scholarly journals Body Mass Index Reduction and Selected Cardiometabolic Risk Factors in Obstructive Sleep Apnea: Meta-Analysis

2021 ◽  
Vol 10 (7) ◽  
pp. 1485
Author(s):  
Marta Stelmach-Mardas ◽  
Beata Brajer-Luftmann ◽  
Marta Kuśnierczak ◽  
Halina Batura-Gabryel ◽  
Tomasz Piorunek ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Body Mass ◽  
Meta Analysis ◽  
Apnea Hypopnea Index ◽  
Metabolic Risk ◽  
Index Reduction ◽  
Obstructive Sleep

Although clinical studies have been carried out on the effects of weight reduction in sleep apnea patients, no direct link has been shown between weight reduction and changes in cardio-metabolic risk factors. We aimed to analyze changes in the apnea–hypopnea index and selected cardio-metabolic parameters (total cholesterol, triglycerides, glucose, insulin, blood pressure) in relation to the reduction in body mass index in obstructive sleep apnea patients. Medline, Web of Science and Cochrane databases were searched to combine results from individual studies in a single meta-analysis. We identified 333 relevant articles, from which 30 papers were assigned for full-text review, and finally 10 (seven randomized controlled trials and three nonrandomized studies) were included for data analysis. One unit of body mass index reduction was found to significantly influence changes in the apnea–hypopnea index (−2.83/h; 95% CI: −4.24, −1.41), total cholesterol (−0.12 mmol/L; 95% CI: −0.22, −0.01), triglycerides (−0.24 mmol/L; 95% CI: −0.46, −0.02), fasting insulin (−7.3 pmol/L; 95% CI: −11.5, −3.1), systolic (−1.86 mmHg; 95% CI: −3.57, −0.15) and diastolic blood pressure (−2.07 mmHg; 95% CI: −3.79, −0.35). Practical application of lifestyle modification resulting in the reduction of one unit of body mass index gives meaningful changes in selected cardio-metabolic risk factors in obstructive sleep apnea patients.

Expansion Sphincter Pharyngoplasty: A New Technique for the Treatment of Obstructive Sleep Apnea

2007 ◽  
Vol 137 (1) ◽  
pp. 110-114 ◽  
Author(s):  
Kenny P. Pang ◽  
B. Tucker Woodson
Keyword(s):  
Body Mass Index ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Body Mass ◽  
Apnea Hypopnea Index ◽  
Type I ◽  
Pharyngeal Wall ◽  
Obstructive Sleep ◽  
Expansion Sphincter Pharyngoplasty ◽  
Sphincter Pharyngoplasty

OBJECTIVE: In this study, we assessed the efficacy of a new method (expansion sphincter pharyngoplasty [ESP]) to treat obstructive sleep apnea. STUDY DESIGN: We conducted a prospective, randomized controlled trial. METHODS: Forty-five adults with small tonsils, body mass index less than 30 kg/m 2 , of Friedman stage II or III, of type I Fujita, and with lateral pharyngeal wall collapse were selected for the study. RESULTS: The mean body mass index was 28.7 kg/m 2 . The apnea-hypopnea index improved from 44.2 ± 10.2 to 12.0 ± 6.6 ( P < 0.005) following ESP and from 38.1 ± 6.46 to 19.6 ± 7.9 in the uvulopalatopharyngoplasty group ( P < 0.005). Lowest oxygen saturation improved from 78.4 ± 8.52% to 85.2 ± 5.1% in the ESP group ( P = 0.003) and from 75.1 ± 5.9% to 86.6 ± 2.2% in the uvulopalatopharyngoplasty group ( P < 0.005). Selecting a threshold of a 50% reduction in apnea-hypopnea index and apnea-hypopnea index less than 20, success was 82.6% in ESP compared with 68.1% in uvulopalatopharyngoplasty ( P < 0.05). CONCLUSION/SIGNIFICANCE: The ESP may offer benefits in a selected group of OSA patients.

scholarly journals Polysomnographic and clinical characteristics of positional obstructive sleep apnea patients

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

Long-term Effects of Gastric Bypass Surgery in Patients with Obstructive Sleep Apnea

2020 ◽  
Vol 16 (1) ◽  
pp. 34-38
Author(s):  
Nathir Obeidat ◽  
Saif Aldeen AlRyalat ◽  
Khaled Al Oweidat ◽  
Mahmoud Abu-Khalaf ◽  
Asma Btoush ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Body Mass Index ◽  
Obstructive Sleep Apnea ◽  
Gastric Bypass ◽  
Sleep Apnea ◽  
Body Mass ◽  
Apnea Hypopnea Index ◽  
Obstructive Sleep ◽  
The Mean

Background: Obstructive sleep apnea is a common disorder involving, intermittent mechanical obstruction of the upper airway during sleep. Obesity is the most powerful risk factor for obstructive sleep apnea. Objective: This study aimed to investigate the long-term effect of Roux-en-Y gastric bypass bariatric surgery on patients with obstructive sleep apnea. Methods: This study included patients were referred for bariatric surgery (Roux-en-Y gastric bypass) to control symptoms and complications of obesity during a 5-year period. An overnight sleep study was performed for each patient before and after the bariatric surgery, to study its effect on different obstructive sleep apnea-related variables. Results: This study included 179 patients (mean age 35.9 ± 10.7 years). The mean duration from preoperative assessment to postoperative assessment was 2.4 ± 2.2 years. The mean change in body mass index and weight showed a decrease of 16.0 ± 16.0 kg/m2 and48.7 ± 25.9 kg, respectively. The apnea hypopnea index decreased by a mean of 22.6 ± 26.3 events/hour. Conclusion: We concluded that a decrease in the body mass index by 1 kg/m2 could predict a decrease in the apnea hypopnea index by 0.46 events/hour. Moreover, after mean follow-up duration of 2.4 years, 84.3% of mild and 83.3% of moderate obstructive sleep apnea patients became normal postoperatively.

scholarly journals Explorating the Involvement of Plasma Sestrin2 in Obstructive Sleep Apnea

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Rong Jiang ◽  
Qiru Wang ◽  
Huifen Zhai ◽  
Xiaohua Du ◽  
Shibo Sun ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Body Mass Index ◽  
Coronary Heart Disease ◽  
Obstructive Sleep Apnea ◽  
Heart Disease ◽  
Sleep Apnea ◽  
Body Mass ◽  
Control Group ◽  
Apnea Hypopnea Index ◽  
Obstructive Sleep

Obstructive sleep apnea (OSA) can lead to serious complications such as coronary heart disease and hypertension due to oxidative stress. Sestrin2 expression is upregulated under conditions of oxidative stress. This study aimed to explore whether Sestrin2 was involved in OSA. OSA and healthy control subjects were recruited and matched with age, gender, and body mass index (BMI). Plasma Sestrin2 levels were measured and compared. A multivariate stepwise regression model was used to detect the relationship between Sestrin2 and other variable factors. The Sestrin2 levels were compared between before and after four weeks treatment by nasal continuous positive airway pressure (nCPAP) in severe OSA patients. Fifty-seven subjects were divided into two groups: control group (39.33 ± 9.40 years, n = 21) and OSA group (38.81 ± 7.84 years, n = 36). Plasma Sestrin2 levels increased in the OSA group (control group 2.06 ± 1.76 ng/mL, OSA group 4.16 ± 2.37 ng/mL; P=0.001). Sestrin2 levels decreased after four-week nCPAP treatment (pre-nCPAP 5.21 ± 2.32 ng/mL, post-nCPAP 4.01 ± 1.54 ng/mL; P=0.004). Sestrin2 was positively correlated with apnea/hypopnea index (AHI) oxygen desaturation index, while negatively correlated with mean oxygen saturation. Moreover, these correlations remained unchanged after adjusting for gender, age, waist-to-hip ratio, and body mass index. Multiple regression analysis showed that there was an association between Sestrin2 and AHI. Our findings suggest that Sestrin2 is involved in OSA. The increase of plasma Sestrin2 is directly related to the severity of OSA. To some extent, Sestrin2 may be useful for determining the severity of OSA and monitoring the effect of CPAP. In addition, since some complications of OSA such as coronary heart disease and diabetes are usually related with oxidative stress, the role of Sestrin2 in those OSA complications needs further study.

Glottic and cervical tracheal narrowing in patients with obstructive sleep apnea

1989 ◽  
Vol 67 (6) ◽  
pp. 2427-2431 ◽  
Author(s):  
I. Rubinstein ◽  
T. D. Bradley ◽  
N. Zamel ◽  
V. Hoffstein
Keyword(s):  
Body Mass Index ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Body Mass ◽  
Upper Airway ◽  
The Body ◽  
Apnea Hypopnea Index ◽  
Structural Abnormality ◽  
Pathophysiological Mechanism ◽  
Obstructive Sleep

There are several studies showing that patients with idiopathic obstructive sleep apnea (OSA) have a narrow and collapsible pharynx that may predispose them to repeated upper airway occlusions during sleep. We hypothesized that this structural abnormality may also extend to the glottic and tracheal region. Consequently, we measured pharyngeal (Aph), glottic (Agl), cervical tracheal (Atr1), midtracheal (Atr2), and distal (Atr3) tracheal areas during tidal breathing in 66 patients with OSA (16 nonobese and 50 obese) and 8 nonapneic controls. We found that Aph, Agl, and Atr1, but not Atr2 or Atr3, were significantly smaller in the OSA group than in the control group. Obese patients with OSA had the smallest upper airway area, although the nonapneic controls had the largest areas. Multiple linear regression analysis revealed that the pharyngeal area, cervical tracheal area, and body mass index were all independent determinants of the apnea-hypopnea index, accounting for 31% of the variability in apnea-hypopnea index. Aph, Agl, and Atr showed significant correlation with the body mass index. We conclude that sleep-disordered breathing is associated with diffuse upper airway narrowing and that obesity contributes to this narrowing. Furthermore, we speculate that a common pathophysiological mechanism may be responsible for this reduction in upper airway area extending from the pharynx to the proximal trachea.

scholarly journals HUBUNGAN UKURAN ANTROPOMETRI DENGAN DERAJAT OBSTRUCTIVE SLEEP APNEA

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

scholarly journals Υπερηχοκαρδιογραφικά ευρήματα και βιοχημικοί δείκτες σε ασθενείς με σύνδρομο αποφρακτικής υπνικής άπνοιας

2021 ◽  
Author(s):  
Μελπομένη Νταλαπάσχα
Keyword(s):  
Body Mass Index ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Body Mass ◽  
Sleep Apnea Syndrome ◽  
Apnea Hypopnea Index ◽  
Obstructive Sleep ◽  
Apnea Syndrome

Εισαγωγή: Η αποφρακτική άπνοια του ύπνου (obstructive sleep apnea syndrome-OSAS) είναι μια πολύ κοινή διαταραχή ύπνου. Η σοβαρότητά της χαρακτηρίζεται κυρίως από τα συνολικά επεισόδια άπνοιας και υπόπνοιας ανά ώρα ύπνου. Συνήθως συνυπάρχει με καρδιολογικά προβλήματα.Σκοπός: Να μελετηθεί η επίδραση σοβαρής OSA στη συνολική λειτουργία της καρδιάς (και ιδίως στη διαστολική λειτουργία της αριστερής κοιλίας), καθώς και η επίδρασή της στο οξειδωτικό στρες. Τα δείγματα που συγκεντρώθηκαν ήταν ομάδα ασθενών και ομάδα control χωρίς συννοσηρότητες.Μέθοδοι: Συγκεντρώθηκε ένα δείγμα από 42 ασθενείς με πρωτοδιαγνωσθείσα σοβαρή ΟSA (δείκτη απνοιών-υποπνοιών, apnea hypopnea index, ΑΗΙ>30) και 25 περιπτώσεις ελέγχου (ΑΗΙ<5) από το Eργαστήριο Ύπνου του Νοσοκομείου ΠΓΝΛάρισας που υποβλήθηκαν σε εξετάσεις πολυυπνογραφίας και υπερηχοκαρδιογραφήματος. Η υπερηχοκαρδιογραφία (και η διάγνωση και η σταδιοποίηση της διαστολικής δυσλειτουργίας) στηρίχθηκε στις συστάσεις της Αμερικάνικης και Ευρωπαϊκής Καρδιολογικής Εταιρείας (2016 ASE/EACVI). Οι ασθενείς αξιολογήθηκαν με βάση την κλίμακα ύπνου Epworth και υποβλήθηκαν και σε σπιρομέτρηση. Κριτήρια εισόδου ήταν η ηλικία ανάμεσα 30 έως 65 έτη καθώς και η απουσία τόσο συννοσηροτήτων από το καρδιαγγειακό σύστημα όσο και παραγόντων που αυξάνουν το οξειδωτικό στρες. Στους 18 από τους ασθενείς με σοβαρού βαθμού υπνική άπνοια και στις 13 από τις περιπτώσεις ελέγχου συλλέχτηκαν επίσης δείγματα αίματος και για την εκτίμηση του οξειδωτικού στρες. Μετρήθηκαν βιοδείκτες [πρωτεινικά καρβονύλια, ανηγμένη γλουταθειόνη (GSH), οξειδωμένη γλουταθειόνη (GSSG), 8-ισοπροστάνιο, ουσίες που αντιδρούν με το θειοβαρβιτουρικό οξύ (TBARS), η δραστηριότητα της καταλάσης, η Cu-Zn δισμουτάση του σουπεροξειδίου (SOD), η συνολική αντιοξειδωτική ικανότητα (TAC), πριν και μετά την εξέταση της πολυυπνογραφίας. Αποτελέσματα: Οι ασθενείς με σοβαρού βαθμού υπνική άπνοια παρουσίασαν πιο συχνά και μεγαλύτερο βαθμό διαστολικής δυσλειτουργίας (26/42;61.9%) συγκριτικά με τους υγιείς (7/25;28%) [p=0.007] . Επιπρόσθετα, ο AHI ≥ 55 χαρακτηρίστηκε από μεγαλύτερη συχνότητα και βαθμό διαστολικής δυσλειτoυργίας συγκριτικά με τουςασθενείς με 30<AHI<55 [p= 0.015]. Στην υποομάδα με σοβαρή υπνική άπνοια, η ηλικία > 45 έτη, το ύψος<1.745 m, ο δείκτης μάζας σώματος (body mass index, BMI)>27.76kgrm-2, ο AHI > 57. 35, το οξειδωτικό στρες (η μείωση κατά τη διάρκεια της νύχτας του λόγου της ανηγμένης προς την οξειδωμένη γλουταθειόνη< 18.44%), και ο λόγος BMI/ύψος >16.155 kg m-3 παρουσίασαν σημαντική διαγνωστική χρησιμότητα στην ανίχνευση διαστολικής δυσλειτουργίας στη καμπύλη ROC [0.697 ≥ AUC≥ 0.855, 0.001≤ p ≤0.018]. Στο μοντέλο δυαδικής λογιστικής παλινδρόμησης η προχωρημένη ηλικία [ΟER 1.23, 95%CI 1.025-1.477; p=0.026] και o AHI [ΟR 1.123, 95% CI 1.007-1.253; p=0.036] εμφάνισαν ανεξάρτητη συσχέτιση με την διαστολική δυσλειτουργία στους ασθενείς με σοβαρού βαθμού υπνική άπνοια. Η μεταβολή (%) κατά τη διάρκεια της νύχτας του λόγου της ανηγμένης γλουταθειόνης/οξειδωμένης γλουταθειόνης και της ανηγμένης γλουταθειόνης παρουσίασε στατιστικά σημαντική διαφορά ανάμεσα στους ασθενείς με υπνική άπνοια και στα υγιή άτομα (p=0.03 και p=0.048, αντίστοιχα). Τα πρωτεινικά καρβονύλια, το 8-ισοπροστάνιο, τα TBARS, η δραστηριότητα της καταλάσης, η δισμουτάση του σουπεροξειδίου και η αντιοξειδωτική ικανότητα δεν παρουσίασαν στατιστικά σημαντική διαφορά ανάμεσα στους ασθενείς με υπνική άπνοια και στους υγιείς (p>0.05).Συμπέρασμα: Στην μελέτη φάνηκε ότι η σοβαρού βαθμού υπνική άπνοια σχετίζεται με διαστολική δυσλειτουργία της αριστερής κοιλίας. Επιπρόσθετα, οι ασθενείς που έπασχαν από OSA παρουσίασαν αυξημένο οξειδωτικό στρες σε σχέση με το δείγμα ελέγχου.

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