scholarly journals Sleep Disturbances and Neurobehavioral Performance in Juvenile Idiopathic Arthritis

2017 ◽  
Vol 44 (3) ◽  
pp. 361-367
Author(s):  
Teresa M. Ward ◽  
Dean W. Beebe ◽  
Maida Lynn Chen ◽  
Carol A. Landis ◽  
Sarah Ringold ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Juvenile Idiopathic Arthritis ◽  
Sleep Apnea ◽  
Daytime Sleepiness ◽  
Sleep Disturbances ◽  
Periodic Limb Movements ◽  
Apnea Hypopnea Index ◽  
Neurobehavioral Performance ◽  
Pain Medications ◽  
Obstructive Sleep

Objective.To examine the extent of polysomnographic (PSG) sleep disturbances [obstructive apnea hypopnea index (OAHI), number of wake bouts, arousals, periodic limb movements] and the effect of OAHI on neurobehavioral performance in juvenile idiopathic arthritis (JIA) with obstructive sleep apnea (OSA), JIA without OSA, and controls without OSA, adjusting for intelligence quotient (IQ), pain, medications, daytime sleepiness, and wake bouts.Methods.Children 6–11 years, 68 with JIA and 67 controls, underwent 1 night of PSG and completed self-reported daytime sleepiness surveys, multiple sleep latency tests for physiological sleepiness, and neurobehavioral performance tests the next day.Results.Compared with JIA and controls without OSA, mean OAHI and arousals were significantly higher in JIA with OSA (p < 0.001, respectively). In comparison with JIA and controls without OSA, mean simple reaction time and sustained attention were significantly slower in JIA with OSA, adjusting for IQ, pain, any medication, daytime sleepiness, and wake bouts.Conclusion.Elevated OAHI is suggestive of obstructive sleep apnea and a comorbidity in JIA that may predispose children with JIA to daytime sleepiness and impaired neurobehavioral performance.

scholarly journals Clinical Features and Contributing Factors of Excessive Daytime Sleepiness in Chinese Obstructive Sleep Apnea Patients: The Role of Comorbid Symptoms and Polysomnographic Variables

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Chuan Shao ◽  
Huan Qi ◽  
Ruyi Lang ◽  
Biyun Yu ◽  
Yaodong Tang ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Clinical Features ◽  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Memory Loss ◽  
Apnea Hypopnea Index ◽  
Contributing Factors ◽  
Obstructive Sleep ◽  
Work Commute

Background. The occurrence and severity of excessive daytime sleepiness (EDS) vary considerably among obstructive sleep apnea (OSA) patients. This study was designed to investigate the characteristics of EDS and identify its contributing factors in OSA patients. Methods. This was a cross-sectional study from a tertiary medical center in China. A total of 874 consecutive patients with newly diagnosed OSA were included. Subjective daytime sleepiness was assessed with the Epworth Sleepiness Scale (ESS). The subjects were assigned to the non-EDS group (582 patients), mild to moderate EDS group (227 patients), and severe EDS group (65 patients) according to the ESS scores. The clinical features and polysomnographic parameters were acquired and analyzed to identify the differences between groups and the determinants of EDS. Results. The age of patients with severe EDS (49.5 ± 11.3) was slightly greater than that of patients with mild to moderate EDS (44.5 ± 10.2) (p<0.05) and non-EDS patients (45.2 ± 12.0) (p<0.05). Body mass index (BMI) was highest in the severe EDS group (29.1 ± 3.6 kg/m2) (p<0.0001), intermediate in the mild to moderate EDS group (27.9 ± 3.3 kg/m2), and lower in the non-EDS group (26.8 ± 3.3 kg/m2). Logistic regression analysis showed waist circumference, memory loss, work/commute disturbances, and sleep efficiency were independently associated with mild to moderate EDS, and the microarousal index, apnea-hypopnea index (AHI), and saturation impair time below 90% were independent contributing factors of mild to moderate EDS. Meanwhile, age, neck circumference, gasping/choking, memory loss, work/commute disturbances, and sleep latency were independently associated with severe EDS, and the AHI and mean SpO2 were independent contributing factors of severe EDS. Conclusions. OSA patients with various severities of EDS are more obese and have more comorbid symptoms compared to patients without EDS. Sleep fragmentation, respiratory events, and nocturnal hypoxia may be predictors of EDS. Comprehensive consideration of demographic, clinical, and polysomnographic factors is required when evaluating OSA patients.

Polysomnography in Pediatric Otolaryngology: If Not Obstructive Sleep Apnea, What Is It?

2017 ◽  
Vol 157 (6) ◽  
pp. 1053-1059 ◽  
Author(s):  
Christine H. Heubi ◽  
Jareen Meinzen-Derr ◽  
Sally R. Shott ◽  
David F. Smith ◽  
and Stacey L. Ishman
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Disturbances ◽  
Case Series ◽  
Central Sleep Apnea ◽  
Categorical Variables ◽  
Periodic Limb Movements ◽  
Continuous Variables ◽  
Retrospective Case ◽  
Obstructive Sleep

Objective To determine common polysomnographic (PSG) diagnoses for children referred by otolaryngologists. Study Design Retrospective case series with chart review. Setting Single tertiary pediatric hospital (2010-2015). Subjects and Methods Review of the medical records of 1258 patients undergoing PSG by otolaryngology referral. Patients who underwent previous otolaryngologic surgery were excluded. Data distributions were evaluated using means with standard deviations for continuous variables and frequencies with percentages for categorical variables. Results A total of 1258 patients were included; 55.9% were male, 64.5% were Caucasian, 16.6% had Down syndrome, and 48% had public insurance. The median age at the time of PSG was 5.2 years (range = 0.2-18.94). Indications for PSG were sleep-disordered breathing (SDB; 69.4%), restless sleep (12.7%), airway anomalies (7.5%), and laryngomalacia (7.2%). SDB was seen in 73.4%, obstructive sleep apnea (OSA) in 53.2%, OSA + central sleep apnea (CSA) in 4.5%, CSA in 0.9%, and non-OSA snoring in 15%. Other diagnoses included periodic limb movements of sleep (PLMS; 7.4%), hypoventilation (6.8%), and nonapneic hypoxemia (2.6%). SDB was more common in younger children and seen in 91.4% of children <12 months and in 69.2% of children ≥24 months, while non-OSA snoring was more common with increasing age (3.7% in children <12 months, 17.7% of children ≥24 months). PLMS were seen in 8.9% of children ≥24 months and in no children <12 months. Conclusion While OSA and snoring were the most common diagnoses reported, PLMS, alveolar hypoventilation, and CSA occurred in 7.4%, 6.8%, and 5.4%, respectively. These findings indicate that additional diagnoses other than OSA should be considered for children seen in an otolaryngology clinic setting who undergo PSG for sleep disturbances.

scholarly journals Comparison of nasal geometry among adults with obstructive sleep apnea: a preliminary study

Revista CEFAC ◽  
2019 ◽  
Vol 21 (6) ◽  
Author(s):  
Jackson Ítalo Tavares da Rocha ◽  
Anna Myrna Jaguaribe de Lima ◽  
Hilton Justino da Silva ◽  
Adriana de Oliveira Camargo Gomes ◽  
Paulo Augusto Vitorino ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Daytime Sleepiness ◽  
Anterior Part ◽  
Posterior Part ◽  
Apnea Hypopnea Index ◽  
Nasal Valve ◽  
Significance Level ◽  
Nasal Turbinate ◽  
Obstructive Sleep

ABSTRACT Purpose: to compare nasal geometry between two groups of patients with different degrees of obstructive sleep apnea and to correlate apnea-hypopnea index, apnea severity and degree of daytime sleepiness with nasal areas and volume. Methods: a total of 20 adults (15 women and 5 men, mean age of 52.0±11.4 years old) without nasal obstruction were submitted to polysomnography. The subjects were divided into two groups: a) 10 individuals without apnea or with mild-grade apnea; b) 10 with moderate or severe apnea. Nasal geometry was evaluated by acoustic rhinometry. The volume, comprising the distance from the nasal valve to the posterior part of the middle nasal turbinate, and the three sectional areas corresponding to nasal valve, anterior part of the inferior nasal turbinate and posterior part of the inferior nasal turbinate, were considered. The Shapiro-Wilk, Mann-Whitney, Student’s t tests for independent samples and Spearman’s correlation coefficient were used for the analysis, with a significance level lower than 5%. Results: group 2 presented lower values in the area corresponding to the nasal valve (on the right), and higher values in the nasal turbinate areas. There was no correlation between the drowsiness scale and nasal areas and volumes. Conclusion: the area of the nasal valve was unilaterally smaller in the group with moderate and severe apnea. There was no correlation between volumes and nasal areas and excessive daytime sleepiness.

Association between radiotherapy and obstructive sleep apnea in cancer patients: A systematic review and meta-analysis.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e17576-e17576
Author(s):  
Gehad Mohamed Tawfik ◽  
Abdulmueti Alshareef ◽  
Esraa Mahmoud Mostafa ◽  
Samar Khaled ◽  
AlMotsim Ben Hmeda ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Cancer Patients ◽  
Sleep Disturbances ◽  
Early Recognition ◽  
Meta Analysis ◽  
Apnea Hypopnea Index ◽  
Obstructive Sleep

e17576 Background: With the increase in survival of cancer patients, consequently, increasing their quality of life is mandatory as well. Sleep disturbances, particularly Obstructive Sleep Apnea (OSA), is one of the main complaints of cancer patients in which patients face frequent episodes of upper airway closure during sleep. Possible causes for OSA include either the specific cancer or its treatment whether sedatives, narcotics, radiotherapy, or chemotherapy, but the primary cause is still hard to prove. Our aim was to investigate the association between the occurrence of OSA and radiotherapy in cancer patients. Methods: On the 9th of September, 2018, we have searched comprehensively 12 electronic databases to retrieve relevant studies. All eligible studies that assess the association between OSA and radiotherapy in cancer patients were included in our meta-analysis. Quality assessment of included studies was done using the NIH tool for cohort and cross-sectional studies. Results: Fourteen studies met our selection criteria, eight studies were eligible for our meta-analysis. There was a positive association between the occurrence of OSA and radiotherapy in cancer patients (OR 1.16, 95% CI [0.52–2.56]; P = 0.718). OSA was noted in 103 of 181 cancer patients who received radiotherapy, yielding a remarkable overall prevalence of 63% (95% CI [0.36–0.85]; P = 0.343). A positive risk ratio for the development of OSA in cancer patients treated with radiotherapy was detected (RRs 1.27, 95% CI [0.81–2.00]; P = 0.297). The overall mean of apnea hypopnea index (AHI) for patients with OSA in six studies was 22.45. Conclusions: These findings point to a striking association between OSA risk and radiotherapy in cancer patients. Since the early recognition and management of OSA in such patients may play an important role in improving their quality of life, we recommend screening all cancer patients treated with radiation for early signs of OSA to further improve their survival.

scholarly journals Evaluation of Obstructive Sleep Apnea Phenotypes Treatment Effectiveness

Medicina ◽  
2021 ◽  
Vol 57 (4) ◽  
pp. 335
Author(s):  
Karolina Charčiūnaitė ◽  
Rasa Gauronskaitė ◽  
Goda Šlekytė ◽  
Edvardas Danila ◽  
Rolandas Zablockis
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Treatment Effectiveness ◽  
Response To Treatment ◽  
Periodic Limb Movements ◽  
Apnea Hypopnea Index ◽  
Arterial Blood Gas ◽  
Treatment Techniques ◽  
Arterial Blood ◽  
Obstructive Sleep

Background and Objective: Obstructive sleep apnea (OSA) is a heterogeneous chronic sleep associated disorder. A common apnea-hypopnea index (AHI)-focused approach to OSA severity evaluation is not sufficient enough to capture the extent of OSA related risks, it limits our understanding of disease pathogenesis and may contribute to a modest response to conventional treatment. In order to resolve the heterogeneity issue, OSA patients can be divided into more homogenous therapeutically and prognostically significant groups–phenotypes. An improved understanding of OSA phenotype relationship to treatment effectiveness is required. Thus, in this study several clinical OSA phenotypes are identified and compared by their treatment effectiveness. Methods and materials: Retrospective data analysis of 233 adult patients with OSA treated with continuous positive airway pressure (CPAP) was performed. Statistical analysis of data relating to demographic and anthropometric characteristics, symptoms, arterial blood gas test results, polysomnografic and respiratory polygraphic tests and treatment, treatment results was performed. Results: 3 phenotypes have been identified: “Position dependent (supine) OSA” (Positional OSA), “Severe OSA in obese patients” (Severe OSA) and “OSA and periodic limb movements (PLM)” (OSA and PLM). The highest count of responders to treatment with CPAP was in the OSA and PLM phenotype, followed by the Positional OSA phenotype. Treatment with CPAP, despite the highest mean pressure administered was the least effective among Severe OSA phenotype. Conclusions: Different OSA phenotypes vary significantly and lead to differences in response to treatment. Thus, treatment effectiveness depends on OSA phenotypes and treatment techniques other than CPAP may be needed. This emphasizes the importance of a more individualized approach when treating OSA.

scholarly journals Patients’ symptoms as a reason for consulting a doctor and obtaining a diagnosis of obstructive sleep apnea

2017 ◽  
Vol 145 (3-4) ◽  
pp. 136-140
Author(s):  
Dimitar Karkinski ◽  
Dejan Dokic
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Medical History ◽  
Disease Severity ◽  
Daytime Sleepiness ◽  
Apnea Hypopnea Index ◽  
Common Symptom ◽  
Self Awareness ◽  
Obstructive Sleep ◽  
To Come

Introduction/Objective. Obstructive sleep apnea (OSA) is characterized by a number of symptoms of which the patient is sometimes not aware. The aim of this study was to determine the symptoms due to which patients came to our sleep department, and to examine to which extent patients? self-awareness plays a role in diagnosing OSA. Methods. The study included 388 patients who came to the Sleep Department of the Clinic of Pulmonology, Skopje, Macedonia, from 2012 to 2016, with suspicion of OSA. Medical history was taken from all patients and polysomnography was performed in order to diagnose OSA. All patients with symptoms of OSA and Apnea?Hypopnea Index score of over 5 were diagnosed with OSA. Results. We identified a list of 23 symptoms that lead patients to visit a doctor. The most common symptom was snoring, which occurs in 86% of patients. It is followed by a feeling of under-sleeping with 68% and witnessed apnea with 63%. A total of 258 patients were diagnosed with OSA. The most important primary symptoms that led OSA-positive patients to our clinic were snoring, witnessed apnea, and daytime sleepiness. The percentage of snoring was decreasing with disease severity. Percentage of witnessed apnea and daytime sleepiness were increasing with disease severity. Self-awareness of symptoms led a majority of the patients to come to the Sleep Department. Conclusion. Patients who have symptoms such as snoring, witnessed apnea, and daytime sleepiness are likely to suffer from OSA. Most of the patients are aware of their symptoms and seek help from a doctor.

scholarly journals Validity of the STOP-Bang Questionnaire in Identifying OSA in a Dental Patient Cohort

Medicina ◽  
2020 ◽  
Vol 56 (7) ◽  
pp. 324 ◽  
Author(s):  
Letizia Lonia ◽  
Marco Scalese ◽  
Gianluca Rossato ◽  
Giovanni Bruno ◽  
Francesca Zalunardo ◽  
...  
Keyword(s):  
At Risk ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Diagnostic Tools ◽  
Apnea Hypopnea Index ◽  
Obstructive Sleep ◽  
Type 3

Background and objectives: Obstructive Sleep Apnea represents a widespread problem in the population, but it is often not diagnosed and not considered a true pathology. Different diagnostic tools are available for the diagnosis of sleep apnea. This study aims to demonstrate the ability of the STOP-Bang (Snoring, Tiredness, Observed apnea, high blood Pressure, Body mass index, Age, Neck circumference, and Gender) questionnaire in identifying subjects with Obstructive Sleep Apnea (OSA) Syndrome, highlighting the role of dentists as epidemiological sentinels. Materials and methods: the STOP-Bang questionnaire was administered to a cohort of 1000 patients, assessing three private dental clinics in Italy. Excessive daytime sleepiness was measured using Epworth Sleepiness Scale (ESS) and defined as ≥ 10. Subjects were considered at risk of OSA if they had three or more positive items at STOP-Bang and were invited to undergo further examination with a type 3 polygraph. Presence of OSA was measured with the apnea-hypopnea index (AHI) and defined as AHI ≥ 5. Results: 482/1000 subjects (48.2%) had three or more positive items in the STOP-Bang questionnaire and were considered at risk for Obstructive Sleep Apnea Syndrome (OSAS). Excessive daytime sleepiness (EDS ≥ 10) was more frequent among subjects at risk for OSAS (73/482, 15.1%) vs. those not at risk for OSAS (30/518, 5.8%) (p < 0.0001). Moreover, 153/482 subjects at risk for OSAS (31.7%) accepted further examination with a type 3 polygraph. Presence of OSAS (AHI ≥ 5) was suggested in 121/153 subjects (79.1%, 95% CI 71.6% to 85.1%), with 76/121 subjects (62.8%) needing treatment (AHI ≥ 15). Conclusion: the high prevalence of OSAS highlights the role of dentists as “epidemiological sentinels”. The STOP-Bang questionnaire is a simple and efficacious instrument for screening sleep apnea patients.

Sign in / Sign up

Export Citation Format

Share Document