4) ◽  
pp. 65S
Author(s):  
Ashok K. Janmeja ◽  
Anup K. Singh ◽  
Naveen Dutt ◽  
Sushant Khanduri ◽  
Preeti Sharma ◽  
...  

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Hui-Wei Feng ◽  
Tao Jiang ◽  
Hong-Ping Zhang ◽  
Zhe Wang ◽  
Hai-Ling Zhang ◽  
...  

Objective. The aim of this study was to compare the differences in thyroid hormone, intelligence, attention, and quality of life (QoL) of children with obstructive sleep apnea hypopnea syndrome (OSAHS) before and after endoscopic adenoidectomy.Method. A total of 35 OSAHS children (21 males and 14 females with a mean age of6.81±1.08years) were included in this study for analyzing the levels of thyroid hormone, intelligence, attention, and QoL. There were 22 children underwent endoscopic adenoidectomy with bilateral tonsillectomy (BT), while the other 13 children who underwent endoscopic adenoidectomy without bilateral tonsillectomy without BT.Results. Our results revealed no significant difference in serum free triiodothyronine (FT3), free thyroxine (FT4), and thyroid stimulating hormone (TSH) levels in OSAHS children before and after endoscopic adenoidectomy (allP>0.05). However, there were significant differences in full-scale intelligence quotient (FIQ) (92.45±5.88versus106.23±7.39,P<0.001), verbal intelligence quotient (VIQ) (94.17±15.01versus103.91±9.74,P=0.006), and performance intelligence quotient (PIQ) (94.12±11.04versus104.31±10.05,P=0.001), attention (98.48±8.74versus106.87±8.58,P<0.001), and total OSA-18 scores (87.62±17.15versus46.61±10.15,P<0.001) between before and after endoscopic adenoidectomy in OSAHS children.Conclusion. Our findings provided evidence that the intelligence, attention, and QoL of OSAHS children may be significantly improved after endoscopic adenoidectomy.


2021 ◽  
Vol 10 (6) ◽  
pp. 1255
Author(s):  
Hiroyuki Ishiyama ◽  
Masayuki Hideshima ◽  
Shusuke Inukai ◽  
Meiyo Tamaoka ◽  
Akira Nishiyama ◽  
...  

The aim of this study was to determine the utility of respiratory resistance as a predictor of oral appliance (OA) response in obstructive sleep apnea (OSA). Twenty-seven patients with OSA (mean respiratory event index (REI): 17.5 ± 6.5 events/h) were recruited. At baseline, the respiratory resistance (R20) was measured by impulse oscillometry (IOS) with a fitted nasal mask in the supine position, and cephalometric radiographs were obtained to analyze the pharyngeal airway space (SPAS: superior posterior airway space, MAS: middle airway space, IAS: inferior airway space). The R20 and radiographs after the OA treatment were evaluated, and the changes from the baseline were analyzed. A sleep test with OA was carried out using a portable device. The subjects were divided into Responders and Non-responders based on an REI improvement ≥ 50% from the baseline, or REI < 5 after treatment, and the R20 reduction rate between the two groups were compared. The subjects comprised 20 responders and 7 non-responders. The R20 reduction rate with OA in responders was significantly greater than it was in non-responders (14.4 ± 7.9 % versus 2.4 ± 9.8 %, p < 0.05). In responders, SPAS, MAS, and IAS were significantly widened and R20 was significantly decreased with OA (p < 0.05). There was no significant difference in non-responders (p > 0.05). A logistic multiple regression analysis showed that the R20 reduction rate was predictive for OA treatment responses (2% incremental odds ratio (OR), 24.5; 95% CI, 21.5–28.0; p = 0.018). This pilot study confirmed that respiratory resistance may have significant clinical utility in predicting OA treatment responses.


Author(s):  
Carlos Mena Canata ◽  
Rebeca Noemí Ruiz Vallejos

The objective of this study is to determine the impact of adenotonsillectomy on the quality of life of postoperative patients.The study is observational, cross-sectional, and retrospective. The files of all postoperative adenotonsillectomy patients in Otorhinolaryngology Service, Hospital de Clínicas, San Lorenzo Paraguay. The Obstructive sleep apnea – 18 questionnaire (OSA 18) was applied, asking patients about symptoms before and after surgery. An effective sample of 143 postoperative patients was obtained. The average age was 6.05 ± 2.08 years, 55.10% (81) were male and 44.89% (66) were female, 65.30% (96) were from urban areas and 34.69% (51) from the rural areas. The t test was performed for means of two paired samples, comparing the results of the Obstructive sleep apnea – 18 questionnaire surveys before and after surgery which presented a significant difference (p <0.05) with a tendency to improve the quality of life after surgery. It has been shown that there is a significant difference, a considerable improvement in the quality of life of patients after adenotonsillectomy.


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