Introduction: Obstructive Sleep Apnea (OSA) and Metabolic Syndrome (MS) are common disorders with an escalating prevalence and systemic consequences. OSA is defined as recurrent episodes of complete or partial upper airway closure during sleeping. Metabolic syndrome comprises a heterogeneous group of changes including diabetes, dyslipidemia, obesity, hypertension.The aim of this study was to evaluate the association between OSA and MS. Methods:We conducted a prospective study of patients who underwent seep study in Constanta Sleep Disorders Center, between 2015-2019. The patient group consisted of 151 individuals (103 male and 48 females). All patients underwent polygraphy, blood sampling and measurement of anthropometric variables. OSA was consider present when AHI >15. MS was defined according to the National Heart, Lung, and Blood Institute (NHLBI) and the American Heart Association (AHA) guidelines.Results: Out of a total of 151 patients with OSA, 90 (59.6%) were found to have MS. All of the separate components of metabolic syndrome were common in our patients, but the diagnosis was made based on three (57.7%), four or all criteria (42.3%). Furthermore, all the anthropometric variables were associated with MS. The prevalence of MS among OSA patients increased with increasing AHI. Obesity was a strong link to both, in particular visceral obesity for MS and enlargement of soft tissue structure within and surrounding the airway for OSA. Conclusion:Patients with OSA have a high prevalence of metabolic syndrome. Thus, this interplay could disclose a role for OSA screening in patient with metabolic abnormalities.
Background In the management of chronic respiratory diseases such as asthma and chronic obstructive pulmonary disease (COPD), adherence to therapy represents a key to success. Objective The objective was to increase adherence to treatment through the development of educational intervention (EI) for asthma and COPD, addressed to patients and general practitioners (GPs). The educational programme includes group educational sessions and educational materials and was carried out in five Romanian hospitals. The results were assessed through Test of Adherence to Inhalers (TAI) questionnaire. Results Of note, 347 GPs and 435 patients were included. Seventy-six per cent of the GPs considered that the main causes of non-adherence are the disease misunderstanding, difficulty of using inhaled medication, fear of adverse effects, the patient’s conviction that no medicine is useful for his illness and financial nature (20%). Fifty-five per cent of surveyed GPs believed that their patients always or most of the time adhere to inhaled therapy but 57% of the same surveyed GPs checked the inhalation technique of their patients sometimes, rarely or never. Only 44% of the GPs discussed with the pulmonologist about their patient’s disease. Before the EI, only 32% of patients had a good adherence score to therapy; this percentage increases to 57% after EI. The most common reasons for non-adherence were: patient forgets to administer his inhalation medication daily (49%), fear of adverse effects (33%), belief that medication is useless (26%), and fear that inhalation medication affects everyday life of the patient (24%). Nearly half of the patients (47%) give up medication when they feel better. Forty per cent of patients drop off inhalation treatments due to financial reasons. The most influenced behaviours as a result of the EI were psychological component (85%), fear of the adverse events (82%) and social component (79%). Conclusions The non-adherence to therapy remains a real problem in asthma and COPD patients in our study group, but EI had positive effects. Extending medical education programmes for patients focused on main reasons of poor adherence, such as forgetting to take medication daily, use of inhalator devices, not understanding their disease, may significantly increase adherence to inhalation treatment.
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