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Liao Z, Chen Y, Wu L, Huang Y, Li S, Liu J, Zong X, Tai J, Chen F. Associations of Obstructive Sleep Apnea Risk with Obesity, Body Composition and Metabolic Abnormalities in School-Aged Children and Adolescents. Nutrients 2024; 16:2419. [PMID: 39125300 PMCID: PMC11313962 DOI: 10.3390/nu16152419] [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: 06/28/2024] [Revised: 07/17/2024] [Accepted: 07/22/2024] [Indexed: 08/12/2024] Open
Abstract
The objective of this study is to explore the associations between obesity, body composition, and the self-reported risk of obstructive sleep apnea (OSA) and to examine whether the risk of OSA is related to metabolic abnormalities in children and adolescents aged 6-17 years. Utilizing data from the 2022 to 2023 Beijing Children and Adolescents Health Cohort baseline survey, 5000 school-aged participants were analyzed. OSA risk was assessed via the Pediatric Sleep Questionnaire, with anthropometric and body composition measurements taken. Metabolic markers included blood pressure, lipid levels, blood glucose, and uric acid. Associations were analyzed using logistic regression and generalized linear models. Results showed that 88.6% were low-risk and 11.4% were high-risk for OSA. Overweight (aOR 1.53, 95% CI 1.22-1.92), obesity (aOR 1.94, 95% CI 1.57-2.40), and abdominal obesity (aOR 1.59, 95% CI 1.31-1.93) significantly increased OSA risk. High fat mass was a critical factor, while muscle mass was not, especially in those who were overweight and obese. Associations of OSA risk with metabolic abnormalities were non-significant after adjusting for BMI. Our research highlights the significant associations of obesity and body composition with OSA risk, with child BMI influencing the relationship between OSA and metabolic abnormalities. Future research should explore causative relationships and the enduring impacts of OSA on metabolic health in children.
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Affiliation(s)
| | | | | | | | | | | | | | - Jun Tai
- Capital Institute of Pediatrics, Beijing 100020, China; (Z.L.); (Y.C.); (L.W.); (Y.H.); (S.L.); (J.L.); (X.Z.)
| | - Fangfang Chen
- Capital Institute of Pediatrics, Beijing 100020, China; (Z.L.); (Y.C.); (L.W.); (Y.H.); (S.L.); (J.L.); (X.Z.)
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Li Y, Miao Y, Tan J, Zhang Q. Association of modifiable risk factors with obstructive sleep apnea: a Mendelian randomization study. Aging (Albany NY) 2023; 15:14039-14065. [PMID: 38085646 PMCID: PMC10756101 DOI: 10.18632/aging.205288] [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: 07/06/2023] [Accepted: 10/16/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND The risk factors involved in obstructive sleep apnea (OSA) have not been clearly identified yet. We attempted to systematically investigate genetically predicted modifiable risk factors and lifestyle behaviors associated with OSA. METHODS The association between 34 risk factors and OSA was evaluated using the two-sample Mendelian randomization (MR). Genetic variants for risk factors were acquired from European-descent genome-wide studies. Data sources for OSA were extracted from FinnGen study with 16,761 cases and 201,194 controls. The primary analysis chosen was the inverse-variance weighted method. RESULTS MR analyses provide evidence of genetically predicted poor overall health rating (odds ratio (OR), 2.82; 95% confidence interval (CI), 1.95-4.08), nap during day (OR, 2.01; 95% CI, 1.37-2.93), high body mass index (BMI) (OR, 1.14; 95% CI, 1.09-1.19), increased body fat mass (OR, 1.83; 95% CI, 1.83-2.05), elevated body water mass (OR, 1.50; 95% CI, 1.31-1.70) and hypertension (OR, 1.81; 95% CI, 1.34-2.45) were associated with higher OSA risk, while high education level (OR, 0.55; 95% CI, 0.40-0.75) correlated with reduced OSA risk. Suggestive evidence was obtained for smoking and waist-to-hip ratio (WHR) with higher OSA odds, and vigorous physical activity, and HDL cholesterol with lower OSA odds. After adjusting for BMI using multivariable MR analysis, the effects of smoking, WHR, vigorous physical activity, and HDL-cholesterol were fully attenuated. CONCLUSIONS This MR study indicates that overall health rating, nap during day, BMI, body fat mass, body water mass, hypertension, and education are causally associated with the risk of OSA, which means that these modifiable risk factors are key targets for OSA prevention.
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Affiliation(s)
- Ye Li
- Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin 300052, China
- Tianjin Geriatrics Institute, Tianjin 300052, China
| | - Yuyang Miao
- Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin 300052, China
- Tianjin Geriatrics Institute, Tianjin 300052, China
| | - Jin Tan
- Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin 300052, China
- Tianjin Geriatrics Institute, Tianjin 300052, China
| | - Qiang Zhang
- Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin 300052, China
- Tianjin Geriatrics Institute, Tianjin 300052, China
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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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Mohammadi I, Sadeghi M, Tajmiri G, Brühl AB, Sadeghi Bahmani L, Brand S. Evaluation of Blood Levels of Omentin-1 and Orexin-A in Adults with Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis. Life (Basel) 2023; 13:245. [PMID: 36676194 PMCID: PMC9865616 DOI: 10.3390/life13010245] [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: 11/27/2022] [Revised: 12/29/2022] [Accepted: 01/10/2023] [Indexed: 01/18/2023] Open
Abstract
Background and objective: Obstructive sleep apnea (OSA) can be related to changes in the levels of adipokines and neuropeptides, which in turn may affect the energy balance components of neuronal cells. Herein, a systematic review and meta-analysis checked the changes in serum/plasma levels of omentin-1 (OM-1: an adipokine) and orexin-A (OXA: a neuropeptide) in adults (age > 18 years old) with OSA (aOSA) compared to controls. Materials and methods: Four databases (Cochrane Library, PubMed, Web of Science, and Scopus) were systematically searched until 14 November 2022, without any restrictions. The Joanna Briggs Institute (JBI) critical appraisal checklist adapted for case−control studies was used to assess the quality of the papers. The effect sizes were extracted using the Review Manager 5.3 software for the blood levels of OM-1 and OXA in aOSA compared with controls. Results: Thirteen articles, with six studies for OM-1 levels and eight for OXA levels, were included. The pooled standardized mean differences were −0.85 (95% confidence interval (CI): −2.19, 0.48; p = 0.21; I2 = 98%) and −0.20 (95%CI: −1.16, 0.76; p = 0.68; I2 = 96%) for OM-1 and OXA levels, respectively. Among the studies reporting OM-1, five were high and one was moderate quality. Among the studies reporting OXA, six were moderate, one was high, and one was low quality. Based on the trial sequential analysis, more participants are needed to confirm the pooled results of the analyses of blood levels of OM-1 and OXA. In addition, the radial plot showed outliers as significant factors for high heterogeneity. Conclusions: The main findings indicated a lack of association between the blood levels of OM-1 and OXA and OSA risk. Therefore, OM-1 and OXA did not appear to be suitable biomarkers for the diagnosis and development of OSA.
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Affiliation(s)
- Iman Mohammadi
- Department of Oral and Maxillofacial Surgery, Dental Implants Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan 8174673461, Iran
| | - Masoud Sadeghi
- Department of Biology, Science and Research Branch, Islamic Azad University, Tehran 1477893855, Iran
| | - Golnaz Tajmiri
- Dental Implants Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan 8174673461, Iran
| | - Annette Beatrix Brühl
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric University Hospital Basel, 4002 Basel, Switzerland
| | - Laleh Sadeghi Bahmani
- Department of Education and Psychology, Shahid Ashrafi Esfahani University, Ishafan 8179949999, Iran
| | - Serge Brand
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric University Hospital Basel, 4002 Basel, Switzerland
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran
- Department of Sport, Exercise and Health, Division of Sport Science and Psychosocial Health, University of Basel, 4052 Basel, Switzerland
- Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences, Kermanshah 67146, Iran
- School of Medicine, Tehran University of Medical Sciences, Tehran 25529, Iran
- Center for Disaster Psychiatry and Disaster Psychology, Psychiatric University Hospital Basel, 4002 Basel, Switzerland
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Lages M, Barros R, Carmo-Silva S, Guarino MP. Linking dietary intake, circadian biomarkers, and clock genes on obesity: A study protocol. Front Nutr 2023; 10:1134789. [PMID: 37113302 PMCID: PMC10126511 DOI: 10.3389/fnut.2023.1134789] [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: 12/30/2022] [Accepted: 03/16/2023] [Indexed: 04/29/2023] Open
Abstract
Background The prevalence of obesity continues to rise, and although this is a complex disease, the screening is made simply with the value of the Body Mass Index. This index only considers weight and height, being limited in portraying the multiple existing obesity phenotypes. The characterization of the chronotype and circadian system as an innovative phenotype of a patient's form of obesity is gaining increasing importance for the development of novel and pinpointed nutritional interventions. Objective The present study is a prospective observational controlled study conducted in Portugal, aiming to characterize the chronotype and determine its relation to the phenotype and dietary patterns of patients with obesity and healthy participants. Methods Adults with obesity (study group) and healthy adults (control group), aged between 18 and 75, will be enrolled in this study. Data will be collected to characterize the chronotype, dietary intake, and sleep quality through validated questionnaires. Body composition will also be assessed, and blood samples will be collected to quantify circadian and metabolic biomarkers. Discussion This study is expected to contribute to a better understanding of the impact of obesity and dietary intake on circadian biomarkers and, therefore, increase scientific evidence to help future therapeutic interventions based on chronobiology, with a particular focus on nutritional interventions.
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Affiliation(s)
- Marlene Lages
- ciTechCare—Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal
- Faculty of Nutrition and Food Science, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
- EPIUnit—Institute of Public Health, University of Porto, Porto, Portugal
| | - Renata Barros
- Faculty of Nutrition and Food Science, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
- EPIUnit—Institute of Public Health, University of Porto, Porto, Portugal
| | - Sara Carmo-Silva
- Polytechnic Institute of Castelo Branco, Castelo Branco, Portugal
| | - Maria P. Guarino
- ciTechCare—Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal
- ESSLei, School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal
- *Correspondence: Maria P. Guarino,
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Muacevic A, Adler JR, Boike S, Kashyap R, Khan SA, Surani S. Nutritional Elements in Sleep. Cureus 2022; 14:e32803. [PMID: 36694494 PMCID: PMC9859770 DOI: 10.7759/cureus.32803] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2022] [Indexed: 12/24/2022] Open
Abstract
Sleep comprises one-third of our day and plays an integral role in human health and well-being. Many factors influence sleep, with nutrition being a key element that impacts various sleep parameters. Meal-timing through strategies like chrono-nutrition leads to positive sleep outcomes. In addition, consuming a high-protein diet with essential amino acids, low-glycemic-index foods, and certain fruits rich in antioxidants can all contribute to better sleep quality. Other facets of nutrition that can affect sleep outcomes include weight loss and limiting certain nutritional elements such as caffeine, nicotine, and alcohol. In this article, we will shed some light on how some of these factors can play a vital role in sleep quality.
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Howarth TP, Heraganahally SS, Gentin N, Jonas C, Williamson B, Jing MX, Suresh S. Comparison of polysomnographic characteristics between low birthweight and normal birthweight children in the Northern Territory of Australia: A case-control study. Sleep Health 2022; 8:625-631. [PMID: 36055934 DOI: 10.1016/j.sleh.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 06/28/2022] [Accepted: 07/12/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To describe the sleep architecture of pediatric patients according to whether they were born low birthweight (birthweight <2500 g, LBW) or normal birthweight (birthweight >2500 g). DESIGN Case control study. SETTING Pediatric sleep laboratory in the Northern Territory of Australia during a 5-year study period (2015- 2020). PARTICIPANTS Pediatric patients (aged <18 years) referred to the specialist sleep service for assessment of clinically suspected sleep disorders. MEASUREMENTS Sleep onset latency, rapid eye movement (REM) sleep latency, wake time after sleep onset, total sleep time, sleep efficiency, non-rapid eye movement stages N1/N2/N3, and REM sleep duration, total/spontaneous/respiratory/limb related arousal indexes, total/non-rapid eye movement/REM obstructive apnea-hypopnea index and oxygen saturation. RESULTS One hundred and seventy-two pediatric patients had birthweight data available of whom 19 were LBW. LBW patients showed significantly greater sleep disruption and higher prevalence of poor sleepers (<80% efficiency). In multivariate regression models, increasing birthweight was associated with significantly greater sleep efficiency and total sleep time. After accounting for gestational age LBW was associated with increased odds of obstructive sleep apnea. CONCLUSIONS Among pediatric patients LBW is associated with increased sleep disruption and reduced sleep efficiency. This is attenuated by gestational age, though both gestational age and LBW significantly influence odds of obstructive sleep apnea. This sleep health deficit may contribute to development of chronic disease in this vulnerable population, and should be monitored to provide avenues for early intervention.
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Affiliation(s)
- Timothy P Howarth
- College of Health and Human Science, Charles Darwin University, Darwin, Northern Territory, Australia; Darwin Respiratory and Sleep Health, Darwin Private Hospital, Darwin, Northern Territory, Australia
| | - Subash S Heraganahally
- Darwin Respiratory and Sleep Health, Darwin Private Hospital, Darwin, Northern Territory, Australia; Department of Respiratory and Sleep Medicine, Royal Darwin Hospital, Darwin, Northern Territory, Australia; Flinders University, College of Medicine and Public Health, Adelaide, South Australia, Australia
| | - Natalie Gentin
- Darwin Respiratory and Sleep Health, Darwin Private Hospital, Darwin, Northern Territory, Australia; Sydney Children's Hospital, Sydney, New South Wales, Australia; University of New South Wales, Sydney, New South Wales, Australia
| | - Catherine Jonas
- Darwin Respiratory and Sleep Health, Darwin Private Hospital, Darwin, Northern Territory, Australia
| | - Bruce Williamson
- Sydney Children's Hospital, Sydney, New South Wales, Australia; University of New South Wales, Sydney, New South Wales, Australia
| | - Matthias X Jing
- Health Information Services, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Sadasivam Suresh
- Queensland Children's Hospital, Brisbane, Queensland, Australia; Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
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Waist-hip ratio is an independent predictor of moderate-to-severe OSA in nonobese males: a cross-sectional study. BMC Pulm Med 2022; 22:151. [PMID: 35459124 PMCID: PMC9034636 DOI: 10.1186/s12890-022-01886-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 03/07/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adiposity is a well-established risk factor for obstructive sleep apnea (OSA), but whether a combination of preferable anthropometric measurements may improve the accuracy of detecting OSA is unknown. This study aimed to explore the accuracies of the waist-hip ratio (WHR) in conjunction with the body mass index (BMI) when identifying the severity of OSA. DESIGN A total of 2012 participants in the China-Japan Friendship Hospital from January 2018 to December 2019 underwent anthropometric measurements and an overnight home sleep test (HST). The 244 subjects who met the criteria for obstructive sleep apnea (apnea-hypopnea index (AHI) ≥ 5 events/hour) were divided into four groups: Group A (55 patients with WHR ≥ 0.9 and BMI ≥ 28 kg/m2); Group B (12 patients with WHR < 0.9 and BMI ≥ 28 kg/m2); Group C (69 patients with WHR ≥ 0.9 and BMI < 28 kg/m2); and group D (108 patients with WHR < 0.9 and BMI < 28 kg/m2). RESULTS The AHI, apnea index (AI), hypopnea index (HI), and oxygen desaturation index (ODI) were significantly different among the 4 groups (p < 0.05). The WHR was positively correlated with AHI (r = 0.22, p < 0.001), AI (r = 0.270, p = 0.004), and ODI (r = 0.286, p = 0.0022) and negatively correlated with lowest oxygen pulse saturation (LSpO2) (r = 0.246, p = 0.008) only in nonobese patients. Moreover, the WHR was found to be a screening marker for moderate-to-severe OSA in Group D (p < 0.05). When used to identify severe OSA in Group D, the WHR cut-off point of 0.873 yielded a sensitivity of 65% and specificity of 56% (p < 0.05). CONCLUSION In nonobese male OSA patients, WHR is a moderate screening marker for moderate-to-severe OSA and an independent risk factor for OSA severity.
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Grillo PM, Punaro GR, Elias MC, Parise ER. OBSTRUCTIVE SLEEP APNEA SYNDROME RISK IN PATIENTS WITH NON-ALCOHOLIC FATTY LIVER DISEASE IS ASSOCIATED WITH OBESITY AND PRESENCE OF NASH. ARQUIVOS DE GASTROENTEROLOGIA 2022; 59:251-256. [PMID: 35830037 DOI: 10.1590/s0004-2803.202202000-45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 03/21/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Non-alcoholic fatty liver disease (NAFLD) is the most common form of liver disease and refers to a wide spectrum of histological abnormalities ranging from simple steatosis (HE) to non-alcoholic steatohepatitis (NASH), fibrosis, cirrhosis and hepatocellular carcinoma. OBJECTIVE To assess the risk of obstructive sleep apnea syndrome (OSAS) and relating it to demographic, biochemical and histological data in patients with non-alcoholic fatty liver disease. METHODS Cross-sectional cohort study in individuals with biopsy-proven NAFLD. Anthropometric and biochemical parameters, presence of metabolic syndrome and insulin resistance were evaluated. The Berlin Questionnaire (BQ) was applied to assess the risk of apnea and a food record was requested. Based on the BQ, participants were classified as high or low risk for OSAS. In the correlation of sleep apnea with the severity of NAFLD, presence of nonalcoholic steatohepatitis (NASH) and the degree of liver fibrosis were evaluated. Statistical analysis used the chi-square test, Student's t and bivariate logistic regression; values were expressed as mean ± standard deviation. This research project was approved by the Ethics Committee. RESULTS Regarding the parameters evaluated, significant differences were observed between the groups in terms of body mass index (BMI), waist and neck circumference. In the histological evaluation, patients classified as high risk were more likely to have fibrosis and NASH. In bivariate regression, the BMI, presence of fibrosis and steatohepatitis in the biopsy were independently associated with an elevated risk of the syndrome. CONCLUSION A high prevalence of risk for OSAS was observed in the studied group, with a higher risk being independently associated with BMI and presence of steatohepatitis, suggesting that it is a factor associated with the severity of the disease.
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Affiliation(s)
- Penelope Michele Grillo
- Universidade Federal de São Paulo, Departamento de Medicina, Disciplina de Gastroenterologia, São Paulo, SP, Brasil
| | - Giovana Rita Punaro
- Universidade Federal de São Paulo, Departamento de Medicina, Disciplina de Nefrologia, São Paulo, SP, Brasil
| | - Maria Cristina Elias
- Universidade Federal de São Paulo, Departamento de Medicina, Disciplina de Gastroenterologia, São Paulo, SP, Brasil
| | - Edison Roberto Parise
- Universidade Federal de São Paulo, Departamento de Medicina, Disciplina de Gastroenterologia, São Paulo, SP, Brasil
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Lin CH, Chen CH, Hong SY, Chou IC, Liang SJ, Hang LW. Polysomnography Is an Important Method for Diagnosing Pediatric Sleep Problems: Experience of One Children’s Hospital. CHILDREN 2021; 8:children8110991. [PMID: 34828704 PMCID: PMC8622789 DOI: 10.3390/children8110991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/19/2021] [Accepted: 10/26/2021] [Indexed: 11/16/2022]
Abstract
In this study, we collected and analyzed polysomnography (PSG) data to investigate the value of PSG in diagnosing sleep problems in children. The results of PSG studies of children (<18 years old) with sleep problems conducted from April 2015 to May 2017 at a children’s hospital in Taiwan were collected and analyzed retrospectively. Data for 310 patients (209 males and 101 females) who underwent PSG were collected. The final diagnoses were as follows: obstructive sleep apnea in 159 (51.3%), snoring in 81 (26.4%), limb movement sleep disorder in 25 (8.1%), hypersomnias in 12 (3.9%), central apnea in 8 (2.9%), enuresis in 7 (2.3%), bruxism in 5 (1.6%), sleep terrors in 5 (1.6%), narcolepsy in 3 (1.0%), sleep seizures in 3 (1.0%), sleep walking in 1 (0.3%), and insomnia in 1 (0.3%). PSG may help detect significant sleep-related problems in children and is useful for making therapeutic decisions regarding children. Obstructive sleep apnea syndrome (OSAS) was the primary sleep problem for most of the children (51.3%); however, only 7.4% of them underwent surgery for OSAS. We therefore suggest that children with sleep problems should undergo PSG.
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Affiliation(s)
- Chien-Heng Lin
- Division of Pediatric Pulmonology, China Medical University Children’s Hospital, Taichung 404327, Taiwan; (C.-H.L.); (C.-H.C.)
- College of Medicine, China Medical University, Taichung 404328, Taiwan;
| | - Chieh-Ho Chen
- Division of Pediatric Pulmonology, China Medical University Children’s Hospital, Taichung 404327, Taiwan; (C.-H.L.); (C.-H.C.)
| | - Syuan-Yu Hong
- College of Medicine, China Medical University, Taichung 404328, Taiwan;
- Division of Pediatric Neurology, China Medical University Children’s Hospital, Taichung 404327, Taiwan;
| | - I-Ching Chou
- Division of Pediatric Neurology, China Medical University Children’s Hospital, Taichung 404327, Taiwan;
- Graduate Institute of Integrated Medicine, China Medical University, Taichung 404328, Taiwan
| | - Shinn-Jye Liang
- Sleep Medicine Center, Department of Pulmonary and Critical Care Medicine, China Medical University Hospital, Taichung 404327, Taiwan;
| | - Liang-Wen Hang
- Sleep Medicine Center, Department of Pulmonary and Critical Care Medicine, China Medical University Hospital, Taichung 404327, Taiwan;
- School of Nursing & Graduate Institute of Nursing, China Medical University, Taichung 404328, Taiwan
- Correspondence:
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陈 李, 方 永, 王 世, 卢 镇, 陶 晶, 卢 永, 聂 国. [Ultrasound measurement of upper airway related indicators and patients with obstructive sleep apnea hypopnea correlation study of disease severity]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2021; 35:971-976. [PMID: 34886598 PMCID: PMC10128361 DOI: 10.13201/j.issn.2096-7993.2021.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Indexed: 06/13/2023]
Abstract
Objective:To compare the difference of upper airway anatomy between non-obstructive sleep apnea(OSA) patients and OSA patients, and to analyse the correlation between upper airway anatomy and the disease severity based on the upper airway ultrasound examination. Methods:Eighty-five OSA patients (OSA group) and 36 non-OSA subjects (non-OSA group) who were admitted to the Second Hosipital of Shenzhen from January 2021 to May 2021 were recruited to perform upper airway ultrasound measurement. The airway anatomical parameters were compared and analyzed by t-test. The Spearman correlation analysis was performed on the ultrasound measurement values of OSA patients with the apnea-hypopnea index (AHI) and minimum blood oxygen saturation ( LSaO2). Results:There were statistically significant differences in BMI, the distance between the soft and hard palate junction and the hyoid bone, the angle between the hard palate and the soft palate, and the angle between the hyoid bone and the hard palate between the OSA group and the non-OSA group(P<0.001,respectively); For 85 cases of OSA, correlation analysis between the patient's upper airway B-ultrasound measurements and AHI and LSaO2 showed that the distance from the soft and hard palate junction to the mandible, the distance from the soft and hard palate junction to the hyoid bone, the thickness of the tongue(longitudinal section), and the thickness of the soft palate(longitudinal section)are positively correlated with AHI(r=0.3758, 0.4619, 0.3227, 0.2738, P<0.05, respectively); the distance from the soft and hard palate to the mandible, the distance from the soft and hard palate to the hyoid bone, the width of tongue(transverse section),and the tongue thickness(longitudinal section) are negatively correlated with LSaO2(r=-0.3566, -0.5470, -0.3168, -0.3098, P<0.05, respectively); the angle between the hard palate and the soft palate is negatively correlated with AHI(r=-0.2262, P<0.05); the angle between the hyoid bone and the hard palate is positively correlated with AHI and negatively correlated with LSaO2(r=0.2889, -0.3351, P<0.01). Conclusion:The upper airway related anatomical parameters based on ultrasound measurement, such as the distance from the soft and hard palate junction to the mandible, the distance from the soft and hard palate junction to the hyoid bone, the angle between the hyoid bone and the hard palate, and the angle between the hard palate and the soft palate, etc., are associated with the disease severity in OSA patients. The correlation may be used as a potential objective indicator to evaluate the severity of patients with OSA.
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Affiliation(s)
- 李清 陈
- 安徽医科大学深圳二院临床学院 深圳市第二人民医院耳鼻咽喉科(广东深圳,518000)Anhui Medical University Shenzhen Second Hospital Clinical College, Department of Otorhinolaryngology, the Second Hospital of Shenzhen, Shenzhen, 518000, China
| | - 永涵 方
- 深圳市第二人民医院超声科Department of Ultrasound, the Second Hospital of Shenzhen
| | - 世雄 王
- 深圳市第二人民医院呼吸与危重症医学科Department of Respiratory and Critical Care Medicine, the Second Hospital of Shenzhen
| | - 镇章 卢
- 深圳大学附属华南医院耳鼻咽喉头颈外科Department of Otolaryngology Head and Neck Surgery, South China Hospital Affiliated to Shenzhen University
| | - 晶 陶
- 安徽医科大学深圳二院临床学院 深圳市第二人民医院耳鼻咽喉科(广东深圳,518000)Anhui Medical University Shenzhen Second Hospital Clinical College, Department of Otorhinolaryngology, the Second Hospital of Shenzhen, Shenzhen, 518000, China
| | - 永田 卢
- 安徽医科大学深圳二院临床学院 深圳市第二人民医院耳鼻咽喉科(广东深圳,518000)Anhui Medical University Shenzhen Second Hospital Clinical College, Department of Otorhinolaryngology, the Second Hospital of Shenzhen, Shenzhen, 518000, China
| | - 国辉 聂
- 安徽医科大学深圳二院临床学院 深圳市第二人民医院耳鼻咽喉科(广东深圳,518000)Anhui Medical University Shenzhen Second Hospital Clinical College, Department of Otorhinolaryngology, the Second Hospital of Shenzhen, Shenzhen, 518000, China
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Katz SL, Blinder H, Naik T, Barrowman N, Narang I. Does neck circumference predict obstructive sleep apnea in children with obesity? Sleep Med 2021; 78:88-93. [PMID: 33418431 DOI: 10.1016/j.sleep.2020.12.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 12/16/2020] [Accepted: 12/17/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Obstructive sleep apnea (OSA) affects 10-50% of children with obesity, but its identification is challenging and wait times for testing are long. Previous studies suggest that neck circumference (NC) and neck-to-height ratio (NHR) may predict OSA. Our objectives were to 1) evaluate associations of NC and NHR with OSA; 2) model NHR as a predictor of OSA, adjusting for age, sex, and Tanner stage; and 3) identify thresholds of NHR associated with OSA, in children with obesity. METHODS Participants were aged 8-17 years, with obesity (BMI >95%ile), undergoing polysomnography. Associations between NC and NHR with OSA were evaluated. NHR, age, sex and self-reported Tanner stage (early/late) were included in a negative binomial multiple regression model to predict obstructive apnea hypopnea index (OAHI). RESULTS 71 children participated, with median age 14.8 years (IQR 12.6, 16.0), 54% male, median BMI z-score 2.5 (IQR 2.3, 2.7), and 77% late Tanner stage. OSA was severe in 18 children (25.4%), moderate in 12 (16.9%), and mild in 18 (25.4%). In the model, each 0.01 increase in NHR was associated with a 55% increase in OAHI (95% CI: 36%, 80%); boys had a 119% higher OAHI than girls (95% CI: 10%, 337%). Threshold NHR associated with moderate-severe OSA was 0.25 in females and 0.23 in males. CONCLUSIONS NHR and male sex independently predict OSA severity in children with obesity, adjusting for age and Tanner stage. Children with obesity and NHR above identified thresholds are more likely to have moderate-severe OSA, and may benefit from earlier polysomnography.
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Affiliation(s)
- Sherri L Katz
- Children's Hospital of Eastern Ontario, University of Ottawa, 401 Smyth Road, Ottawa, Ontario, K1H 8L1, Canada; Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, Ontario, K1H 5B2, Canada.
| | - Henrietta Blinder
- Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, Ontario, K1H 5B2, Canada
| | - Tanvi Naik
- Division of Respiratory Medicine, Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, Ontario, M5G1X8, Canada
| | - Nicholas Barrowman
- Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, Ontario, K1H 5B2, Canada
| | - Indra Narang
- Division of Respiratory Medicine, Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, Ontario, M5G1X8, Canada
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Gomes MF, Giannasi LC, Fillietaz-Bacigalupo E, de Mancilha GP, de Carvalho Silva GR, Soviero LD, da Silva GYS, Nazario LDM, Dutra MTDS, Silvestre PR, de Oliveira LVF, Nacif SR, de Oliveira EF, Serafim IM, Pereira BD, Greca AR, Goulart MDGV, Rode SDM, Tanaka MH, Koga-Ito CY, Amorim JBDO, Salgado MAC. Evaluation of the masticatory biomechanical function in Down syndrome and its Influence on sleep disorders, body adiposity and salivary parameters. J Oral Rehabil 2020; 47:1007-1022. [PMID: 32463923 DOI: 10.1111/joor.13023] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 04/29/2020] [Accepted: 05/11/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate the phenotypic features of the masticatory biomechanics in atypical subjects with Down syndrome (DS). Its influence was analysed on sleep disorders, body adiposity and its risks, and some physicochemical properties of saliva. METHODS Seventy subjects were enrolled to assess masticatory biomechanical function and divided into two groups: DS and control groups. Electrical activities of the masseter and temporal muscles (at rest and in maximum voluntary clench-MVC), maximum bite force-MBF and maximum mouth opening-MMO were investigated. Among the atypical subjects, just 24 participants underwent the anthropometry, the polysomnography II and the saliva testing (salivary flow rate-SFR, buffer capacity-BC and salivary cortisol levels, morning/SC-AM and night/SC-PM). RESULTS MVC and MBF values showed high statistical significance in the control group (P < .001) than in the DS group of 35. MMO values were slightly increased in the DS group in relation to the control group. Overweight and obesity were found in both genders. Atypical women showed higher risk to develop cardiovascular-metabolic diseases than in atypical men. OSA severe was 20% for atypical women and 42.8% for atypical men, whereas snoring index was present in all genders. SFR was reduced in 100% of atypical subjects (hyposalivation in 10% women and 28.5% men). Furthermore, 100% BC, 66.6% SC-AM and 91.6% SC-PM showed normal patterns. CONCLUSION Masseter and temporal muscle hypotonia was found in all atypical subjects with DS. This muscle dysfunction strongly was related to overweight/obesity, risks for development of cardiovascular/metabolic diseases, OSA severity, successive snoring episodes and salivary flow reduction in DS.
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Affiliation(s)
- Mônica Fernandes Gomes
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | - Lilian Chrystiane Giannasi
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | - Elaine Fillietaz-Bacigalupo
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | - Gabriela Pinto de Mancilha
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | - Gabriela Raine de Carvalho Silva
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | - Laura Dias Soviero
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | - Gabriella Yasmin Santos da Silva
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | - Letícia de Miguel Nazario
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | - Marignês Theotonio Dos Santos Dutra
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | | | | | | | | | - Irene Moreira Serafim
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | - Bruna Dicieri Pereira
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | - Amanda Reis Greca
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | - Maria das Graças Vilela Goulart
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | - Sigmar de Mello Rode
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | | | - Cristiane Yumi Koga-Ito
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | - José Benedito de Oliveira Amorim
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | - Miguel Angel Castillo Salgado
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
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Kuvat N, Tanriverdi H, Armutcu F. The relationship between obstructive sleep apnea syndrome and obesity: A new perspective on the pathogenesis in terms of organ crosstalk. CLINICAL RESPIRATORY JOURNAL 2020; 14:595-604. [PMID: 32112481 DOI: 10.1111/crj.13175] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 02/13/2020] [Accepted: 02/23/2020] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Obstructive sleep apnea syndrome (OSAS) is a common disorder that has a major impact on public health. The connection between OSAS and obesity is very complex and likely represents an interaction between biological and lifestyle factors. Oxidative stress, inflammation and metabolic dysregulation are both actors involved in the pathogenesis of OSAS and obesity. Also, the current evidence suggests that gut microbiota plays a significant role in the emergence and progression of some metabolic disorders. When the relationship between OSAS and obesity is evaluated extensively, it is understood that they show mutual causality with each other, and that metabolic challenges such as impaired microbiota affect this bidirectional organ interaction, and by ensuing organ injury. OBJECTIVES The aim of this study is to investigate the association between OSAS and obesity, and the effect of "organ crosstalk" on the pathogenesis of the relationship and to contribute to the diagnosis and treatment options in the light of current data. DATA SOURCE We performed an electronic database search including PubMed, EMBASE and Web of Science. We used the following search terms: OSAS, obesity, inflammation, metabolic dysregulation and gut microbiota. CONCLUSION Obesity and OSAS adversely affect many organs and systems. Besides the factors affecting the diagnosis of the OSAS-obesity relationship, mutual organ interactions among the respiratory system, adipose tissue and intestines should not be ignored for prevention and treatment of OSAS and obesity. Comprehensive clinical trials addressing the efficacy and efficiency of current or potential treatments on therapeutic applications in the OSAS-obesity relationship are needed.
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Affiliation(s)
- Nuray Kuvat
- Infectious Diseases and Clinical Microbiology, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Hakan Tanriverdi
- Department of Chest Diseases, Faculty of Medicine, Bulent Ecevit University, Zonguldak, Turkey
| | - Ferah Armutcu
- Department of Biochemistry, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
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Wang YH, Zhang P, Chen L, Jiang Z, Li LX, He K, Li XQ. Correlation between obstructive sleep apnea and central retinal vein occlusion. Int J Ophthalmol 2019; 12:1634-1636. [PMID: 31637201 DOI: 10.18240/ijo.2019.10.17] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 03/21/2019] [Indexed: 11/23/2022] Open
Abstract
To investigate the possible correlation between obstructive sleep apnea (OSA) and central retinal vein occlusion (CRVO). Thirty consecutive patients with a recent (<3mo) CRVO and an age- and sex-matched group of 30 control subjects were recruited. All subjects underwent full-night polysomnography to measure apnea-hypopnea index (AHI) and oxygen desaturation index (ODI). The average AHI and ODI were significantly higher in CRVO patients (AHI: 13.86±8.63, ODI: 9.21±4.47) than in control subjects (AHI: 8.51±6.36, ODI: 5.87±3.18; P=0.008 and 0.001 respectively). Additionally, the AHI was positively correlated with body mass index (BMI; r=0.476, P=0.017) and ODI (r=0.921, P<0.01) in both CRVO and control subjects. According to AHI scores, twenty-two (73.33%) CRVO patients had OSA and 12 (40.00%) control subjects had OSA, a difference that was statistically significant (P=0.019). OSA may be a risk factor for or a trigger of CRVO development.
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Affiliation(s)
- Yan-Hui Wang
- Department of Otolaryngology, Xi'an No.3 Hospital, the Affiliated Hospital of Northwest University, Xi'an 710018, Shaanxi Province, China
| | - Peng Zhang
- Department of Ophthalmology, Xi'an No.3 Hospital, the Affiliated Hospital of Northwest University, Xi'an 710018, Shaanxi Province, China
| | - Lian Chen
- Department of Ophthalmology, Xi'an No.3 Hospital, the Affiliated Hospital of Northwest University, Xi'an 710018, Shaanxi Province, China
| | - Zhao Jiang
- Department of Ophthalmology, Xi'an No.3 Hospital, the Affiliated Hospital of Northwest University, Xi'an 710018, Shaanxi Province, China
| | - Lu-Xi Li
- Department of Ophthalmology, Xi'an No.3 Hospital, the Affiliated Hospital of Northwest University, Xi'an 710018, Shaanxi Province, China
| | - Ke He
- Department of Ophthalmology, Xi'an No.3 Hospital, the Affiliated Hospital of Northwest University, Xi'an 710018, Shaanxi Province, China
| | - Xiao-Qing Li
- Department of Ophthalmology, Xi'an No.3 Hospital, the Affiliated Hospital of Northwest University, Xi'an 710018, Shaanxi Province, China
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MacLean JE. Assessment and treatment of pediatric obstructive sleep apnea in Canada: history and current state of affairs. Sleep Med 2019; 56:23-28. [PMID: 30745075 DOI: 10.1016/j.sleep.2019.01.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 01/04/2019] [Accepted: 01/06/2019] [Indexed: 02/07/2023]
Abstract
AIM To highlight Canada's contributions to the assessment and treatment of pediatric obstructive sleep apnea as well as outline the current state of pediatric obstructive sleep apnea in Canada. METHODS A search was conducted in MEDLINE (Ovid) using Medical Subject Headings (MeSH) and free-text terms for 'child' and 'obstructive sleep apnea' with subsequent 'human' limit. The results were reviewed to identify publications where any author's listed a Canadian institution. RESULTS Canadian contributions to the field of pediatric obstructive sleep apnea have grown over the last 30 years with an increase in number of contributors and centres. Much of the early work stemmed from McGill University with important contributions in examining alternatives to polysomnography and post-adenotonsillectomy respiratory compromise. Today, contributors from centres across the country are engaged in the field and come from a greater diversity of disciplines. With continued challenges and opportunities, Canada will continue to help advance the field of pediatric OSA. CONCLUSION Canada has a strong community of people invested in continuing to work to improve the lives of Canadian children with pediatric OSA.
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Affiliation(s)
- Joanna E MacLean
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada; Women & Children's Health Research Institute, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada; Stollery Children's Hospital, Edmonton, Alberta, Canada.
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Kalashnikova TP, Anisimov GV, Yastrebova AV, Starikova NL. [Etiopathogenesis of obstructive sleep apnoea and its consequences in the children]. Vestn Otorinolaringol 2018; 83:79-83. [PMID: 30412183 DOI: 10.17116/otorino20188305179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The article presents the modern view of etiology of the obstructive sleep apnoea/hypopnoea syndrome (OAHSS) in the children taking into consideration the ontogenetic stage and the principal mechanisms of its formation including the short-term and long-term consequences of sleep apnoea with special reference to the pathogenetic commonness of OAHSS with endothelial dysfunction, metabolic syndrome, cardiac disorders, and systemic chronic inflammation. The role of ENT diseases in the children with obstructive sleep apnoea is discussed. The results of genetic studies of the processes influencing the formation of the risk of development of sleep apnoea/hypopnoea syndrome and its outcomes in the children are discussed.
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Affiliation(s)
- T P Kalashnikova
- V.P. Pervushin Department of Neurology, Academician E.A. Vagner Perm State Medical University, Ministry of Health of the Russian Federation, Perm, Russia
| | - G V Anisimov
- The First Medico-Pedagogical Centre 'Lingva Bona', Perm, Russia
| | - A V Yastrebova
- V.P. Pervushin Department of Neurology, Academician E.A. Vagner Perm State Medical University, Ministry of Health of the Russian Federation, Perm, Russia
| | - N L Starikova
- Department of Neurology, Faculty of Advanced Training and Professional Retraining of Specialists with the course of neurorehabitology, Academician E.A. Vagner Perm State Medical University, Ministry of Health of the Russian Federation, Perm, Russia
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The Impact of Sleep-Disordered Breathing on Severity of Pregnancy-Induced Hypertension and Feto-Maternal Outcomes. J Obstet Gynaecol India 2018; 69:111-121. [PMID: 31686743 DOI: 10.1007/s13224-018-1134-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 05/08/2018] [Indexed: 10/14/2022] Open
Abstract
Background There is a close association between sleep-disordered breathing (SDB) and preeclampsia. Both conditions have poor pregnancy outcomes. Methods Forty women with new-onset hypertension of pregnancy and 60 age-matched normotensive pregnant women were subjected to polysomnography. The maternal and fetal outcomes of all the subjects were noted. Results SDB occurs more frequently (p = 0.018; OR 13.1) and with more severity (p 0.001; OR 1.8) in women with hypertensive disorders of pregnancy even after controlling for pre-pregnancy body mass index (BMI). Furthermore, the BMI significantly correlated with both the Apnea-Hypopnea Index (AHI; r = 0.745; p < 0.001) and the blood pressure (r = 0.617; p < 0.001) highlighting the contribution of obesity in the causation of hypertension and SDB. We also found a significant correlation between AHI and blood pressure even after adjustment for BMI pointing toward an independent role of SDB in the development of hypertension (r = 0.612; p = 0.01). Maternal and fetal complications significantly correlated with different parameters of SDB-AHI, Arousal Index and minimum oxygen saturation, in the cases and with the fetal complications in the controls as well. Conclusion SDB occurs more frequently and with more severity in women with pregnancy-induced hypertension and is associated with more severe preeclampsia and adverse feto-maternal outcomes.
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