Evolution of Sleep Apnea Syndrome in Sleepy Snorers

Lindberg, Eva; Elmasry, Ahmed; Gíslason, Þórarinn; Janson, Christer; Bengtsson, Harriet; Hetta, Jerker; Nettelbladt, Marika; Boman, Gunnar

doi:10.1164/ajrccm.159.6.9805070

Cited by 77 publications

(55 citation statements)

References 10 publications

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“…However, owing to the sparse and conflicting data available to date, controversy arises as to whether OSA is a progressive disease. In total, 18 longitudinal studies have dealt with the evolution and risk factors associated with snoring and OSA syndrome [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. Several studies found that mild-to-moderate OSA has a tendency to worsen over time [2][3][4][5][6][7][8][9][10][11].…”

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confidence: 99%

“…Of these 18 studies, nine assessed patients seeking treatment, but most of them are relatively old studies including a small number of participants (between 11 and 55), which did not allow meaningful subgroup comparisons. All but one study included both sexes [6]. In some studies the time between the two polysomnographic (PSG) evaluations was relatively short [4,5] or analysis was restricted to an older population (table 1) [3,12,14,16,18].…”

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confidence: 99%

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Progression of snoring and obstructive sleep apnoea: the role of increasing weight and time

Berger¹,

Berger²,

Oksenberg³

2008

European Respiratory Journal

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The aim of the present study was to examine the natural evolution of primary snoring and obstructive sleep apnoea (OSA) in adult male patients.Retrospective analysis was performed on 160 untreated patients with primary snoring and mild, moderate and severe OSA who had two polysomnographic recordings. The mean time between recordings (TBR) was 5.1¡3 yrs.The mean apnoea/hypopnoea index (AHI), body mass index (BMI), and lowest arterial oxygen saturation level during rapid eye movement (REM) and non-REM sleep showed a significant worsening effect. The change in AHI differed among the groups showing a similar significant increase in AHI for primary snoring, mild and moderate OSA and an insignificant decrease for severe OSA patients. Stepwise linear regression showed that only DBMI and time were significant predictors for AHI change. A model for the mean AHI change showed that DAHI 5 (4.336DBMI) + (0.666TBR). After adjusting for confounders, multiple regression analysis indicated that age and high BMI, but not AHI, were significant risk factors for developing hypertension and/or cardiovascular disease.Patients with primary snoring and mild and moderate obstructive sleep apnoea had a similar increase in the apnoea/hypopnoea index over time, which depended mainly on weight gain and, to a lesser extent, on time.

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confidence: 99%

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confidence: 99%

Progression of snoring and obstructive sleep apnoea: the role of increasing weight and time

Berger¹,

Berger²,

Oksenberg³

2008

European Respiratory Journal

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“…Positional OSA is defined as a supine AHI that is doubled compared to the one in the lateral position [23][24][25]. It can occur independently of BMI, age, upper airway anatomy, or lung function [26,27]. However, the patients who respond to positional therapy tend to be younger, have a milder form of OSA with a lower BMI [15,24,25,28,29].…”

Section: Positional Therapymentioning

confidence: 99%

Non-positive airway pressure therapy for obstructive sleep apnea

Jafari

Roux

2012

Curr Respir Care Rep

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Obstructive sleep apnea (OSA) is a common disorder associated with cardiovascular morbidity. Various methods are offered to improve symptoms of OSA and its outcome. Although positive airway pressure is the most effective treatment for OSA, its clinical effectiveness is limited by patients' compliance. Other suggested treatments for OSA focus on expanding upper airway and reducing its collapsibility. For example, mandibular advancement device (MAD) achieves this goal by mechanically protruding the mandible. Other available treatments including weight reduction, positional therapy, drugs, nasal dilators, and nasal expiratory pressure device are clearly inferior to CPAP.

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“…The prevalence of daytime naps is common in subjects with increasing age (Asplund 1996), with exhaustion syndrome (van Diest & Appels 1994), with MI or unstable angina (Redeker 1998), respiratory problems (Lindberg et al 1998) and those undergoing CABG. This is partly due to a fragmented sleep (Asplund 1994(Asplund , 1996 (Moldofsky 1994, Davidson et al 1991 show that both body temperature and plasma cortisol were reduced during the naps in association with SWS, compared to wakefulness, independently of time for napping.…”

Section: Daytime Sleepiness and Nappingmentioning

confidence: 99%

Sleep, psychological symptoms and quality of life in patients undergoing coronary artery bypass grafting

Edéll-Gustafsson

1999

Nordic Journal of Psychiatry

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In this thesis sleep, psychological symptoms and quality of life (Qol) in patients undergoing coronary artery bypass grafting (CABG) at the University Hospital in Linköping were evaluated. Interviews and 24-hour polysomnography were performed prior to surgery, immediately after surgery and again at one month, with a six-monthfollow-up mailed questionnaire. Habitual sleep was evaluated using the Uppsala Sleep Inventory questionnaire and a diary the recorded mornings. The Spielberger State of Anxiety Scale and the Zung´s Self-rating Depression Scale were used to measure anxiety and depression, respectively. Physical functional capacity was assessed according to the New York Heart Association´s (NYHA) classes and Qol, with the Nottingham Health Profile instrument (NHP).A retrospective evaluation of nurse's documentation about sleep was also performed. In addition, the quality and quantity of sleep were assessed before surgery and in the immediate postoperative period in a pilot study, with a one-month follow-up interview. The results indicated disturbed sleep, and changes in behaviour and mental state after surgery due to fragmented sleep, pain and anxiety.Forty-four patients were examined prior to surgery. The results showed that almost two-fifths experienced too little sleep habitually and 50 % had a combination of at least two sleep problems. Poorer health, higher level of anxiety and increased difficulties maintaining sleep (DMS) were consistent with significantly longer sleep latency, increased fragmented sleep, and reduced stages 3 and 4 and REM sleep measured by polysomnography. The level of Qol on the NHP was significantly associated with objectively measured sleep.In the immediate period following CABG there is a changed distribution of sleep, with a reduction of nocturnal sleep duration and an increase in daytime sleep, which had almost returned to preoperative values one month after surgery. Qol was significantly improved six months after surgery compared to before surgery.It was noted that patients with a more anxiety prone reactivity during six months following CABG had significantly more sleep disturbances, reduced energy and functional physical capacity, and lower quality of life, compared to those without such reactivity. Significantly more sleep disturbances, reduced energy and lower quality of life were more prominent among those with sadness/depression or cognitive/behavioural fatigue as reactions to sleep loss. A higher degree of cognitive/behavioural fatigue and dysphoria reactions were associated with a higher NYHA class.In conclusion, patients with coronary artery disease have poor quantity and quality of sleep. Increased psychological symptoms in patients with CAD prior to surgery were associated with greater symptoms six months after surgery. Physical functional capacity and quality of life were significantly improved six months after surgery

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Evolution of Sleep Apnea Syndrome in Sleepy Snorers

Cited by 77 publications

References 10 publications

Progression of snoring and obstructive sleep apnoea: the role of increasing weight and time

Progression of snoring and obstructive sleep apnoea: the role of increasing weight and time

Non-positive airway pressure therapy for obstructive sleep apnea

Sleep, psychological symptoms and quality of life in patients undergoing coronary artery bypass grafting

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