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Dipalma G, Inchingolo AM, Palumbo I, Guglielmo M, Riccaldo L, Morolla R, Inchingolo F, Palermo A, Charitos IA, Inchingolo AD. Surgical Management of Pediatric Obstructive Sleep Apnea: Efficacy, Outcomes, and Alternatives—A Systematic Review. Life (Basel) 2024; 14:1652. [PMCID: PMC11677306 DOI: 10.3390/life14121652] [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: 11/12/2024] [Revised: 11/29/2024] [Accepted: 12/11/2024] [Indexed: 01/04/2025] Open
Abstract
Aim: Obstructive sleep apnea (OSA) is the most prevalent sleep-related breathing disorder. OSA affects approximately 2 million Italians, although only 3% receive a diagnosis and correct treatment. This review aims to provide an overview to guide clinical decision making, ensuring that patients receive the most appropriate treatment for their specific condition. Material and Methods: This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered at PROSPERO under the ID CRD42024593760. A search on PubMed, Scopus, and Web of Science was performed to find papers that matched the topic, using the following Boolean keywords: (“obstructive sleep apnea” OR “OSA” OR “sleep apnea, obstructive”) AND (“surgery” OR “surgical” OR “surgical techniques” OR “surgical treatment” OR “operative” OR “surgical procedures”) AND (“treatment” OR “therapy” OR “management”). Result: The electronic database search found 20337 publications. After the screening and eligibility phase, 15 papers were chosen for the qualitative analysis. Conclusions: Adenotonsillectomy (AT) significantly improves secondary outcomes like behavioral issues and quality of life, compared to watchful waiting with supportive care (WWSC). Alternative approaches such as tonsillotomy and adenopharyngoplasty (APP) offer promising results, with less postoperative discomfort and lower complication rates. However, further large-scale studies are needed to refine surgical techniques, assess long-term outcomes, and optimize individualized treatment strategies for OSA.
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Affiliation(s)
- Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70121 Bari, Italy; (A.M.I.); (M.G.); (L.R.); (R.M.); (A.D.I.)
| | - Angelo Michele Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70121 Bari, Italy; (A.M.I.); (M.G.); (L.R.); (R.M.); (A.D.I.)
| | - Irene Palumbo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70121 Bari, Italy; (A.M.I.); (M.G.); (L.R.); (R.M.); (A.D.I.)
| | - Mariafrancesca Guglielmo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70121 Bari, Italy; (A.M.I.); (M.G.); (L.R.); (R.M.); (A.D.I.)
| | - Lilla Riccaldo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70121 Bari, Italy; (A.M.I.); (M.G.); (L.R.); (R.M.); (A.D.I.)
| | - Roberta Morolla
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70121 Bari, Italy; (A.M.I.); (M.G.); (L.R.); (R.M.); (A.D.I.)
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70121 Bari, Italy; (A.M.I.); (M.G.); (L.R.); (R.M.); (A.D.I.)
| | - Andrea Palermo
- Department of Experimental Medicine, University of Salento, 73100 Lecce, Italy;
| | - Ioannis Alexandros Charitos
- Pneumology and Respiratory Rehabilitation Unit, Istituti Clinici Scientifici Maugeri IRCCS, 70124 Bari, Italy;
| | - Alessio Danilo Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70121 Bari, Italy; (A.M.I.); (M.G.); (L.R.); (R.M.); (A.D.I.)
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Vrooman OPJ, van Kerrebroeck PEV, van Balken MR, van Koeveringe GA, Rahnama'i MS. Nocturia and obstructive sleep apnoea. Nat Rev Urol 2024; 21:735-753. [PMID: 38783115 DOI: 10.1038/s41585-024-00887-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2024] [Indexed: 05/25/2024]
Abstract
Nocturia, the need to urinate at night, is a common symptom in patients with obstructive sleep apnoea (OSA). Continuous positive airway pressure treatment can reduce nocturia in some patients, but the underlying mechanisms are complex and not fully understood. OSA affects the autonomic nervous system, oxidative stress and endothelial damage. Furthermore, the commonly held theory attributing polyuria to a false signal of cardiac overload and response natriuresis has limitations. A comprehensive approach to the management of nocturia in OSA, considering factors such as comorbidities, medication use, alcohol consumption and lifestyle, is needed. Effective management of nocturia in OSA requires a multidisciplinary approach, and urologists should be aware of the potential effect of OSA on physiology and refer patients for further testing at a sleep centre. In addition to continuous positive airway pressure, other interventions such as oral appliances and surgical obstruction treatment could be beneficial for some patients. Overall, understanding the complex interplay between OSA and nocturia is crucial for optimizing patient outcomes.
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Affiliation(s)
- Olaf P J Vrooman
- Department of Urology, Hospital Rijnstate Arnhem, Arnhem, Netherlands.
| | | | | | | | - Mohammad S Rahnama'i
- Department of Urology Nij Smellinghe Hospital, Drachten, Netherlands
- Society of Urological research and education (SURE), Maastricht, Netherlands
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Amorim P, Ferreira-Santos D, Drummond M, Rodrigues PP. Prospective Validation and Usability Evaluation of a Mobile Diagnostic App for Obstructive Sleep Apnea. Diagnostics (Basel) 2024; 14:2519. [PMID: 39594186 PMCID: PMC11592544 DOI: 10.3390/diagnostics14222519] [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: 09/27/2024] [Revised: 11/01/2024] [Accepted: 11/07/2024] [Indexed: 11/28/2024] Open
Abstract
Background/Objectives: Obstructive sleep apnea (OSA) classification relies on polysomnography (PSG) results. Current guidelines recommend the development of clinical prediction algorithms in screening prior to PSG. A recent intuitive and user-friendly tool (OSABayes), based on a Bayesian network model using six clinical variables, has been proposed to quantify the probability of OSA. Our aims are (1) to validate OSABayes prospectively, (2) to build a smartphone app based on the proposed model, and (3) to evaluate app usability. Methods: We prospectively included adult patients suspected of OSA, without suspicion of other sleep disorders, who underwent level I or III diagnostic PSG. Apnea-hypopnea index (AHI) and OSABayes probabilities were obtained and compared using the area under the ROC curve (AUC [95%CI]) for OSA diagnosis (AHI ≥ 5/h) and higher severity levels (AHI ≥ 15/h) prediction. We built the OSABayes app on 'App Inventor 2', and the usability was assessed with a cognitive walkthrough method and a general evaluation. Results: 216 subjects were included in the validation cohort, performing PSG levels I (34%) and III (66%). OSABayes presented an AUC of 83.6% [77.3-90.0%] for OSA diagnosis and 76.3% [69.9-82.7%] for moderate/severe OSA prediction, showing good response for both types of PSG. The OSABayes smartphone application allows one to calculate the probability of having OSA and consult information about OSA and the tool. In the usability evaluation, 96% of the proposed tasks were carried out. Conclusions: These results show the good discrimination power of OSABayes and validate its applicability in identifying patients with a high pre-test probability of OSA. The tool is available as an online form and as a smartphone app, allowing a quick and accessible calculation of OSA probability.
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Affiliation(s)
- Pedro Amorim
- Sleep and Non-Invasive Ventilation Unit, São João University Hospital, 4200-319 Porto, Portugal
- Center for Health Technology and Services Research (CINTESIS), 4200-450 Porto, Portugal
- Faculty of Medicine, University of Porto (FMUP), 4200-319 Porto, Portugal
- School of Health—P.Porto, 4200-072 Porto, Portugal
| | - Daniela Ferreira-Santos
- INESC TEC—Institute for Systems and Computer Engineering, Technology and Science, 4200-465 Porto, Portugal
| | - Marta Drummond
- Sleep and Non-Invasive Ventilation Unit, São João University Hospital, 4200-319 Porto, Portugal
- Faculty of Medicine, University of Porto (FMUP), 4200-319 Porto, Portugal
| | - Pedro Pereira Rodrigues
- Center for Health Technology and Services Research (CINTESIS), 4200-450 Porto, Portugal
- Faculty of Medicine, University of Porto (FMUP), 4200-319 Porto, Portugal
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Napolitano L, Abate M, Di Bello F, Morra S, Cirillo L, Fusco GM, Califano G, Collà Ruvolo C, Creta M, La Rocca R, Crocetto F, Barone B, Pantano I, Russo P, Arcaniolo D, Manfredi C. Sexual Dysfunctions and Gynecomastia in Male Rheumatological Patients Treated with Methotrexate: A Systematic Review. J Clin Med 2024; 13:6455. [PMID: 39518594 PMCID: PMC11547054 DOI: 10.3390/jcm13216455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2024] [Revised: 10/17/2024] [Accepted: 10/23/2024] [Indexed: 11/16/2024] Open
Abstract
Objectives: The aim of the current review was to elucidate the clinical context and presentation of sexual dysfunction (SD) and gynecomastia in rheumatological patients undergoing methotrexate treatment. Moreover, we aimed also to make physicians aware of the occurrence of these side effects, to adequately inform the patient before starting treatment. Methods: Systematic review (PROSPERO id: CRD42022358275) was performed according to preferred reporting items for systematic reviews and meta-analyses. Studies (1 January 1995 to 31 May 2022) were identified by highly sensitive searches of electronic databases (Medline, Embase, Cochrane Library databases). Key terms included: (("sexual dysfunction" OR "erectile dysfunction" OR "impotence") AND ("methotrexate" OR "MTX")) and (("gynecomastia" OR "male breast") AND ("methotrexate" OR "MTX")). Results: A total of seven papers (seven case reports), involving a total of eleven patients (min one, max three), were included in the final analysis. The age of the patients ranged from 19 to 68 years (median: 50.9 years). Rheumatoid arthritis (RA) was the most frequent rheumatic disease reported (n = 8, 72.7%). No patients reported erectile dysfunction (ED) and/or gynecomastia before using MTX. Time to onset of SD and gynecomastia after MTX ranged from 2 to 104 weeks (median: 22.7 weeks). ED (n = 5, 45.4%) and gynecomastia (n = 3, 27.2%) were the most common forms of presentation. Conclusions: Future prospective controlled studies with a large sample size and long follow-up as well as randomized controlled trials are needed to confirm this association, investigate its pathophysiological basis, assess the safest dosages, evaluate the most appropriate management, and provide clear recommendations.
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Affiliation(s)
- Luigi Napolitano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80138 Napoli, Italy; (L.N.); (M.A.); (S.M.); (L.C.); (G.M.F.); (G.C.); (C.C.R.); (M.C.); (R.L.R.); (F.C.); (B.B.)
| | - Marco Abate
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80138 Napoli, Italy; (L.N.); (M.A.); (S.M.); (L.C.); (G.M.F.); (G.C.); (C.C.R.); (M.C.); (R.L.R.); (F.C.); (B.B.)
| | - Francesco Di Bello
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80138 Napoli, Italy; (L.N.); (M.A.); (S.M.); (L.C.); (G.M.F.); (G.C.); (C.C.R.); (M.C.); (R.L.R.); (F.C.); (B.B.)
| | - Simone Morra
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80138 Napoli, Italy; (L.N.); (M.A.); (S.M.); (L.C.); (G.M.F.); (G.C.); (C.C.R.); (M.C.); (R.L.R.); (F.C.); (B.B.)
| | - Luigi Cirillo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80138 Napoli, Italy; (L.N.); (M.A.); (S.M.); (L.C.); (G.M.F.); (G.C.); (C.C.R.); (M.C.); (R.L.R.); (F.C.); (B.B.)
| | - Giovanni Maria Fusco
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80138 Napoli, Italy; (L.N.); (M.A.); (S.M.); (L.C.); (G.M.F.); (G.C.); (C.C.R.); (M.C.); (R.L.R.); (F.C.); (B.B.)
| | - Gianluigi Califano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80138 Napoli, Italy; (L.N.); (M.A.); (S.M.); (L.C.); (G.M.F.); (G.C.); (C.C.R.); (M.C.); (R.L.R.); (F.C.); (B.B.)
| | - Claudia Collà Ruvolo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80138 Napoli, Italy; (L.N.); (M.A.); (S.M.); (L.C.); (G.M.F.); (G.C.); (C.C.R.); (M.C.); (R.L.R.); (F.C.); (B.B.)
| | - Massimiliano Creta
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80138 Napoli, Italy; (L.N.); (M.A.); (S.M.); (L.C.); (G.M.F.); (G.C.); (C.C.R.); (M.C.); (R.L.R.); (F.C.); (B.B.)
| | - Roberto La Rocca
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80138 Napoli, Italy; (L.N.); (M.A.); (S.M.); (L.C.); (G.M.F.); (G.C.); (C.C.R.); (M.C.); (R.L.R.); (F.C.); (B.B.)
| | - Felice Crocetto
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80138 Napoli, Italy; (L.N.); (M.A.); (S.M.); (L.C.); (G.M.F.); (G.C.); (C.C.R.); (M.C.); (R.L.R.); (F.C.); (B.B.)
| | - Biagio Barone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80138 Napoli, Italy; (L.N.); (M.A.); (S.M.); (L.C.); (G.M.F.); (G.C.); (C.C.R.); (M.C.); (R.L.R.); (F.C.); (B.B.)
| | - Ilenia Pantano
- Rheumatology Unit, Department of Precision Medicine, University Della Campania L. Vanvitelli, 80138 Naples, Italy;
| | - Pierluigi Russo
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy;
- Urology Unit, Fondazione Policlinico A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Davide Arcaniolo
- Urology Unit, Department of Woman Child and of General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (D.A.); (C.M.)
| | - Celeste Manfredi
- Urology Unit, Department of Woman Child and of General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (D.A.); (C.M.)
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Sun Y, Jia Y, Wang S, Xu C, Qu Y, Hu M, Jiang H. Effectiveness of mandibular advancement orthodontic appliances with maxillary expansion device in children with obstructive sleep apnea: a systematic review. BMC Oral Health 2024; 24:1303. [PMID: 39465357 PMCID: PMC11514814 DOI: 10.1186/s12903-024-04931-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Accepted: 09/19/2024] [Indexed: 10/29/2024] Open
Abstract
BACKGROUND The current review aims to explore the evidence regarding the effectiveness of mandibular advancement orthodontic appliances with maxillary expansion device in treating pediatric Obstructive Sleep Apnea (OSA). MATERIALS AND METHODS A systematic literature search was conducted across PubMed, Cochrane Central, Web of Science, Embase, Scopus databases, Chinese Biomedical Database, Chinese National Knowledge Infrastructure, and Wanfang. The research involved children and adolescents (under 16 years old) who received mandibular advancement and maxillary expansion functional orthopedic appliances for OSA treatment. We performed narrative reviews and subsequently amalgamated the findings from the studies. RESULTS Six articles were included for review. Although a small number of studies were included, the research suggested the potential advantages of mandibular advancement for children with OSA. Following treatment, there was a decrease in AHI/RDI, an improvement in sleep quality, and the increase in oxygen saturation. CONCLUSIONS The limited quantity and quality of existing studies necessitate caution when drawing conclusions about the effectiveness of mandibular advancement and maxillary expansion for OSA. In the future, larger and well-designed randomized controlled trials (RCTs) are needed to provide more robust evidence. Patients should be carefully selected, and their orthodontic indications should be thoroughly evaluated before inclusion in such trials.We encourage researchers to design studies that monitor patients over several years to provide a comprehensive understanding of the long-term effectiveness. TRIAL REGISTRATION This study was registered in PROSPERO(CRD42023480407) on November 20, 2023.
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Affiliation(s)
- Yue Sun
- Department of Orthodontics, School and Hospital of Stomatology, Jilin University, Changchun, 130021, China
| | - Yifan Jia
- Department of Orthodontics, School and Hospital of Stomatology, Jilin University, Changchun, 130021, China
| | - Shaotai Wang
- Department of Orthodontics, School and Hospital of Stomatology, Jilin University, Changchun, 130021, China
| | - Chengjing Xu
- Department of Orthodontics, School and Hospital of Stomatology, Jilin University, Changchun, 130021, China
| | - Yue Qu
- Department of Orthodontics, School and Hospital of Stomatology, Jilin University, Changchun, 130021, China
| | - Min Hu
- Department of Orthodontics, School and Hospital of Stomatology, Jilin University, Changchun, 130021, China.
| | - Huan Jiang
- Department of Orthodontics, School and Hospital of Stomatology, Jilin University, Changchun, 130021, China.
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Chang TL, Kuo HC. Nocturia, nocturnal polyuria, and nocturnal enuresis in adults: What we know and what we do not know. Tzu Chi Med J 2024; 36:370-376. [PMID: 39421492 PMCID: PMC11483088 DOI: 10.4103/tcmj.tcmj_53_24] [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] [Received: 02/27/2024] [Revised: 03/29/2024] [Accepted: 04/13/2024] [Indexed: 10/19/2024] Open
Abstract
Nocturia is defined as the nocturnal frequency of one or more voiding episodes per night. It increases with aging and has an impact on sleep quality and the risks of falling and mortality. Nocturia disorder involves nighttime frequency, nocturnal polyuria, and nocturnal enuresis. In older adults with nocturia disorder, multiple factors could contribute to nocturia severity and characteristics, including poor sleep quality, lower urinary tract dysfunction, and excessive fluid output. Several nonurological medical diseases have been found to result in nocturia, such as hypertension, congestive heart failure, chronic kidney disease, chronic obstructive pulmonary disease, metabolic syndrome, and diabetes. Urological and medical assessments should be performed to diagnose nocturia disorder. A frequency volume chart to evaluate the nocturnal polyuria index, functional bladder capacity, and urodynamic study can reveal the presence of nocturnal polyuria and lower urinary tract dysfunction. Treatment should be based on multiple nocturia etiologies, and a combination of multiple therapies for individual pathophysiology will achieve a better treatment outcome.
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Affiliation(s)
- Tien-Lin Chang
- Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan
| | - Hann-Chorng Kuo
- Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan
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Liu Y, Zhang Z, Huijie Hu, He X, Xu P, Qifeng Dou, Song C, Zhang H, Franco I, Kamperis K, Rittig S, Jianguo Wen. Prevalence and relevant factors of nocturia and its impact on sleep quality in Chinese university students. Sci Rep 2024; 14:13883. [PMID: 38880809 PMCID: PMC11180657 DOI: 10.1038/s41598-024-60656-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 04/25/2024] [Indexed: 06/18/2024] Open
Abstract
The purpose of this study was to investigate the prevalence and relevant factors of nocturia and its impact on sleep quality in university students in Mainland China. A large-scale survey was conducted on 14,000 university students from 3 universities in Henan province, China by using an anonymous questionnaire. The questionnaire collected the information from the past six months. The relationships between the prevalence of nocturia and its relevant factors were evaluated. A total of 13,874 questionnaires were collected and 13,104 qualified for statistical analysis. A total of 659 students suffered from clinically relevant nocturia (CRN) (4.56% in male and 5.34% in female). Both univariate analysis and the logistic stepwise regression model showed that the prevalence of nocturia was significantly related to female, history of enuresis, ease of waking up, urgency, frequency and RUTI (P < 0.05). The sleep quality and the university entrance score of CRN group was significantly lower than that of control group (P < 0.05). Nocturia was common in Chinese university students and showed a negative impact on sleep and academic performance. Gender of female, history of enuresis, ease of waking up, urgency, frequency and RUTI were relevant factors for CRN.
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Affiliation(s)
- Yakai Liu
- Department of Pediatric Surgery, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Zhenwei Zhang
- Third Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Huijie Hu
- School of Nursing, Sanquan College of Xinxiang Medical University, Xinxiang, China
| | - Xiangfei He
- Pediatric Urodynamic Center and Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Pengchao Xu
- Pediatric Urodynamic Center and Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Qifeng Dou
- Department of Urology, the First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Cuiping Song
- Department of Pediatric Surgery, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Huiqing Zhang
- Department of Urology, the First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Israel Franco
- Yale New Haven Children's Hospital, New Haven, CT, USA
| | - Konstantinos Kamperis
- Department of Child and Adolescent Health, Aarhus University Hospital, Palle Juul-Jensens Blvd. 99, 8200, Aarhus, Denmark
| | - Søren Rittig
- Department of Child and Adolescent Health, Aarhus University Hospital, Palle Juul-Jensens Blvd. 99, 8200, Aarhus, Denmark
| | - Jianguo Wen
- Henan Joint International Pediatric Urodynamic Laboratory, First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China.
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Çoşğun İG, Gürel A. Obstructive sleep apnea and bladder pain syndrome/interstitial cystitis in women. Sleep Breath 2024; 28:999-1003. [PMID: 38147287 DOI: 10.1007/s11325-023-02967-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 11/21/2023] [Accepted: 12/04/2023] [Indexed: 12/27/2023]
Abstract
PURPOSE The relationship between obstructive sleep apnea (OSA) and bladder pain syndrome/interstitial cystitis (BPS/IC) remains uncertain. Therefore, this study aimed to compare the frequency of BPS/IC seen in women diagnosed with OSA and in women without OSA. MATERIAL AND METHODS The study included a patient group of women with OSA and a control group of women without OSA. All the study participants were administered the Berlin Questionnaire, Epworth Sleepiness Scale, Interstitial Cystitis Symptom Index (ICSI), and the Interstitial Cystitis Problem Index (ICPI). Differences between the women with OSA and the control group were examined. RESULTS The study sample consisted of 46 women with OSA and 46 controls. No significant difference was determined between the OSA and control groups concerning age and body mass index (p = 0.810, p = 0.060, respectively). The ESS was greater in the OSA group than in the control group (p = 0.007). The median (IQR) ICSI was 8 (4-11.25) in women with OSA and 5 (1.75-7.15) in controls (p < 0.001). The median (IQR) ICPI was 7 (6.00-10.25) in women with OSA and 6 (1.75-8.00) in controls (p < 0.001). CONCLUSIONS: The ICSI symptoms and subsequent problems in daily life caused by the symptoms (ICPI) were experienced at a higher rate in patients with OSA than in the control group. There is an association between BPS/IC and OSA.
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Affiliation(s)
- İbrahim Güven Çoşğun
- Department of Pulmonology, Afyonkarahisar Health Sciences University Medical Faculty, Afyonkarahisar, Turkey.
| | - Abdullah Gürel
- Department of Urology, Afyonkarahisar Health Sciences University Medical Faculty, Afyonkarahisar, Turkey
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Fanaridis M, Bouloukaki I, Stathakis G, Steiropoulos P, Tzanakis N, Moniaki V, Mavroudi E, Tsiligianni I, Schiza S. Prevalence and Characteristics of Patients with Obstructive Sleep Apnea and Chronic Obstructive Pulmonary Disease: Overlap Syndrome. Life (Basel) 2024; 14:547. [PMID: 38792569 PMCID: PMC11122385 DOI: 10.3390/life14050547] [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: 03/21/2024] [Revised: 04/21/2024] [Accepted: 04/22/2024] [Indexed: 05/26/2024] Open
Abstract
Overlap syndrome (OVS) is a distinct clinical entity that seems to result in potential cardiovascular consequences. We aimed to estimate the prevalence and risk factors for OVS in OSA patients and analyze clinical and PSG characteristics associated with OVS. In this cross-sectional study, 2616 patients evaluated for OSA underwent type-1 polysomnography (PSG). They were grouped as pure OSA (AHI > 15/h) and OVS patients. Demographics, PSG data, pulmonary function tests and arterial blood gases (ABGs) were compared between groups after adjustments for confounders. OSA was diagnosed in 2108 out of 2616 patients. Of those, 398 (19%) had OVS. Independent predictors of OVS were older age [OR: 5.386 (4.153-6.987)], current/former smoking [OR: 11.577 (7.232-18.532)], BMI [OR: 2.901 (2.082-4.044)] and ABG measurements [PaCO2 ≥ 45 OR: 4.648 (3.078-7.019), PO2 [OR: 0.934 (0.920-0.949)], HCO3- [OR: 1.196 (1.133-1.263), all p < 0.001]. OVS was also associated with prevalent hypertension [OR: 1.345 (1.030-1.758), p = 0.03] and cardiovascular disease [OR: 1.617 (1.229-2.126), p < 0.001], depressive symptoms [OR: 1.741 (1.230-2.465), p = 0.002] and nocturia [OR: 1.944 (1.378-2.742), p < 0.001], as well as with indices of OSA severity. Disturbances in sleep architecture were more prominent in OVS expressed by lower %N3 and REM% and higher arousal index. Our data suggest that OVS is prevalent among OSA patients, with distinct clinical and PSG characteristics. These characteristics could be utilized as predictive factors for early identification and further evaluation of these patients towards desirable patient-reported outcomes.
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Affiliation(s)
- Michail Fanaridis
- Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, 70013 Heraklion, Greece; (M.F.); (G.S.); (V.M.); (E.M.); (S.S.)
| | - Izolde Bouloukaki
- Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, 70013 Heraklion, Greece; (M.F.); (G.S.); (V.M.); (E.M.); (S.S.)
- Department of Social Medicine, School of Medicine, University of Crete, 71410 Heraklion, Greece;
| | - Georgios Stathakis
- Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, 70013 Heraklion, Greece; (M.F.); (G.S.); (V.M.); (E.M.); (S.S.)
| | - Paschalis Steiropoulos
- Department of Respiratory Medicine, Medical School, Democritus University of Thrace, University General Hospital Dragana, 68100 Alexandroupolis, Greece;
| | - Nikos Tzanakis
- Department of Thoracic Medicine, University Hospital of Heraklion, Medical School, University of Crete, 70013 Heraklion, Greece;
| | - Violeta Moniaki
- Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, 70013 Heraklion, Greece; (M.F.); (G.S.); (V.M.); (E.M.); (S.S.)
| | - Eleni Mavroudi
- Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, 70013 Heraklion, Greece; (M.F.); (G.S.); (V.M.); (E.M.); (S.S.)
| | - Ioanna Tsiligianni
- Department of Social Medicine, School of Medicine, University of Crete, 71410 Heraklion, Greece;
| | - Sophia Schiza
- Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, 70013 Heraklion, Greece; (M.F.); (G.S.); (V.M.); (E.M.); (S.S.)
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Avidan AY. The Clinical Spectrum of the Parasomnias. Sleep Med Clin 2024; 19:1-19. [PMID: 38368057 DOI: 10.1016/j.jsmc.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2024]
Abstract
Parasomnias are defined as abnormal movements or behaviors that occur in sleep or during arousals from sleep. Parasomnias vary in frequency from episodic events that arise from incomplete sleep state transition. The framework by which parasomnias are categorized and diagnosed is based on the International Classification of Sleep Disorders-Third Edition, Text Revision (ICSD-3-TR), published by the American Academy of Sleep Medicine. The recent Third Edition, Text Revision (ICSD-3-TR) of the ICSD provides an expert consensus of the diagnostic requirements for sleep disorders, including parasomnias, based on an extensive review of the current literature.
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Affiliation(s)
- Alon Y Avidan
- Department of Neurology, UCLA Sleep Disorders Center, UCLA, David Geffen School of Medicine at UCLA, 710 Westwood Boulevard, RNRC, C153, Mail Code 176919, Los Angeles, CA 90095-1769, USA.
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11
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Di Bello F, Pezone G, Muzii B, Cilio S, Ruvolo CC, Scandurra C, Mocini E, Creta M, Morra S, Bochicchio V, Salzano G, Vaira LA, Mangiapia F, Motta G, Maldonato NM, Longo N, Cantone E, Califano G. Lower urinary tract symptoms in young-middle aged males with a diagnosis of obstructive sleep apnea syndrome. Neurourol Urodyn 2024; 43:144-152. [PMID: 38010890 DOI: 10.1002/nau.25338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/09/2023] [Accepted: 11/10/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND The aim of the current study is to measure the prevalence and the potential role of International Prostate Symptom Score (IPSS) score as a predictor of obstructive sleep apnea syndrome (OSAS) in male experienced lower urinary tract symptoms (LUTS). METHODS A cross-sectional web-based Italian survey was administered via Google Forms between July 17 and October 31, 2022. The urinary functioning was measured through the IPSS questionnaire. Specifically, we considered symptoms occurring more than "about half the time" (score ≥ 3) as bothering symptoms. Multivariable logistic regression models (LRMs) adjusting for age, body mass index (BMI), International Index of Erectile Function-5, IPSS, and hypertension were fitted to predict OSAS in the cohort of men responding to the survey and experiencing LUTS. RESULTS Overall, 58 (24.4%) patients had a confirmed diagnosis of OSAS. The overall median IPSS was 5 (inter quartile range [IQR]: 3-8), respectively. According to IPSS items, 24 (10%), 44 (18.4%), 12 (5%), 12 (5%), 12 (5%), 11 (4.6%), 63 (26.4%) patients exhibit incomplete bladder emptying, urinary frequency, intermittency, urgency, weak stream, straining, nocturia with a score ≥ 3, respectively. After multivariable LRMs predicting the developing OSAS, age (odds ratio [OR]: 1.09, p < 0.001), BMI (OR:1.12, p < 0.001) and IPSS total score (OR:1.08, p = 0.02) were independent predicting factors. CONCLUSION This analysis revealed that the IPSS total score, age, and BMI are independent predictors of OSAS in males. In this context, the use of IPSS in daily practice could be helpful in assessing the LUTS presence and in supporting physicians to identify a hidden sleep apnea condition.
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Affiliation(s)
- Francesco Di Bello
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Gabriele Pezone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Benedetta Muzii
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Simone Cilio
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Claudia Collà Ruvolo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Cristiano Scandurra
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Edoardo Mocini
- Department of Experimental Medicine, Sapienza University, Rome, Italy
| | - Massimiliano Creta
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Simone Morra
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | | | - Giovanni Salzano
- Maxillofacial Surgery Operative Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Hospital of Naples "Federico II", Naples, Italy
| | - Luigi Angelo Vaira
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
| | - Francesco Mangiapia
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Gaetano Motta
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Nelson Mauro Maldonato
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Nicola Longo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Elena Cantone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Gianluigi Califano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
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12
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Takewaki F, Hosaka T, Ishitobi M, Kinjo M, Ishida H, Yasuda K. Characteristics of storage and voiding symptoms in adult patients with type 2 diabetes with lower urinary tract symptoms. THE JOURNAL OF MEDICAL INVESTIGATION 2024; 71:237-245. [PMID: 39462558 DOI: 10.2152/jmi.71.237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/29/2024]
Abstract
AIMS We aimed to assess the relationships between lower urinary tract symptoms (LUTS) and various parameters including diabetes complications in patients with type 2 diabetes. METHODS In this single-center cross-sectional study, we enrolled 404 patients hospitalized for diabetes. We ultimately analyzed data from 160 patients. To evaluate LUTS, the International Prostate Symptom Score and overactive bladder symptom score were used. The identified relationships were then analyzed considering parameters such as age, sex, body mass index (BMI), HbA1c, creatinine, and urinary albumin excretion. RESULTS The prevalences of overactive bladder (OAB), storage symptoms and voiding symptoms were 21.9%, 63.8%, and 39.4%, respectively. In multivariate logistic regression analysis, the coefficient of variation of the R-R interval, indicating autonomic neuropathy, correlated negatively with OAB, while BMI and duration of diabetes correlated positively with storage symptoms. A history of cerebrovascular disease correlated significantly with voiding symptoms in multivariate logistic analysis. CONCLUSIONS Our analysis of diabetic patients with LUTS revealed differences in the characteristics of storage and voiding symptoms. These findings provide evidence that the features of LUTS associated with diabetes may have different pathogenic origins. J. Med. Invest. 71 : 237-245, August, 2024.
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Affiliation(s)
- Fumie Takewaki
- Department of Diabetes, Endocrinology and Metabolism, Kyorin University School of Medicine, Tokyo, Japan
| | - Toshio Hosaka
- Laboratory of Clinical Nutrition, School of Food and Nutritional Sciences, University of Shizuoka, Shizuoka, Japan
| | - Minori Ishitobi
- Department of Diabetes, Endocrinology and Metabolism, Kyorin University School of Medicine, Tokyo, Japan
| | - Manami Kinjo
- Department of Urology, Kyorin University School of Medicine, Tokyo, Japan
| | - Hitoshi Ishida
- Research Center for Health Care, Nagahama City Hospital, Shiga, Japan
| | - Kazuki Yasuda
- Department of Diabetes, Endocrinology and Metabolism, Kyorin University School of Medicine, Tokyo, Japan
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Di Bello F, Scandurra C, Muzii B, Colla’ Ruvolo C, Califano G, Mocini E, Creta M, Napolitano L, Morra S, Fraia A, Bochicchio V, Salzano G, Vaira LA, Mangiapia F, Motta G, Motta G, Maldonato NM, Longo N, Cantone E. Are Excessive Daytime Sleepiness and Lower Urinary Tract Symptoms the Triggering Link for Mental Imbalance? An Exploratory Post Hoc Analysis. J Clin Med 2023; 12:6965. [PMID: 38002580 PMCID: PMC10672561 DOI: 10.3390/jcm12226965] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/04/2023] [Accepted: 11/06/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Both lower urinary tract symptoms (LUTS) and excessive daytime sleepiness (EDS) could negatively impair the patients' quality of life, increasing the sensitivity to psychological distress that results in mental health disorders. The relationships of both urinary and respiratory domains with psychological distress in obstructive sleep apnea patients is still underestimated. METHODS This study was a post hoc analysis of a web-based Italian survey, which included 1998 participants. Three hierarchical multiple linear regression analyses with psychological distress as dependent variable were performed on the study of 1988 participants enrolled in the final analysis. Cohen's f2 was used for the assessment of the effect size. RESULTS From the hierarchical multiple linear regression analyses, it emerged that the final statistical model (including sociodemographic characteristics, comorbidities, perceived urinary function, and excessive daytime sleepiness) for all dimensions accounted for 16.7% of the variance in psychological distress, with a medium effect size (f2 = 0.15). CONCLUSIONS People reported psychological distress was impaired by the presence of LUTS and EDS. Specifically, our study showed that higher levels of distress were scored especially in young women exhibiting urinary symptoms and with high values of daytime sleepiness.
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Affiliation(s)
- Francesco Di Bello
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.D.B.); (C.S.); (C.C.R.); (G.C.); (M.C.); (L.N.); (S.M.); (A.F.); (F.M.); (N.M.M.); (N.L.); (E.C.)
| | - Cristiano Scandurra
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.D.B.); (C.S.); (C.C.R.); (G.C.); (M.C.); (L.N.); (S.M.); (A.F.); (F.M.); (N.M.M.); (N.L.); (E.C.)
| | - Benedetta Muzii
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.D.B.); (C.S.); (C.C.R.); (G.C.); (M.C.); (L.N.); (S.M.); (A.F.); (F.M.); (N.M.M.); (N.L.); (E.C.)
| | - Claudia Colla’ Ruvolo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.D.B.); (C.S.); (C.C.R.); (G.C.); (M.C.); (L.N.); (S.M.); (A.F.); (F.M.); (N.M.M.); (N.L.); (E.C.)
| | - Gianluigi Califano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.D.B.); (C.S.); (C.C.R.); (G.C.); (M.C.); (L.N.); (S.M.); (A.F.); (F.M.); (N.M.M.); (N.L.); (E.C.)
| | - Edoardo Mocini
- Department of Experimental Medicine, Sapienza University, 00185 Rome, Italy;
| | - Massimiliano Creta
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.D.B.); (C.S.); (C.C.R.); (G.C.); (M.C.); (L.N.); (S.M.); (A.F.); (F.M.); (N.M.M.); (N.L.); (E.C.)
| | - Luigi Napolitano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.D.B.); (C.S.); (C.C.R.); (G.C.); (M.C.); (L.N.); (S.M.); (A.F.); (F.M.); (N.M.M.); (N.L.); (E.C.)
| | - Simone Morra
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.D.B.); (C.S.); (C.C.R.); (G.C.); (M.C.); (L.N.); (S.M.); (A.F.); (F.M.); (N.M.M.); (N.L.); (E.C.)
| | - Agostino Fraia
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.D.B.); (C.S.); (C.C.R.); (G.C.); (M.C.); (L.N.); (S.M.); (A.F.); (F.M.); (N.M.M.); (N.L.); (E.C.)
| | - Vincenzo Bochicchio
- Department of Humanistic Studies, University of Calabria, 87036 Rende, Italy;
| | - Giovanni Salzano
- Maxillofacial Surgery Operative Unit, University Hospital of Naples “Federico II”, 80131 Naples, Italy;
| | - Luigi Angelo Vaira
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy;
| | - Francesco Mangiapia
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.D.B.); (C.S.); (C.C.R.); (G.C.); (M.C.); (L.N.); (S.M.); (A.F.); (F.M.); (N.M.M.); (N.L.); (E.C.)
| | - Gaetano Motta
- ENT Unit, Department of Mental, Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (G.M.); (G.M.)
| | - Giovanni Motta
- ENT Unit, Department of Mental, Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (G.M.); (G.M.)
| | - Nelson Mauro Maldonato
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.D.B.); (C.S.); (C.C.R.); (G.C.); (M.C.); (L.N.); (S.M.); (A.F.); (F.M.); (N.M.M.); (N.L.); (E.C.)
| | - Nicola Longo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.D.B.); (C.S.); (C.C.R.); (G.C.); (M.C.); (L.N.); (S.M.); (A.F.); (F.M.); (N.M.M.); (N.L.); (E.C.)
| | - Elena Cantone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.D.B.); (C.S.); (C.C.R.); (G.C.); (M.C.); (L.N.); (S.M.); (A.F.); (F.M.); (N.M.M.); (N.L.); (E.C.)
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Jung SY, Mun YM, Lee GM, Kim SW. The Effect of Multilevel Surgery for Obstructive Sleep Apnea on Fatigue, Stress and Resilience. J Clin Med 2023; 12:6282. [PMID: 37834925 PMCID: PMC10573978 DOI: 10.3390/jcm12196282] [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: 09/14/2023] [Revised: 09/25/2023] [Accepted: 09/27/2023] [Indexed: 10/15/2023] Open
Abstract
OBJECTIVE To evaluate the effects of surgical treatment on fatigue, stress, and resilience in patients with obstructive sleep apnea (OSA). METHODS Sixty patients who underwent multilevel sleep surgery for OSA (OSA group) and 32 non-OSA participants (control group) were recruited at a university hospital in Korea between January 2020 and March 2022. Fatigue, stress, and resilience levels were evaluated in both groups using the Chalder fatigue scale (CFS), daily hassles scale revised (DHS-R), and Connor-Davidson resilience scale (CD-RISC), respectively. The scores of each group were compared before and 6 months after surgery. RESULTS The initial CFS and DHS-R scores were significantly higher, while the CD-RISC score was significantly lower, in the OSA group than in the control group (p < 0.05). In the patients with OSA, all three scores significantly improved after surgery (p < 0.05). Additionally, when compared between the groups at 6 months, there were no differences in the CFS, DHS-R, or CD-RISC scores (p > 0.05). Even when the OSA group was divided into a success group and a failure group according to surgical outcomes and compared with the control group, the three scores of both groups did not show statistical differences from the control group (p > 0.05). CONCLUSIONS Multilevel surgery may reduce fatigue as well as stress and increase resilience in patients with OSA to levels similar to those in non-OSA individuals.
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Affiliation(s)
- Su Young Jung
- Department of Otorhinolaryngology-Head and Neck Surgery, Myongji Hospital, Hanyang University Medical Center, Goyang 10475, Republic of Korea
| | - Young Min Mun
- Department of Otorhinolaryngology-Head and Neck Surgery, Myongji Hospital, Hanyang University Medical Center, Goyang 10475, Republic of Korea
| | - Gyu Man Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Myongji Hospital, Hanyang University Medical Center, Goyang 10475, Republic of Korea
| | - Sung Wan Kim
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
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Jiang YH, Kuo HC. Current optimal pharmacologic therapies for overactive bladder. Expert Opin Pharmacother 2023; 24:2005-2019. [PMID: 37752121 DOI: 10.1080/14656566.2023.2264183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 09/25/2023] [Indexed: 09/28/2023]
Abstract
INTRODUCTION Overactive bladder (OAB) is a common syndrome in adults. Current pharmacologic treatment includes antimuscarinic agents and β-3 adrenoceptor agonists. For non-responders to oral medication, intravesical injection of botulinum toxin A (BoNT-A) is an effective option. However, these treatments have potential adverse events and should be cautiously selected for appropriate patients. This review presents the recently published results of clinical trials and studies for patients with OAB and the underlying pathophysiology of OAB. Appropriate medical therapy based on pathophysiology of OAB is also presented. AREAS COVERED Literature search from Pubmed from 2001 to 2023 including clinical background, pharmacology, and clinical studies for OAB medications. EXPERT OPINION Treatment of OAB syndrome with any antimuscarinic or β-3 adrenoceptor agonist is feasible as a first-line approach. For patients with suboptimal therapeutic effect to full-dose antimuscarinics or mirabegron, combination with both drugs can improve efficacy. Intravesical BoNT-A 100-U injection provides therapeutic effects for refractory OAB. Patients who are refractory to initial pharmacotherapies should be investigated for the underlying pathophysiology; then an appropriate medication can be added, such as an α1-blocker or anti-inflammatory agents. Patient education about behavioral modification and therapies should always be provided with oral medication or BoNT-A injection for OAB patients.
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Affiliation(s)
- Yuan-Hong Jiang
- Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan
| | - Hann-Chorng Kuo
- Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan
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Stilo G, Vicini C, Pollicina I, Maniaci A, Lechien JR, Calvo-Henríquez C, Yáñez MM, Iannella G, Pace A, Cammaroto G, Meccariello G, Cannavicci A, Moffa A, Casale M, La Mantia I. Is Continuous Positive Airway Pressure a Valid Alternative to Sildenafil in Treating Sexual Dysfunction among OSA Patients? A Systematic Review and Meta-Analysis. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1318. [PMID: 37512129 PMCID: PMC10384051 DOI: 10.3390/medicina59071318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 06/26/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023]
Abstract
Background and Objectives: This study aimed to assess the comparative effectiveness of continuous positive airway pressure (CPAP) therapy and sildenafil pharmacological therapy in improving sexual function among patients with obstructive sleep apnea (OSA) and erectile dysfunction (ED). Materials and methods: Population: Patients affected by OSA and ED; Intervention: CPAP therapy vs. Comparison: Sildenafil pharmacological therapy; Outcomes: Improvement in erectile function, as measured by the International Index of Erectile Function 5 (IIEF-5) scoring system; Time: A systematic review of the literature from the past 20 years; Study Design: Observational studies comparing erectile function improvements after OSA treatment. Results: A total of eight papers were included in the qualitative summary, involving four hundred fifty-seven patients with ED and OSA. Erectile function improvements were observed in both treatment groups. After sildenafil and CPAP treatment, the mean IIEF-5 domain scores were 37.7 and 27.3, respectively (p < 0.001). Sildenafil 100 mg demonstrated a higher therapeutic impact compared to CPAP treatment. Conclusions: CPAP therapy significantly improved sexual parameters in most studies for OSA patients with ED. The findings suggest that CPAP therapy effectively alleviates erectile dysfunction symptoms, resulting in improved sexual performance in OSA patients. The comparison of the two treatments indicates that sildenafil has a more substantial therapeutic impact on erectile function than CPAP therapy; however, a combined treatment will provide a cumulative effect.
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Affiliation(s)
- Giovanna Stilo
- Department of Medical and Surgical Sciences and Advance and Echnologies "GF Ingrassia", ENT Section, University of Catania, 95123 Catania, Italy
| | - Claudio Vicini
- Oral Surgery Unit, Department of Head-Neck Surgery, Otolaryngology, Head-Neck, Morgagni Pierantoni Hospital, 47121 Forli, Italy
| | - Isabella Pollicina
- Department of Medical and Surgical Sciences and Advance and Echnologies "GF Ingrassia", ENT Section, University of Catania, 95123 Catania, Italy
| | - Antonino Maniaci
- Department of Medical and Surgical Sciences and Advance and Echnologies "GF Ingrassia", ENT Section, University of Catania, 95123 Catania, Italy
- Research Committee Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), 75000 Paris, France
| | - Jérôme René Lechien
- Research Committee Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), 75000 Paris, France
- Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), 7000 Mons, Belgium
| | - Christian Calvo-Henríquez
- Research Committee Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), 75000 Paris, France
- Service of Otolaryngology, Hospital Complex of Santiago de Compostela, 15701 Santiago de Compostela, Spain
| | - Miguel Mayo Yáñez
- Research Committee Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), 75000 Paris, France
- Otorhinolaryngology-Head and Neck Surgery Department, Complexo Hospitalario Universitario A Coruña (CHUAC), 15006 A Coruña, Spain
| | - Giannicola Iannella
- Research Committee Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), 75000 Paris, France
- Department of "Organi di Senso", University "Sapienza", 00185 Rome, Italy
| | - Annalisa Pace
- Department of "Organi di Senso", University "Sapienza", 00185 Rome, Italy
| | - Giovanni Cammaroto
- Oral Surgery Unit, Department of Head-Neck Surgery, Otolaryngology, Head-Neck, Morgagni Pierantoni Hospital, 47121 Forli, Italy
- Research Committee Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), 75000 Paris, France
| | - Giuseppe Meccariello
- Oral Surgery Unit, Department of Head-Neck Surgery, Otolaryngology, Head-Neck, Morgagni Pierantoni Hospital, 47121 Forli, Italy
| | - Angelo Cannavicci
- Oral Surgery Unit, Department of Head-Neck Surgery, Otolaryngology, Head-Neck, Morgagni Pierantoni Hospital, 47121 Forli, Italy
- Research Committee Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), 75000 Paris, France
| | - Antonio Moffa
- Unit of Otolaryngology, University Campus Bio-Medico, 00185 Rome, Italy
| | - Manuele Casale
- Unit of Otolaryngology, University Campus Bio-Medico, 00185 Rome, Italy
| | - Ignazio La Mantia
- Department of Medical and Surgical Sciences and Advance and Echnologies "GF Ingrassia", ENT Section, University of Catania, 95123 Catania, Italy
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17
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Wyszomirski K, Walędziak M, Różańska-Walędziak A. Obesity, Bariatric Surgery and Obstructive Sleep Apnea-A Narrative Literature Review. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1266. [PMID: 37512076 PMCID: PMC10385107 DOI: 10.3390/medicina59071266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 06/26/2023] [Accepted: 07/05/2023] [Indexed: 07/30/2023]
Abstract
The purpose of this review was to analyze the available literature on the subject of obesity and obstructive sleep apnea. We searched for available articles for the time period from 2013 to 2023. Obesity is listed as one of the most important health issues. Complications of obesity, with obstructive sleep apnea (OSA) listed among them, are common problems in clinical practice. Obesity is a well-recognized risk factor for OSA, but OSA itself may contribute to worsening obesity. Bariatric surgery is a treatment of choice for severely obese patients, especially with present complications, and remains the only causative treatment for patients with OSA. Though improvement in OSA control in patients after bariatric surgery is well-established knowledge, the complete resolution of OSA is achieved in less than half of them. The determination of subpopulations of patients in whom bariatric surgery would be especially advantageous is an important issue of OSA management. Increasing the potential of non-invasive strategies in obesity treatment requires studies that assess the efficacy and safety of combined methods.
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Affiliation(s)
- Krzysztof Wyszomirski
- Department of Human Physiology and Pathophysiology, Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszynski University in Warsaw, 01-938 Warsaw, Poland
| | - Maciej Walędziak
- Department of General, Oncological, Metabolic and Thoracic Surgery, Military Institute of Medicine-National Research Institute, Szaserów 128 St., 04-141 Warsaw, Poland
| | - Anna Różańska-Walędziak
- Department of Human Physiology and Pathophysiology, Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszynski University in Warsaw, 01-938 Warsaw, Poland
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