scholarly journals A Minimum Set of Physiological Parameters to Diagnose Obstructive Sleep Apnea Syndrome Using Non-Invasive Portable Monitors. A Systematic Review

Life ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 1249
Author(s):  
Ángel Serrano Alarcón ◽  
Natividad Martínez Madrid ◽  
Ralf Seepold
Keyword(s):  
Systematic Review ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Apnea Syndrome ◽  
Physiological Parameters ◽  
Physiological Signals ◽  
Sleep Study ◽  
Obstructive Sleep ◽  
Minimum Number ◽  
Portable Monitors

Introduction. Despite its high accuracy, polysomnography (PSG) has several drawbacks for diagnosing obstructive sleep apnea (OSA). Consequently, multiple portable monitors (PMs) have been proposed. Objective. This systematic review aims to investigate the current literature to analyze the sets of physiological parameters captured by a PM to select the minimum number of such physiological signals while maintaining accurate results in OSA detection. Methods. Inclusion and exclusion criteria for the selection of publications were established prior to the search. The evaluation of the publications was made based on one central question and several specific questions. Results. The abilities to detect hypopneas, sleep time, or awakenings were some of the features studied to investigate the full functionality of the PMs to select the most relevant set of physiological signals. Based on the physiological parameters collected (one to six), the PMs were classified into sets according to the level of evidence. The advantages and the disadvantages of each possible set of signals were explained by answering the research questions proposed in the methods. Conclusions. The minimum number of physiological signals detected by PMs for the detection of OSA depends mainly on the purpose and context of the sleep study. The set of three physiological signals showed the best results in the detection of OSA.

scholarly journals TLRs and RAGE are elevated in carotid plaques from patients with moderate-to-severe obstructive sleep apnea syndrome

2020 ◽  
Vol 24 (4) ◽  
pp. 1573-1580 ◽  
Author(s):  
Wioletta Olejarz ◽  
Alicja Głuszko ◽  
Agata Cyran ◽  
Katarzyna Bednarek-Rajewska ◽  
Robert Proczka ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Significant Role ◽  
Sleep Apnea Syndrome ◽  
Vascular Endothelial ◽  
Sleep Study ◽  
Carotid Plaques ◽  
Obstructive Sleep ◽  
Glycation End Products ◽  
Rage Expression

Abstract Background There is growing evidence that obstructive sleep apnea (OSA) promotes vascular endothelial dysfunction and atherogenesis. Pathways that mediate this pathology may include Toll-like receptors (TLRs) and receptor for advanced glycation end products (RAGE) which play a significant role in proinflammatory processes. The aim of this study was to measure the expression of the above-mentioned receptors in relation to OSA severity in carotid plaques obtained during open endarterectomy. Methods This prospective study included patients with a sleep study prior to surgery and a plaque specimen obtained during standard open endarterectomy. Immunohistochemistry of TLR2, TLR4, TLR7, TLR9, RAGE, HMGB1, and NF-κB was performed on atherosclerotic plaques from carotid arteries of patients with and without OSA. Results There were 46 patients (22 women, mean age 73.2 ± 1.3 years): 14 control patients, 13 with mild, 11 with moderate, and 8 with severe OSA. The expression of all TLRs and RAGE increased proportionately with increasing OSA severity. The largest differences between patients with severe OSA and no OSA were found for TLR2 (2.88 ± 0.35 vs. 1.27 ± 0.47, p < 0.001), TLR4 (2.88 ± 0.35 vs. 1.64 ± 0.5, p < 0.001), TLR9 (2.38 ± 0.52 vs. 1.45 ± 0.52, p < 0.01), and RAGE (2.5 ± 0.53 vs. 1.82 ± 0.6, p < 0.05). Conclusion TLR2, TLR4, TLR9, and RAGE expression was significantly increased in carotid plaques of patients with moderate-to-severe OSA when compared with control patients with no OSA and those with mild OSA. TLR and RAGE-mediated pathways may play a significant role in OSA-dependent atherogenesis.

Effectiveness of mandibular advancement appliances in treating obstructive sleep apnea syndrome: A systematic review

2015 ◽  
Vol 126 (2) ◽  
pp. 507-514 ◽  
Author(s):  
Sara Serra-Torres ◽  
Carlos Bellot-Arcís ◽  
José M. Montiel-Company ◽  
Jaime Marco-Algarra ◽  
José M. Almerich-Silla
Keyword(s):  
Systematic Review ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Mandibular Advancement ◽  
Obstructive Sleep ◽  
Apnea Syndrome ◽  
Mandibular Advancement Appliances

scholarly journals Predictive factors facilitate identification of potential aortic dissection in patients with obstructive sleep apnea syndrome

2021 ◽  
Author(s):  
dinghui wu ◽  
Dandan Jiang ◽  
Qu Chen ◽  
xiangyang yao ◽  
chunping dong ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Aortic Dissection ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Sleep Study ◽  
Hypertensive Patients ◽  
Lymphocyte Ratio ◽  
Obstructive Sleep ◽  
Apnea Syndrome

Objective: Investigating potential predictors of aortic dissection development in high-risk hypertensive patients with obstructive sleep apnea syndrome (OSAS). Methods: Hypertensive patients with aortic dissection, admitted to hospital between January 2010 and July 2020, was diagnosed with OSAS by overnight sleep study with polysomnography (PSG). Results: Male was liable to aortic dissection compared to female in both groups（84.7% and 86% respectively）.There were actually significant differences with regard to neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), mean platelet volume (MPV) / platelet count (PLT) ratio and D-dimer that we concerned about and were of great value in aortic dissection as previously reported. As multivariable regression analysis revealed, NLR (odds rate [OR], 2.258, 95% confidence interval [CI], 1.464-3.482, P<0.05), MPV/PLT (OR, 2.743, 95%CI, 1.713-4.392, P<0.05) and apnea and hypopnea index (AHI) (OR, 1.746,95% CI, 1.225-1.320, P<0.05) were all independent risk factors for aortic dissection. receiver operating characteristic curves analysis of NLR, MPV/PLT, AHI and combination of indicators for aortic dissection revealed combination of NLR, MPV/PLT ratio and AHI is of outstanding predictive value with sensitivity of 0.904 and specificity of 0.847. At the thresholds of 4.41 for NLR and 5.14 for MPV/PLT and 35.95 for AHI, 87.5% of all studied patients were expected to be correctly diagnosed with regard to aortic dissection. Conclusion: Inflammation, platelet alteration is crucial for initiation and progression of aortic dissection. Combined detection of NLR, MPV/PLT ratio and AHI could assist sleep physicians to identify silent or potential aortic dissection in patient comorbidity OSAS and hypertension.

scholarly journals A Pharyngoplasty with a Dorsal Palatal Flap Expansion: The Evaluation of a Modified Surgical Treatment Method for Obstructive Sleep Apnea Syndrome—A Preliminary Report

2021 ◽  
Vol 10 (16) ◽  
pp. 3746
Author(s):  
Ewa Olszewska ◽  
Piotr Fiedorczuk ◽  
Adam Stróżyński ◽  
Agnieszka Polecka ◽  
Ewa Roszkowska ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Oxygen Saturation ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Apnea Hypopnea Index ◽  
Upper Airways ◽  
Sleep Study ◽  
Obstructive Sleep ◽  
Apnea Syndrome

Surgical techniques for obstructive sleep apnea syndrome (OSAS) constantly evolve. This study aims to assess the effectiveness and safety of a new surgical approach for an OSAS pharyngoplasty with a dorsal palatal flap expansion (PDPFEx). A total of 21 participants (mean age 49.9; mean BMI 32.5) underwent a type III sleep study, an endoscopy of the upper airways, a filled medical history, a visual analog scale for snoring loudness, an Epworth Sleepiness Scale, and a Short Form Health Survey-36 questionnaire. A follow-up re-evaluation was performed 11 ± 4.9 months post-operatively. The study group (4 with moderate, 17 with severe OSAS) showed an improvement in all measured sleep study characteristics (p < 0.05), apnea-hypopnea index (pre-median 45.7 to 29.3 post-operatively, p = 0.009, r = 0.394), oxygen desaturation index (pre-median 47.7 and 23.3 post-operatively, p = 0.0005, r = 0.812), mean oxygen saturation (median 92% pre-operatively and median 94% post-operatively, p = 0.0002, r = 0.812), lowest oxygen saturation (p = 0.0001, r = 0.540) and time of sleep spent with blood oxygen saturation less than 90% (p = 0.0001, r = 0.485). The most commonly reported complications were throat dryness (11 patients) and minor difficulties in swallowing (5 patients transient, 3 patients constant). We conclude that a PDPFEx is a promising new surgical method; however, further controlled studies are needed to demonstrate its safety and efficacy for OSAS treatment in adults.

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