scholarly journals Resistant Hypertension and Obstructive Sleep Apnea in the Primary-Care Setting

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
M. Demede ◽  
A. Pandey ◽  
F. Zizi ◽  
R. Bachmann ◽  
M. Donat ◽  
...  
Keyword(s):  
Primary Care ◽  
Metabolic Syndrome ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Resistant Hypertension ◽  
Evaluation System ◽  
Care Setting ◽  
Primary Care Setting ◽  
Obstructive Sleep ◽  
Risk Evaluation System

We ascertained the prevalence of resistant hypertension (RH) among blacks and determined whether RH patients are at greater risk for obstructive sleep apnea (OSA) than hypertensives.Method. Data emanated from Metabolic Syndrome Outcome Study (MetSO), a study investigating metabolic syndrome among blacks in the primary-care setting. Sample of 200 patients (mean age = 63 ± 13 years; female = 61%) with a diagnosis of hypertension provided subjective and clinical data. RH was defined using the JNC 7and European Society guidelines. We assessed OSA risk using the Apnea Risk Evaluation System ARES), defining high risk as a total ARES score ≥6.Results. Overall, 26% met criteria for RH and 40% were at high OSA risk. Logistic regression analysis, adjusting for effects of age, gender, and medical co morbidities, showed that patients with RH were nearly 2.5 times more likely to be at high OSA risk, relative to those with hypertension (OR = 2.46, 95% CI: 1.03–5.88,P<.05).Conclusion. Our findings show that the prevalence of RH among blacks fell within the range of RH for the general hypertensive population (3–29%). However, patients with RH were at significantly greater risk of OSA compared to patients with hypertension.

scholarly journals A new tool to screen patients with severe obstructive sleep apnea in the primary care setting: a prospective multicenter study

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Patricia Peñacoba ◽  
Maria Antònia Llauger ◽  
Ana María Fortuna ◽  
Xavier Flor ◽  
Gabriel Sampol ◽  
...  
Keyword(s):  
Primary Care ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Care Setting ◽  
Primary Care Setting ◽  
The Body ◽  
Clinical Test ◽  
Apnea Test ◽  
Second Stage ◽  
Obstructive Sleep

Abstract Background The coordination between different levels of care is essential for the management of obstructive sleep apnea (OSA). The objective of this multicenter project was to develop a screening model for OSA in the primary care setting. Methods Anthropometric data, clinical history, and symptoms of OSA were recorded in randomly selected primary care patients, who also underwent a home sleep apnea test (HSAT). Respiratory polygraphy or polysomnography were performed at the sleep unit to establish definite indication for continuous positive airway pressure (CPAP). By means of cross-validation, a logistic regression model (CPAP yes/no) was designed, and with the clinical variables included in the model, a scoring system was established using the β coefficients (PASHOS Test). In a second stage, results of HSAT were added, and the final accuracy of the model was assessed. Results 194 patients completed the study. The clinical test included the body mass index, neck circumference and observed apneas during sleep (AUC 0.824, 95% CI 0.763–0.886, P < 0.001). In a second stage, the oxygen desaturation index (ODI) of 3% (ODI3% ≥ 15%) from the HSAT was added (AUC 0.911, 95% CI 0.863–0.960, P < 0.001), with a sensitivity of 85.5% (95% CI 74.7–92.1) and specificity of 67.8% (95% CI 55.1–78.3). Conclusions The use of this model would prevent referral to the sleep unit for 55.1% of the patients. The two-stage PASHOS model is a useful and practical screening tool for OSA in primary care for detecting candidates for CPAP treatment. Clinical Trial Registration Registry: ClinicalTrials.gov; Name: PASHOS Project: Advanced Platform for Sleep Apnea Syndrome Assessment; URL: https://clinicaltrials.gov/ct2/show/NCT02591979; Identifier: NCT02591979. Date of registration: October 30, 2015.

scholarly journals 0486 PROCESS IMPROVEMENT INITIATIVE TO INCREASE RECOGNITION OF OBSTRUCTIVE SLEEP APNEA (OSA) IN THE PRIMARY CARE SETTING

SLEEP ◽  
2017 ◽  
Vol 40 (suppl_1) ◽  
pp. A181-A181
Author(s):  
S Alagheband ◽  
P Valestra ◽  
L Quintos ◽  
A Tse ◽  
M Weinstein
Keyword(s):  
Primary Care ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Process Improvement ◽  
Care Setting ◽  
Primary Care Setting ◽  
Obstructive Sleep

scholarly journals Understanding the role of oxidative stress in the incidence of metabolic syndrome and obstructive sleep apnea

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Behnam Kargar ◽  
Zahra Zamanian ◽  
Majid Bagheri Hosseinabadi ◽  
Vahid Gharibi ◽  
Mohammad Sanyar Moradi ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Metabolic Syndrome ◽  
Obstructive Sleep Apnea ◽  
Logistic Regression ◽  
Sleep Apnea ◽  
International Diabetes Federation ◽  
Binary Logistic Regression ◽  
Stress Index ◽  
Obstructive Sleep

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.

Obstructive Sleep Apnea Syndrome Is Associated With Some Components of Metabolic Syndrome

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