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Kandasamy G, Almeleebia T. A Prospective Study on Obstructive Sleep Apnea, Clinical Profile and Polysomnographic Variables. J Pers Med 2023; 13:919. [PMID: 37373908 DOI: 10.3390/jpm13060919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 05/28/2023] [Accepted: 05/29/2023] [Indexed: 06/29/2023] Open
Abstract
Background: Obstructive sleep apnea (OSA) is characterized by recurring episodes of pharyngeal collapse, which can partially or completely block airflow during sleep and cause cardiorespiratory and neurological imbalances. Therefore, the purpose of this study was to assess OSA and the relationship between AHI and polysomnographic characteristics in OSA patients. Methodology: A prospective study was conducted at the Department of Pulmonology and Sleep Medicine for two years. All 216 participants underwent polysomnography, and 175 of them were reported to have OSA (AHI ≥ 5), while 41 of them did not (AHI < 5). ANOVA and Pearson's correlation coefficient test were performed. Results: In terms of the study population's average AHI, Group 1 had 1.69 ± 1.34, mild OSA had 11.79 ± 3.55, moderate OSA had 22.12 ± 4.34, and severe OSA was found to have 59.16 ± 22.15 events/hour. The study group's average age was 53.77 ± 7.19 out of 175 OSA patients. According to AHI, the BMI for mild OSA was 31.66 ± 8.32 kg/m2, for moderate OSA, it was 30.52 ± 3.99 kg/m2, and for severe OSA, it was 34.35 ± 8.22 kg/m2. The average number of oxygen desaturation events and snoring duration were 25.20 ± 18.63 and 24.61 ± 28.53 min, respectively. BMI (r = 0.249, p < 0.001), average oxygen saturation (r = -0.387, p < 0.000), oxygen desaturation (r = 0.661, p < 0.000), snoring time (r = 0.231, p < 0.002), and the number of snores (r = 0.383, p < 0.001) were the polysomnographic variables that showed significant correlations with AHI in the study group. Conclusions: In this study, a substantial prevalence of obesity and a high OSA frequency were found in men. Our research showed that individuals with obstructive sleep apnea experience nocturnal desaturations. Polysomnography is the primary test for early detection of this treatable condition.
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Affiliation(s)
- Geetha Kandasamy
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University (KKU), Abha 61421, Saudi Arabia
| | - Tahani Almeleebia
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University (KKU), Abha 61421, Saudi Arabia
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Yu Y, Wu AMS, Wing YK, Chan JWY, Lau MMC, Lau JTF. Validation of the Revised Illness Perception Questionnaire of Obstructive Sleep Apnea among Elderly Chinese in the General Population. Sleep Breath 2023; 27:337-344. [PMID: 35377089 DOI: 10.1007/s11325-022-02598-y] [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: 10/25/2021] [Revised: 03/02/2022] [Accepted: 03/10/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE The prevalence of under-diagnosis among individuals with obstructive sleep apnea (OSA) is alarming, and may be associated with perceptions regarding OSA. To facilitate future studies on OSA, this study validated the revised version of the Illness Perception Questionnaire (IPQ-R) for OSA in a general population. METHODS A random anonymous population-based telephone survey interviewed 580 adults aged ≥ 50 years in Hong Kong, who self-reported not having been told by doctors as having OSA, from February 5 to March 19, 2021. RESULTS The confirmatory factor analysis identified a modified 7-factor model (i.e., timeline chronic, consequence, personal control, treatment control, illness coherence, timeline cyclical, and emotional representation) that showed satisfactory model fit index and internal consistency. Nine items were removed from the original version because of low factor loadings. No floor and ceiling effects were observed. Convergent validity was supported by the positive associations between the consequence subscale with perceived negative outcomes of OSA and between the illness coherence subscale and perceived understanding of OSA symptoms. The participants tended to endorse the items of timeline chronic, treatment control, and illness coherence but not with those of emotional representations. The mean scores of the IPQ-R subscales differed by age and education level. CONCLUSION The modified IPQ-R of OSA showed acceptable psychometric properties. It is applicable to assessing illness perceptions of OSA in the Chinese general population aged ≥ 50 years not having received OSA diagnosis. The validated tool would support future studies and health practices related to OSA.
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Affiliation(s)
- Yanqiu Yu
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Anise M S Wu
- Department of Psychology, Faculty of Social Sciences, University of Macau, Macau, China
| | - Yun-Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Joey W Y Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Mason M C Lau
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Joseph T F Lau
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
- Department of Psychology, School of Psychiatry, Wenzhou Medical University, Wenzhou, China.
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Daytime Sleepiness and Quality of Life in Obstructive Sleep Apnoea Patients before and after Long-Term Mandibular Advancement Device Treatment. Dent J (Basel) 2022; 10:dj10120226. [PMID: 36547042 PMCID: PMC9776804 DOI: 10.3390/dj10120226] [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: 10/14/2022] [Revised: 11/09/2022] [Accepted: 11/23/2022] [Indexed: 12/02/2022] Open
Abstract
This study compared daytime sleepiness and quality of life in OSA patients with healthy controls and compared sleepiness and quality of life in OSA patients before and after long-term treatment with a mandibular advancement device (MAD). A total of 27 OSA patients (18 men, 9 women, mean age 52.3 years) and 32 healthy age- and sex-matched controls (20 men, 12 women, mean age 51.1 years) were included. At baseline and after MAD treatment, daytime sleepiness and quality of life were recorded by the Epworth Sleepiness Scale (ESS) and Short Form-36 questionnaires (SF-36). Daytime sleepiness occurred significantly more often in OSA patients compared to controls at baseline (p = 0.01). The quality of life domains Energy and vitality (p < 0.0001), General perception of health (p = 0.0002), Mental health (p = 0.0031), Social functioning (p = 0.0119), Role limitations due to emotional problems (p = 0.0173) and Physical functioning (p = 0.0226) were significantly poorer in OSA patients compared to controls at baseline. After long-term MAD treatment, daytime sleepiness decreased (p < 0.01) and the quality of life domain Energy and Vitality increased (p < 0.01) in OSA patients compared to baseline. The results of the present study support the relevance of MAD treatment as an effective tool for decreasing daytime sleepiness and increasing the quality of life in OSA patients—also in the long term.
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Parveen N, Parganiha A. Consequences and factors associated with OSA: a brief review. BIOL RHYTHM RES 2022. [DOI: 10.1080/09291016.2022.2054558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Noorshama Parveen
- School of Studies in Life Science, Pandit Ravishankar Shukla University, Raipur, India
| | - Arti Parganiha
- School of Studies in Life Science, Pandit Ravishankar Shukla University, Raipur, India
- Center for Translational Chronobiology, Pandit Ravishankar Shukla University, Raipur, India
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Rostampour M, Noori K, Heidari M, Fadaei R, Tahmasian M, Khazaie H, Zarei M. White matter alterations in patients with obstructive sleep apnea: a systematic review of diffusion MRI studies. Sleep Med 2020; 75:236-245. [DOI: 10.1016/j.sleep.2020.06.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 06/17/2020] [Accepted: 06/18/2020] [Indexed: 12/25/2022]
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Garbarino S, Bardwell WA, Guglielmi O, Chiorri C, Bonanni E, Magnavita N. Association of Anxiety and Depression in Obstructive Sleep Apnea Patients: A Systematic Review and Meta-Analysis. Behav Sleep Med 2020; 18:35-57. [PMID: 30453780 DOI: 10.1080/15402002.2018.1545649] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background: Obstructive sleep apnea (OSA) has been associated with mental disorders, but the strength of this association is unknown. The aim of our study was to investigate the association among OSA, depression, and anxiety in adults and to quantitatively summarize the results. Methods: A literature search in Medline, PubMed, PsycInfo, Scopus, and Web of Science was conducted. Seventy-three articles were selected for study. Results: The pooled prevalence of depressive and anxious symptoms in OSA patients was 35% (95% CI, 28-41%) and 32% (95% CI, 22-42%), respectively. Conclusions: The association between OSA, anxiety, and depression indicates the value of an early diagnosis and personalized treatment of OSA to improve mental disorders conditioning compliance to therapy. These conditions share a probably bidirectional relationship.
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Affiliation(s)
- Sergio Garbarino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal/Child Sciences (DINOGMI), University of Genoa, Genoa, Italy.,Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Wayne A Bardwell
- Department of Psychiatry, University of California San Diego, San Diego, California
| | - Ottavia Guglielmi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal/Child Sciences (DINOGMI), University of Genoa, Genoa, Italy
| | - Carlo Chiorri
- Department of Educational Sciences, University of Genoa, Genoa, Italy
| | - Enrica Bonanni
- Center of Sleep Medicine, Neurology Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Nicola Magnavita
- Institute of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
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Kim JY, Ko I, Kim DK. Association of Obstructive Sleep Apnea With the Risk of Affective Disorders. JAMA Otolaryngol Head Neck Surg 2019; 145:1020-1026. [PMID: 31513273 DOI: 10.1001/jamaoto.2019.2435] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Importance Obstructive sleep apnea (OSA) is a common subtype of sleep breathing disorder; however, the association between OSA and the psychological health of affected individuals has not been fully evaluated. Objective To investigate the association between OSA and development of affective disorders. Design, Setting, and Participants This study used a nationwide representative cohort sample from the Korea National Health Insurance Service-National Sample Cohort database comprising data from 1 025 340 patients. The study included 197 patients with OSA diagnosed between January 2004 and December 2006 and 780 individuals without OSA who were matched using propensity score matching. Data were analyzed from September 28, 2018, to March 30, 2019. Main Outcomes and Measures Affective disorder events over a 9-year follow-up period. Kaplan-Meier survival curves with log-rank tests and Cox proportional hazards regression models were used to calculate cumulative incidence and hazard ratios (HRs) of affective disorders for each group. Results Of the total population of 985 (860 male [87.3%], 540 [54.8%] were aged <45 years), the incidences per 1000 person-years of affective disorders were 49.57 and 27.18 in the OSA and comparison groups, respectively. A total of 1371.7 person-years in the OSA group and 6328.6 person-years in the comparison group were evaluated for affective disorder events. After adjustment for sociodemographic factors (age, residential area, and household income), disability, and comorbidities, the adjusted HRs for patients with OSA developing affective disorders in patients with OSA during the 9-year follow-up period was 2.04 (95% CI, 1.53-2.70). In a subgroup analysis, the adjusted HRs for patients with OSA who developed depressive and anxiety disorders were 2.90 (95% CI, 1.98-4.24) and 1.75 (95% CI, 1.26-2.44), respectively. Moreover, female patients with OSA had a significant likelihood of prospective development of depression and anxiety (adjusted HR for depression, 3.97 [95% CI, 1.54-10.19]; adjusted HR for anxiety, 2.42 [95% CI, 1.17-5.02]) compared with male patients with OSA (adjusted HR for depression, 2.74 [95% CI, 1.80-4.17]; adjusted HR for anxiety, 1.64 [95% CI, 1.13-2.39]). Conclusions and Relevance This observational study using nationwide data suggests that OSA is associated with an increased incidence of affective disorder, such as depression and anxiety. Further studies appear to be needed to confirm our findings and, if validated, then studies are needed to explore the nature of the observed association, including potential causality, between OSA and affective symptoms.
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Affiliation(s)
- Jong-Yeup Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Konyang University, Daejeon, Republic of Korea.,Department of Biomedical Informatics, College of Medicine, Konyang University, Daejeon, Republic of Korea
| | - Inseok Ko
- Department of Biomedical Informatics, College of Medicine, Konyang University, Daejeon, Republic of Korea
| | - Dong-Kyu Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea.,Institute of New Frontier Research, Hallym University College of Medicine, Chuncheon, Republic of Korea
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Kim JY, Ko I, Cho BJ, Kim DK. Association of Obstructive Sleep Apnea With the Risk of Ménière's Disease and Sudden Sensorineural Hearing Loss: A Study Using Data From the Korean National Health Insurance Service. J Clin Sleep Med 2019; 15:1293-1301. [PMID: 31538600 PMCID: PMC6760412 DOI: 10.5664/jcsm.7922] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Revised: 05/09/2019] [Accepted: 05/09/2019] [Indexed: 12/17/2022]
Abstract
STUDY OBJECTIVES Several studies have reported an association between obstructive sleep apnea (OSA) and neuro-otologic diseases, such as Ménière's disease or sudden sensorineural hearing loss (SSNHL). However, the exact relationship between OSA and those diseases has not been fully evaluated. Therefore, the aim of this study was to investigate the prospective link between OSA and Ménière's disease or SSNHL. METHODS We used a nationwide cohort sample of data for 2002-2013 representing approximately 1 million patients. The OSA group (n = 942) included patients diagnosed between 2004 and 2006; the comparison group was selected using propensity score matching (n = 3,768). We investigated Ménière's disease and SSNHL events over a 9-year follow-up period. Survival analysis, log-rank test, and Cox proportional hazards regression models were used to calculate incidence, survival rate, and hazard ratios for each group. RESULTS In the OSA group, the incidences of Ménière's disease and SSNHL were 7,854.4 and 7,876.3 person-years, respectively. Cox proportional hazards analysis revealed no overall association between patients with OSA and the risk of subsequent Ménière's disease or SSNHL. In a subgroup analysis, female and middle-aged patients with OSA were independently associated with a two-fold higher incidence of subsequent Ménière's disease, compared to those without OSA. However, we could not find any significant association between patients with OSA and SSNHL even in the subgroup analysis. CONCLUSIONS Our findings suggest that female or middle-aged patients with OSA are associated with an increased incidence of Ménière's disease. However, there was no association between OSA and SSNHL. CITATION Kim J-Y, Ko I, Cho B-J, Kim D-K. Association of obstructive sleep apnea with the risk of Ménière's disease and sudden sensorineural hearing loss: a study using data from the Korean National Health Insurance Service. J Clin Sleep Med. 2019;15(9):1293-1301.
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Affiliation(s)
- Jong-Yeup Kim
- Department of Otorhinolaryngology–Head and Neck Surgery, College of Medicine, Konyang University, Daejeon, Republic of Korea
- Department of Biomedical Informatics, College of Medicine, Konyang University, Daejeon, Republic of Korea
| | - Inseok Ko
- Department of Biomedical Informatics, College of Medicine, Konyang University, Daejeon, Republic of Korea
| | - Bum-Joo Cho
- Department of Ophthalmology, Hallym University College of Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
- Institute of New Frontier Research, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Dong-Kyu Kim
- Institute of New Frontier Research, Hallym University College of Medicine, Chuncheon, Republic of Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea
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Lipford MC, Wahner-Roedler DL, Welsh GA, Mandrekar J, Thapa P, Olson EJ. Correlation of the Epworth Sleepiness Scale and Sleep-Disordered Breathing in Men and Women. J Clin Sleep Med 2019; 15:33-38. [PMID: 30621827 DOI: 10.5664/jcsm.7564] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 08/29/2018] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES To compare Epworth Sleepiness Scale (ESS) scores of men and women and determine if there is a correlation with sleep-disordered breathing (SDB) based on subsequent polysomnography (PSG). METHODS Consecutive adult patients were identified who completed ESS and PSG at Mayo Clinic in Rochester, Minnesota, between January 1, 2013, and January 31, 2015. Apnea-hypopnea index (AHI) ≥ 5 events/h was classified as presence of SDB, and increasing values represented greater severity. RESULTS Among 6,593 patients with valid ESS scores and timely subsequent PSG, 42% were women. Mean (standard deviation [SD]) age of women was 56.2 (15.2) years; men, 58.5 (15.1) years. Mean (SD) ESS score was 9.5 (5.4) for women and 9.5 (5.3) for men. SDB was present in 83.6% of men and 68.3% of women. Mean (SD) AHI of men was 25.9 (26.7) events/h; women, 16.1 (22.4) events/h (P < .001). Each unit increase in ESS score of men was associated with a 0.51-unit increase in AHI (P < .001); women had a 0.16-unit associated increase (P = .04) (effect ratio, threefold greater for men). PSG demonstrated that women had greater sleep efficiency, less respiratory effort-related arousals, and less hypoxemia (all P < .001). Among women, ESS did not correlate with presence of SDB or mild to moderate SDB. There was a small association in women with severe SDB. CONCLUSIONS ESS is not correlated with SDB at mild to moderate levels in women and has a smaller association than in men with severe SDB. Further work is necessary to understand sex-specific differences in patients with SDB.
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Affiliation(s)
- Melissa C Lipford
- Center for Sleep Medicine, Mayo Clinic, Rochester, Minnesota.,Department of Neurology, Mayo Clinic, Rochester, Minnesota
| | | | - Gail A Welsh
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Jay Mandrekar
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota
| | - Prabin Thapa
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota
| | - Eric J Olson
- Center for Sleep Medicine, Mayo Clinic, Rochester, Minnesota.,Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota
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Abstract
PURPOSE OF REVIEW To summarize recent research investigating the interaction between obstructive sleep apnea (OSA) and anxiety, and contextualize their bidirectional relationship. RECENT FINDINGS Recent investigations corroborate the bidirectional relationship between sleep-disordered breathing (SDB) and anxiety, evaluate the etiological and clinical manifestations through different mechanisms, and provide insight into clinical implications of this interaction. Much of the literature about anxiety as it relates to SDB is from small samples, using different tools of symptom measurement that are often subjectively quantified. The objective severity of OSA does not appear to be associated with subjectively reported sleepiness and fatigue, whereas physiological manifestations of anxiety are associated with the severity of subjective symptoms reported. Recent findings support that women are more likely to have comorbid SDB and anxiety than men. SDB may precipitate and perpetuate anxiety, whereas anxiety in OSA negatively impacts quality-of-life. Treating SDB may improve anxiety symptoms, whereas anxiety symptoms can be an obstacle and deterrent to appropriate treatment. SUMMARY The interaction between anxiety and SDB is still poorly elucidated. Being aware of the clinical associations, risk factors, and treatment implications for SDB as related to anxiety disorders in different populations can help clinicians with the diagnosis and management of both SDB and anxiety.
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Kacem I, Kalboussi H, Ben Salem H, Maoua M, El Guedri S, Laayouni M, Abdelghani A, Boughattas W, Brahem A, Debbabi F, El Maalel O, Chatti S, Benzarti M, Mrizak N. [Quality of life in adult patient (Tunisian) with severe OSA]. REVUE DE PNEUMOLOGIE CLINIQUE 2017; 73:163-171. [PMID: 28838623 DOI: 10.1016/j.pneumo.2017.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2016] [Revised: 07/01/2017] [Accepted: 07/17/2017] [Indexed: 06/07/2023]
Abstract
INTRODUCTION The negative impact of obstructive sleep apnea (OSA) on quality of life of affected individuals is a central consequence of this disease. The recognition of the quality of life as a therapeutic target is a relatively new concept. OBJECTIVES To evaluate the quality of life and its determinants in patients with OSA. MATERIALS AND METHODS We conducted a cross-sectional study during the period from 1st July 2012 to 30th June 2013. The target population was patients with OSA and in employment examined in consultations of pneumology in the teaching hospital Farhat-Hached in Sousse (Tunisia). This study was based on a generic questionnaire (SF-36) to assess the quality of life. RESULTS The study population included 103 cases with a mean age of 55.15±11.4years and a sex ratio of 0.71. Our patients were obese in 95.1 % of cases with an average BMI of 39.13±7.19kg/m2. The majority of our patients had an impaired quality of life with an average score of 44.76 (SF36) and extremes of 22 and 70. There was a positive linear relationship between physical and mental components of the SF-36 and gender, age, BMI, and anxiety and depressive disorders. CONCLUSION The OSA is a demanding disease whose impact on the quality of life seems important and requires special attention. The management of this disease should not be limited to controlling the disease but aspire to overall patient satisfaction.
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Affiliation(s)
- I Kacem
- Service de médecine de travail et de pathologie professionnelle, CHU Farhat-Hached, avenue Ibn ElJazzar, 4000 Sousse, Tunisie.
| | - H Kalboussi
- Service de médecine de travail et de pathologie professionnelle, CHU Farhat-Hached, avenue Ibn ElJazzar, 4000 Sousse, Tunisie
| | - H Ben Salem
- Service de pneumologie et allergologie, CHU Farhat-Hached, avenue Ibn ElJazzar, 4000 Sousse, Tunisie
| | - M Maoua
- Service de médecine de travail et de pathologie professionnelle, CHU Farhat-Hached, avenue Ibn ElJazzar, 4000 Sousse, Tunisie
| | - S El Guedri
- Service de médecine de travail et de pathologie professionnelle, CHU Farhat-Hached, avenue Ibn ElJazzar, 4000 Sousse, Tunisie
| | - M Laayouni
- Service de pneumologie et allergologie, CHU Farhat-Hached, avenue Ibn ElJazzar, 4000 Sousse, Tunisie
| | - A Abdelghani
- Service de pneumologie et allergologie, CHU Farhat-Hached, avenue Ibn ElJazzar, 4000 Sousse, Tunisie
| | - W Boughattas
- Service de médecine de travail et de pathologie professionnelle, CHU Farhat-Hached, avenue Ibn ElJazzar, 4000 Sousse, Tunisie
| | - A Brahem
- Service de médecine de travail et de pathologie professionnelle, CHU Farhat-Hached, avenue Ibn ElJazzar, 4000 Sousse, Tunisie
| | - F Debbabi
- Service de médecine de travail et de pathologie professionnelle, CHU Farhat-Hached, avenue Ibn ElJazzar, 4000 Sousse, Tunisie
| | - O El Maalel
- Service de médecine de travail et de pathologie professionnelle, CHU Farhat-Hached, avenue Ibn ElJazzar, 4000 Sousse, Tunisie
| | - S Chatti
- Service de médecine de travail et de pathologie professionnelle, CHU Farhat-Hached, avenue Ibn ElJazzar, 4000 Sousse, Tunisie
| | - M Benzarti
- Service de pneumologie et allergologie, CHU Farhat-Hached, avenue Ibn ElJazzar, 4000 Sousse, Tunisie
| | - N Mrizak
- Service de médecine de travail et de pathologie professionnelle, CHU Farhat-Hached, avenue Ibn ElJazzar, 4000 Sousse, Tunisie
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Iacono Isidoro S, Salvaggio A, Lo Bue A, Romano S, Marrone O, Insalaco G. Immediate effect of CPAP titration on perceived health related quality of life: a prospective observational study. BMC Pulm Med 2016; 16:172. [PMID: 27905903 PMCID: PMC5133738 DOI: 10.1186/s12890-016-0336-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Accepted: 11/24/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Perceived Health Related Quality of Life (HRQoL) is impaired in obstructive sleep apnea (OSA). This study examines changes in HRQoL aspects occurring immediately after CPAP titration. Furthermore, we analyzed variations in each gender and in patients undergoing home or laboratory-based CPAP titration pathways. METHODS Twohundredfive outpatients (151 M) (56.7 ± 10.3 years) were evaluated, before first visit and nocturnal diagnostic examination (T0), and the morning after CPAP titration (T1). Two self-reported HRQoL questionnaires were administered: Psychological General Well-Being Index (PGWBI), composed by six subscales, and 12-Item Short-Form Health Survey (SF-12), including Physical (PCS) and Mental Component Summaries (MCS). CPAP titration was performed using auto-adjusting CPAP units at patients' home or in the sleep laboratory. RESULTS PGWBI scores at T1 improved compared to T0 (p < 0.0001). A similar improvement was observed in SF-12 MCS (p = 0.0011), but not in SF-12 PCS. Changes were independent from anthropometric parameters, OSA severity and excessive daytime sleepiness. Gender comparisons showed better HRQoL in males at both times. At T0, patients who received home or laboratory CPAP titration pathways did not show any differences in PGWBI and SF-12 scores. At T1, PGWBI and SF-12 MCS improved in both home and laboratory groups. CONCLUSIONS This study gives evidence that first time CPAP application for titration can lead to a general increase in perceived well-being. Gender comparisons showed better perceived HRQoL with more subscales improvements in males after CPAP titration. The improvement was similar with both home and laboratory CPAP titration pathways.
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Affiliation(s)
- Serena Iacono Isidoro
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology "A. Monroy", Via Ugo La Malfa, 153, Palermo, 90146, Italy
| | - Adriana Salvaggio
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology "A. Monroy", Via Ugo La Malfa, 153, Palermo, 90146, Italy.
| | - Anna Lo Bue
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology "A. Monroy", Via Ugo La Malfa, 153, Palermo, 90146, Italy
| | - Salvatore Romano
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology "A. Monroy", Via Ugo La Malfa, 153, Palermo, 90146, Italy
| | - Oreste Marrone
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology "A. Monroy", Via Ugo La Malfa, 153, Palermo, 90146, Italy
| | - Giuseppe Insalaco
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology "A. Monroy", Via Ugo La Malfa, 153, Palermo, 90146, Italy
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Wimms A, Woehrle H, Ketheeswaran S, Ramanan D, Armitstead J. Obstructive Sleep Apnea in Women: Specific Issues and Interventions. BIOMED RESEARCH INTERNATIONAL 2016; 2016:1764837. [PMID: 27699167 PMCID: PMC5028797 DOI: 10.1155/2016/1764837] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 07/26/2016] [Accepted: 08/11/2016] [Indexed: 12/21/2022]
Abstract
Obstructive sleep apnea (OSA) has traditionally been seen as a male disease. However, the importance of OSA in women is increasingly being recognized, along with a number of significant gender-related differences in the symptoms, diagnosis, consequences, and treatment of OSA. Women tend to have less severe OSA than males, with a lower apnea-hypopnea index (AHI) and shorter apneas and hypopneas. Episodes of upper airway resistance that do not meet the criteria for apneas are more common in women. Prevalence rates are lower in women, and proportionally fewer women receive a correct diagnosis. Research has also documented sex differences in the upper airway, fat distribution, and respiratory stability in OSA. Hormones are implicated in some gender-related variations, with differences between men and women in the prevalence of OSA decreasing as age increases. The limited data available suggest that although the prevalence and severity of OSA may be lower in women than in men, the consequences of the disease are at least the same, if not worse for comparable degrees of severity. Few studies have investigated gender differences in the effects of OSA treatment. However, given the differences in physiology and presentation, it is possible that personalized therapy may provide more optimal care.
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Affiliation(s)
- Alison Wimms
- ResMed Science Centre, Fraunhoferstraße 16, 82152 Planegg, Germany
- University of Sydney, Fisher Road, Sydney, NSW, Australia
| | - Holger Woehrle
- ResMed Science Centre, Fraunhoferstraße 16, 82152 Planegg, Germany
- Sleep and Ventilation Center Blaubeuren, Lung Center Ulm, Ulm, Germany
| | | | - Dinesh Ramanan
- ResMed Science Centre, Fraunhoferstraße 16, 82152 Planegg, Germany
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Abad Massanet F, Rivero Pérez J, Vera Osorio J. Diferencias en la calidad de vida relacionada con la salud entre hombres y mujeres con trastorno respiratorio del sueño. Semergen 2015; 41:407-12. [DOI: 10.1016/j.semerg.2014.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Revised: 10/09/2014] [Accepted: 10/13/2014] [Indexed: 11/26/2022]
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Palomares JA, Tummala S, Wang DJJ, Park B, Woo MA, Kang DW, St Lawrence KS, Harper RM, Kumar R. Water Exchange across the Blood-Brain Barrier in Obstructive Sleep Apnea: An MRI Diffusion-Weighted Pseudo-Continuous Arterial Spin Labeling Study. J Neuroimaging 2015; 25:900-5. [PMID: 26333175 DOI: 10.1111/jon.12288] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 07/17/2015] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND AND PURPOSE Obstructive sleep apnea (OSA) subjects show brain injury in sites that control autonomic, cognitive, and mood functions that are deficient in the condition. The processes contributing to injury may include altered blood-brain barrier (BBB) actions. Our aim was to examine BBB function, based on diffusion-weighted pseudo-continuous arterial spin labeling (DW-pCASL) procedures, in OSA compared to controls. METHODS We performed DW-pCASL imaging in nine OSA and nine controls on a 3.0-Tesla MRI scanner. Global mean gray and white matter arterial transient time (ATT, an index of large artery integrity), water exchange rate across the BBB (Kw, BBB function), DW-pCASL ratio, and cerebral blood flow (CBF) values were compared between OSA and control subjects. RESULTS Global mean gray and white matter ATT (OSA vs. controls; gray matter, 1.691 ± .120 vs. 1.658 ± .109 second, P = .49; white matter, 1.700 ± .115 vs. 1.650 ± .114 second, P = .44), and CBF values (gray matter, 57.4 ± 15.8 vs. 58.2 ± 10.7 ml/100 g/min, P = .67; white matter, 24.2 ± 7.0 vs. 24.6 ± 6.7 ml/100 g/min, P = .91) did not differ significantly, but global gray and white matter Kw (gray matter, 158.0 ± 28.9 vs. 220.8 ± 40.6 min(-1) , P = .002; white matter, 177.5 ± 57.2 vs. 261.1 ± 51.0 min(-1) , P = .006), and DW-pCASL ratio (gray matter, .727 ± .076 vs. .823 ± .069, P = .011; white matter, .722 ± .144 vs. .888 ± .100, P = .004) values were significantly reduced in OSA over controls. CONCLUSIONS OSA subjects show compromised BBB function, but intact large artery integrity. The BBB alterations may introduce neural damage contributing to abnormal functions in OSA, and suggest a need to repair BBB function with strategies commonly used in other fields.
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Affiliation(s)
- Jose A Palomares
- Department of Anesthesiology, University of California, Los Angeles, Los Angeles, CA
| | - Sudhakar Tummala
- Department of Anesthesiology, University of California, Los Angeles, Los Angeles, CA
| | - Danny J J Wang
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA.,Department of Radiological Sciences, University of California, Los Angeles, Los Angeles, CA
| | - Bumhee Park
- Department of Anesthesiology, University of California, Los Angeles, Los Angeles, CA
| | - Mary A Woo
- UCLA School of Nursing, University of California, Los Angeles, Los Angeles, CA
| | - Daniel W Kang
- Department of Medicine, University of California, Los Angeles, Los Angeles, CA
| | | | - Ronald M Harper
- Department of Neurobiology, University of California, Los Angeles, Los Angeles, CA.,Brain Research Institute, University of California, Los Angeles, Los Angeles, CA
| | - Rajesh Kumar
- Department of Anesthesiology, University of California, Los Angeles, Los Angeles, CA.,Department of Radiological Sciences, University of California, Los Angeles, Los Angeles, CA.,Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA.,Brain Research Institute, University of California, Los Angeles, Los Angeles, CA
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Broadbent E, Wilkes C, Koschwanez H, Weinman J, Norton S, Petrie KJ. A systematic review and meta-analysis of the Brief Illness Perception Questionnaire. Psychol Health 2015; 30:1361-85. [DOI: 10.1080/08870446.2015.1070851] [Citation(s) in RCA: 282] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Beck MC, Piccin CF, Oliveira LCAD, Scapini F, Coser Neto RF, Silva AMVD. Obstructive sleep apnea: acute effects of CPAP on polyssonographic variables. FISIOTERAPIA EM MOVIMENTO 2015. [DOI: 10.1590/0103-5150.028.002.ao02] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction The use of non-invasive ventilation in the form of continuous positive airway pressure (CPAP) is among the main therapeutic options for patients with obstructive sleep apnea (OSA). Yet the effects of CPAP obtained on the first night of use are underreported. Objective To evaluate the acute effects of CPAP on polysomnographic variables in patients with OSA. Materials and methods This study is a case series with 31 patients (55.8 ± 11.4 years; 22 men) in the initial phase of CPAP treatment. The subjects were evaluated by means of polysomnography with and without CPAP (10.2 ± 3.1 cmH2O) and without CPAP, on different days, by means of the following variables: sleep stages 1, 2 and 3 (N1, N2 and N3), rapid eye movement (REM) sleep, apnea and hypopnea index (AHI), AHI in REM sleep (AHIREM) and the micro-arousal index (MAI). Results The use of CPAP resulted in a reduction of N2 (p < 0.001), AHI (p < 0.001), AHIREM (p < 0.001) and MAI (p = 0.001). There was an increase in N3 (p = 0.006) and REM sleep (p < 0.001) during the night with use of CPAP. Conclusion This study demonstrated that, from the first night of use by patients with OSA, CPAP promotes greater balance between sleep phases, and improves sleep quality. These results should be presented to patients and their families in order to encourage greater adherence in the initial phase of treatment with CPAP.
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Affiliation(s)
| | - Chaiane Facco Piccin
- Universidade Federal de Santa Maria, Brazil; Instituto do Sono de Santa Maria, Brazil
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McKinney J, Ortiz-Young D, Jefferson F. Gender differences in obstructive sleep apnea and the associated public health burden. Sleep Biol Rhythms 2015. [DOI: 10.1111/sbr.12107] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Janell McKinney
- Department of Neuroscience; Agnes Scott College; Decatur Georgia USA
| | - Deborah Ortiz-Young
- Department of Bioscience Technology; Atlanta Technical College; Atlanta Georgia USA
| | - Felicia Jefferson
- Division of Natural Sciences and Mathematics; Spelman College; Atlanta Georgia USA
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Gupta MA, Simpson FC. Obstructive sleep apnea and psychiatric disorders: a systematic review. J Clin Sleep Med 2015; 11:165-75. [PMID: 25406268 DOI: 10.5664/jcsm.4466] [Citation(s) in RCA: 182] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Accepted: 10/13/2014] [Indexed: 12/11/2022]
Abstract
STUDY OBJECTIVES Obstructive sleep apnea (OSA) has been associated with psychiatric pathology. Psychiatric comorbidity in OSA may affect patient quality of life and adherence to CPAP. A focused evaluation of OSA in highly selected groups of primarily psychiatric patients may provide further insights into the factors contributing to comorbidity of OSA and psychopathology. The goal of this study is to examine the prevalence and treatment of OSA in psychiatric populations. METHODS A systematic review following the PRISMA guidelines was conducted to determine the prevalence of OSA in schizophrenia and other psychotic disorders, mood disorders, and anxiety disorders, and to examine potential interventions. The PubMed, EMBASE, and PsycINFO databases were searched (last search April 26, 2014) using keywords based on the ICD-9-CM coding for OSA and the DSM-IV-TR diagnostic groups. RESULTS The search retrieved 47 records concerning studies of OSA in the selected disorders. The prevalence studies indicate that there may be an increased prevalence of OSA in individuals with major depressive disorder (MDD) and posttraumatic stress disorder (PTSD), despite considerable heterogeneity and a high risk of bias. There was insufficient evidence to support increased OSA in schizophrenia and psychotic disorders, bipolar and related disorders, and anxiety disorders other than PTSD. Studies of treatment of OSA indicate an improvement in both OSA and psychiatric symptoms. CPAP adherence was reduced in veterans with PTSD. CONCLUSIONS OSA prevalence may be increased in MDD and PTSD. In individuals with OSA and psychiatric illness, treatment of both disorders should be considered for optimal treatment outcomes.
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Affiliation(s)
- Madhulika A Gupta
- Department of Psychiatry, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Fiona C Simpson
- Department of Psychiatry, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
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Shapiro AL, Culp S, Azulay Chertok IR. OSA symptoms associated with and predictive of anxiety in middle-aged men: secondary analysis of NHANES data. Arch Psychiatr Nurs 2014; 28:200-5. [PMID: 24856274 DOI: 10.1016/j.apnu.2014.02.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2013] [Revised: 02/11/2014] [Accepted: 02/15/2014] [Indexed: 11/19/2022]
Abstract
OBJECT This population-based study examined obstructive sleep apnea (OSA) symptoms predictive of anxiety in middle-aged men. METHOD Secondary analyses were conducted on the National Health and Nutrition Examination Survey (NHANES) 2007-2008 data using weighted samples and complex sample analysis techniques (unweighted N=1,217). FINDINGS Nonrefreshing sleep (χ(2)=69.333, p<0.001), excessive daytime sleepiness (χ(2)=47.766, p<0.001), and sleep fragmentation (χ(2)=30.692, p<0.001) were significantly associated with anxiety. Nonrefreshing sleep (OR 3.582, p<0.001) and awakenings due to apneic episodes (OR 2.047, p=0.001) were predictive of anxiety. CONCLUSION Comorbid anxiety and OSA symptoms are common and have implications for activities of daily living, social responsibilities, and quality of life. Screening for anxiety among men with OSA symptoms is recommended.
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Affiliation(s)
- April L Shapiro
- School of Nursing, West Virginia University, 600 Harley O. Staggers Sr. Drive, Keyser, WV.
| | - Stacey Culp
- School of Nursing, West Virginia University, 6404 Health Sciences South Morgantown, WV.
| | - Ilana R Azulay Chertok
- School of Nursing, West Virginia University, 6504 Health Sciences South, Morgantown, WV.
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Sikka P, Aigner M, Mann A, Banerjee A. Outcomes of Therapy for Hypersomnia for Obstructive Sleep Apnea. Sleep Med Clin 2013. [DOI: 10.1016/j.jsmc.2013.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Wu H, Zhao X, Fritzsche K, Salm F, Leonhart R, Jing W, Yang J, Schaefert R. Negative illness perceptions associated with low mental and physical health status in general hospital outpatients in China. PSYCHOL HEALTH MED 2013; 19:273-85. [DOI: 10.1080/13548506.2013.802358] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Roles of gender, age, race/ethnicity, and residential socioeconomics in obstructive sleep apnea syndromes. Curr Opin Pulm Med 2013; 18:568-73. [PMID: 22990656 DOI: 10.1097/mcp.0b013e328358be05] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
PURPOSE OF REVIEW Review recent research on the roles of gender, race/ethnicity, residential socioeconomics and age in obstructive sleep apnea syndromes (OSA) and their treatment. RECENT FINDINGS Men have a higher prevalence of OSA than women and require higher continuous positive airway pressure (CPAP) pressures for treatment, given similar severity of OSA. When comparing age, women have less severe apnea at all ages. Menopause, pregnancy and polycystic ovarian syndrome increase the risk for OSA in women. Neck fat and BMI influence apnea-hypopnea index (AHI) severity in women; abdominal fat and neck-to-waist ratio do so in men. Obesity, craniofacial structure, lower socioeconomic status and neighborhood disadvantage may better explain ethnic/racial differences in the prevalence and severity of OSA. Ethnicity was no longer significantly associated with OSA severity when WHO criteria for obesity were used. SUMMARY OSA has a male predominance; women have a lower AHI than men during certain stages of sleep; women require less CPAP pressure for treatment of similar severity of OSA, and there are ethnic/racial differences in the prevalence and severity of OSA but these may be due to environmental factors, such as living in disadvantaged neighborhoods.
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Macey PM, Kumar R, Yan-Go FL, Woo MA, Harper RM. Sex differences in white matter alterations accompanying obstructive sleep apnea. Sleep 2012. [PMID: 23204603 DOI: 10.5665/sleep.2228] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
STUDY OBJECTIVES Females with obstructive sleep apnea (OSA) show different psychological and physiological symptoms from males, which may be associated with sex-related variations in neural injury occurring with the disorder. To determine whether male- or female-specific brain injury is present in OSA, we assessed influences of sex on white matter changes in the condition. DESIGN Two-group factorial. SETTING University medical center. PATIENTS OR PARTICIPANTS 80 subjects total, with newly diagnosed, untreated OSA groups of 10 female (age mean ± SE: 52.6 ± 2.4 years, AHI 22.5 ± 4.1 events/h) and 20 male (age 48.9 ± 1.7, AHI 25.5 ± 2.9) patients, and 20 female (age 50.3 ± 1.7) and 30 male (age 49.2 ± 1.4) healthy control subjects. INTERVENTIONS None. MEASUREMENTS AND RESULTS Brain fiber integrity was assessed with fractional anisotropy (FA), a diffusion tensor imaging-derived measure. Sleep quality, daytime sleepiness, depression, and anxiety were assessed with questionnaires. We identified regions of differing injury in male versus female OSA patients by assessing brain regions with significant interaction effects of OSA and sex on FA. Areas of sex-specific, OSA-related FA reductions appeared in females relative to males, including in the bilateral cingulum bundle adjacent to the mid hippocampus, right stria terminalis near the amygdala, prefrontal and posterior-parietal white matter, corpus callosum, and left superior cerebellar peduncle. Females with OSA showed higher daytime sleepiness, anxiety and depression levels, and reduced sleep quality. CONCLUSIONS Sex differences in white matter structural integrity appeared in OSA patients, with females more affected than males. These female-specific structural changes may contribute to or derive from neuropsychological and physiological symptom differences between sexes.
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Affiliation(s)
- Paul M Macey
- School of Nursing, University of California at Los Angeles, Los Angeles, CA 90095-1702, USA
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