OSA: Special suspected in spontaneous cerebrospinal fluid leakage

Objectives: Loss of Cerebrospinal Fluid (CSF-L) results from a rupture of the skull base and overlying meninges, and pathological communication between the subarachnoid space and the nasal or middle ear cavity. Recently, the pathogenesis has been linked with Intracranial Hypertension (IIH), elevated Body Mass Index (BMI) and Obstructive Sleep Apnea (OSA). Methods: A single institution retrospective study was conducted on 14 patients from our spontaneous CSFL series, which included 167 patients over a 15-year period from 2004 to 2019. All patients underwent to home respiratory polygraphy. Epidemiological and clinical data were reviewed. For the statistical analysis, the confidence interval for a proportion was defined, according to the methods described by RG Newcombe. Results: 14 patients, previously operated on duraplasty in our ENT department, were enrolled. They underwent to polygraphy. The data were compared with those derived from the literature and the results are neither in the range of the general population nor in the non-spontaneous CSFL Conclusion: OSA can increase Intracranial Pressure (ICP) and thus spontaneous CSF losses. However, OSA and BMI may not be independent. Therefore, further studies are needed to analyze the data in detail.

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Upper Airway Stimulation in Patients With Obstructive Sleep Apnea and an Elevated Body Mass Index: A Multi-institutional Review

The Laryngoscope ◽

10.1002/lary.27426 ◽

2018 ◽

Vol 128 (10) ◽

pp. 2425-2428 ◽

Cited By ~ 12

Author(s):

Colin Huntley ◽

Armin Steffen ◽

Karl Doghramji ◽

Benedikt Hofauer ◽

Clemens Heiser ◽

...

Keyword(s):

Body Mass Index ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Body Mass ◽

Upper Airway ◽

Upper Airway Stimulation ◽

Elevated Body Mass Index ◽

Institutional Review ◽

Obstructive Sleep

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Correlation between body mass index and obstructive sleep apnea severity indexes — A retrospective study

American Journal of Otolaryngology ◽

10.1016/j.amjoto.2018.03.026 ◽

2018 ◽

Vol 39 (4) ◽

pp. 388-391 ◽

Cited By ~ 9

Author(s):

Domenico Ciavarella ◽

Michele Tepedino ◽

Claudio Chimenti ◽

Giuseppe Troiano ◽

Manuela Mazzotta ◽

...

Keyword(s):

Body Mass Index ◽

Obstructive Sleep Apnea ◽

Retrospective Study ◽

Sleep Apnea ◽

Body Mass ◽

Obstructive Sleep Apnea Severity ◽

Obstructive Sleep ◽

Severity Indexes

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Association between body mass index and effectiveness of continuous positive airway pressure in patients with obstructive sleep apnea: a retrospective study

Sleep And Breathing ◽

10.1007/s11325-019-01960-x ◽

2019 ◽

Vol 24 (3) ◽

pp. 1075-1081

Author(s):

Xinmei Huang ◽

Liyan Bao ◽

Xuxia Tang ◽

Jun Shen ◽

Xupei Ni ◽

...

Keyword(s):

Body Mass Index ◽

Obstructive Sleep Apnea ◽

Retrospective Study ◽

Sleep Apnea ◽

Continuous Positive Airway Pressure ◽

Body Mass ◽

Airway Pressure ◽

Positive Airway Pressure ◽

Obstructive Sleep

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Validity and Cost-Effectiveness of Pediatric Home Respiratory Polygraphy for the Diagnosis of Obstructive Sleep Apnea in Children: Rationale, Study Design, and Methodology

Methods and Protocols ◽

10.3390/mps4010009 ◽

2021 ◽

Vol 4 (1) ◽

pp. 9

Author(s):

Esther Oceja ◽

Paula Rodríguez ◽

María Jurado ◽

Maria Luz Alonso ◽

Genoveva del Río ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Cost Effectiveness ◽

Sleep Apnea ◽

Therapeutic Interventions ◽

Diagnostic Process ◽

Urine Biomarkers ◽

Obstructive Sleep ◽

Respiratory Polygraphy ◽

The Cost ◽

The Impact

Obstructive sleep apnea (OSA) in children is a prevalent, albeit largely undiagnosed disease associated with a large spectrum of morbidities. Overnight in-lab polysomnography remains the gold standard diagnostic approach, but is time-consuming, inconvenient, and expensive, and not readily available in many places. Simplified Home Respiratory Polygraphy (HRP) approaches have been proposed to reduce costs and facilitate the diagnostic process. However, evidence supporting the validity of HRP is still scarce, hampering its implementation in routine clinical use. The objectives were: Primary; to establish the diagnostic and therapeutic decision validity of a simplified HRP approach compared to PSG among children at risk of OSA. Secondary: (a) Analyze the cost-effectiveness of the HRP versus in-lab PSG in evaluation and treatment of pediatric OSA; (b) Evaluate the impact of therapeutic interventions based on HRP versus PSG findings six months after treatment using sleep and health parameters and quality of life instruments; (c) Discovery and validity of the urine biomarkers to establish the diagnosis of OSA and changes after treatment.

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P.5 Association of body fluid distribution with obstructive sleep apnea in pregnant women with body mass index ⩾ 40 kg/m2: A prospective observational pilot study

International Journal of Obstetric Anesthesia ◽

10.1016/j.ijoa.2021.103003 ◽

2021 ◽

Vol 46 ◽

pp. 103003

Author(s):

J. Wicker ◽

C.V. Maxwell ◽

K. Downey ◽

M. Singh ◽

M. Balki

Keyword(s):

Body Mass Index ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Pilot Study ◽

Pregnant Women ◽

Body Mass ◽

Body Fluid ◽

Fluid Distribution ◽

Obstructive Sleep

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The Association Between Obstructive Sleep Apnea and Cotton-Wool Spots in Nonproliferative Diabetic Retinopathy

Journal of VitreoRetinal Diseases ◽

10.1177/2474126421989576 ◽

2021 ◽

pp. 247412642198957

Author(s):

Halward M.J. Blegen ◽

Grant A. Justin ◽

Bradley A. Bishop ◽

Anthony R. Cox ◽

James K. Aden ◽

...

Keyword(s):

Body Mass Index ◽

Obstructive Sleep Apnea ◽

Diabetic Retinopathy ◽

Sleep Apnea ◽

Body Mass ◽

Smoking Status ◽

Cotton Wool ◽

Nonproliferative Diabetic Retinopathy ◽

Cotton Wool Spots ◽

Obstructive Sleep

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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