Obstructive sleep apnea

Qureshi, Asher; Ballard, Robert D.

doi:10.1016/j.jaci.2003.08.031

Cited by 82 publications

(92 citation statements)

References 219 publications

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“…Obstructive sleep apnea (OSA) is characterized by reductions in breathing amplitude during sleep caused by complete or partial obstruction of the upper airways (1). OSA usually results in signifi cant arterial hypoxemia and hypercapnia.…”

Section: Introductionmentioning

confidence: 99%

The association of neutrophil to lymphocyte ratio with presence and severity of obstructive sleep apnea

Sünbül¹,

Sünbül²,

Kanar³

et al. 2015

BLL

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BACKGROUND: Obstructive sleep apnea (OSA) is characterized by reductions in breathing amplitude during sleep caused by an obstructed or collapsed upper airway. The neutrophil to lymphocyte ratio (NLR) has been proposed as a novel biomarker for systemic infl ammatory response. The aim of the present study was to evaluate the relationship between NLR and OSA. METHODS: The study population consisted of 195 consecutive patients with clinical suspicion of OSA. Full night polysomnography was performed for all patients. Patients with an apnea hypopnea index (AHI) ≥ 5 were considered to have OSA. NLR was calculated as the ratio of neutrophil count to lymphocyte count. RESULTS: While 130 patients (91 male, mean age: 49.9±9.8 years) had OSA, 65 patients (42 male, mean age: 48.7 ± 10.2 years) had normal fi ndings according to AHI scores. Cardiovascular risk factors such as hypertension, hyperlipidemia, diabetes mellitus and smoking were more common in patients with OSA. Patients with OSA had signifi cantly higher NLR than controls (1.87±0.80 vs 1.49±0.48, p=0.005). AHI score was signifi cantly correlated with NLR (r=0.228, p=0.001). NLR and presence of hyperlipidemia were independent predictors of OSA (OR: 2.451, 2.850, p=0.001, 0.004, respectively). NLR of 1.62 or higher predicted OSA with a sensitivity of 56.2 % and specifi city of 63.1 %. CONCLUSIONS: NLR was higher and also correlated with AHI score in patients with OSA which has not been reported previously. NLR more than 1.62 was an independent predictor of OSA. A simple, cheap white blood cell count may also give an idea about the presence and severity of OSA (Tab. 3, Fig. 3, Ref. 30). Text in PDF www.elis.sk. KEY WORDS: infl ammation, cardiovascular risk, neutrophil to lymphocyte ratio, obstructive sleep apnea.

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Section: Introductionmentioning

confidence: 99%

The association of neutrophil to lymphocyte ratio with presence and severity of obstructive sleep apnea

Sünbül¹,

Sünbül²,

Kanar³

et al. 2015

BLL

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“…Some have also recommended that rhinoplasty can cause an improvement in symptoms (decrease in nightly snoring) in groups of patients who suffer from respiratory distress during sleep, but since, in the patients with OSA, the level of obstruction is usually confined to anatomical pharynx, rhinoplasty has not affected symptom improvement drastically [1,22].…”

Section: Discussionmentioning

confidence: 99%

“…Obstructive sleep apnea (OSA) applies to complete or partial obstruction of the airway during sleep causes airflow cessation (apnea) or airflow reduction (hypopnea) despite the resulting increase in breathing effort [1]. The prevalence of this disorder increases with age, which is most common in 62 % of elderly men over 65 years old [2].…”

Section: Introductionmentioning

confidence: 99%

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The Effect of Uvulopalatopharyngoplasty with Tonsillectomy in Patients with Obstructive Sleep Apnea

Baradaranfar

Edalatkhah

Dadgarnia

et al. 2014

Indian J Otolaryngol Head Neck Surg

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In the current study, we evaluated the effectiveness of uvulopalatopharyngoplasty (UPPP) in treatment of patients with obstructive sleep apnea (OSA) syndrome. All patients were previously received medical treatment but their symptoms did not resolve. A prospective study was conducted in Shahid Sadoughi Hospital in Yazd, Iran. Several sleep indices were evaluated using polysomnography (PSG) in all patients before performing UPPP and tonsillectomy. All patients were visited 6 months after surgery and PSG was repeated to assess the efficacy of surgical intervention. A total of 48 patients were enrolled and underwent UPPP and tonsillectomy. Six months after surgery, significant improvements were observed in all indices of sleep (apnea-hypopnea index, respiratory distress index, arterial oxygen saturation, and snoring index). The score of daytime sleepiness (assessed by Epworth score) was also improved. According to the result of this study, using UPPP surgery in patients with OSA can cause symptoms improvement in 64 % of cases. It seems thatMuller's maneuver test has assisted in briefly increasing success rate after surgery, though to prove this claim; other studies should be designed and performed in a randomized clinical trial.

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“…in those cases it has been postulated that an increase in carbon dioxide sensitivity can destabilise breathing during sleep, giving rise to recurrent cycles of central apnoea and hyperventilation during sleep. [35][36][37][38][39][40][41][42] This study has several limitations, the most important being the small sample size of mild stroke cases, who were not submitted to neither oRl evaluation nor a sleep study before stroke. Since no relationship was found in this study between the site of brain injury and SdB, we are not able to evaluate its possible role on SdB.…”

Section: Discussionmentioning

confidence: 99%

Sleep Disordered Breathings in Patients with Stabilised Stroke – A Case Control Study

Minni¹,

Toni²,

Caramia³

et al. 2012

European Neurological Review

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Aim of the study: in order to characterise sleep disordered breathing (SdB) in patients with stable stroke, a prospective observational study is ongoing in Rome. We report the results of the first 55 cases studied. Methods: a consecutive series of patients with acute stroke, admitted to the stroke unit of two different Roman university hospitals, were screened. Participants were submitted to both clinical and instrumental evaluations at stroke onset and then at 4 months. The diagnostic tests included polisomnographyc (PSG) study and brain MRi. SdB, either central or obstructive, was diagnosed in presence of an apnoea/hypopnoea index (ahi) value ≥5. Statistical analysis was performed with SPSS version 18.0 for Windows. comparisons were done by χ2 tests or via Fisher's exact test depending on which was more appropriate. correlations were done with non-parametric tests (Spearman's rho). Statistical significance was set at p<0.05. Results: Fifty-five PSG studies were performed. Forty-two cases (76.4 %) had a SdB. Twenty-eight out of the 42 (67 %) cases with an ahi ≥5 had an obstructive sleep apnoea-hypopnoea (oSah) and 12 (29 %) cases had a central sleep apnoea-hypopnoea (cSah). Patients affected by cSah were significantly older than those affected by oSah (p=0.052). in the group of patients affected by predominantly oSah, the longer the time interval from stroke to PSG, the shorter both the total sleep period and the total sleep time. Patients with predominantly cSah were more frequently arrhythmic and more frequently affected by increase in pharyngeal tissue and referred significantly more frequently inattention or unrefreshing sleep. Discussion and Conclusions: The hypothesis we postulate is that, in a subgroup of patients with stroke, stroke moves to worsen patients' pre-existing breathing condition, causing ventilatory instability. in these cases, central apnoea may take precedence over the obstructive one, in a loop gain circuit over than one, that gives rise to alternating obstructive and central events (possible complex-sleep apnoeas). Multicentre studies, capable of enrolling larger cohorts, are needed to confirm this hypothesis. KeywordsStroke, sleep disordered breathing, complex sleep apnoea in order to characterise SdB in patients with stable stroke, a prospective observational study is ongoing in Rome. We report the results of the first 55 cases studied.

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Obstructive sleep apnea

Cited by 82 publications

References 219 publications

The association of neutrophil to lymphocyte ratio with presence and severity of obstructive sleep apnea

The association of neutrophil to lymphocyte ratio with presence and severity of obstructive sleep apnea

The Effect of Uvulopalatopharyngoplasty with Tonsillectomy in Patients with Obstructive Sleep Apnea

Sleep Disordered Breathings in Patients with Stabilised Stroke – A Case Control Study

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