scholarly journals [Management of Adult Obstructive Sleep Apnea Syndrome in General Practice: a new model of risk prevention]

2017 ◽  
Vol 11 (1) ◽  
Author(s):  
Carla Bruschelli ◽  
Germano Bettoncelli ◽  
Giorgio Carlo Monti
Keyword(s):  
General Practice ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Treatment Protocol ◽  
Upper Airways ◽  
Obstructive Sleep ◽  
Apnea Syndrome ◽  
Management Of Care

Obstructive Sleep Apnea Syndrome is a condition characterized by paused breathing during sleep due to complete or partial obstruction of the upper airways. It is still underdiagnosed and underestimated, despite its respiratory, cardiovascular, and neurocognitive complications. Polysomnography is the gold standard for diagnosis. The treatment protocol, that has to be agreed with the patient, is behavioral, ventilator, and sometimes surgical.The role of general practitioners is essential for early identification of patients with high probability of OSAS. Physicians are supported by specific instruments of general practice, such as continuity of care, computerized medical records for oriented problems, medical history, and diagnostic-therapeutic methodology for an exclusive management model. Among their duties, there is also the management of care priorities for patients’ comorbidities.

scholarly journals Obstructive sleep apnea syndrome and cognitive impairment: effects of CPAP

2011 ◽  
Vol 2 (4) ◽  
pp. 209
Author(s):  
Alessandra Giordano ◽  
Alessandro Cicolin ◽  
Roberto Mutani
Keyword(s):  
Obstructive Sleep Apnea ◽  
Cognitive Impairment ◽  
Sleep Apnea ◽  
Executive Functions ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Muscular Activity ◽  
Upper Airways ◽  
Obstructive Sleep ◽  
Apnea Syndrome

Obstructive Sleep Apnea Syndrome (OSAS) is a sleep disorder characterised by repetitive episodes of upper airway obstruction (apnea) or reduced airflow (hypopnoea) despite persistent respiratory effort. Apnea is defined as the cessation of breathing for at least 10 seconds during sleep, while hypopnoea is defined as at least 30% reduction in airflow for 10 seconds associated with oxygen desaturation and sleep fragmentation. The presence in the general population is about 4%. The principal symptoms are: excessive daytime sleepiness (EDS), snoring, dry throat, morning headache, night sweats, gastro-esophageal reflux, and increased blood pressure.Long term complications can be: increased cardio-cerebrovascular risk and cognitive impairment such as deficiency in attention, vigilance, visual abilities, thought, speech, perception and short term memory.Continuous Positive Airway Pressure (CPAP) is currently the best non-invasive therapy for OSAS.CPAP guarantees the opening of upper airways using pulmonary reflexive mechanisms increasing lung volume during exhalation and resistance reduction, decreasing electromyografical muscular activity around airways.The causes of cognitive impairments and their possible reversibility after CPAP treatment have been analysed in numerous studies. The findings, albeit controversial, show that memory, attention and executive functions are the most compromised cognitive functions.The necessity of increasing the patient compliance with ventilotherapy is evident, in order to prevent cognitive deterioration and, when possible, rehabilitate the compromised functions, a difficult task for executive functions.

scholarly journals A Pharyngoplasty with a Dorsal Palatal Flap Expansion: The Evaluation of a Modified Surgical Treatment Method for Obstructive Sleep Apnea Syndrome—A Preliminary Report

2021 ◽  
Vol 10 (16) ◽  
pp. 3746
Author(s):  
Ewa Olszewska ◽  
Piotr Fiedorczuk ◽  
Adam Stróżyński ◽  
Agnieszka Polecka ◽  
Ewa Roszkowska ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Oxygen Saturation ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Apnea Hypopnea Index ◽  
Upper Airways ◽  
Sleep Study ◽  
Obstructive Sleep ◽  
Apnea Syndrome

Surgical techniques for obstructive sleep apnea syndrome (OSAS) constantly evolve. This study aims to assess the effectiveness and safety of a new surgical approach for an OSAS pharyngoplasty with a dorsal palatal flap expansion (PDPFEx). A total of 21 participants (mean age 49.9; mean BMI 32.5) underwent a type III sleep study, an endoscopy of the upper airways, a filled medical history, a visual analog scale for snoring loudness, an Epworth Sleepiness Scale, and a Short Form Health Survey-36 questionnaire. A follow-up re-evaluation was performed 11 ± 4.9 months post-operatively. The study group (4 with moderate, 17 with severe OSAS) showed an improvement in all measured sleep study characteristics (p < 0.05), apnea-hypopnea index (pre-median 45.7 to 29.3 post-operatively, p = 0.009, r = 0.394), oxygen desaturation index (pre-median 47.7 and 23.3 post-operatively, p = 0.0005, r = 0.812), mean oxygen saturation (median 92% pre-operatively and median 94% post-operatively, p = 0.0002, r = 0.812), lowest oxygen saturation (p = 0.0001, r = 0.540) and time of sleep spent with blood oxygen saturation less than 90% (p = 0.0001, r = 0.485). The most commonly reported complications were throat dryness (11 patients) and minor difficulties in swallowing (5 patients transient, 3 patients constant). We conclude that a PDPFEx is a promising new surgical method; however, further controlled studies are needed to demonstrate its safety and efficacy for OSAS treatment in adults.

scholarly journals Risk Factors for Obstructive Sleep Apnea Syndrome in Children: State of the Art

2019 ◽  
Vol 16 (18) ◽  
pp. 3235 ◽  
Author(s):  
Giampiero Gulotta ◽  
Giannicola Iannella ◽  
Claudio Vicini ◽  
Antonella Polimeni ◽  
Antonio Greco ◽  
...  
Keyword(s):  
Risk Factors ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
State Of The Art ◽  
Sleep Apnea Syndrome ◽  
Upper Airway Resistance Syndrome ◽  
Upper Airways ◽  
Obstructive Sleep ◽  
Apnea Syndrome

The obstructive sleep apnea syndrome (OSAS) represents only part of a large group of pathologies of variable entity called respiratory sleep disorders (RSD) which include simple snoring and increased upper airway resistance syndrome (UARS). Although the etiopathogenesis of adult OSAS is well known, many aspects of this syndrome in children are still debated. Its prevalence is about 2% in children from 2 to 8 years of age, mostly related to the size of the upper airways adenoid tissue. Several risk factors linked to the development of OSAS are typical of the pediatric age. The object of this paper is to analyze the state of the art on this specific topic, discussing its implications in terms of diagnosis and management.

The aging effect on upper airways collapse of patients with obstructive sleep apnea syndrome

2018 ◽  
Vol 275 (12) ◽  
pp. 2983-2990 ◽  
Author(s):  
Claudio Vicini ◽  
Andrea De Vito ◽  
Giannicola Iannella ◽  
Riccardo Gobbi ◽  
Ruggero Massimo Corso ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Aging Effect ◽  
Upper Airways ◽  
Obstructive Sleep ◽  
Apnea Syndrome

scholarly journals The Therapeutic Means of Obstructive Sleep Apnea Syndrome (OSAS)

2018 ◽  
Vol 15 (1) ◽  
pp. 35-48
Author(s):  
Jeler Elena-Corina
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Work Capacity ◽  
Night Time ◽  
Upper Airways ◽  
Aged People ◽  
Obstructive Sleep ◽  
Apnea Syndrome

AbstractObstructive sleep apnea syndrome (OSAS) is one of the most common conditions that occur during sleep. OSAS involves the existence of at least 5 breathing breaks of at least 10 seconds in a sleeping hour.OSAS etiologic factors are numerous, the most important being the increased body weight of patients (a high percentage of 50% of patients with OSAS with different degrees of obesity), age (OSAS is diagnosed in middle-aged people), craniofacial deformities, multiple pathologies leading to narrowing of the upper airways, gender (is more common in men), genetic causes (more common in black and Hispanic people), alcohol, tobacco, hypnotic and sedative medications.Symptoms of OSAS are characterized by daytime and night-time symptoms. Of the daytime symptoms, patients frequently report headache and morning fatigue, daytime somnolence, memory impairment and concentration. Of the nocturnal symptoms, the most common symptoms experienced by patients are snoring and repeated episodes of apnea. Patients also report nocturia, polakiuria, decreased libido, symptoms that are often attributed to other pathologies. Due to concentration disturbances and low cognitive performance among patients with OSAS, they will experience a decrease in work capacity, which is reflected by the loss of work, reflected by the decrease in the number of working days.OSAS treatment is complex, different depending on the severity of the disease and the existing comorbidities of the patient.

scholarly journals Obstructive sleep apnea syndrome and cognitive impairment: effects of CPAP

2011 ◽  
Vol 2 (4) ◽  
pp. 209-227
Author(s):  
Alessandra Giordano ◽  
Alessandro Cicolin ◽  
Roberto Mutani
Keyword(s):  
Obstructive Sleep Apnea ◽  
Cognitive Impairment ◽  
Sleep Apnea ◽  
Executive Functions ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Muscular Activity ◽  
Upper Airways ◽  
Obstructive Sleep ◽  
Apnea Syndrome

Obstructive Sleep Apnea Syndrome (OSAS) is a sleep disorder characterised by repetitive episodes of upper airway obstruction (apnea) or reduced airflow (hypopnoea) despite persistent respiratory effort. Apnea is defined as the cessation of breathing for at least 10 seconds during sleep, while hypopnoea is defined as at least 30% reduction in airflow for 10 seconds associated with oxygen desaturation and sleep fragmentation. The presence in the general population is about 4%. The principal symptoms are: excessive daytime sleepiness (EDS), snoring, dry throat, morning headache, night sweats, gastro-esophageal reflux, and increased blood pressure.Long term complications can be: increased cardio-cerebrovascular risk and cognitive impairment such as deficiency in attention, vigilance, visual abilities, thought, speech, perception and short term memory.Continuous Positive Airway Pressure (CPAP) is currently the best non-invasive therapy for OSAS.CPAP guarantees the opening of upper airways using pulmonary reflexive mechanisms increasing lung volume during exhalation and resistance reduction, decreasing electromyografical muscular activity around airways.The causes of cognitive impairments and their possible reversibility after CPAP treatment have been analysed in numerous studies. The findings, albeit controversial, show that memory, attention and executive functions are the most compromised cognitive functions.The necessity of increasing the patient compliance with ventilotherapy is evident, in order to prevent cognitive deterioration and, when possible, rehabilitate the compromised functions, a difficult task for executive functions.

scholarly journals The Course of Obstructive Sleep Apnea Syndrome in Patients With Acromegaly During Treatment

2019 ◽  
Vol 105 (1) ◽  
pp. 290-304 ◽  
Author(s):  
Thalijn L C Wolters ◽  
Sean H P P Roerink ◽  
Linda C A Drenthen ◽  
Jolanda H G M van Haren-Willems ◽  
Margaretha A E M Wagenmakers ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Treatment Protocol ◽  
First Year ◽  
Obstructive Sleep ◽  
Treatment Naïve ◽  
Active Acromegaly ◽  
Apnea Syndrome

Abstract Background Obstructive sleep apnea syndrome (OSAS) is common in active acromegaly and negatively influences quality of life, morbidity, and mortality. This prospective study with 3 predetermined timepoints and a standardized treatment protocol investigates changes in sleep parameters during the first 2.5 years of acromegaly treatment. Methods Before initiation of acromegaly treatment (medical pretreatment followed by surgery), polysomnography (PSG) was performed in 27 consecutive patients with treatment-naive acromegaly. PSG was repeated after 1 year (N = 24) and 2.5 years (N = 23), and anthropometric and biochemical parameters were obtained. Results At baseline, 74.1% of the patients was diagnosed with OSAS. The respiratory disturbance index (RDI; P = 0.001), oxygen desaturation index (ODI; P = 0.001), lowest oxygen saturation (LSaO2; P = 0.007) and the Epworth Sleepiness Scale (ESS; P &lt; 0.001) improved significantly during treatment, with the greatest improvement in the first year. After 2.5 years of treatment, all patients had controlled acromegaly. Of the 16 patients with repeated PSG and OSAS at baseline, 11 (68.8%) were cured of OSAS. Changes in RDI, ODI, LSaO2, and ESS correlated with insulin-like growth factor 1 levels. Conclusion OSAS has a high prevalence in active acromegaly. There is a substantial decrease in prevalence and severity of OSAS following acromegaly treatment, with the largest improvement during the first year. Most patients recover from OSAS following surgical or biochemical control of the acromegaly. Therefore, a PSG is advised after diagnosis of acromegaly. When OSAS is present, it should be treated and PSG should be repeated during acromegaly treatment.

Anatomic Abnormalities in Obstructive Sleep Apnea

1982 ◽  
Vol 91 (6) ◽  
pp. 595-596 ◽  
Author(s):  
Dale Wilms ◽  
John Popovich ◽  
Shiro Fujita ◽  
William Conway ◽  
Frank Zorick
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Airway Compromise ◽  
Muscular Hypotonia ◽  
Upper Airways ◽  
Airway Narrowing ◽  
Obstructive Sleep ◽  
Apnea Syndrome

Both muscular hypotonia and anatomic abnormalities have been implicated in the pathogenesis of the obstructive sleep apnea syndrome (OSAS). The upper airways of 25 patients with OSAS were evaluated to determine potential sites of obstruction. Significant airway compromise was found in all patients with some patients having multiple sites of airway narrowing.

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