Endorsement of: “clinical practice guideline for diagnostic testing for adult obstructive sleep apnea: an American academy of sleep medicine clinical practice guideline” by the World Sleep Society

Hamilton, Garun S.; Gupta, Ravi; Vizcarra, Darwin; Insalaco, Giuseppe; Escobar, Franklin; Kadotani, Hiroshi

doi:10.1016/j.sleep.2020.12.044

Cited by 9 publications

(7 citation statements)

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“…Furthermore, we utilized CFD computations to calculate concomitant airflow velocity and airway pressure at the narrowest upper airway, which indicated acceptable predictors of moderate to severe OSA. Although overnight polysomnography in a sleep center is considered a diagnostic standard for OSA (26), the method is time consuming and cannot determine the anatomic obstruction site of the upper airway. BMI, neck circumference, and waist circumference were not found to be factors contributing to mild OSA and moderate to severe OSA in our study.…”

Section: Discussionmentioning

confidence: 99%

Prediction of Moderate to Severe Obstructive Sleep Apnea Using Neck Computed Tomography With Computational Fluid Dynamics Study

Chung

2022

Front. Med.

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BackgroundModerate to severe obstructive sleep apnea (OSA) is associated with cardiovascular disease. Polysomnography is time intensive and difficult to access for diagnosis of OSA. Neck computed tomography (CT) provides upper airway delineation but not diagnostic criteria for moderate to severe OSA. We explored neck CT with computational fluid dynamics (CFD) study for airway pressure and airflow velocity to predict moderate to severe OSA.MethodsEnrolled from February 1, 2020, to June 30, 2021, patients with OSA with overnight oxygen desaturation (sPO2 <90%) received awake neck CT with a CFD study of their airway pressure and airflow velocity. CTL12 and CTL34 were defined as airflow velocity <3 and ≥3 m/s, respectively, and airway pressure <10 and ≥10 pa, respectively, in the narrowest upper airway.ResultsSixty-two patients (42 male and 20 female; mean age: 50.4 ± 14.6 years) were included; 12 and 50 patients had mild OSA and moderate to severe OSA, respectively. The minimum sPO2 in the supine position was 80.7 ± 9.1%. The total time of sPO2 <90% at overnight oximetry was 29.3 ± 51.1 min. Most (85.5%) neck CT examinations with CFD study presented CTL34. Patients with CTL34 had a lower minimum sPO2 in the supine position (78.4 vs. 88.1%, P = 0.004) and longer duration of sPO2 <90% at overnight oximetry (33.9 vs. 1.9 min, P = 0.001) than those with CTL12. The values of the area under the receiver operating characteristic curves of airway pressure and of airflow velocity at the narrowest upper airway were 0.788 and 0.733, respectively.ConclusionNeck CT with CFD study of airway pressure and airflow velocity may provide a quick prediction of moderate to severe OSA.

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Section: Discussionmentioning

confidence: 99%

Prediction of Moderate to Severe Obstructive Sleep Apnea Using Neck Computed Tomography With Computational Fluid Dynamics Study

Chung

2022

Front. Med.

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“…Patients mentioned above can be diagnosed with OSA. The severity of OSA is divided into mild (5 times/h ≤ AHI < 15 times/h), moderate (15 times/h ≤ AHI < 30 times/h), and severe (AHI ≥30 times/h) according to the level of AHI 12 …”

Section: Methodsmentioning

confidence: 99%

Factors influencing new‐onset hypertension in elderly patients with obstructive sleep apnea: A multicenter cohort study

Zhao,

Gao,

et al. 2023

Clinical Translational Sci

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Investigating the influencing factors of new‐onset hypertension in the elderly with obstructive sleep apnea (OSA). 450 Chinese older patients with OSA who were non‐hypertensive at baseline were enrolled. All patients had undergone polysomnography monitoring in the multicenter study. The primary endpoint was incident hypertension. Kaplan–Meier survival analysis was performed, and multivariate Cox proportional hazards models were generated to determine the factors influencing new‐onset hypertension. A total of 176 (39.1%) patients developed hypertension. The hypertension group had older age, higher hemoglobin (Hb) level and apnea‐hypopnea index (AHI) values than the non‐hypertension group (all p < 0.05). During the median 33‐month follow‐up period, multivariate Cox analysis showed age (hazard ratio (HR) = 1.039, 95% confidence interval (95% CI): 1.016–1.062), AHI (HR = 1.015, 95% CI: 1.007–1.023) and Hb level (HR = 1.016, 95% CI: 1.008–1.025) were independent predictors of new‐onset hypertension. However, continuous positive airway pressure (CPAP; HR = 0.508, 95% CI: 0.271–0.951) reduced the risk of developing hypertension. Notably, the subgroup analysis demonstrated that the plasma glucose level (HR = 1.168, 95% CI: 1.029–1.326) was a risk factor for male patients. Besides length of time with the pulse oxygen saturation less than 90% (Tsat90; HR = 1.005, 95% CI: 1.003–1.007), body mass index (BMI; HR = 1.170, 95% CI: 1.043–1.311), and dyslipidemia (HR = 2.335, 95% CI: 1.144–4.766) had statistically significant effects on the incidence of hypertension in certain subgroups. Although this study lacked analysis of items such as living habits and medication, it did show age, AHI, Hb and CPAP affected the development of hypertension in elderly OSA patients. These findings suggested that targeted interventions in specific populations may be more effective in preventing hypertension.

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“…Obstructive sleep apnoea (OSA) is a condition in which repetitive upper airway closure occurs during sleep, leading to decreased oxygen saturation and impaired sleep architecture 10–13. It is estimated to affect approximately one billion people worldwide 14…”

Section: Introductionmentioning

confidence: 99%

Drug therapies for obstructive sleep apnoea: a systematic review and meta-analysis protocol

Nobre,

Sarmento,

Medeiros

et al. 2024

BMJ Open

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IntroductionObstructive sleep apnoea (OSA) is a common disorder that can affect the quality of life and increase the risk for psychiatric, neurological and cardiometabolic diseases. Despite the significant burden, it poses on health and well-being, there is a lack of evidence regarding the use of drug therapies in these patients. This work aims to evaluate the efficacy and safety of pharmacological treatment alternatives for patients with OSA.Methods and analysisDatabases, including PubMed, Embase, Web of Science, SciELO, LILACS, Scopus, Cochrane Register of Controlled Trials and ClinicalTrials.gov, will be used for the search. A search strategy was developed to retrieve clinical trials that have evaluated polysomnographic primary outcome (Apnoea-Hypopnoea index) and secondary outcomes (eg, daytime sleepiness, adverse events) of any drug therapy used for OSA. No date or language restrictions will be applied. Two authors will independently select the studies meeting the inclusion criteria by screening the title, abstract and full text. Data will be extracted, and the risk of bias will be evaluated using the Cochrane Risk of Bias Tool. Review Manager V.5.4.1 will be used for data synthesis. The Grading of Recommendation Assessment, Development and Evaluation will be used to assess the strength of the evidence.Ethics and disseminationAs a review of published data, it is not necessary to obtain ethical approval. The findings of this systematic review will be published in a peer-reviewed journal.PROSPERO registration numberCRD42022362639.

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Endorsement of: “clinical practice guideline for diagnostic testing for adult obstructive sleep apnea: an American academy of sleep medicine clinical practice guideline” by the World Sleep Society

Cited by 9 publications

References 0 publications

Prediction of Moderate to Severe Obstructive Sleep Apnea Using Neck Computed Tomography With Computational Fluid Dynamics Study

Prediction of Moderate to Severe Obstructive Sleep Apnea Using Neck Computed Tomography With Computational Fluid Dynamics Study

Factors influencing new‐onset hypertension in elderly patients with obstructive sleep apnea: A multicenter cohort study

Drug therapies for obstructive sleep apnoea: a systematic review and meta-analysis protocol

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