Objectives Intermittent hypoxemia is a risk factor for developing complications in obstructive sleep apnea (OSA) patients. The objective of this systematic review was to identify articles evaluating the accuracy of the oxygen desaturation index (ODI) as compared with the apnea–hypopnea index (AHI) and then provide possible values to use as a cutoff for diagnosing adult OSA. Study Design Systematic Review of Literature. Methods PubMed, the Cochrane Library, and SCOPUS databases were searched through November 2019. Results Eight studies (1,924 patients) met criteria (age range: 28–70.9 years, body mass index range: 21.9–37 kg/m2, and AHI range: 0.5–62 events/hour). Five studies compared ODI and AHI simultaneously, and three had a week to months between assessments. Sensitivities ranged from 32% to 98.5%, whereas specificities ranged from 47.7% to 98%. Significant heterogeneity was present; however, for studies reporting data for a 4% ODI ≥ 15 events/hour, the specificity for diagnosing OSA ranged from 75% to 98%, and only one study reported the positive predictive value, which was 97%. Direct ODI and AHI comparisons were not made because of different hypopnea scoring, different oxygen desaturation categories, and different criteria for grading OSA severity. Conclusion Significant heterogeneity exists in studies comparing ODI and AHI. Based on currently published studies, consideration should be given for diagnosing adult OSA with a 4% ODI of ≥ 15 events/hour and for recommending further evaluation for diagnosing OSA with a 4% ODI ≥ 10 events/hour. Screening with oximetry may be indicated for the detection of OSA in select patients. Further study is needed before a definitive recommendation can be made. Laryngoscope, 131:440–447, 2021

Replacing an undivided nasal cannula with a divided nasal cannula is easy to implement, adding another physiologic measure to polysomnography. Although the divided nasal cannula did not significantly affect traditional polysomnographic metrics such as the apnea-hypopnea index or periodic limb movement index based on this small pilot study, we were able to replicate past nasal cycle findings that may be of interest to sleep clinicians and researchers. Given the ease with which the divided nasal cannula can be integrated, we encourage other sleep researchers to investigate the utility of using a divided nasal cannula during polysomnography.

Context: Acromegaly is a chronic disease associated with excessive growth hormone (GH) and insulin-like growth factor secretion, most commonly as a result of a pituitary adenoma. Patients diagnosed with acromegaly have a high incidence of obstructive sleep apnea. The introduction of endoscopic transnasal transphenoidal pituitary surgery has significantly decreased the risks and morbidities. It remains unclear, however, whether directed pituitary surgery has a significant long-term effect in reducing OSA indices among this population of patients.Objective: To assess whether treatment of acromegaly by means of endoscopic transnasal transphenoidal excision of pituitary adenoma has any significant longterm effects on the hypopnea index and oxygen desaturation index among patients with acromegaly and a co-morbid diagnosis of OSA. Our primary outcome was to evaluate the pre-and post-surgical values for AHI, and our secondary outcomes were the evaluation of GH, ODI, and IGF-1 values.Methods: In a systematic review and meta-analysis, studies relating to transsphenoidal pituitary adenomectomy in acromegalic patients with obstructive sleep apnea were extracted and analysed based on the inclusion criteria. A search was performed on Scopus, MED-LINE, Pubmed and The Cochrane Library, initially September 3 2015, with an update on October 10, 2015. The effect of the endoscopic transnasal transphenoidal surgery on primary and secondary outcomes was evaluated by metaanalysis.Results: Three studies (16 patients) were included. The mean age was 46.6±10.7 years old and a body mass index (BMI) of 28.7±2.4kg/m2. Our meta-analysis showed significant surgical treatment effect for AHI (p=0.0003) and IGF-1 (p<0.0001). One study reported GH values, which significantly improved following TSS (p<0.05). No studies included ODI. Each study analysed the results on different amount of time after TSS surgery. Levels of AHI and IGF-1 were significant lower when compared to to the pre-op. same for the conclusion. Conclusion:The Transsphenoidal surgery could be an option for selected patients to treat acromegaly with good results. Included studies reported an improvement on OSAS following TSS and hormonal control some months after the procedures.