Existence Of Obstructive Sleep Apnea Research Articles

Consider obstructive sleep apnea in patients with oropharyngeal vascular malformations.

Patients with oropharyngeal vascular malformations with complaints of upper airway obstruction were referred to a sleep specialist to investigate the existence of obstructive sleep apnea (OSA). Demography, complaints, localization, and extent of the malformation were noted. The Epworth Sleeping Scale (ESS) and a polysomnography were performed to analyze the existence of OSA. Thirteen patients with vascular malformations in the upper oropharyngeal tract were referred, with a mean age of 49 years (range, 20-77 years). The male: female ratio was 7:6. In 2 patients the ESS was missed, and in the other 11 patients the mean ESS was 11.7 (range, 4-23). After polysomnography, 11 of the 13 patients (85%) were diagnosed with OSA, of whom 7 patients had severe OSA. Patients with oropharyngeal vascular malformations with complaints of upper airway obstruction have a high risk of OSA, and should be referred to a sleep specialist.

Submental Ultrasound Measurement of Dynamic Tongue Base Thickness in Patients with Obstructive Sleep Apnea

Dynamic tongue base thickness (TBT) may be an important anatomic factor in airway narrowing in patients with obstructive sleep apnea (OSA). The development of an accurate clinical assessment of the retroglossal airway in patients with OSA is still evolving. Submental ultrasound was used to investigate the association between measurements of TBT in response to negative airway pressure and the existence of OSA. Twenty OSA patients and 20 control participants underwent ultrasound measurement of TBT on eupneic breathing and with the Mueller maneuver, as well as clinical and polysomnographic assessments. Logistic regression analyses indicated that after adjustment for confounding factors, independent predictors of OSA included TBT in response to negative airway pressure, as measured by submental ultrasound with the Mueller maneuver (odds ratio: 2.11, 95% confidence interval: 1.15–3.87, p < 0.05), and the difference between TBT with the Muller maneuver and that without the Mueller maneuver (odds ratio: 2.47, 95% confidence interval: 1.09–5.58, p < 0.05). Ultrasound measurement of TBT during the Mueller maneuver provides a quantitative assessment of the retroglossal airway in OSA patients with minimal invasiveness and easy accessibility.

EPA-0113 – Cpap treatment compliance in combat veternas with obstructive sleep apnea and ptsd and how it affects their ptsd symptoms

As a Psychiatrist working at Veterans Affairs Hospital, I have seen many patients with co existence of Obstructive Sleep Apnea and PTSD. As we know sleep disturbances are very common in combat veterans with PTSD, most common of which are nightmares and insomnia. There have been studies showing that people with OSA can have worsening of PTSD but PTSD is not found to be deleterious for OSA. CPAP is the treatment of choice for OSA and it has been found that people who start using CPAP machine have less occurance of nightmares and they sleep better. There is considerable ratio of veterans seen in my practice who do not use CPAP despite being prescribed for it, I compared the veterans with OSA who use CPAP mahcine versus those who do not use CPAP machine. Patient's subjective reporting of improvement in PTSD symptoms in those who use CPAP machine will be compared to those who do not use CPAP machine and continued to have PTSD symptoms.

Impact of nasal continuous positive airway pressure for congenital adrenal hyperplasia with obstructive sleep apnea and bruxism

Congenital adrenal hyperplasia (CAH) is a group of autosomal recessive disorders in humans. The most frequent CAH variant is 21-hydroxylase deficiency. Patients with 21-hydroxylase deficiency require long-term glucocorticoid replacement treatment. Although sleep disturbance is frequently observed under glucocorticoid replacement treatment, a case of obstructive sleep apnea(OSA) in patients with CAH has not been reported. A 43-year-old man with CAH who complained about sleep disturbance and sleep bruxism was diagnosed as obstructive sleep apnea (OSA) by polysomnography (PSG). Following the introduction of nasal continuous positive airway pressure (nCPAP), his sleep disturbance with symptoms also improved; in addition, he was able to reduce the dose of glucocorticoid replacement therapy without any adverse consequences on his sleep pattern. Physicians who treat a patient with CAH should know the possibility in the existence of OSA in their patients. Because symptoms with OSA in CAH patient may increase the dosage of long-term glucocorticoid treatment for the patient, which may induce several adverse effects including body weight gain on the patient.