scholarly journals Characteristics of Obstructive Sleep Apnea Patients With Hypertension and Factors Associated With Autotitration Acceptance

2022 ◽  
Vol 12 ◽  
Author(s):  
Xuan Zhang ◽  
Ning Zhang ◽  
Yang Yang ◽  
Shuo Wang ◽  
Ping Yu ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Eye Movement ◽  
Total Sleep Time ◽  
Sleep Time ◽  
Sleep Efficiency ◽  
Apnea Hypopnea Index ◽  
Rapid Eye Movement ◽  
Obstructive Sleep ◽  
Severe Group

In order to explore the characteristics and treatment status of obstructive sleep apnea (OSA) patients with hypertension, a retrospective study was conducted on 306 patients admitted from October 2018 to December 2019. According to the apnea hypopnea index (AHI), OSA patients with hypertension were divided into three groups. 69 cases were mild OSA (5 ≤ AHI < 15), 86 cases were moderate (15 ≤ AHI < 30), and 151 cases were severe (AHI ≥ 30). Compared with patients in the mild and moderate groups, the severe group had more male patients, with higher body mass index (BMI) and non-rapid eye movement stage 1 accounted for total sleep time (N1%), and lower non-rapid eye movement stage 2 accounted for total sleep time (N2%), average and minimum blood oxygen. Among all the patients, those who underwent the titration test accounted for 20.6% (63/306). Multivariate analysis showed that sleep efficiency (p < 0.001) and AHI (p < 0.001) were independent factors for patients to accept titration test. OSA patients with hypertension had a low acceptance of titration therapy. These people with higher sleep efficiency and AHI were more likely to receive autotitration.

scholarly journals 0567 Hypoxic Burden and Apnea-Hypopnea Duration in Patients with Positional Obstructive Sleep Apnea

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A217-A218
Author(s):  
J A Ramzy ◽  
R Rengan ◽  
M Mandal ◽  
S Rani ◽  
M E Vega Sanchez ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Total Sleep Time ◽  
Sleep Time ◽  
Apnea Hypopnea Index ◽  
Apnea Test ◽  
Positional Obstructive Sleep Apnea ◽  
Obstructive Sleep ◽  
Respiratory Event ◽  
The Mean

Abstract Introduction Recently, the measurement of the hypoxic burden and apnea-hypopnea duration has been shown to correlate with mortality in patients with obstructive sleep apnea (OSA). We hypothesized that in patients with mild positional OSA (apnea-hypopnea index [AHI] < 5 events/hr in the non-supine position) the hypoxic burden would be increased and apnea-hypopnea duration shortened and similar to patients with non-positional OSA. Methods Fourteen patients with positional OSA and 24 patients non-positional OSA with similar severity of OSA based on the respiratory event index (REI) were included. All patients had a home sleep apnea test for suspected OSA. The hypoxic burden was calculated by the multiplication of REI and the mean area under the desaturation curves. Results Thirty-eight patients [12 (35%) males, 50±12 yrs, BMI 35±7 kg/m2, Epworth Sleepiness Scale (ESS) 11±8, REI 10±3 events/hr, apnea-hypopnea duration 19±4 sec, mean SaO2 94±2%, lowest SaO2 79±8%, % total sleep time (TST) SaO2 < 90% 11±16%, hypoxic burden 30±17 %min/hr] completed the study. Fourteen patients [9 (64%) males, 46±14 yrs, BMI 31±6 kg/m2, ESS 7±5, REI 9±3 events/hr, mean SaO2 94±2%, lowest SaO2 81±6%, %TST SaO2 < 90% 4±6%] had positional OSA (supine REI 16±7 events/hr, non-supine REI 3±1 events/hr) and 24 patients had non-positional OSA [3 (13%) males, 52±10 yrs, BMI 38±7 kg/m2, ESS 12±9, REI 10±3 events/hr, mean SaO2 94±2%, lowest SaO2 77±9%, %TST SaO2 < 90% 14±19%]. The hypoxic burden was elevated in both the positional and non-positional OSA patients with no difference between the groups (26±19 %min/hr and 32±15 %min/hr, respectively, p=0.13). The apnea-hypopnea duration was similar in positional and non-positional OSA patients (20±3 sec and 18±4 sec, respectively, p=0.08 sec). Conclusion In patients with mild positional OSA the hypoxic burden, which has been associated with cardiovascular mortality, is elevated and similar to patients with non-positional OSA. Support None

scholarly journals 0722 The Association Between Obstructive Sleep Apnea and Neurobehavioural Function in Men: A Large, Population-Based Cohort Study

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A274-A275
Author(s):  
J L Parker ◽  
R J Adams ◽  
S L Appleton ◽  
Y A Melaku ◽  
A Vakulin
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Total Sleep Time ◽  
Sleep Time ◽  
Inspection Time ◽  
Sleep Disruption ◽  
Clinical Samples ◽  
Apnea Hypopnea Index ◽  
Cross Sectional ◽  
Obstructive Sleep

Abstract Introduction Obstructive sleep apnea (OSA) is linked with impaired vigilance, attention, memory and executive function. However, this evidence largely comes from small experimental studies or larger studies in clinical samples and therefore the scope and magnitude of OSA driven neurobehavioural dysfunction in the general population remains unclear. This study aimed to examine the cross-sectional association between OSA and neurobehavioural function in a large community sample of men. Methods A total of 837 participants from the Men Androgen Inflammation Lifestyle Environment and Stress (MAILES) study, a longitudinal cohort of men 40+ years, underwent full overnight polysomnography. Participants completed the inspection time (IT) test, mini-mental state examination (MMSE), Fuld object memory evaluation (FOME), and trail-making test (TMT) part A (TMT-A) and part B (TMT-B). Using regression models adjusted for multiple important covariates, we examined the association between neurobehavioural function scores, clinical metrics of OSA severity (Apnea-Hypopnea Index (AHI); percentage total sleep time with oxygen saturation <90% (TST90), and measures of sleep disruption (duration of rapid eye movement (REM) and non-REM (NREM) sleep; and total sleep time (TST). Results In multivariable linear regressions, greater TST was associated with worse IT scores (B=13.688, 95% CI [0.134, 27.241], P=0.048) and TMT-B scores (B=19.255, 95% CI [0.931, 37.578], P=0.040). In logistic regressions, greater TST was associated with better MMSE scores (Odds ratio [OR]=0.440, 95% CI [0.194, 0.997], P=0.049); and higher AHI was strongly associated with worse FOME scores in fully adjusted models (OR=1.358, 95% CI [1.252, 1.472], P<0.001). Conclusion The AHI and TST were positively, significantly associated with neurobehavioural function across different domains. This cross-sectional data shows that neurobehavioural function deficits in OSA are directly related to sleep and breathing disruptions. Future large prospective studies are needed to determine if OSA and sleep disruption predict future onset of neurobehavioural dysfunction and cognitive decline. Support National Health and Medical Research Council and the Adelaide Institute for Sleep Health.

scholarly journals Continuous positive airway pressure in patients with rapid eye movement (REM)-specific obstructive sleep apnea, a retrospective match-controlled chart review

F1000Research ◽  
2019 ◽  
Vol 7 ◽  
pp. 1848
Author(s):  
Rodolfo Soca ◽  
Erica Buchner ◽  
Hrayr Attarian
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Continuous Positive Airway Pressure ◽  
Eye Movement ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Apnea Hypopnea Index ◽  
Rapid Eye Movement ◽  
Retrospective Case ◽  
Obstructive Sleep

Background: Rapid eye movement (REM) obstructive sleep apnea (OSA) represents 13 to 35% of all OSA cases and is more common in women. Continuous positive airway pressure (CPAP) is the gold standard for treatment of all forms of OSA but we do not know if patients with REM OSA have different pressure requirements than those with non-stage dependent OSA. Methods: This was a retrospective case control study. We first identified individuals with REM OSA and then tried to identify apnea hypopnea index (AHI), gender, and body mass index (BMI) matching controls that had non-stage specific OSA. Individuals were considered to have REM OSA if the REM AHI was greater than 5 events/hour, and the ratio of REM AHI / non-rapid eye movement (NREM) AHI was greater than 2. Demographic variables and the recommended CPAP pressure were analyzed using paired Student’s T-Tests. Results: Our study included a total of 16 individuals with REM OSA and equal number of AHI, gender, and BMI matching controls. Both groups had similar demographic and polysomnographic characteristics.  Individuals with REM OSA required similar CPAP pressures as controls (7.5 cm H 2O vs 7.4 cm H 2O p=0.78). Conclusion: Individuals with REM might require similar CPAP pressures as their AHI, gender, and BMI matching controls.

scholarly journals Estimated respiratory arousal threshold in patients with rapid eye movement obstructive sleep apnea

2021 ◽  
Author(s):  
Tetsuro Hoshino ◽  
Ryujiro Sasanabe ◽  
Kenta Murotani ◽  
Reiko Hori ◽  
Mamiko Mano ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Eye Movement ◽  
Clinical Phenotype ◽  
Apnea Hypopnea Index ◽  
Rapid Eye Movement ◽  
Arousal Threshold ◽  
Obstructive Sleep ◽  
Definition Of

Abstract Purpose Rapid eye movement (REM) obstructive sleep apnea (OSA) is a prevalent clinical phenotype. However, the literature focusing on the pathophysiology of REM OSA is limited. This study compared the proportion of individuals with a low respiratory arousal threshold between patients with REM and non-REM OSA. Methods REM OSA was defined as having an apnea–hypopnea index (AHI) ≥ 5 and AHI during REM (AHI-REM)/AHI during NREM (AHI-NREM) ≥ 2. REM OSA was sub-divided into REM-predominant OSA and REM-isolated OSA. REM-predominant OSA was defined as satisfying the definition of REM OSA and having an AHI-NREM ≥ 5. REM-isolated OSA was defined as satisfying the definition of REM OSA and having an AHI-NREM < 5. Patients with an AHI-REM/AHI-NREM < 2 were defined as having non-REM OSA. A low respiratory arousal threshold was defined as having 2 or more of the following conditions: AHI < 30 events/h, proportion of hypopnea > 58.3%, and nadir SpO2 > 82.5%. Results The proportions of individuals with low respiratory arousal thresholds among individuals with REM-predominant OSA and REM-isolated OSA were significantly higher (77.2% and 93.7%, respectively) than that of patients with non-REM OSA (48.6%). This was also true when the analysis was performed according to sex. Conclusion These results indicate that a low respiratory arousal threshold might be an important endotype that contributes to the pathogenesis of REM OSA, especially in REM-isolated OSA.

scholarly journals Sleep architecture, obstructive sleep apnea and functional outcomes in adults with a history of Tick-borne encephalitis

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246767
Author(s):  
Malin Veje ◽  
Marie Studahl ◽  
Erik Thunström ◽  
Erika Stentoft ◽  
Peter Nolskog ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Functional Outcomes ◽  
Sleep Disturbances ◽  
Total Sleep Time ◽  
Sleep Time ◽  
Apnea Hypopnea Index ◽  
Northern Asia ◽  
Tick Borne Encephalitis ◽  
Obstructive Sleep

Tick-borne encephalitis (TBE) is a widespread viral infection of the central nervous system with increasing incidence in Europe and northern Asia. Post-infectious sequelae are frequent, and patients with TBE commonly experience long-term fatigue and subjective sleep disturbances. Obstructive sleep apnea (OSA) may be a contributing factor, and objective sleep studies with polysomnography (PSG) are lacking. Forty-two adults, 22 TBE patients (cases), diagnosed in Region Västra Götaland, Sweden, between 2012 and 2015, and 20 controls without a known TBE history, underwent an overnight PSG, respectively. All participants responded to questionnaires. The cases and controls were similar regarding age, sex, obesity, concomitant diseases, smoking, and alcohol habits. Despite similar PSG characteristics such as total sleep time and OSA severity indices, the TBE cases reported statistically more sleep-related functional impairment on the Functional Outcome of Sleep Questionnaire (FOSQ) compared with the controls (median scores 18.1 vs. 19.9; p<0.05). In a multivariate analysis, TBE correlated significantly with the lower FOSQ scores (unstandardized β −1.80 [%95 confidence interval −3.02 - −0.58]; p = 0.005) independent of age, sex, total sleep time and apnea-hypopnea-index. TBE cases with OSA reported the lowest scores on the FOSQ compared with the other subgroups with TBE or OSA alone, and the ones with neither TBE nor OSA. TBE is associated with impaired functional outcomes, in which concomitant OSA may worsen the subjective symptoms. Further studies are warranted to determine the effect of treatment of concomitant OSA on functional outcomes with regard to optimal rehabilitation of TBE.

scholarly journals Continuous positive airway pressure in patients with rapid eye movement (REM)-specific obstructive sleep apnea, a retrospective match-controlled chart review

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 1848
Author(s):  
Rodolfo Soca ◽  
Erica Buchner ◽  
Hrayr Attarian
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Continuous Positive Airway Pressure ◽  
Eye Movement ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Apnea Hypopnea Index ◽  
Rapid Eye Movement ◽  
Retrospective Case ◽  
Obstructive Sleep

Background: Rapid eye movement (REM) obstructive sleep apnea (OSA) represents 13 to 35% of all OSA cases and is more common in women. Continuous positive airway pressure (CPAP) is the gold standard for treatment of all forms of OSA but we do not know if patients with REM OSA have different pressure requirements than those with non-stage dependent OSA. Methods: This was a retrospective case control study. We first identified individuals with REM OSA and then tried to identify apnea hypopnea index (AHI), gender, and body mass index (BMI) matching controls that had non-stage specific OSA. Individuals were considered to have REM OSA if the REM AHI was greater than 5 events/hour, and the ratio of REM AHI / non-rapid eye movement (NREM) AHI was greater than 2. Demographic variables and the recommended CPAP pressure were analyzed using paired Student’s T-Tests. Results: Our study included a total of 16 individuals with REM OSA and equal number of AHI, gender, and BMI matching controls. Both groups had similar demographic and polysomnographic characteristics.  Individuals with REM OSA required similar CPAP pressures as controls (7.5 cm H2O vs 7.4 cm H2O p=0.78). Conclusion: Individuals with REM require similar CPAP pressures as their AHI, gender, and BMI matching controls.

scholarly journals Obstructive sleep apnea related to rapid-eye-movement or non-rapid-eye-movement sleep: comparison of demographic, anthropometric, and polysomnographic features

2016 ◽  
Vol 42 (1) ◽  
pp. 48-54 ◽  
Author(s):  
Aysel Sunnetcioglu ◽  
Bunyamin Sertogullarından ◽  
Bulent Ozbay ◽  
Hulya Gunbatar ◽  
Selami Ekin
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Eye Movement ◽  
Sleep Stage ◽  
Treatment Modalities ◽  
Sleep Stages ◽  
Apnea Hypopnea Index ◽  
Rapid Eye Movement ◽  
Obstructive Sleep ◽  
The Mean

Objective : To determine whether there are significant differences between rapid-eye-movement (REM)-related obstructive sleep apnea (OSA) and non-REM (NREM)-related OSA, in terms of the demographic, anthropometric, and polysomnographic characteristics of the subjects. Methods : This was a retrospective study of 110 patients (75 males) with either REM-related OSA (n = 58) or NREM-related OSA (n = 52). To define REM-related and NREM-related OSA, we used a previously established criterion, based on the apnea-hypopnea index (AHI): AHI-REM/AHI-NREM ratio > 2 and ≤ 2, respectively. Results : The mean age of the patients with REM-related OSA was 49.5 ± 11.9 years, whereas that of the patients with NREM-related OSA was 49.2 ± 12.6 years. The overall mean AHI (all sleep stages combined) was significantly higher in the NREM-related OSA group than in the REM-related OSA group (38.6 ± 28.2 vs. 14.8 ± 9.2; p < 0.05). The mean AHI in the supine position (s-AHI) was also significantly higher in the NREM-related OSA group than in the REM-related OSA group (49.0 ± 34.3 vs. 18.8 ± 14.9; p < 0.0001). In the NREM-related OSA group, the s-AHI was higher among the men. In both groups, oxygen desaturation was more severe among the women. We found that REM-related OSA was more common among the patients with mild-to-moderate OSA, whereas NREM-related OSA was more common among those with severe OSA. Conclusions : We found that the severity of NREM-related OSA was associated mainly with s-AHI. Our findings suggest that the s-AHI has a more significant effect on the severity of OSA than does the AHI-REM. When interpreting OSA severity and choosing among treatment modalities, physicians should take into consideration the sleep stage and the sleep posture.

scholarly journals Comparison of Polysomnographic and Cephalometric Parameters Based on Positional and Rapid Eye Movement Sleep Dependency in Obstructive Sleep Apnea

2021 ◽  
Author(s):  
Jung-Hwan Jo ◽  
Sung-Hun Kim ◽  
Ji-Hee Jang ◽  
Ji-Woon Park ◽  
Jin-Woo Chung
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Eye Movement ◽  
Rem Sleep ◽  
Upper Airway ◽  
Apnea Hypopnea Index ◽  
Rapid Eye Movement ◽  
Maximum Width ◽  
Obstructive Sleep ◽  
Positional Dependency

Abstract The aim of this study is to investigate the differences in polysomnographic and cephalometric features according to positional and rapid eye movement (REM) sleep dependencies in obstructive sleep apnea patients. Standard polysomnography and cephalometric analyses were performed on 133 OSA patients. The subjects were categorized into positional and non-positional, and REM-related and not-REM-related OSA groups according to positional and REM sleep dependency on severity of sleep apnea. Polysomnographic and cephalometric parameters were compared between groups. Positional and REM-related OSA patients showed significantly lower non-supine apnea-hypopnea index (AHI), non-REM (NREM) AHI and overall AHI and higher NREM oxygen saturation (SpO2) and mean SpO2 compared to non-positional and not-REM-related OSA patients, respectively. Cephalometric features between positional and non-positional OSA patients did not show any significant differences. However, REM-related OSA patients showed significantly larger inferior oral airway space and shorter perpendicular distance between mandibular plane and anterior hyoid bone and the distance between uvula and posterior nasal spine, and narrower maximum width of soft palate than not-REM-related OSA patients. Positional and REM-related OSA patients have lower severity of sleep apnea, suggesting the possibility of lower collapsibility of the upper airway. Anatomical factors maybe more closely related to REM sleep than positional dependency.

scholarly journals Altered K-complex morphology during sustained inspiratory airflow limitation is associated with next-day lapses in vigilance in obstructive sleep apnea

SLEEP ◽  
2021 ◽  
Author(s):  
Ankit Parekh ◽  
Korey Kam ◽  
Anna E Mullins ◽  
Bresne Castillo ◽  
Asem Berkalieva ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Spectral Characteristics ◽  
Sleep Time ◽  
Airflow Limitation ◽  
Apnea Hypopnea Index ◽  
Complex Morphology ◽  
Obstructive Sleep ◽  
Inspiratory Airflow Limitation ◽  
Psychomotor Vigilance

Abstract Study Objectives Determine if changes in K-complexes associated with sustained inspiratory airflow limitation (SIFL) during N2 sleep are associated with next-day vigilance and objective sleepiness. Methods Data from thirty subjects with moderate-to-severe obstructive sleep apnea who completed three in-lab polysomnograms: diagnostic, on therapeutic continuous positive airway pressure (CPAP), and on suboptimal CPAP (4 cmH2O below optimal titrated CPAP level) were analyzed. Four 20-min psychomotor vigilance tests (PVT) were performed after each PSG, every 2 h. Changes in the proportion of spontaneous K-complexes and spectral characteristics surrounding K-complexes were evaluated for K-complexes associated with both delta (∆SWAK), alpha (∆αK) frequencies. Results Suboptimal CPAP induced SIFL (14.7 (20.9) vs 2.9 (9.2); %total sleep time, p &lt; 0.001) with a small increase in apnea–hypopnea index (AHI3A: 6.5 (7.7) vs 1.9 (2.3); p &lt; 0.01) versus optimal CPAP. K-complex density (num./min of stage N2) was higher on suboptimal CPAP (0.97 ± 0.7 vs 0.65±0.5, #/min, mean ± SD, p &lt; 0.01) above and beyond the effect of age, sex, AHI3A, and duration of SIFL. A decrease in ∆SWAK with suboptimal CPAP was associated with increased PVT lapses and explained 17% of additional variance in PVT lapses. Within-night during suboptimal CPAP K-complexes appeared to alternate between promoting sleep and as arousal surrogates. Electroencephalographic changes were not associated with objective sleepiness. Conclusions Sustained inspiratory airflow limitation is associated with altered K-complex morphology including the increased occurrence of K-complexes with bursts of alpha as arousal surrogates. These findings suggest that sustained inspiratory flow limitation may be associated with nonvisible sleep fragmentation and contribute to increased lapses in vigilance.

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