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Goyal A, Meena R, Gupta S, Kar A, Ali R, Bohra A, Solanki V, Chaudhary P, Pakhare A. Sex-specific differences in presenting symptoms of obstructive sleep apnea. Lung India 2024; 41:115-120. [PMID: 38700405 PMCID: PMC10959312 DOI: 10.4103/lungindia.lungindia_235_22] [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: 05/02/2022] [Revised: 04/17/2023] [Accepted: 06/07/2023] [Indexed: 05/05/2024] Open
Abstract
OBJECTIVES Scant data from India are available on the gender differences in presenting features of Obstructive Sleep Apnea (OSA) in India. This study aims to compare male and female patients with OSA for general characteristics and presenting symptoms. METHODOLOGY Retrospective study was done in OSA patients diagnosed in our sleep lab. History, biochemical reports, and polysomnography variables were retrieved from the sleep registry and were compared between males and females. RESULTS Out of 514 patients of OSA (367 males; 147 females). Females were older (55.97 ± 9.73 v/s 50.2 + 12.70 years, P<0.001) and more obese (BMI 35.26 ± 7.17 v/s 29.58 ± 5.49 Kg/m2; P<0.001). Waist and hip circumference were significantly higher in the female patients (P = 0.009 and <0.001 respectively). Morning headache, nocturia, fatigability (P < 0.001), and depression (P = 0.005) was more common in females (P = 0.036). Hypersomnia was more commonly seen in males (P < 0.001). Mean diastolic blood pressure was significantly higher in males, although no difference was seen in Systolic BP. Females had higher mean Fasting Blood glucose (FBS) (P = 0.02). Apnea hypopnea index was significantly higher in females {P = 0.01}. CONCLUSION Women with OSA are more obese, elderly, and with higher fasting blood glucose than males at the time of diagnosis. Females have a higher prevalence of symptoms like fatigability, depression, nocturia and early morning headache and had more severe AHI than males.
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Affiliation(s)
| | | | - Suruchi Gupta
- Community and Family Medicine, AIIMS Bhopal, Madhya Pradesh, India
| | - Avishek Kar
- Pulmonary Medicine, AIIMS Raipur, Chhattisgarh, India
| | - Rashida Ali
- Pulmonary Medicine, AIIMS Bhopal, Madhya Pradesh, India
| | - Arwa Bohra
- Pulmonary Medicine, AIIMS Bhopal, Madhya Pradesh, India
| | | | | | - Abhijit Pakhare
- Community and Family Medicine, AIIMS Bhopal, Madhya Pradesh, India
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Shao C, Wang H, He Y, Yu B, Zhao H. Clinical phenotype of obstructive sleep apnea in older adults: a hospital-based retrospective study in China. Ir J Med Sci 2023; 192:2305-2312. [PMID: 36705790 DOI: 10.1007/s11845-023-03290-0] [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: 12/16/2022] [Accepted: 01/18/2023] [Indexed: 01/28/2023]
Abstract
BACKGROUND The prevalence of obstructive sleep apnea (OSA) in older people (aged over 65 years) is high. However, OSA in older populations has not received sufficient attention. This study examined the clinical phenotypic characteristics of older patients with newly diagnosed OSA. METHODS A total of 110 older patients (≥ 65 years) and 220 younger patients (< 65 years), matched by gender, body mass index (BMI), and apnea-hypopnea index (AHI), were enrolled in this retrospective study. Clinical manifestations, comorbidities, and polysomnographic results were compared between the two groups, and correlations between age ≥ 65 years and OSA comorbidities were explored. RESULTS Nocturia was more common in older patients with OSA, as with lower sleep efficiency, longer wake after sleep onset, increased stage N1 sleep, and decreased stage N3 sleep and average SpO2. The proportions of older OSA patients who had comorbid hypertension, coronary artery disease (CAD), chronic obstructive pulmonary disease, and ischemic stroke were significantly higher than those of younger patients. The incidence of tonsillar enlargement and pharyngeal narrowing was lower in older patients. Age ≥ 65 years was an independent risk factor for patients with OSA to have hypertension (OR: 1.89, 95% CI: 1.11-3.21), CAD (OR: 4.83, 95% CI: 2.29-10.21), and ischemic stroke (OR: 2.92, 95% CI: 1.02 to 8.38). CONCLUSIONS The presence of OSA in older adults was associated with significant abnormalities of sleep architecture, aggravated nocturnal hypoxia and increased risks of hypertension, CAD, and stroke, which can be distinguished as a unique clinical phenotype.
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Affiliation(s)
- Chuan Shao
- Department of Respiratory and Critical Care Medicine, Ningbo Medical Center Lihuili Hospital, Ningbo University, Ningbo, China.
| | - Hailong Wang
- Department of Respiratory and Critical Care Medicine, Ningbo Medical Center Lihuili Hospital, Ningbo University, Ningbo, China
| | - Yibing He
- Department of Respiratory and Critical Care Medicine, Ningbo Medical Center Lihuili Hospital, Ningbo University, Ningbo, China
| | - Biyun Yu
- Department of Respiratory and Critical Care Medicine, Ningbo Medical Center Lihuili Hospital, Ningbo University, Ningbo, China
| | - Haiying Zhao
- Department of Geriatric Medicine, Ningbo Medical Center Lihuili Hospital, Ningbo University, Ningbo, China
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Verbraecken J. More than sleepiness: prevalence and relevance of nonclassical symptoms of obstructive sleep apnea. Curr Opin Pulm Med 2022; 28:552-558. [PMID: 36101923 PMCID: PMC9553267 DOI: 10.1097/mcp.0000000000000915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW The purpose of this review is to describe the nonclassical symptoms and manifestations occurring in patients with obstructive sleep apnea (OSA), both from a standpoint of prevalence and in terms of clinical relevance. Particular emphasis will be given to nightmares, comorbid insomnia, restless legs syndrome and periodic limb movement disorder, bruxism, morning headache, nocturia, acid reflux, chronic cough and dysphagia. RECENT FINDINGS A review of the recent literature suggests that nonclassical symptoms have a high prevalence, are underestimated, and can interact with quality of life. Although these disturbances may occur together by mere coincidence, they may interact reciprocally. However, the degree of symptoms is not always correlated with OSA severity. SUMMARY OSA is a heterogeneous disease with variable clinical manifestations. This review highlights the need for detailed evaluation of patients with OSA to diagnose other important sleep disorders and clinical manifestations, given their frequent association.
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Affiliation(s)
- Johan Verbraecken
- Department of Pulmonary Medicine and Multidisciplinary Sleep Disorders Centre, Antwerp University Hospital and University of Antwerp, Edegem, Belgium
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Obstructive Sleep Apnea in a Clinical Population: Prevalence, Predictive Factors, and Clinical Characteristics of Patients Referred to a Sleep Center in Mongolia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212032. [PMID: 34831784 PMCID: PMC8624414 DOI: 10.3390/ijerph182212032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 10/29/2021] [Accepted: 11/11/2021] [Indexed: 11/23/2022]
Abstract
Obstructive sleep apnea (OSA) disrupts sleep. This study examined factors related to OSA severity. A cross-sectional, prospective, hospital-based study was conducted with 205 patients who underwent polysomnography (PSG). Demographic, anthropometric, clinical, PSG, and sleep quality assessment data were analyzed. Participants (N = 205) were classified into four groups based on apnea–hypopnea index (AHI); no OSA (AHI < 5/h; N = 14), mild (mOSA, 5 < AHI < 15/h; N = 50), moderate (modOSA, 15 < AHI < 30/h; N = 41), severe (sOSA, 30 < AHI < 60/h; N = 50), and very severe (vsOSA, AHI ≥ 60; N = 50). Men had more severe OSA than women (p < 0.001). Anthropometric characteristics differed with OSA severity (p < 0.001). OSA patients had decreased sleep quality and increased excessive daytime sleepiness (EDS). Body mass index (BMI), neck/waist circumference, and blood pressure (BP) differed between groups (p < 0.001). Patients with vsOSA had the highest Mallampati grades (p < 0.001). Multiple linear regression indicated that OSA severity was related to gender and sleep quality. PSG parameters (oxygen saturation, systolic BP, and arousal/respiratory arousal) were strongly related to OSA severity. In conclusion, about half of study-referred patients had severe/very severe OSA; these groups were predominantly obese men with high BP. OSA severity associated with high BP, BMI, waist circumference, and neck circumference.
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Goyal A, Joshi A, Mitra A, Khurana A, Chaudhary P. Predictive factors for CPAP failure in obstructive sleep apnea patients. Lung India 2021; 38:540-544. [PMID: 34747736 PMCID: PMC8614613 DOI: 10.4103/lungindia.lungindia_867_20] [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] [Indexed: 11/13/2022] Open
Abstract
Objectives: Some patients with obstructive sleep apnea (OSA) do not respond to Continuous Positive Airway Pressure (CPAP) and for these patients, Bi-level PAP is the next level modality. This study by a theory driven hierarchical approach, tries to identify the predictors for CPAP failure among OSA patients. Methodology: The potential predictors for the model were identified from a theoretical framework rooted in clinical examination, laboratory parameters, and polysomnographic variables pertaining to OSA patients. All patients of OSA who underwent manual titration with CPAP or Bi-level PAP (in case of CPAP Failure) between June 2015 and October 2017 were included in model building. This study compared five competitive models blocks deliberated by increasing order of diagnostic complexity and availability of resources. The fitting of the model was determined by both internal and external validation. Results: Among the five competitive models, the selected model has the significant deviance reduction (−2LL = 121.99, X2 = 25.55, P < 0.0001) from the baseline model (−2LL = 217.356). This logistic regression model consists of the following binary predictors – Age >60 years (odds ratio [OR] = 3.23 [1.27–8.23]), body mass index >35 Kg/m2 (OR = 4.25 [1.78–10.13]), forced expiratory volume <60% (OR = 7.33 [2.83–18.72]), apnea-hypopnea index >75 (OR = 4.31 [1.61–11.56]) and T90 > 30% (OR = 6.67 [2.57–17.36]). Conclusion: These five factors (acronym as BIPAP) may aid to the clinical decision-making by predicting failure of CPAP and therefore may assist in more vigilant clinical care.
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Affiliation(s)
- Abhishek Goyal
- Department of Pulmonary Medicine, AIIMS, Bhopal, Madhya Pradesh, India
| | - Ankur Joshi
- Department of Community and Family Medicine, Madhya Pradesh, India
| | - Arun Mitra
- Department of Community and Family Medicine, Madhya Pradesh, India
| | - Alkesh Khurana
- Department of Pulmonary Medicine, AIIMS, Bhopal, Madhya Pradesh, India
| | - Poonam Chaudhary
- Department of Biochemistry, AIIMS, Bhopal, Madhya Pradesh, India
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Chaudhary P, Goyal A, Pakhare A, Goel SK, Kumar A, Reddy MA, Anoohya V. Metabolic syndrome in non-obese patients with OSA: learning points of a cross-sectional study from a tertiary care hospital in Central India. Sleep Breath 2021; 26:681-688. [PMID: 34283339 PMCID: PMC8289879 DOI: 10.1007/s11325-021-02401-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 05/04/2021] [Accepted: 05/05/2021] [Indexed: 01/14/2023]
Abstract
STUDY OBJECTIVES Obesity is often considered mandatory for the diagnosis of Metabolic Syndrome (MS). Data on the prevalence of MS in non-obese patients with Obstructive Sleep Apnea (OSA) is scarce. This study was aimed to determine the prevalence of MS in non-obese patients with OSA. METHODOLOGY All consecutively diagnosed patients with OSA between October 2018 and November 2019 were screened for metabolic syndrome. Patients with OSA and BMI < 25 kg/m2 (NOOSA) vs BMI > 25 kg/m2 (obese OSA) were compared. Lean waist NOOSA was defined as BMI < 25 kg/m2 and WC < 80 cm (32 in.) for women or < 90 cm (36 in.) for men. RESULTS During the study period, 502 patients were diagnosed with OSA. MS was observed in 35% of patients with NOOSA compared to obese patients with OSA (79%). In the NOOSA group, hypertension, impaired fasting glucose, diabetes mellitus and dyslipidemia were observed in 65, 48, 14 and 61% respectively and all of these parameters were significantly more common in the obese group (p < 0.001). Parameters of OSA severity (apnea-hypopnea index or AHI, time spent below 90% saturated or T90, and nadir oxygen) were significantly more severe in the obese group with OSA. Approximately 83% of patients in the NOOSA group had at least two metabolic risk factors, compared to the obese OSA group, in which 95% had two or more metabolic risk factors. Sixty-four percent of patients with NOOSA with lean waist had at least two metabolic risk factors. At BMI cut-offs of < 25, < 27 and < 30 kg/m2; 35, 46 and 57% of patients with OSA respectively had metabolic syndrome. CONCLUSION Metabolic syndrome was observed in approximately one in three patients with OSA and BMI < 25 kg/m2. Approximately two of every three lean waist non-obese patients with OSA had at least two markers of metabolic syndrome. The role of OSA in the development of metabolic syndrome in non-obese individuals needs further exploration.
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Affiliation(s)
| | - Abhishek Goyal
- Pulmonary Medicine, AIIMS, Saket Nagar, Bhopal, 462024, India.
| | | | - S K Goel
- Department of Biochemistry, AIIMS, Bhopal, India
| | - Ashok Kumar
- Department of Biochemistry, AIIMS, Bhopal, India
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Goyal A, Saxena K, Kar A, Khurana A, Bhagtana PK, Sridevi CSKR, Pakhare A. Obstructive sleep apnea is highly prevalent in COVID19 related moderate to severe ARDS survivors: findings of level I polysomnography in a tertiary care hospital. Sleep Med 2021; 91:226-230. [PMID: 34246548 PMCID: PMC8214316 DOI: 10.1016/j.sleep.2021.06.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 04/25/2021] [Accepted: 06/11/2021] [Indexed: 12/31/2022]
Abstract
Study objectives Studies have found Obstructive Sleep Apnea (OSA) as a risk factor for increased risk for COVID19 Acute respiratory Distress Syndrome (ARDS); but most of the studies were done in already known patients of OSA. This study was done to find prevalence of OSA in patients with COVID-19 related acute respiratory distress syndrome. Methodology A hospital based longitudinal study was conducted among COVID 19 Intensive Care Unit (ICU) survivors. All consecutive COVID19 with moderate to severe ARDS were evaluated for OSA by Level I Polysomnography (PSG) after 4–6 weeks of discharge. Prevalence of OSA and PSG variables {Total sleep time, Sleep efficiency, sleep stage percentage, Apnea Hypopnea Index (AHI), T90, nadir oxygen} was estimated. Results Out of 103 patients discharged from ICU during study period (October 2020 to 15 December 2020), 67 underwent Level I PSG. Mean Age was 52.6 ± 10.9 years and mean Body Mass Index was 27.5 ± 6.2 kg/m2. Total sleep time was 343.2 ± 86 min, sleep efficiency was 75.9 ± 14.2%. OSA (AHI ≥5) was seen in 65/67 patients and 49 patients had moderate to severe OSA (ie AHI ≥15). Conclusion Moderate-severe OSA was highly prevalent (73%) in COVID19 moderate to severe ARDS survivors. Role of OSA in pathophysiology of COVID19 ARDS needs further evaluation.
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Assessment of Obstructive Sleep Apnea in Association with Severity of COVID-19: A Prospective Observational Study. ACTA ACUST UNITED AC 2021; 5:111-118. [PMID: 33972929 PMCID: PMC8100738 DOI: 10.1007/s41782-021-00142-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/23/2021] [Accepted: 04/19/2021] [Indexed: 01/01/2023]
Abstract
Introduction OSA has been postulated to be associated with mortality in COVID-19, but studies are lacking thereof. This study was done to estimate the prevalence of OSA in patients with COVID-19 using various screening questionnaires and to assess effect of OSA on outcome of disease. Methodology In this prospective observational study, consecutive patients with RT-PCR confirmed COVID-19 were screened for OSA by different questionnaires (STOPBANG, Berlin Questionnaire, NoSAS, and Epworth Scale). Association between OSA, outcome (mortality) and requirement for respiratory support was assessed. Results In study of 213 patients; screening questionnaires for OSA [STOPBANG, Berlin Questionnaire (BQ), NoSAS] were more likely to be positive in patients who died compared to patients who survived. On binary logistic regression analysis, age ≥ 55 and STOPBANG score ≥ 5 were found to have small positive but independent effect on mortality even after adjusting for other variables. Proportion of patients who were classified as high risk for OSA by various OSA screening tools significantly increased with increasing respiratory support (p < 0.001 for STOPBANG, BQ, ESS and p = 0.004 for NoSAS). Conclusion This is one of the first prospective studies of sequentially hospitalized patients with confirmed COVID-19 status who were screened for possible OSA could be an independent risk factor for poor outcome in patients with COVID-19.
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Combination of positional therapy with positive airway pressure for titration in patients with difficult to treat obstructive sleep apnea. Sleep Breath 2021; 25:1867-1873. [PMID: 33486667 DOI: 10.1007/s11325-021-02291-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 12/30/2020] [Accepted: 01/05/2021] [Indexed: 01/24/2023]
Abstract
INTRODUCTION Positional therapy has been described as add-on therapy to a mandibular advancement device, but the efficacy of combination of positional therapy and positive airway pressure (PPAP) has not been documented. We have found PPAP therapy as an effective method of titration in patients with difficult to treat OSA (obstructive sleep apnea). METHODOLOGY This retrospective analysis was done in patients who had difficult to treat OSA, i.e., in whom titration in the supine position was unacceptable with any PAP device (CPAP or bilevel PAP) and could only be successfully titrated with a PAP device in the lateral position. This study describes our experience of PPAP therapy. Baseline characteristics and polysomnography data of patients who were successfully titrated in supine v/s lateral positions were compared. RESULTS Of 272 consecutive patients with OSA selected for analysis, 218 patients (191 and 27 with CPAP and bilevel PAP, respectively) could be successfully titrated in supine position. Further 54 (20%) patients in whom titration in supine position was unacceptable were titrated in lateral position. Patients titrated with PAP in the lateral position therapy group had higher BMI, higher neck and waist circumference, and lower awake sPO2 and nadir sPO2 during sleep, and spent more time in sleep with sPO2 < 90%. CONCLUSION Combination of positional therapy and PAP device is an effective way of titration for difficult to treat OSA patients. It can be tried in patients who fail titration in supine position.
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Chaudhary P, Goyal A, Goel SK, Kumar A, Chaudhary S, Kirti Keshri S, Phadke Subhedar R. Women with OSA have higher chances of having metabolic syndrome than men: effect of gender on syndrome Z in cross sectional study. Sleep Med 2021; 79:83-87. [PMID: 33482457 DOI: 10.1016/j.sleep.2020.12.042] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 12/27/2020] [Accepted: 12/30/2020] [Indexed: 01/14/2023]
Abstract
STUDY OBJECTIVES This study was done to find out prevalence of Metabolic syndrome (MS) in patients with Obstructive Sleep Apnea (OSA) and whether there is any difference in prevalence of syndrome Z in male and female. METHODOLOGY All consecutive diagnosed patients with OSA between June 2015 and Oct 2019 were screened for metabolic syndrome and factors associated with metabolic syndrome in OSA were analyzed. RESULTS During study period, 502 patients (357 males; 145 females) were diagnosed with OSA. Mean age was 51.88 ± 12.18 years (females and males:55.91 ± 9.74 and 50.24 ± 12.70 years, respectively). Mean BMI was 31.60 ± 11.09 kg/m2 (female: 35.29 ± 7.19 and male: 30.1 ± 12.0 kg/m2) (p < 0.001). Mean AHI was 62.67 ± 35.22. Mild, moderate and severe category of OSA constituted 7.3%, 15.3% and 77.4% respectively. MS was found in 72.7% (365 out of 502) individuals with OSA. MS was found in 75.8%, 68.4 and 48.7% in severe, moderate and mild OSA patients respectively (p < 0.001). Females OSA patients had significantly high percentage (88.27%) of metabolic syndrome compared to males OSA patients (66.38%) {p < 0.001}. Female patients with SZ had higher metabolic score (p = 0.019) and were older (p < 0.001). CONCLUSION Metabolic syndrome is highly prevalent in OSA population (72.7%) and is much more common in female OSA patients (88%) than males OSA (68%). All OSA patients should be screened for MS so that early intervention can be done in these patients so as to prevent cardiovascular complications.
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Affiliation(s)
| | | | - S K Goel
- Biochemistry, AIIMS Bhopal, India
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Um YH, Oh JH, Kim TW, Seo HJ, Kim SM, Chung JS, Jeong JH, Hong SC. Nocturia and Sleep: Focus on Common Comorbidities and Their Association with Obstructive Sleep Apnea. SLEEP MEDICINE RESEARCH 2020. [DOI: 10.17241/smr.2020.00731] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Polysomnography and Nocturia Evaluations after Uvulopalatopharyngoplasty for Obstructive Sleep Apnea Syndrome. J Clin Med 2020; 9:jcm9103089. [PMID: 32992690 PMCID: PMC7600720 DOI: 10.3390/jcm9103089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 09/12/2020] [Accepted: 09/21/2020] [Indexed: 12/14/2022] Open
Abstract
A higher incidence rate of nocturia in patients with obstructive sleep apnea (OSA) has been observed. We investigated the differences in clinical examinations between OSA patients with and without nocturia, and further compared those with successful and unsuccessful uvulopalatopharyngoplasty (UPPP). This retrospective study enrolled 103 patients with OSA undergoing UPPP. Patients were diagnosed with OSA by following the 2018 American Academy of Sleep Medicine (AASM) Scoring Manual Version 2.5. Patients were divided into two groups depending on if they urinated more than twice per night. The medical data of body mass index (BMI), nocturia frequency per night, apnea–hypopnea index (AHI), Epworth Sleepiness Scale (ESS), International Prostatic Symptom Score (IPSS), and Overactive Bladder Symptom Score (OABSS) were analyzed before and after uvulopalatopharyngoplasty (UPPP) surgery. All of the measurements were compared between successful and unsuccessful surgery in the non-nocturia or nocturia groups, respectively. Fifty patients (41 males and nine females) without nocturia were assigned to group 1, and 53 patients (43 males and 10 females) with nocturia were assigned to group 2. Nocturia frequency and post-surgery AHI in group 2 were significantly higher than those in group 1 (p < 0.05). Significant decreases in IPSS and OABSS were observed in the successful surgery subgroup of group 2 (p < 0.05). A significant decrease in post-surgery AHI was observed between unsuccessful and successful surgery in patients with nocturia (p < 0.05), but not in the non-nocturia group (p > 0.05). Although AHI had a significant correlation to nocturia frequency in all OSA patients before UPPP, no significant correlation between AHI reduction and nocturia frequency was found. UPPP appeared to be an effective treatment for nocturia associated with OSA. OSA should be taken into consideration for patients who complain of nocturia syndrome. The relationship of AHI reduction and nocturia improvement after OSA treatment with UPPP is still unclear. In addition, it is necessary to establish the existence of nocturia in patients with OSA, as a result of its high prevalence in OSA patients. UPPP could reduce the symptoms of OSA and could also contribute to a reduction of nocturia even in the unsuccessful surgery group.
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Santiapillai J, Tadtayev S, Miles A, Arumainayagam N, Yeong K, Murray P. Dihydropyridine calcium channel blockers and obstructive sleep apnea: Two underrecognized causes of nocturia? Neurourol Urodyn 2020; 39:1612-1614. [PMID: 32315095 DOI: 10.1002/nau.24359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 03/25/2020] [Indexed: 12/25/2022]
Affiliation(s)
| | - Sergey Tadtayev
- Ashford and St. Peter's Hospitals NHS Foundation Trust, Chertsey, UK
| | - Alenka Miles
- Ashford and St. Peter's Hospitals NHS Foundation Trust, Chertsey, UK
| | | | - Keefai Yeong
- Ashford and St. Peter's Hospitals NHS Foundation Trust, Chertsey, UK
| | - Paul Murray
- Ashford and St. Peter's Hospitals NHS Foundation Trust, Chertsey, UK
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Association between obstructive sleep apnea syndrome and nocturia: a meta-analysis. Sleep Breath 2020; 24:1293-1298. [DOI: 10.1007/s11325-019-01981-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 11/13/2019] [Accepted: 11/20/2019] [Indexed: 02/06/2023]
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Krupp K, Wilcox M, Srinivas A, Srinivas V, Madhivanan P, Bastida E. Snoring is associated with obesity among middle aged Slum-dwelling women in Mysore, India. Lung India 2020; 37:210-219. [PMID: 32367842 PMCID: PMC7353948 DOI: 10.4103/lungindia.lungindia_515_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Background: Globally, rates of obesity have trebled in the past four decades. India has more than 9.8 million men and 20 million women classified as obese. While poor diet and sedentary lifestyles are major causes, growing evidence suggests other factors like sleep-disordered-breathing may also be contributors. Methods: A cross-sectional survey was carried out between October 2017 and May 2018 among a nonprobability sample of slum-dwelling women, 40–64 years of age, in government-designated slums in Mysore, India. After the informed consent process, data were collected on sociodemographics, tobacco and alcohol consumption, diet, physical activity, sleep, quality of life, and personal and family history of diagnosed cardiometabolic disorders. Body mass index (BMI) was calculated using anthropometry. The serum was tested for HbA1c and lipid profile. Results: In this sample of slum-dwelling women, snoring was associated with obesity. Habitual snorers had more than double the odds (adjusted odds ratio [aOR] 2.05; 95% confidence interval [CI] 1.26–3.33; P < 0.004) of obesity I, and seven times the odds (aOR 7.71; CI: 3.58–16.62; P < 0.001) of being in the obesity II category compared to nonsnorers after adjustment for age, diabetes, hypertension, hypercholesterolemia, and daytime sleepiness. There was no difference in obesity status among participants reporting abnormal sleep duration, napping, daytime sleepiness, sleep apnea, insomnia, or the use of sleep medication. Conclusion: The relationship between snoring and obesity has not been well explored. This study among slum-dwelling Indian women found a significant relationship between snoring and obesity. Future research should explore the underlying mechanisms connecting snoring to BMI.
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Affiliation(s)
- Karl Krupp
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA; Public Health Research Institute of India, Mysore, Karnataka, India
| | - Meredith Wilcox
- Midwest Biomedical Research/Center for Metabolic and Cardiovascular Health, Addison, IL; MB Clinical Research, Boca Raton, FL, USA
| | - Arun Srinivas
- Department of Cardiology, Apollo Hospital, Mysore, Karnataka, India
| | - Vijaya Srinivas
- Public Health Research Institute of India, Mysore, Karnataka, India
| | - Purnima Madhivanan
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health; Public Health Research Institute of India, Mysore, Karnataka, India; Division of Infectious Diseases, College of Medicine; Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, Arizona, USA
| | - Elena Bastida
- Department of Health Promotion and Disease Prevention, Stempel College of Public Health, Florida International University, Miami, Florida, USA
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