Prevalence of Obstructive Sleep Apnea Syndrome: A Single-Center Retrospective Study

Obstructive sleep apnea syndrome (OSAS) is a sleep breathing disorder that often remains undiagnosed and untreated. OSAS prevalence is increasing exponentially. Starting on the dentist’s role as an epidemiological and diagnostic “sentinel”, the purpose of this study was to assess the prevalence of OSAS. The clinical diaries of 4659 patients were reviewed through a single-center retrospective analytic study. Descriptive statistical analysis was performed. Only 0.26% of patients reported to suffer from sleep apnea and were then diagnosed with OSAS. It was found that, out of 4487 patients, 678 suffered from hypertension (14.80%), 188 from gastro-esophageal-reflux-disease (GERD = 4.10%) and 484 from gastritis (10.78%). These results could be related to a difficult diagnosis of OSAS and to the absence of a dedicated section on sleep disorders in medical records. Therefore, the introduction of a question dedicated to sleep disorders, the administration of questionnaires (such as the STOP-BANG questionnaire) for early diagnosis, a multidisciplinary approach and pneumological examination could support the dentist in identifying patients at risk of OSAS.

An Overnight Rhythmic Sleep-Wake Pattern in Stroke and Obstructive Sleep Apnea: A Case Report and Literature Review

Background and Objective: Obstructive sleep apnea (OSA) is a common sleep breathing disorder and a comorbid condition in patients with stroke. The prevalence of sleep disorders as a stroke consequence is high. Being independent of vascular risk factors, OSA is associated with increased risk of ischemic stroke. Here, we report a patient with OSA and stroke. Case Report: This case report presents a patient with a history of stroke and hemiparesis who underwent polysomnog-raphy (PSG) for evaluating OSA because of snoring, witnessed apnea, and excessive daytime sleepiness (EDS). Then the subject underwent continuous positive airway pressure (CPAP) titration for treating OSA. In first night of PSG, there was a repetitive cyclic pattern of sleep and arousals. After CPAP titration study and with CPAP pressure of 15 cmH2o, OSA and rhythmic changes of electroencephalography (EEG) were resolved. Conclusion: OSA as a risk factor for stroke can be associated with PSG cyclic wake-sleep pattern in these patients, and this pattern can be resolved by CPAP therapy.

0716 The Clinical Characteristics And Therapeutic Efficacy Of Catathrenia

Introduction Catathrenia/nocturnal groaning, is a rare sleep disorder characterized by repeated groaning in a protracted expiration preceded by a deep inspiration. The classification was moved from ICSD-2 as parasomnia to sleep-disordered breathing(SDB) in ICSD-3. The pathogenesis of catathrenia is unknown. Methods To investigate catathrenia’s response to continuous positive airway pressure (CPAP) treatment, and its relationship with SDB. We analyzed patients diagnosed at the Sleep Center of Peking University People’s Hospital from 2009 to 2016. All patients were confirmed with nocturnal groaning by polysomnography(PSG), and recording of the sounds. The patients were recommended for treatment of CPAP. Results A total of 49 patients were recruited into this study, including 31 female and 18 male, age ranging from 16 to 64 years. The average onset age was 19.81 ± 8.65 years old, the average BMI was 21.76 ± 2.62 kg/m², the average groaning index (GI) was 11.58 ± 13.32 times per hour, and the average apnea hypopnea index (AHI) was 3.59 ± 8.83 times per hour. The GI in REM and NREM sleep were 39.31 ± 44.39 and 6.74 ± 8.5 times per hour respectively (p <0.01). The GI of 26 patients who received CPAP treatment decreased from 10.57 ± 12.01 to 5.65 ± 7.10 times per hour (p <0.001). Conclusion Catathrenia occurs mainly in REM sleep, and treatment with CPAP is effective, although cannot be completely eliminated. Suggest that catathrenia might be a sleep breathing disorder Support There is no support of this study

Questionnaire-assessed risk of sleep apnea in inpatients with various endocrine disorders

Background: Sleep breathing disorders can be an additional risk factor for the development of cardiovascular disorders in patients with endocrine disorders.Aim: To assess the sleep apnea risk in patients with various endocrine disorders undergoing inpatient treatment.Materials and methods: The sleep apnea risk and the severity of daytime sleepiness were evaluated in 282 inpatients with endocrine disorders based on the following questionnaires: the Epworth Sleepiness Scale (ESS), the sleep apnea screening questionnaire (SAS), and the Berlin sleep apnea risk questionnaire (BQ). To identify the real prevalence of sleep respiratory disorders in endocrine patients we performed cardio-respiratory monitoring with Watch-PAT200 (“Itamar Medical”, Israel) device in 81 patients.Results: A high sleep apnea risk according to the BQ was detected in 59.9% (160/267) of the patients, according to the SAS in 53.53% (144/269), excessive daytime sleepiness (≥ 11 points) was found in 21.66% (60/277) of the patients with the ESS. Among the patients undergoing cardiorespiratory monitoring, sleep apnea was detected in 84% (68/81), including severe apnea in 38.2% (26/68). The highest sleep apnea risk by BQ and SAS was observed in the patients with type 2 diabetes, acromegaly and hypercortisolism. Excessive daytime sleepiness by the ESS was most noticeable in those with hypercortisolism and thyrotoxicosis.Conclusion: The high risk of sleep apnea in the inpatients with type 2 diabetes mellitus, acromegaly, hypercorticism, and hypothyroidism makes it necessary to include its active screening into the algorithm of their inpatient assessment to rule out any sleep breathing disorder.

Accuracy of Type III Portable Monitors for Diagnosing Obstructive Sleep Apnea

Objectives: We evaluated whether the results from portable monitor (PM) devices for the diagnosis of obstructive sleep apnea (OSA), classified into type III and type IV devices by the American Academy of Sleep Medicine, correlated with the results from polysomnography (PSG) testing. Methods: Sixty-four patients with a sleep-breathing disorder used type III or type IV PM devices at home and were subsequently admitted for testing using PSG. The apnea-hypopnea index (AHI) from each machine was measured, and the AHI component, apnea index (AI), and hypopnea index (HI) were also analyzed. Results: There was a stronger correlation between the AHI values from PSG testing and those from the type III PM devices (r = 0.92, p < 0.001) than for the data from type IV devices (r = 0.69, p < 0.001). However, the correlation of HI values (type III: r = 0.43, p = 0.024; type IV: r = 0.14, p = 0.41) was poorer than that of the AI values (type III: r = 0.95, p < 0.001; type IV: r = 0.68, p < 0.001). Moreover, the type III PM devices tended to evaluate a patient's condition as less severe than did PSG testing when the AHI value was over 30. Conclusions: Although type III PM devices outperformed type IV devices as substitutes for PSG, the clinical state must be evaluated for patients suspected of having obstructive sleep apnea.