Obstructive Sleep Apnea Syndrome

We previously showed that upper airway resistance can be inferred from the inspiratory flow contour during continuous positive airway pressure (CPAP) titration in obstructive sleep apnea syndrome (OSAS). The present study examines whether similar information can be obtained from inspiratory flow measured by a nasal cannula/pressure transducer. Ten symptomatic patients (snoring, upper airway resistance syndrome [UARS], or OSAS) and four asymptomatic subjects underwent nocturnal polysomnography (NPSG) with monitoring of flow (nasal cannula) and respiratory driving pressure (esophageal or supraglottic catheter). For each breath the inspiratory flow signal was classified as normal, flattened, or intermediate by custom software. "Resistance" was calculated from peak inspiratory flow and pressure, and normalized to the resistance during quiet wakefulness. Resistance in all stages of sleep was increased for breaths with flattened (387 +/- 188%) or intermediate (292 +/- 163%) flow...

Background: The aim of this study was to validate the predictive value of the questionnaire "STOP BANG" in the detection
of obstructive sleep apnea syndrome syndrome (OSAS) and to identify patients at high risk of OSASS in anesthesia
consultation in North African population.
Methods: Prospective clinical study, consecutive, about 759 patients proposed for elective surgery and enjoying a remote
anesthesia consultation in H. Bourguiba hospital in Sfax, Tunisia. Included patients answered the questionnaire "STOP
BANG". Patients with a score below 3 are considered low risk and represent the group (1). Patients with a score greater
than or equal to 3 are considered high risk and represented the group (2). All patients were investigated by ventilator polygraphy
to confirm the diagnosis of obstructive apnea syndrome. The apnea hypopnea index (AHI) greater than or equal to
5 confirmed the diagnosis of OSAS.
Results: One hundred and fifty patients were included in the study. 41 patients had low risk of OSAS and represented the
group (1) and 27.33% of included patients. 109 patients had high risk of OSAS and represented the group (2) and 72.66%
of included patients. The diagnosis of OSAS was confirmed among 127 patients including 99 in the group (1) and 28 in
the group (2). In our study results showed that the sensitivity of the score STOP BANG questionnaire was to the order
of 87.1%, specificity was 47.8%, with positive and negative predictive values 90% and 40.74 respectively. The sensitivity of
the questionnaire increased significantly with increasing AHI, it was 91.3% for IAH ≥ 15/H and 93.9% for AHI ≥ 30/H.
Similarly, the predictive negative value of the questionnaire increased parallel with the increase in the AHI, it was 70.37%
for AHI ≥ 15/H and 88.9% for AHI ≥ 30/H.
Conclusion: The sensitivity, specificity, positive and negative predictive value vary by IAH and score STOP BANG. These
results show that the STOP BANG questionnaire is a good simple screening tool, easy, particularly suitable for anesthesia
consultation. The questionnaire has excellent sensitivity and specificity to identify patients at high risk of OSAS.

OSAS patients had higher plasma viscosity than controls, both in the morning (1.74±0.3 vs. 1.36±0.2 mPa s, P<0.002) and evening (1.55±0.2 vs. 1.27±0.1 mPa s, P<0.002), and morning plasma viscosity was significantly higher than the evening level (P<0.05). Morning ...

The increasing prevalence of obesity in children seems to be associated with an increased prevalence of obstructive sleep apnea syndrome (OSAS) in children. Possible pathophysiological mechanisms contributing to this association include the following: adenotonsillar hypertrophy due to increased somatic growth, increased critical airway closing pressure, altered chest wall mechanics, and abnormalities of ventilatory control. However, the details of these mechanisms and their interactions have not been elucidated. In addition, obesity and OSAS are both associated with metabolic syndrome, which is a constellation of features such as hypertension, insulin resistance, dyslipidemia, abdominal obesity, and prothrombotic and proinflammatory states. There is some evidence that OSAS may contribute to the progression of metabolic syndrome with a potential for significant morbidity. The treatment of OSAS in obese children has not been standardized. Adenotonsillectomy is considered the primary i...

Background  Continuous positive airway pressure (CPAP) is an effective treatment for obstructive sleep apnea syndrome (OSAS). Consistent adherence to CPAP improves the patient’s longevity and quality of life as well as public safety. However, nonadherence is a significant contributor to the growing burden of untreated OSAS, and is associated with negative consequences for the patient, public safety, and the healthcare system.

Formerly known as Obesity Research, Obesity is the official journal of The Obesity Society. Available in print and online, Obesity is dedicated to increasing knowledge, fostering research, and promoting better treatment for people with obesity and their loved ones. Obesity publishes ...

These practice parameters are an update of the previously published recommendations regarding use of oral appliances in the treatment of snoring and Obstructive Sleep Apnea (OSA). Oral appliances (OAs) are indicated for use in patients with mild to moderate OSA who prefer them to continuous positive airway pressure (CPAP) therapy, or who do not respond to, are not appropriate candidates for, or who fail treatment attempts with CPAP. Until there is higher quality evidence to suggest efficacy, CPAP is indicated whenever possible for patients with severe OSA before considering OAs. Oral appliances should be fitted by qualified dental personnel who are trained and experienced in the overall care of oral health, the temporomandibular joint, dental occlusion and associated oral structures. Follow-up polysomnography or an attended cardiorespiratory (Type 3) sleep study is needed to verify efficacy, and may be needed when symptoms of OSA worsen or recur. Patients with OSA who are treated wi...

Background: The aim of this paper was to determine the most common craniofacial changes in patients suffering Obstructive Sleep Apnea Syndrome (OSAS) with regards to the degree of obesity. Accordingly, cephalometric data reported in the literature was searched ...

Snoring occurs commonly in children and is sometimes associated with obstructive sleep apnea syndrome (OSAS). Based on clinical history alone, it is difficult to distinguish primary snoring, characterized by noisy breathing during sleep without apnea or ...

The epidemiology of obstructive sleep apnea (OSA) and obstructive sleep apnea syndrome (OSAS) is not well studied among Indians. We sought to determine the prevalence and risk factors of OSA in a middle-aged urban Indian population.We conducted a two-stage, cross-sectional, community-based study in four different socioeconomic zones of the South Delhi district, India, from April 2005 to June 2007. In stage 1, subjects of either gender aged 30–65 yrs were administered a questionnaire by door-to-door survey using systematic random sampling. Subjects that responded were classified as habitual and non-habitual snorers. In stage 2, all the habitual and 10% of randomly selected non-habitual snorers were invited for overnight polysomnographic study.Of the 2860 subjects approached, 2505 (88%) completed stage 1. Habitual snoring was present in 452 (18%) subjects. In stage 2, OSA defined as apnea–hypopnea index ⩾5 was observed in 94 (32.4%) of 290 habitual snorers and 3 (4%) of 75 non-habitua...