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Zandieh S, Kirschenbaum MA, Greenberg H, Ancoli-Israel S. Keep it simple: A novel technique for measuring airflow using a wireless patch. Sleep Health 2023; 9:100-107. [PMID: 36473786 DOI: 10.1016/j.sleh.2022.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Despite the growing use of home sleep testing for obstructive sleep apnea (OSA), there are significant barriers that make it difficult for patients. This study aimed to evaluate a new set of wireless patches for the detection of OSA as compared to polysomnography (PSG) respiratory signals. Safety was also evaluated. METHODS Patients (n = 25; mean age = 51.3; SD = 15.6) undergoing standard PSG evaluation for OSA wore 2 device patches applied on the chest and abdomen to provide surrogates of respiratory effort and derived airflow. Two sets of respiratory data (with common SpO2 and heart rate as a reference from PSG) were created, one from PSG and one from the device patches. Data were scored by a Registered Polysomnographic Technologist. Linear regression analyses and Bland-Altman plots were used to compare the two derived apnea-hypopnea indices (AHI). Bench testing was performed to determine whether the device patch respiratory signal accuracy remained consistent for different body characteristics. RESULTS There was a significant correlation for AHI between the device patch and PSG (r = 0.979; P < .001; 95% CI 0.952, 1.00). There were also significant correlations between PSG and the device patch for supine AHI (r = 0.866, P < .001, 95% CI 0.610, 0.965) and nonsupine AHI (r = 0.983; <0.001, 95% CI 0.954, 1.00). No differences in respiratory signal accuracy were found with bench testing comparison groups. CONCLUSIONS These preliminary results suggest that the device patch may be an effective way to measure respiratory dynamics, including derived airflow, to evaluate OSA. Results show promise as a new innovative method for home sleep testing.
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Affiliation(s)
- Stephanie Zandieh
- Division of Pediatric Pulmonary and Sleep Medicine, Rutgers New Jersey Medical School/RWJ Barnabas Health, New Brunswick, New Jersey, USA.
| | - Michael A Kirschenbaum
- Department of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY and Northwell Health Feinstein Institutes for Medical Research, Manhasset, New York, USA
| | - Harly Greenberg
- Division of Pulmonary, Critical Care and Sleep Medicine, Donald and Barbara Zucker School o Medicine at Hofstra-Northwell, New Hyde Park, New York, USA
| | - Sonia Ancoli-Israel
- Department of Psychiatry, University of California, San Diego, California, USA
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OSA Wellness Scale (OWS): A New Health-Related Quality of Life Test in Obstructive Sleep Apnea Patients Treated with Mandibular Advancement Device. Int J Dent 2022; 2022:4629341. [PMID: 36187733 PMCID: PMC9519331 DOI: 10.1155/2022/4629341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 07/27/2022] [Accepted: 08/24/2022] [Indexed: 11/17/2022] Open
Abstract
Objectives. To present a new short self-test, called the OSA wellness scale (OWS), for assessing the health-related quality of life (HRQoL) changes in obstructive apnea syndrome (OSA) patients treated with mandibular advancement device (MAD). Methods. 51 OSA patients (8 women and 43 men, mean age 52.3) treated with a fully customizable MAD device (Protrusor) were retrospectively enrolled. Each patient received a home sleep apnea testing (HSAT) at baseline (T0) and after three months of MAD treatment (T1). Two self-test evaluations, the Epworth sleepiness scale (ESS), and OWS were also submitted at T0 and T1. The OWS was a short self-test of 8 questions for evaluating the daytime HRQoL. Patients gave an assessment from 0 to 3 for each question. At the end of the questionnaire, the patients had a score from 0 to 24, resulting from the sum of all 8 scores. The higher the score, the greater the patient’s perceived state of discomfort. Results. At T1, a significant decrease in the oxygen desaturation index (ODI) and apnea-hypopnea index (AHI) was shown (
), while no significant changes in body mass index (BMI) were found. Both the ESS and the OWS records showed a significant reduction in daytime sleepiness and HRQoL (
). Conclusion. The OWS could be a useful method to verify and numerically compare the perceived quality of life in OSA patients, before and after MAD therapy.
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Ciavarella D, Campobasso A, Suriano C, Lo Muzio E, Guida L, Salcuni F, Laurenziello M, Illuzzi G, Tepedino M. A new design of mandibular advancement device (IMYS) in the treatment of obstructive sleep apnea. Cranio 2022:1-8. [PMID: 35171757 DOI: 10.1080/08869634.2022.2041271] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE The mandibular advancement device (MAD) is currently suggested in patients with mild to moderate obstructive sleep apnea (OSA). This study investigated the effects of a new fully customizable MAD-type device called, "It Makes You Sleep" (IMYS), in patients with mild to moderate OSA. METHODS Sixteen patients (14 men and 2 women; mean age 62; SD ± 11 years) were retrospectively enrolled. Each patient received home sleep apnea testing (HSAT) at baseline (T0) and after three months (T1) of IMYS treatment. The Apnea-Hypopnea Index (AHI), the Oxygen Desaturation Index (ODI), the Minimum Oxygen Saturation (minSO2) and the Medium Oxygen Saturation (medSO2) were analyzed. RESULTS From T0 to T1, the IMYS treatment showed a significant reduction of AHI and ODI and a significant increase of minSO2 and medSO2. CONCLUSION The IMYS appliance is an effective device for treating mild or moderate OSA.
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Affiliation(s)
- Domenico Ciavarella
- Department of Clinical and Experimental Medicine, Dental School of Foggia, University of Foggia, Foggia, Italy
| | - Alessandra Campobasso
- Department of Clinical and Experimental Medicine, Dental School of Foggia, University of Foggia, Foggia, Italy
| | - Carmela Suriano
- Department of Clinical and Experimental Medicine, Dental School of Foggia, University of Foggia, Foggia, Italy
| | | | - Laura Guida
- Department of Clinical and Experimental Medicine, Dental School of Foggia, University of Foggia, Foggia, Italy
| | - Fabio Salcuni
- Department of Clinical and Experimental Medicine, Dental School of Foggia, University of Foggia, Foggia, Italy
| | - Michele Laurenziello
- Department of Clinical and Experimental Medicine, Dental School of Foggia, University of Foggia, Foggia, Italy
| | - Gaetano Illuzzi
- Department of Clinical and Experimental Medicine, Dental School of Foggia, University of Foggia, Foggia, Italy
| | - Michele Tepedino
- Department of Biotecnologica and Applied Clinical Sciences, Dental School of L'Aquila, University of L'Aquila, L'Aquila, Italy
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Fraser CL, Hedges TR, Lee AG, Van Stavern GP. Should All Patients With Nonarteritic Anterior Ischemic Optic Neuropathy Receive a Sleep Study? J Neuroophthalmol 2021; 41:542-546. [PMID: 33417413 DOI: 10.1097/wno.0000000000001144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Clare L Fraser
- Medicine and Health (CLF), University of Sydney, Sydney, Australia; Department of Ophthalmology (TRH), Tufts University, Boston, Massachusetts; Blanton Eye Institute (AGL), Houston, Texas; and Department of Ophthalmology of Visual Sciences (GPVS), Washington University in St. Louis, St. Louis, Missouri
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Najjar M. The Utility of Recording Submental Electrical Activity in Polysomnography. Cureus 2021; 13:e17216. [PMID: 34540443 PMCID: PMC8442570 DOI: 10.7759/cureus.17216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2021] [Indexed: 11/06/2022] Open
Abstract
Background Polysomnography is widely utilized as a diagnostic tool in sleep medicine. It is used to diagnose a variety of sleep disorders, including obstructive and central sleep apnea, periodic limb movements, parasomnia, and other sleep disorders. The objective of this study is to discuss the utility of recording submental electrical activity as a tool that provides the additional information needed in producing accurate results of a polysomnogram and emphasize the importance of including this recording in home sleep apnea tests. Methods A total of 1472 consecutive polysomnograms were used to assess the usefulness of submental activity in contributing to the accurate reporting of polysomnographic findings. These records were gathered over a one-year period at a major academic sleep center. Results Some of the observed electrical activities in the submental area are rare, although they may be important in confirming the findings of the polysomnogram or provide additional information. Adding an electroencephalographic channel and submental electromyographic recording is likely to increase the accuracy of home sleep apnea tests. Conclusions Recording of submental electrical activity is an integral part of polysomnography and provides more information than just recording the muscle tone of the submental area and is important in increasing the accuracy of home sleep apnea tests.
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Affiliation(s)
- Muhammad Najjar
- Internal Medicine, University of Illinois at Chicago, Chicago, USA
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6
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Comparing sleep studies in terms of the apnea-hypopnea index using the dedicated Shiny web application. Biomed Signal Process Control 2021. [DOI: 10.1016/j.bspc.2021.102614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Chen J, Lin S, Zeng Y. An Update on Obstructive Sleep Apnea for Atherosclerosis: Mechanism, Diagnosis, and Treatment. Front Cardiovasc Med 2021; 8:647071. [PMID: 33898538 PMCID: PMC8060459 DOI: 10.3389/fcvm.2021.647071] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 03/16/2021] [Indexed: 12/13/2022] Open
Abstract
The occurrence and development of atherosclerosis could be influenced by intermittent hypoxia. Obstructive sleep apnea (OSA), characterized by intermittent hypoxia, is world-wide prevalence with increasing morbidity and mortality rates. Researches remain focused on the study of its mechanism and improvement of diagnosis and treatment. However, the underlying mechanism is complex, and the best practice for OSA diagnosis and treatment considering atherosclerosis and related cardiovascular diseases is still debatable. In this review, we provided an update on research in OSA in the last 5 years with regard to atherosclerosis. The processes of inflammation, oxidative stress, autonomic nervous system activation, vascular dysfunction, platelet activation, metabolite dysfunction, small molecule RNA regulation, and the cardioprotective occurrence was discussed. Additionally, improved diagnosis such as, the utilized of portable device, and treatment especially with inconsistent results in continuous positive airway pressure and mandibular advancement devices were illustrated in detail. Therefore, further fundamental and clinical research should be carried out for a better understanding the deep interaction between OSA and atherosclerosis, as well as the suggestion of newer diagnostic and treatment options.
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Affiliation(s)
- Jin Chen
- Clinical Center for Molecular Diagnosis and Therapy, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Shu Lin
- Centre of Neurological and Metabolic Research, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.,Department of Cardiology, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Yiming Zeng
- Department of Respiratory Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
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8
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Clinical and Research Solutions to Manage Obstructive Sleep Apnea: A Review. SENSORS 2021; 21:s21051784. [PMID: 33806496 PMCID: PMC7961570 DOI: 10.3390/s21051784] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 02/24/2021] [Accepted: 02/26/2021] [Indexed: 12/13/2022]
Abstract
Obstructive sleep apnea (OSA), a common sleep disorder disease, affects millions of people. Without appropriate treatment, this disease can provoke several health-related risks including stroke and sudden death. A variety of treatments have been introduced to relieve OSA. The main present clinical treatments and undertaken research activities to improve the success rate of OSA were covered in this paper. Additionally, guidelines on choosing a suitable treatment based on scientific evidence and objective comparison were provided. This review paper specifically elaborated the clinically offered managements as well as the research activities to better treat OSA. We analyzed the methodology of each diagnostic and treatment method, the success rate, and the economic burden on the world. This review paper provided an evidence-based comparison of each treatment to guide patients and physicians, but there are some limitations that would affect the comparison result. Future research should consider the consistent follow-up period and a sufficient number of samples. With the development of implantable medical devices, hypoglossal nerve stimulation systems will be designed to be smart and miniature and one of the potential upcoming research topics. The transcutaneous electrical stimulation as a non-invasive potential treatment would be further investigated in a clinical setting. Meanwhile, no treatment can cure OSA due to the complicated etiology. To maximize the treatment success of OSA, a multidisciplinary and integrated management would be considered in the future.
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Özden Mat D, Firat S, Aksu K, Aksu F, Duyar SŞ. Obstructive sleep apnea is a determinant of asthma control independent of smoking, reflux, and rhinitis. Allergy Asthma Proc 2021; 42:e25-e29. [PMID: 33404398 DOI: 10.2500/aap.2021.42.200098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background: Asthma control is defined as to what extent manifestations of asthma can be observed in a patient or have been reduced or removed by treatment. Regular use of asthma treatments, correct inhaler technique, adequate information provided about the patient's diseases and medicines, and patient-clinician collaboration aid asthma control. Asthma shares risk factors and links in the pathogenesis with obstructive sleep apnea (OSA), and OSA may aggravate asthma symptoms. Objective: To assess the risk of OSA for asthma control. Methods: The study was carried out in subjects with asthma who were followed up at specific time points and who used asthma medication regularly and with an appropriate inhaler technique. An asthma control test and a questionnaire were used to determine the asthma control levels and OSA risk of the subjects. Results: With regard to the questionnaire scoring, 77 of 137 subjects with asthma had a low OSA risk and 60 had a high OSA risk. The proportion of the subjects with a high OSA risk (p < 0.001) and were smokers (p = 0.020) were significantly higher in the subjects with uncontrolled asthma than in those with controlled asthma. Logistic regression analysis showed that the variables that affect asthma control status were the risk of OSA and obesity. The subjects with a low OSA risk were more likely to have controlled asthma than those with a high OSA risk (odds ratio 7.896 [95% confidence interval, 2.902-21.487]; p < 0.001). Conclusion: In the subjects with asthma and who adhered to therapy and used inhalers with the correct technique, a high risk of OSA was associated with poor control of their asthma. This association was independent of other factors, including rhinitis, gastroesophageal reflux, and smoking.
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Affiliation(s)
- Dilber Özden Mat
- From the University of Health Sciences Atatürk Chest Diseases and Chest Surgery Education and Research Hospital, Department of Chest Diseases, Ankara, Turkey
| | - Selma Firat
- From the University of Health Sciences Atatürk Chest Diseases and Chest Surgery Education and Research Hospital, Department of Chest Diseases, Ankara, Turkey
| | - Kurtuluş Aksu
- University of Health Sciences Atatürk Chest Diseases and Chest Surgery Education and Research Hospital, Division of Immunulugy and Allergy, Department of Chest Diseases, Ankara, Turkey
| | - Funda Aksu
- From the University of Health Sciences Atatürk Chest Diseases and Chest Surgery Education and Research Hospital, Department of Chest Diseases, Ankara, Turkey
| | - Sezgi Şahin Duyar
- From the University of Health Sciences Atatürk Chest Diseases and Chest Surgery Education and Research Hospital, Department of Chest Diseases, Ankara, Turkey
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Morra S, Gauthey A, Hossein A, Rabineau J, Racape J, Gorlier D, Migeotte PF, le Polain de Waroux JB, van de Borne P. Influence of sympathetic activation on myocardial contractility measured with ballistocardiography and seismocardiography during sustained end-expiratory apnea. Am J Physiol Regul Integr Comp Physiol 2020; 319:R497-R506. [PMID: 32877240 DOI: 10.1152/ajpregu.00142.2020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Ballistocardiography (BCG) and seismocardiography (SCG) assess vibrations produced by cardiac contraction and blood flow, respectively, through micro-accelerometers and micro-gyroscopes. BCG and SCG kinetic energies (KE) and their temporal integrals (iK) during a single heartbeat are computed in linear and rotational dimensions. Our aim was to test the hypothesis that iK from BCG and SCG are related to sympathetic activation during maximal voluntary end-expiratory apnea. Multiunit muscle sympathetic nerve traffic [burst frequency (BF), total muscular sympathetic nerve activity (tMSNA)] was measured by microneurography during normal breathing and apnea (n = 28, healthy men). iK of BCG and SCG were simultaneously recorded in the linear and rotational dimension, along with oxygen saturation ([Formula: see text]) and systolic blood pressure (SBP). The mean duration of apneas was 25.4 ± 9.4 s. SBP, BF, and tMSNA increased during the apnea compared with baseline (P = 0.01, P = 0.002,and P = 0.001, respectively), whereas [Formula: see text] decreased (P = 0.02). At the end of the apnea compared with normal breathing, changes in iK computed from BCG were related to changes of tMSNA and BF only in the linear dimension (r = 0.85, P < 0.0001; and r = 0.72, P = 0.002, respectively), whereas changes in linear iK of SCG were related only to changes of tMSNA (r = 0.62, P = 0.01). We conclude that maximal end expiratory apnea increases cardiac kinetic energy computed from BCG and SCG, along with sympathetic activity. The novelty of the present investigation is that linear iK of BCG is directly and more strongly related to the rise in sympathetic activity than the SCG, mainly at the end of a sustained apnea, likely because the BCG is more affected by the sympathetic and hemodynamic effects of breathing cessation. BCG and SCG may prove useful to assess sympathetic nerve changes in patients with sleep disturbances.NEW & NOTEWORTHY Ballistocardiography (BCG) and seismocardiography (SCG) assess vibrations produced by cardiac contraction and blood flow, respectively, through micro-accelerometers and micro-gyroscopes. Kinetic energies (KE) and their temporal integrals (iK) during a single heartbeat are computed from the BCG and SCG waveforms in a linear and a rotational dimension. When compared with normal breathing, during an end-expiratory voluntary apnea, iK increased and was positively related to sympathetic nerve traffic rise assessed by microneurography. Further studies are needed to determine whether BCG and SCG can probe sympathetic nerve changes in patients with sleep disturbances.
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Affiliation(s)
- Sofia Morra
- Department of Cardiology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Anais Gauthey
- Department of Cardiology, Saint-Luc hospital, Université Catholique de Louvain, Brussels, Belgium
| | - Amin Hossein
- Laboratory of Physics and Physiology, Université Libre de Bruxelles, Brussels, Belgium
| | - Jérémy Rabineau
- Laboratory of Physics and Physiology, Université Libre de Bruxelles, Brussels, Belgium
| | - Judith Racape
- Research Centre in Epidemiology, Biostatistics and Clinical Research. School of Public Health. Université Libre de Bruxelles, Brussels, Belgium
| | - Damien Gorlier
- Laboratory of Physics and Physiology, Université Libre de Bruxelles, Brussels, Belgium
| | | | | | - Philippe van de Borne
- Department of Cardiology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
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Barriuso B, Martin L, Sevilla C, Muñoz C, López V, Bello MJ, Manchado N, Pamiés M, Díez P, Sanz R, Ciorba C, Ordax E, Terán-Santos J, Alonso-Alvarez ML. Self-setup of home respiratory polygraphy for the diagnosis of sleep apnea syndrome: cost-efficiency study. Sleep Breath 2020; 24:1067-1074. [PMID: 31786747 DOI: 10.1007/s11325-019-01959-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 08/29/2019] [Accepted: 10/02/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE To evaluate the differences in reliability and costs of home respiratory polygraphy (HRP) when installed by the patient and by a nurse, in order to determine the factors affecting and to consider the possible generalization of self-setup procedure. Several HRP devices have been validated for obstructive sleep apnea (OSA) diagnosis but convenience of a nurse intervention in HRP installation has been scarcely studied. METHODS This is a prospective and interventional study. About 301 participants were assigned to 2 groups: self-setup and nurse intervention. Sleep study, questionnaires, and diagnostic procedures were performed following the clinical practice in 2016. Signals were considered lost above 3 min, and success of the test was established according to guidelines. Costs were calculated according to a previous multicenter study. RESULTS Both groups (self-setup and nurse intervention) resulted homogeneous in age, gender, BMI, and final diagnosis of OSA. Signal losses during the test were similar in both groups. Slightly higher percentage of unsuccessful tests were obtained in the self-setup procedure (5.3 vs 2.0%, p = 0.121). The costs were similar (107 vs 105 €) in the self-setup group as compared to the nurse setup group. CONCLUSIONS The setup of HRP by either the patient or nurse had similar costs and data acquisition. Both installation procedures of HRP were similar regarding test reliability and costs. Main findings are that self-installation by the patient could be similarly reliable and economic as installation by a nurse, as far as consensus guidelines are followed. This study demonstrates that self-setup of HRP is a potentially viable option for the diagnosis of OSA.
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Affiliation(s)
- Blanca Barriuso
- Sleep Unit, Hospital Universitario de Burgos, Avda Baleares 3, 09006, Burgos, Spain.
| | - Lourdes Martin
- Sleep Unit, Hospital Universitario de Burgos, Avda Baleares 3, 09006, Burgos, Spain
| | - Cristina Sevilla
- Sleep Unit, Hospital Universitario de Burgos, Avda Baleares 3, 09006, Burgos, Spain
| | - Carmen Muñoz
- Sleep Unit, Hospital Universitario de Burgos, Avda Baleares 3, 09006, Burgos, Spain
| | - Verónica López
- Sleep Unit, Hospital Universitario de Burgos, Avda Baleares 3, 09006, Burgos, Spain
| | - Ma Jose Bello
- Sleep Unit, Hospital Universitario de Burgos, Avda Baleares 3, 09006, Burgos, Spain
| | - Nieves Manchado
- Sleep Unit, Hospital Universitario de Burgos, Avda Baleares 3, 09006, Burgos, Spain
| | - Montserrat Pamiés
- Sleep Unit, Hospital Universitario de Burgos, Avda Baleares 3, 09006, Burgos, Spain
| | - Patricia Díez
- Sleep Unit, Hospital Universitario de Burgos, Avda Baleares 3, 09006, Burgos, Spain
| | - Rocío Sanz
- Sleep Unit, Hospital Universitario de Burgos, Avda Baleares 3, 09006, Burgos, Spain
| | - Cristina Ciorba
- Sleep Unit, Hospital Universitario de Burgos, Avda Baleares 3, 09006, Burgos, Spain
| | - Estrella Ordax
- Sleep Unit, Hospital Universitario de Burgos, Avda Baleares 3, 09006, Burgos, Spain
| | - Joaquín Terán-Santos
- Sleep Unit, Hospital Universitario de Burgos, Avda Baleares 3, 09006, Burgos, Spain.,CIBER Enfermedades Respiratorias, Group 15, Madrid, Spain
| | - María Luz Alonso-Alvarez
- Sleep Unit, Hospital Universitario de Burgos, Avda Baleares 3, 09006, Burgos, Spain.,CIBER Enfermedades Respiratorias, Group 15, Madrid, Spain
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Abstract
PURPOSE OF REVIEW Obstructive sleep apnea (OSA) is increasing in prevalence. The intermittent hypoxia of OSA has wide-ranging effects on a patient's general health outcomes. However, gold-standard investigations and treatment are expensive and a significant burden on patients. Therefore, OSA research remains focused on improving the means of diagnosing and treating OSA, in high-risk-associated conditions. This review is to provide an update on the advances in the field of OSA. RECENT FINDINGS There has been recent debate about the best practice for diagnosis and treatment of OSA. Further work has been done on conditions associated with OSA including hypertension, atherosclerosis, various types of dementia and intracranial aneurysms. Inflammatory and vascular risk factors associated with OSA increase stroke risk and alter outcomes for recovery. OSA should definitely be considered in patients presenting with nonarteritic anterior ischemic optic neuropathy, and perhaps those with intracranial hypertension. SUMMARY Newer home-based sleep-apnea testing can be implemented via physician clinics, with oversight by a certified sleep physician. Although continuous positive airway pressure (CPAP) is the gold-standard, management should include diet and exercise. It is important to test for, and treat OSA in patients with a range of neurological diseases. However, further studies into the long-term impact of CPAP on health outcomes are still needed.
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