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Ghavami T, Kazeminia M, Ahmadi N, Rajati F. Global Prevalence of Obstructive Sleep Apnea in the Elderly and Related Factors: A Systematic Review and Meta-Analysis Study. J Perianesth Nurs 2023; 38:865-875. [PMID: 37318436 DOI: 10.1016/j.jopan.2023.01.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 12/21/2022] [Accepted: 01/21/2023] [Indexed: 06/16/2023]
Abstract
PURPOSE The aims of current meta-analysis was to combine data and statistics on the global prevalence of OSA and related factors in older adults. DESIGN A systematic review and meta-analysis. METHODS To find related studies, various databases were searched including Embase, PubMed, Scopus, Web of Science (WoS), MagIran, and SID (two local databases) using appropriate keywords, MeSH and controlled vocabulary, with no time limitation up to June, 2021. Heterogeneity of studies was evaluated using I2, and Egger's regression intercept was used to detect publication bias. FINDINGS 39 studies with a total sample size of 33,353 people were included. The pooled prevalence of OSA in older adults was 35.9% (95% confidence interval: 28.7%-43.8%; I2 = 98.81%). Considering the high heterogeneity of included studies, subgroup analysis was conducted and yielded the most prevalent in Asia continent with 37.0% (95% CI: 22.4%-54.5%; I2 = 97.32%). However, heterogeneity was remained at high level. In the majority of studies, OSA was significantly and positively related to obesity, increased BMI, age, cardiovascular diseases, diabetes, and daytime sleepiness. CONCLUSIONS Results of this study showed that global prevalence of OSA in older adults is high and is significantly related to obesity, increased BMI, age, cardiovascular diseases, diabetes, and daytime sleepiness. These findings can be used by experts working on the diagnosis and management of OSA in the geriatric population. These findings can be used by experts on the diagnosis and treatment of OSA in the older adults. Due to high heterogeneity, findings should be interpreted with great caution.
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Affiliation(s)
- Tina Ghavami
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohsen Kazeminia
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nassim Ahmadi
- Department of Communication Sciences and Disorders, College of Health Sciences, University of Delaware, Newark, DE
| | - Fatemeh Rajati
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Liao FC, Zhang T, Huang XP, Sangwatanakul J, Li HY, Zhou N. Correlation analysis of upper airway morphology in patients with obstructive sleep apnea and anatomically small retruded mandibles. Cranio 2023; 41:416-422. [PMID: 33355036 DOI: 10.1080/08869634.2020.1864165] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To investigate the relationship between upper airway morphology and the severity of obstructive sleep apnea (OSA) in patients with anatomically small retruded mandibles. METHODS Fifty-two patients with small retruded mandibles underwent polysomnography and airway computed tomography. The airway morphology parameters and sleep assessment were compared between the patients with or without OSA. RESULTS Twenty-eight patients diagnosed with OSA, according to polysomnography, had a higher distance between the hyoid bone and mandibular plane (HMP), lateral dimension (LAT)/anteroposterior dimension (AP), but lower minimum cross-sectional area (mCSA), AP, surface area, volume, avgCSA, and airway uniformity (U). The apnea-hypopnea index had negative correlations with mCSA, AP, surface area, volume, avgCSA, and U, and had a positive correlation with HMP and LAT/AP. CONCLUSION OSA is common among patients with small retruded mandibles and is associated with a more compressed upper airway shape and longer HMP.
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Affiliation(s)
- Feng-Chun Liao
- Department of Oral and Maxillofacial Surgery, College of Stomatology, Guangxi Medical University, Nanning, People's Republic of China
- Guangxi Clinical Research Center for Craniofacial Deformity, Nanning, People's Republic of China
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Nanning, People's Republic of China
- Guangxi Key Laboratory of Oral and Maxillofacial Surgery Disease Treatment, Nanning, People's Republic of China
| | - Tao Zhang
- Department of Oral and Maxillofacial Surgery, College of Stomatology, Guangxi Medical University, Nanning, People's Republic of China
- Guangxi Clinical Research Center for Craniofacial Deformity, Nanning, People's Republic of China
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Nanning, People's Republic of China
- Guangxi Key Laboratory of Oral and Maxillofacial Surgery Disease Treatment, Nanning, People's Republic of China
| | - Xuan-Ping Huang
- Department of Oral and Maxillofacial Surgery, College of Stomatology, Guangxi Medical University, Nanning, People's Republic of China
- Guangxi Clinical Research Center for Craniofacial Deformity, Nanning, People's Republic of China
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Nanning, People's Republic of China
- Guangxi Key Laboratory of Oral and Maxillofacial Surgery Disease Treatment, Nanning, People's Republic of China
| | - Jirayus Sangwatanakul
- Department of Oral and Maxillofacial Surgery, College of Stomatology, Guangxi Medical University, Nanning, People's Republic of China
- Guangxi Clinical Research Center for Craniofacial Deformity, Nanning, People's Republic of China
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Nanning, People's Republic of China
- Guangxi Key Laboratory of Oral and Maxillofacial Surgery Disease Treatment, Nanning, People's Republic of China
| | - Hong-Yi Li
- Department of Oral and Maxillofacial Surgery, College of Stomatology, Guangxi Medical University, Nanning, People's Republic of China
- Guangxi Clinical Research Center for Craniofacial Deformity, Nanning, People's Republic of China
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Nanning, People's Republic of China
- Guangxi Key Laboratory of Oral and Maxillofacial Surgery Disease Treatment, Nanning, People's Republic of China
| | - Nuo Zhou
- Department of Oral and Maxillofacial Surgery, College of Stomatology, Guangxi Medical University, Nanning, People's Republic of China
- Guangxi Clinical Research Center for Craniofacial Deformity, Nanning, People's Republic of China
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Nanning, People's Republic of China
- Guangxi Key Laboratory of Oral and Maxillofacial Surgery Disease Treatment, Nanning, People's Republic of China
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Silva JMSD, Gomes ADOC, Coriolano MDGWDS, Teixeira JP, Lima HVSLD, Paulino CEB, Silva HJD, Lira ZSD. Oropharyngeal geometry and acoustic parameters of voice in healthy and Parkinson's disease subjects. Codas 2023; 35:e20210304. [PMID: 37075413 PMCID: PMC10137768 DOI: 10.1590/2317-1782/20232021304pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 03/29/2022] [Indexed: 04/21/2023] Open
Abstract
PURPOSE to verify whether there are differences in acoustic measures and oropharyngeal geometry between healthy individuals and people with Parkinson's disease, according to age and sex, and to investigate whether there are correlations between oropharyngeal geometry measures in this population. METHODS 40 individuals participated, 20 with a diagnosis of Parkinson's disease and 20 healthy individuals, matched by age, sex, and body mass index. Acoustic variables included fundamental frequency, jitter, shimmer, glottal-to-noise excitation ratio, noise, and mean intensity. Oropharyngeal geometry variables were measured with acoustic pharyngometry. RESULTS geometry variables were smaller in the group with Parkinson's disease, and older adults with Parkinson's disease had a smaller oropharyngeal junction area than healthy older adults. Regarding acoustic parameters of voice, fundamental frequency values were lower in males with Parkinson's disease, and jitter values were higher in the non-elderly subjects with Parkinson's disease. There was a moderate positive correlation between oral cavity length and volume, pharyngeal cavity length and vocal tract length, and pharyngeal cavity volume and vocal tract volume. CONCLUSION individuals with Parkinson's disease had smaller glottal areas and oropharyngeal junction areas than healthy individuals. When distributed into sex and age groups, the fundamental frequency was lower in males with Parkinson's disease. There was a moderate positive correlation between oropharyngeal length and volume measures in the study sample.
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Affiliation(s)
- Joice Maely Souza da Silva
- Programa de Pós-graduação em Saúde da Comunicação Humana, Universidade Federal de Pernambuco - UFPE - Recife (PE), Brasil
| | - Adriana de Oliveira Camargo Gomes
- Programa de Pós-graduação em Saúde da Comunicação Humana, Universidade Federal de Pernambuco - UFPE - Recife (PE), Brasil
- Departamento de Fonoaudiologia, Universidade Federal de Pernambuco - UFPE - Recife (PE), Brasil
| | | | - Julianne Pitanga Teixeira
- Programa de Pós-graduação em Saúde da Comunicação Humana, Universidade Federal de Pernambuco - UFPE - Recife (PE), Brasil
| | | | | | - Hilton Justino da Silva
- Programa de Pós-graduação em Saúde da Comunicação Humana, Universidade Federal de Pernambuco - UFPE - Recife (PE), Brasil
- Departamento de Fonoaudiologia, Universidade Federal de Pernambuco - UFPE - Recife (PE), Brasil
| | - Zulina Souza de Lira
- Programa de Pós-graduação em Saúde da Comunicação Humana, Universidade Federal de Pernambuco - UFPE - Recife (PE), Brasil
- Departamento de Fonoaudiologia, Universidade Federal de Pernambuco - UFPE - Recife (PE), Brasil
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da Silva JMS, Gomes ADOC, da Silva HJ, de Vasconcelos SJ, de Sales Coriolano MDGW, de Lira ZS. Effect of Resonance Tube Technique on Oropharyngeal Geometry and Voice in Individuals with Parkinson's Disease. J Voice 2020; 35:807.e25-807.e32. [PMID: 32201236 DOI: 10.1016/j.jvoice.2020.01.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Revised: 01/17/2020] [Accepted: 01/23/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To verify the immediate effect of the flexible resonance tube vocal technique on the oropharyngeal geometry and vocal acoustic parameters of individuals with Parkinson's disease (PD) and to study the correlation between oropharyngeal geometry and the intensity and fundamental frequency (f0) parameters of the voice. METHODS Forty individuals participated-20 with PD and 20 healthy individuals, with a mean age of 60.95 (± 5.69) years. There were 10 men and 10 women in each group. All underwent pharyngometric analysis of the vocal tract and voice acoustics parameters before and after use of the vocal technique with a flexible resonance tube. RESULTS After the technique, there was a reduction in pharyngeal cavity volume only in females in the healthy group, a reduction in shimmer values in females in both groups and males in PD group and an improvement in noise parameters in females in the PD group. There was a negative correlation between vocal tract volume and intensity, between f0 and vocal tract volume, between f0 and oropharyngeal junction area, between f0 and oral cavity volume as well as a positive correlation between oral cavity length and f0. CONCLUSION The vocal technique with the flexible resonance tube applied to individuals with PD improved the subjects' voice quality in the perceptual and acoustic voice parameters. Regarding the oropharyngeal geometry, it was possible to observe its correlation with the parameters of vocal intensity and frequency in the studied population.
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Affiliation(s)
- Joice Maely Souza da Silva
- Graduate Program in Human Communication Health at the Federal University of Pernambuco, Health Sciences Center, Speech-Language Pathology and Audiology Department, Recife, Pernambuco, Brazil (Programa de Pós-Graduação em Saúde da Comunicação Humana da Universidade Federal de Pernambuco, Centro de Ciências da Saúde, Departamento de Fonoaudiologia), Av. Prof. Artur de Sá, s/n - Cidade Universitária, Recife/PE, Brazil.
| | - Adriana de Oliveira Camargo Gomes
- Graduate Program in Human Communication Health at the Federal University of Pernambuco, Health Sciences Center, Speech-Language Pathology and Audiology Department, Recife, Pernambuco, Brazil (Programa de Pós-Graduação em Saúde da Comunicação Humana da Universidade Federal de Pernambuco, Centro de Ciências da Saúde, Departamento de Fonoaudiologia), Av. Prof. Artur de Sá, s/n - Cidade Universitária, Recife/PE, Brazil.
| | - Hilton Justino da Silva
- Graduate Program in Human Communication Health at the Federal University of Pernambuco, Health Sciences Center, Speech-Language Pathology and Audiology Department, Recife, Pernambuco, Brazil (Programa de Pós-Graduação em Saúde da Comunicação Humana da Universidade Federal de Pernambuco, Centro de Ciências da Saúde, Departamento de Fonoaudiologia), Av. Prof. Artur de Sá, s/n - Cidade Universitária, Recife/PE, Brazil.
| | - Silvio José de Vasconcelos
- Surgery Department, Health Sciences Center, University Federal of Pernambuco, Recife, Pernambuco, Brazil, Av. Prof. Artur de Sá, s/n - Cidade Universitária, Recife/PE, Brazil.
| | - Maria das Graças Wanderley de Sales Coriolano
- Graduate Program in Human Communication Health at the Federal University of Pernambuco, Health Sciences Center, Speech-Language Pathology and Audiology Department, Recife, Pernambuco, Brazil (Programa de Pós-Graduação em Saúde da Comunicação Humana da Universidade Federal de Pernambuco, Centro de Ciências da Saúde, Departamento de Fonoaudiologia), Av. Prof. Artur de Sá, s/n - Cidade Universitária, Recife/PE, Brazil.
| | - Zulina Souza de Lira
- Graduate Program in Human Communication Health at the Federal University of Pernambuco, Health Sciences Center, Speech-Language Pathology and Audiology Department, Recife, Pernambuco, Brazil (Programa de Pós-Graduação em Saúde da Comunicação Humana da Universidade Federal de Pernambuco, Centro de Ciências da Saúde, Departamento de Fonoaudiologia), Av. Prof. Artur de Sá, s/n - Cidade Universitária, Recife/PE, Brazil.
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Lacombe M, Boré A, Amo Castrillo LD, Boussaïd G, Falaize L, Vlachos E, Orlikowski D, Prigent H, Lofaso F. Peak Cough Flow Fails to Detect Upper Airway Collapse During Negative Pressure Titration for Cough-Assist. Arch Phys Med Rehabil 2019; 100:2346-2353. [PMID: 31351076 DOI: 10.1016/j.apmr.2019.06.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 06/18/2019] [Accepted: 06/20/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To study the ability of peak cough flow (PCF) and effective cough volume, defined as the volume exsufflated >3 L/s, to detect upper airway collapse during mechanical insufflation-exsufflation (MI-E) titration in neuromuscular patients. DESIGN Prospective observational study. SETTING Rehabilitation hospital. PARTICIPANTS Patients (N=27) with neuromuscular disease causing significant impairment of chest wall and/or diaphragmatic movement. INTERVENTIONS The lowest insufflation pressure producing the highest inspiratory capacity was used. Exsufflation pressure was decreased from -20 cm H2O to -60/-70 cm H2O, in 10-cm H2O decrements, until upper airway collapse was detected using the reference standard of flow-volume curve analysis (after PCF, abrupt flattening or flow decrease vs previous less negative exsufflation pressure). MAIN OUTCOME MEASURES PCF and effective cough volume profiles during expiration with MI-E. RESULTS Upper airway collapse occurred in 10 patients during titration. Effective cough volume increased with decreasing expiratory pressure then decreased upon upper airway collapse occurrence. PCF continued to increase after upper airway collapse occurrence. In 5 other patients, upper airway collapse occurred at the initial -20 cm H2O exsufflation pressure, and during titration, PCF increased and effective cough volume remained unchanged at <200 mL. PCF had 0% sensitivity for upper airway collapse, whereas effective cough volume had 100% sensitivity and specificity. CONCLUSION Of 27 patients, 15 experienced upper airway collapse during MI-E titration. Upper airway collapse was associated with an effective cough volume decrease or plateau and with increasing PCF. Accordingly, effective cough volume, but not PCF, can detect upper airway collapse.
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Affiliation(s)
- Matthieu Lacombe
- Réanimation Médicale, Physiologie - Explorations Fonctionnelles, et Centre d'Investigation Clinique, UMR 1429, Hôpital Raymond Poincaré, Garches, France
| | - Aurélien Boré
- Réanimation Médicale, Physiologie - Explorations Fonctionnelles, et Centre d'Investigation Clinique, UMR 1429, Hôpital Raymond Poincaré, Garches, France
| | - Lorena Del Amo Castrillo
- Réanimation Médicale, Physiologie - Explorations Fonctionnelles, et Centre d'Investigation Clinique, UMR 1429, Hôpital Raymond Poincaré, Garches, France
| | - Ghilas Boussaïd
- INSERM-UMR, 1179, Université de Versailles Saint-Quentin-en-Yvelines, Hôpital Raymond Poincaré, Garches, France
| | - Line Falaize
- Réanimation Médicale, Physiologie - Explorations Fonctionnelles, et Centre d'Investigation Clinique, UMR 1429, Hôpital Raymond Poincaré, Garches, France; INSERM-UMR, 1179, Université de Versailles Saint-Quentin-en-Yvelines, Hôpital Raymond Poincaré, Garches, France
| | - Erica Vlachos
- Réanimation Médicale, Physiologie - Explorations Fonctionnelles, et Centre d'Investigation Clinique, UMR 1429, Hôpital Raymond Poincaré, Garches, France
| | - David Orlikowski
- Réanimation Médicale, Physiologie - Explorations Fonctionnelles, et Centre d'Investigation Clinique, UMR 1429, Hôpital Raymond Poincaré, Garches, France; INSERM-UMR, 1179, Université de Versailles Saint-Quentin-en-Yvelines, Hôpital Raymond Poincaré, Garches, France
| | - Hélène Prigent
- Réanimation Médicale, Physiologie - Explorations Fonctionnelles, et Centre d'Investigation Clinique, UMR 1429, Hôpital Raymond Poincaré, Garches, France; INSERM-UMR, 1179, Université de Versailles Saint-Quentin-en-Yvelines, Hôpital Raymond Poincaré, Garches, France
| | - Frédéric Lofaso
- Réanimation Médicale, Physiologie - Explorations Fonctionnelles, et Centre d'Investigation Clinique, UMR 1429, Hôpital Raymond Poincaré, Garches, France; INSERM-UMR, 1179, Université de Versailles Saint-Quentin-en-Yvelines, Hôpital Raymond Poincaré, Garches, France.
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Zhao C, Viana A, Ma Y, Capasso R. The effect of aging on drug-induced sleep endoscopy findings. Laryngoscope 2018; 128:2644-2650. [PMID: 30194857 DOI: 10.1002/lary.27265] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 03/03/2018] [Accepted: 04/09/2018] [Indexed: 12/16/2022]
Abstract
OBJECTIVES/HYPOTHESIS To evaluate the correlation of aging and upper airway collapse characteristics observed by drug-induced sleep endoscopy (DISE), and report the observed differences on obstructive sleep apnea (OSA) subjects, older and younger than 60 years. STUDY DESIGN Case series. METHODS This study analyzed the data of 200 OSA patients who underwent DISE between January 1, 2013 and June 30, 2017. The variables sex, body mass index (BMI), Epworth Sleepiness Scale score, tonsil size, modified Mallampati (MM) classification, apnea-hypopnea index (AHI), oxygen desaturation index (ODI), lowest oxygen saturation, and VOTE (velum, oropharynx, tongue base, epiglottis) classification were compared between two groups: <60 and ≥60 years old. RESULTS Older age had significant correlation with higher AHI, ODI, lower O2 nadir, multisite obstruction, combined upper (palatopharyngeal) + lower (hypopharyngeal) level obstructions, and complete anterior-posterior (AP) velum collapse pattern. Lateral oropharyngeal wall collapse was significantly lower in the older group. Findings remained statistically significant when adjusted for sex, BMI, tonsil size, and MM. CONCLUSIONS Aging was an independent factor that directly correlated with increased AHI and hypoxemia, multisites, combined levels of obstruction, and complete AP velum collapse pattern. Being older than 60 years had higher of complete AP velum collapse and lower incidence of lateral oropharyngeal wall collapse, regardless of OSA severity and tonsil size. LEVEL OF EVIDENCE 4 Laryngoscope, 2644-2650, 2018.
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Affiliation(s)
- Chen Zhao
- Department of Otorhinolaryngology, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China.,Division of Sleep Surgery, Stanford, California, U.S.A
| | - Alonço Viana
- Division of Sleep Surgery, Stanford, California, U.S.A.,Graduate Program of Neurology, Rio de Janeiro State Federal University, Rio de Janeiro, Brazil.,Department of Otorhinolaryngology, Marcílio Dias Naval Hospital, Rio de Janeiro, Brazil
| | - Yifei Ma
- Department of Otolaryngology-Head and Neck Surgery, Stanford University Medical Center, Stanford, California, U.S.A
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