Effect of Sleep Position and Body Mass Index on Severity of Sleep Apnea

Purpose: This work reports the association of obstructive sleep apnea (OSA) and cotton-wool spots (CWS) seen in patients with nonproliferative diabetic retinopathy (DR). Methods: A random sample of patients diagnosed with DR between January 1, 2015 and December 31, 2018, were selected from medical-billing codes. Dilated funduscopic examination findings and medical history were analyzed by reviewing medical records. Results: CWS were present in 12 of 118 patients without OSA, compared with 11 of 32 patients with OSA (10.2% vs 34.4%, respectively; P = .002). OSA was more common in men (68.8%, P = .03) and associated with a higher body mass index (30.0 ± 5.0 without OSA vs 33.6 ± 5.5 with OSA, P < .001). When comparing those with and without OSA, there was no association with age; glycated hemoglobin A1c; stage of DR; insulin dependence; presence of diabetic macular edema; smoking status; or a history of hypertension, hyperlipidemia, cardiovascular disease, or other breathing disorder. Conclusions: The presence of OSA is associated with CWS in patients with DR, as well as male sex and a higher body mass index. Further research is needed to determine the ophthalmologist’s role in the timely referral of patients with CWS for OSA evaluation.

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Rapid Risk Stratification for Obstructive Sleep Apnea, Based on Snoring Severity and Body Mass Index

Otolaryngology ◽

10.1016/j.otohns.2008.08.026 ◽

2008 ◽

Vol 139 (5) ◽

pp. 615-618 ◽

Cited By ~ 12

Author(s):

Luc G.T. Morris ◽

Andrew Kleinberger ◽

Kelvin C. Lee ◽

Lisa A. Liberatore ◽

Omar Burschtin

Keyword(s):

Body Mass Index ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Risk Stratification ◽

Body Mass ◽

Obstructive Sleep

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Obstructive Sleep Apnea Increases the Risk of Cardiopulmonary Adverse Events Associated with Ambulatory Colonoscopy Independent of Body Mass Index

Digestive Diseases and Sciences ◽

10.1007/s10620-017-4731-7 ◽

2017 ◽

Vol 62 (10) ◽

pp. 2834-2839

Author(s):

Vaishali A. Patel ◽

Paul St. Romain ◽

Juan Sanchez ◽

Deborah A. Fisher ◽

Ryan D. Schulteis

Keyword(s):

Body Mass Index ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Adverse Events ◽

Body Mass ◽

Obstructive Sleep

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P078 Oral Appliance Fabrication Settings Impact Treatment Efficacy

SLEEP Advances ◽

10.1093/sleepadvances/zpab014.122 ◽

2021 ◽

Vol 2 (Supplement_1) ◽

pp. A46-A46

Author(s):

D Levendowski ◽

E Sall ◽

W Odom ◽

B Beine ◽

D Cruz Arista ◽

...

Keyword(s):

Body Mass Index ◽

Sleep Apnea ◽

Treatment Outcomes ◽

Body Mass ◽

Treatment Efficacy ◽

Oral Appliance ◽

Chi Squared ◽

Pre Treatment ◽

The Impact

Abstract Purpose Assess the impact of custom oral appliance (CA) fabrication settings on treatment outcomes. Methods CPAP-intolerant patients completed a two-night home-sleep-apnea study (HSAT); Night1=baseline, Night2=Apnea Guard® trial appliance (AG). The AG vertical-dimension-of-occlusion (VDO) selection was based on tongue-scallop (women=5.5/6.5 mm, men= 6.5/8.0 mm), with a target protrusion of 70% from neutral-maximum while in situ. Study1 CA VDO was dependent on sex (women=2.5 mm, men=5 mm), with protrusion set using a George-Gauge measured 70% from maximum retrusion-protrusion with dentist-directed titration. Study2 CA was fabricated to the AG VDO and target protrusion bite-registration. Efficacy HSATs were conducted after completion of Study1 CA titration with vertical-elastics optional, and at the AG target protrusion with vertical-elastics mandatory in Study2. Statistics included Mann-Whitney, Chi-squared, and Bland-Altman analyses. Results The Study1 (n=84) and Study2 (n=46) distributions were equivalent for tongue-scallop (64/63%) and sex (women=45/41%), however, noted differences in age (53.8±11.9 vs. 58.4±12.2; P=0.052), body-mass-index (29.4±5.7 vs. 27.8±4.0; P=0.128) and pre-treatment AHI severities (24.6±14.4 vs. 29.2±17.4 events/h; P=0.155) were observed. The Bland-Altman biases were significant different (Study1=4.2±7.8 vs. Study2=1.3±7.0 events/h, P=0.035). The significant Study1 differences between the CA vs. AG AHIs (12.3±9.2 vs. 8.2±5.9 events/h, P<0.0002) were not apparent in Study2 (11.7±8.0 vs. 10.4±6.7 events/h, P=0.362), however, the Study2 AG AHI values were higher (P=0.055). Discussion Despite the trend toward greater Study2 pre-treatment and AG AHI severities, CA treatment efficacy was equivalent to the AG once VMO was controlled and fabricated using the AG VDO and protrusion bite-registration. These findings confirmed CA fabrication settings impact treatment outcomes.

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