scholarly journals Impact of Insomnia in the Elderly: The Correlation between Snoring and Apnea/Hypopnea Index

2021 ◽  
Author(s):  
Bing Tang
Keyword(s):  
Sleep Apnea ◽  
Sleep Disturbance ◽  
Case Series ◽  
Chronic Obstructive Lung Disease ◽  
Neural Model ◽  
The Elderly ◽  
Community Dwelling ◽  
Apnea Hypopnea Index ◽  
Chronic Obstructive ◽  
The Relationship

The purpose of this study was to examine the relationship between snoring and obstructive sleep apnea/hypopnea index in community dwelling older men and women. In this retrospective case-series study, the author was using a sequential collection of clinical datum design. There were 124 community-dwelling elders (mean age=71.85 years, Standard Deviation=4.85 years) with complaints of sleep disturbance. Including 46 females (F: M= 1:1.71), all the total subjects with sleep disturbance, after meeting the following criteria of exclusion: age below 65 years, heart failure, and chronic obstructive lung disease, were admitted to the sleep medicine laboratory where sleep questionnaire was used. They underwent in laboratory over-night polysomnography (PSG). The period of this study was 13 months; the total number of subjects whom took PSG in this Sleep Center Laboratory was 1,087 individuals during this period. The proposed neural model used is a generalized regression neural network (GRNN). This neural model has some advantages such as cost and time efficiencies in relation to experimental measurements. The training speed of the proposed technique is faster and the network architecture is simpler. In all likelihood, this model can be used in clinical applications that can reduce the necessity of in-laboratory nocturnal sleep studies since it has surpassed current classification approaches in terms of accuracy, simplicity, cost, time efficiency, and generalization. The correlation between snoring and AH1 was evaluated, though there was no measurement of vasopressin-positive and vasoactive-intestinal-polypeptide (AVP) neurons in postmortem examination of suprachiasmatic nucleus (SCN), as there was no death case. To the contrary, focus was set on the analysis of sleep disturbances that could be interpreted as the result of altered SCN function. The relationship between Snoring and AHI for the elderly with regard to its clue and impact on INSOMNIA is presented. The relationship between clinical sleep apnea and the physiological events surrounding the octogenarians was assessed. Clinically no indication for any brain tissue biopsy.

scholarly journals Differences between the Sexes in the Relationship between Chronic Pain, Fatigue, and QuickDASH among Community-Dwelling Elderly People in Japan

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 630
Author(s):  
Satoshi Shimo ◽  
Yuta Sakamoto ◽  
Takashi Amari ◽  
Masaaki Chino ◽  
Rie Sakamoto ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Elderly People ◽  
Physical Disability ◽  
The Elderly ◽  
Daily Basis ◽  
Community Dwelling ◽  
Negative Effects ◽  
The Relationship ◽  
Elderly Healthcare ◽  
Disability Research

Chronic pain and fatigue have negative effects on the health, ADL, work, and hobbies of the elderly. As the proportion of people 65 years of age and older in the population increases, chronic pain and disability research regarding this group is receiving more consideration. However, little empirical evidence of the association between chronic pain, fatigue, and physical disability between the sexes is available. This study investigated the association between chronic pain, fatigue, and instrumental activities of daily living among community-dwelling elderly people by sex in Japan. Concerning the presence of chronic pain, 61% of males and 78% of females reported chronic pain, indicating that many elderly people living in the community suffer from chronic pain and fatigue on a daily basis. The number of sites of chronic pain was higher in females than in males (p = 0.016), with more chronic pain in the knees (p < 0.001) and upper arms (p = 0.014). Regarding chronic pain, males showed a higher correlation with QuickDASH-DS (rs = 0.433, p = 0.017) and QuickDASH-SM (rs = 0.643, p = 0.018) than females. Furthermore, fatigue also showed a higher correlation with QuickDASH-W (rs = 0.531, p = 0.003) in males than in females. These results indicate that the association between chronic pain, fatigue, and QuickDASH differed between the sexes among community-dwelling elderly people in Japan. A better understanding of the risk factors for elderly chronic pain and fatigue among sexes will facilitate the development of elderly healthcare welfare and policies.

scholarly journals Snoring: a source of noise pollution and sleep apnea predictor

SLEEP ◽  
2019 ◽  
Vol 43 (6) ◽  
Author(s):  
Mudiaga Sowho ◽  
Francis Sgambati ◽  
Michelle Guzman ◽  
Hartmut Schneider ◽  
Alan Schwartz
Keyword(s):  
Sleep Apnea ◽  
Operating Characteristic ◽  
Area Under The Curve ◽  
Noise Pollution ◽  
Apnea Hypopnea Index ◽  
Sleep Study ◽  
Sound Levels ◽  
Obstructive Sleep ◽  
Single Night ◽  
The Relationship

Abstract Snoring is a highly prevalent condition associated with obstructive sleep apnea (OSA) and sleep disturbance in bed partners. Objective measurements of snoring in the community, however, are limited. The present study was designed to measure sound levels produced by self-reported habitual snorers in a single night. Snorers were excluded if they reported nocturnal gasping or had severe obesity (BMI &gt; 35 kg/m2). Sound was measured by a monitor mounted 65 cm over the head of the bed on an overnight sleep study. Snoring was defined as sound ≥40 dB(A) during flow limited inspirations. The apnea hypopnea index (AHI) and breath-by-breath peak decibel levels were measured. Snore breaths were tallied to determine the frequency and intensity of snoring. Regression models were used to determine the relationship between objective measures of snoring and OSA (AHI ≥ 5 events/h). The area under the curve (AUC) for the receiver operating characteristic (ROC) was used to predict OSA. Snoring intensity exceeded 45 dB(A) in 66% of the 162 participants studied, with 14% surpassing the 53 dB(A) threshold for noise pollution. Snoring intensity and frequency were independent predictors of OSA. AUCs for snoring intensity and frequency were 77% and 81%, respectively, and increased to 87% and 89%, respectively, with the addition of age and sex as predictors. Snoring represents a source of noise pollution in the bedroom and constitutes an important target for mitigating sound and its adverse effects on bed partners. Precise breath-by-breath identification and quantification of snoring also offers a way to risk stratify otherwise healthy snorers for OSA.

scholarly journals Relationship Between Occlusal Force and Endothelial Function in Community-Dwelling Elderly

2020 ◽  
Author(s):  
Kanna Kato ◽  
Naoko Matsuda ◽  
Miki Takahata ◽  
Chika Koseki ◽  
Michiyasu Yamaki ◽  
...  
Keyword(s):  
Life Expectancy ◽  
Endothelial Function ◽  
Grip Strength ◽  
General Condition ◽  
Force Measurement ◽  
The Elderly ◽  
Community Dwelling ◽  
Healthy Life ◽  
Occlusal Force ◽  
The Relationship

Abstract Background: Prolonged healthy life expectancy, which is duration without the requirement of any kind of help for activities of daily living (ADL), is essential to ensure a long life with a good quality of living in the community. Further, local residents should understand their health conditions and live consciously to prolong healthy life expectancy. The development of a simple general health indicator is necessary. Both occlusal force and flow-medicated dilation (FMD) which reflects endothelial function are useful tools for understanding the general condition of the elderly. However, few studies have investigated the relationship between occlusal force and endothelial function. In the present study we examined this relationship, occlusal force measurement can be a good indicator of the general condition of the elderly. Methods: In 38 community-dwelling women(aged 76.7 ±5.7 years), we measured occlusal force,　grip strength, endothelial function evaluated by FMD, advanced glycation end products (AGEs). In this study we investigate we investigated the relationship between occlusal force, measurement items, and factors independently related to endothelial dysfunction (FMD<7％). Results: There were significantly correlation between occlusal force and grip strength (r=0.54, p<0.01). Degree of FMD significantly associated with occlusal force (r=0.60, p<0.01) and grip strength (r=0.35, p<0.05) or amount of increased AGEs (r=-0.37, p<0.05). Occlusal force was independently associated with degree of FMD after adjusting for age, AGEs, and grip strength (p < 0.05).Conclusion: There was a significant relationship between occlusal force and FMD. Occlusal force can be an important indicator of endothelial function in community-dwelling elderly. This study may help understanding general health of elderly in community.

scholarly journals Multilevel Sleep Surgery Including the Palate in Nonsyndromic, Neurologically Intact Children with Obstructive Sleep Apnea

OTO Open ◽  
2019 ◽  
Vol 3 (2) ◽  
pp. 2473974X1985147
Author(s):  
Jason E. Cohn ◽  
George E. Relyea ◽  
Srihari Daggumati ◽  
Brian J. McKinnon
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Tertiary Care ◽  
Case Series ◽  
T Test ◽  
Velopharyngeal Insufficiency ◽  
Apnea Hypopnea Index ◽  
Sleep Surgery ◽  
Obstructive Sleep ◽  
Neurologically Intact

Objective To examine the effects of multilevel sleep surgery, including palate procedures, on obstructive sleep apnea parameters in the pediatric population. Study Design A case series with chart review was conducted to identify nonsyndromic, neurologically intact pediatric patients who underwent either uvulectomy or uvulopalatopharyngoplasty as part of multilevel sleep surgery from 2011 through 2017. Setting A tertiary care, university children’s hospital. Subjects and Methods Unpaired Student t test was used to compare average pre- and postsurgical apnea-hypopnea index (AHI) and oxygen saturation nadir (OSN). Paired Student t test was used to compare the mean pre- and postsurgical AHI and OSN within the same patient for the effects of adenotonsillectomy (T&A) vs multilevel sleep surgery. Results In patients who underwent T&A previously, multilevel sleep surgery, including palate procedures, resulted in improved OSA severity in 6 (86%) patients and worsened OSA in 1 (14%) patient. Multilevel sleep surgery, including palate procedures, significantly decreased mean AHI from 37.98 events/h preoperatively to 8.91 events/h postoperatively ( P = .005). However, it did not significantly decrease OSN. Conclusion This study includes one of the largest populations of children in whom palate procedures as a part of multilevel sleep surgery have been performed safely with no major complications and a low rate of velopharyngeal insufficiency. Therefore, palatal surgery as a part of multilevel sleep surgery is not necessarily the pariah that we have traditional thought it is in pediatric otolaryngology.

scholarly journals Relationship between Drug-Induced Sleep Endoscopy Findings, Tonsil Size, and Polysomnographic Outcomes of Adenotonsillectomy in Children

2019 ◽  
Vol 161 (3) ◽  
pp. 507-513 ◽  
Author(s):  
Derek J. Lam ◽  
Natalie A. Krane ◽  
Ron B. Mitchell
Keyword(s):  
Rating Scale ◽  
Tertiary Care ◽  
Case Series ◽  
Apnea Hypopnea Index ◽  
Strongly Correlated ◽  
Sleep Endoscopy ◽  
Retrospective Case ◽  
Drug Induced ◽  
Failure Assessment ◽  
The Relationship

Objective (1) Determine the correlation of awake tonsil scores and preadenotonsillectomy (pre-AT) sleep endoscopy findings. (2) Assess the relationship between polysomnographic AT outcomes with awake tonsil scores and sleep endoscopy ratings of tonsil and adenoid obstruction. Study Design Retrospective case series with chart review. Setting Tertiary care children’s hospital. Subjects and Methods Children aged 1 to 18 years who underwent sleep endoscopy and AT from January 1, 2013, to August 30, 2016, were included. Pre-AT sleep endoscopy findings were scored with the Sleep Endoscopy Rating Scale. Awake tonsil scores and sleep endoscopy ratings were compared with Spearman correlation. Associations between changes in pre- and post-AT polysomnography parameters and (1) awake tonsil scoring and (2) sleep endoscopy scoring were assessed with 1-way analysis of variance and linear regression. Results Participants included 36 children (mean ± SD age, 6.8 ± 4.3 years; 68% male, 44% obese). Awake tonsil scores and sleep endoscopy ratings were strongly correlated ( R = 0.58, P = .003). Awake tonsil scores were not associated with changes in any polysomnography parameters after AT (all P > .05), while sleep endoscopy ratings of adenotonsillar obstruction were significantly associated (all P < .05, R2 = 0.16-0.35). Patients with minimal adenotonsillar obstruction during sleep endoscopy had less improvement than those with partial or complete obstruction (mean obstructive apnea-hypopnea index change: −8.2 ± 11.5 vs −15.9 ± 14.3, and −46.8 ± 31.3, respectively; P < .001). Conclusions In children at risk for AT failure, assessment of dynamic collapse with sleep endoscopy may better predict the outcome of AT than awake tonsil size assessment, thus helping to inform surgical expectations.

Periodontitis Is Associated with Chronic Obstructive Pulmonary Disease

2019 ◽  
Vol 98 (5) ◽  
pp. 534-540 ◽  
Author(s):  
K. Takeuchi ◽  
K. Matsumoto ◽  
M. Furuta ◽  
S. Fukuyama ◽  
T. Takeshita ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Population Attributable Fraction ◽  
Community Dwelling ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Increased Risk ◽  
Severe Periodontitis ◽  
The Relationship

Although they are known to share pathophysiological processes, the relationship between periodontitis and chronic obstructive pulmonary disease (COPD) is not fully understood. The aim of the present study was to test the hypothesis that periodontitis is associated with a greater risk of development of COPD, when smoking is taken into account. The analysis in a 5-y follow-up population-based cohort study was based on 900 community-dwelling Japanese adults (age: 68.8 ± 6.3 [mean ± SD], 46.0% male) without COPD aged 60 or older with at least 1 tooth. Participants were classified into 3 categories according to baseline periodontitis severity (no/mild, moderate, and severe). COPD was spirometrically determined by a fixed ratio of <0.7 for forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) and by FEV1/FVC below the lower limit of normal. Poisson regression was used to calculate the relative risk (RR) of developing COPD according to the severity of periodontitis. The population attributable fraction (PAF) was also calculated. During follow-up, 22 (2.4%) subjects developed COPD. Compared with no/mild periodontitis subjects, a significantly increased risk of COPD occurred among severe periodontitis subjects (RR = 3.55; 95% confidence interval [CI], 1.18 to 10.67), but no significant differences were observed between the no/mild and moderate categories (RR = 1.48; 95% CI, 0.56 to 3.90). After adjustment for potential confounders, including smoking intensity, the relationship between severe periodontitis and risk of COPD remained significant (RR = 3.51; 95% CI, 1.15 to 10.74). Likewise, there was a positive association of periodontitis severity with risk of COPD ( P for trend = 0.043). The PAF for COPD due to periodontitis was 22.6%. These data highlight the potential importance of periodontitis as a risk factor for COPD.

Polysomnography Outcomes after Supraglottoplasty in Children with Obstructive Sleep Apnea

2019 ◽  
Vol 161 (4) ◽  
pp. 694-698 ◽  
Author(s):  
Bharat Bhushan ◽  
James W. Schroeder ◽  
Kathleen R. Billings ◽  
Nicholas Giancola ◽  
Dana M. Thompson
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Tertiary Care ◽  
Case Series ◽  
Apnea Hypopnea Index ◽  
Historical Cohort ◽  
Tertiary Care Medical Center ◽  
Obstructive Sleep ◽  
The Mean ◽  
The Impact

ObjectiveLaryngomalacia has been reported to contribute to the severity of obstructive sleep apnea (OSA) in children. It is unclear if surgical treatment of laryngomalacia improves polysomnography (PSG) outcomes in these patients. The objective of this study is to report the impact of supraglottoplasty on PSG parameters in children with laryngomalacia-related OSA.Study DesignRetrospective case series.SettingTertiary care medical center.Subjects and MethodsHistorical cohort study of consecutive children with laryngomalacia who underwent supraglottoplasty and who had undergone overnight PSG before and after surgery.ResultsForty-one patients were included in the final analysis: 22 (53.6%) were male, and 19 (46.3%) were female. The mean ± SEM age of patients at preoperative PSG was 1.3 ± 0.89 years (range, 0.003-2.9). In entire cohort, the mean obstructive apnea-hypopnea index score was reduced from 26.6 events/h before supraglottoplasty to 7.3 events/h after surgery ( P = .003). Respiratory disturbance index was reduced from 27.3 events/h before supraglottoplasty to 7.8 events/h after surgery ( P = .003). The percentage of REM sleep decreased from 30.1% ± 2.4 to 24.8% ± 1.3 ( P = .04). Sleep efficiency was improved ( P = .05).ConclusionOverall, supraglottoplasty significantly improved several PSG outcomes in children with laryngomalacia. However, mild to moderate OSA was still present postoperatively in most children. This suggested a multifactorial cause for OSA in this population.

scholarly journals Relationship between Maximum Tongue Pressure Value and Age, Occlusal Status, or Body Mass Index among the Community-Dwelling Elderly

Medicina ◽  
2020 ◽  
Vol 56 (11) ◽  
pp. 623
Author(s):  
Hiroki Suzuki ◽  
Yasunori Ayukawa ◽  
Yoko Ueno ◽  
Ikiru Atsuta ◽  
Akio Jinnouchi ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
The Elderly ◽  
Community Dwelling ◽  
Tongue Pressure ◽  
Term Care ◽  
Younger Age ◽  
The Difference ◽  
The Relationship

Background and objectives: In an aging society, the maintenance of the oral function of the elderly is of importance for the delay or prevention of frailty and long-term care. In the present study, we focused on the maximum tongue pressure (MTP) value and analyzed the relationship between MTP and age, occlusal status, or body mass index (BMI). Materials and Methods: This one-center observatory study was conducted using a cohort consisting of 205 community-dwelling outpatients over 65 years old. The MTP values of all subjects were measured using a commercially available tongue pressure measurement device and statistically analyzed. In addition, the correlation between MTP value and BMI was analyzed. Results: The MTP value decreased with age, especially in subjects classified as Eichner B and C. The difference in occlusal status did not show any statistically significant influence on MTP value. The correlation between BMI and MTP value was indicated in the tested groups other than an age of 65–74 and Eichner A groups. Conclusions: Although MTP value decreased with age, the difference in occlusal status did not have an impact on MTP value. The correlation between BMI and MTP value was not shown in the youngest group or a group with sufficient occlusal units. The results presented in the present study may imply that, even if MTP is low, younger age and/or better occlusal status compensate for the inferior MTP value in the cohort studied.

scholarly journals Examination of Pulse Oximetry Tracings to Detect Obstructive Sleep Apnea in Patients with Advanced Chronic Obstructive Pulmonary Disease

2014 ◽  
Vol 21 (3) ◽  
pp. 171-175 ◽  
Author(s):  
Adrienne S Scott ◽  
Marcel A Baltzan ◽  
Norman Wolkove
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Pulse Oximetry ◽  
Pulmonary Disease ◽  
Time Scale ◽  
Apnea Hypopnea Index ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Obstructive Sleep

Nocturnal hypoxemia and obstructive sleep apnea (OSA) are common comorbidities in patients with chronic obstructive pulmonary disease (COPD). The authors sought to develop a strategy to interpret nocturnal pulse oximetry and assess its capacity for detection of OSA in patients with stage 3 to stage 4 COPD. A review of consecutive patients with COPD who were clinically prescribed oximetry and polysomnography was conducted. OSA was diagnosed if the polysomnographic apnea-hypopnea index was >15 events/h. Comprehensive criteria were developed for interpretation of pulse oximetry tracings through iterative validation and interscorer concordance of ≥80%. Criteria consisted of visually identified desaturation ‘events’ (sustained desaturation ≥4%, 1 h time scale), ‘patterns’ (≥3 similar desaturation/saturation cycles, 15 min time scale) and the automated oxygen desaturation index. The area under the curve (AUC), sensitivity, specificity and accuracy were calculated. Of 59 patients (27 male), 31 had OSA (53%). The mean forced expiratory volume in 1 s was 46% of predicted (range 21% to 74% of predicted) and 52% of patients were on long-term oxygen therapy. Among 59 patients, 35 were correctly identified as having OSA or not having OSA, corresponding to an accuracy of 59%, with a sensitivity and specificity of 59% and 60%, respectively. The AUC was 0.57 (95% CI 0.55 to 0.59). Using software-computed desaturation events (hypoxemia ≥4% for ≥10 s) indexed at ≥15 events/h of sleep as diagnostic criteria, sensitivity was 60%, specificity was 63% and the AUC was 0.64 (95%CI 0.62 to 0.66). No single criterion demonstrated important diagnostic utility. Pulse oximetry tracing interpretation had a modest diagnostic value in identifying OSA in patients with moderate to severe COPD.

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