Obstructive Sleep Apnea Score Research Articles

Obstructive Sleep Apnea Among Obese Children in Tabuk City, Saudi Arabia.

Introduction Obstructive sleep apnea (OSA) is prevalent among children, impacting their well-being. Obesity and related morbidity may lead to serious health disorders. In obese children, OSA may be a risk factor for systemic diseases that negatively affect their quality of life. This study explored the correlation between obesity and OSA among children aged five to 14 years in Tabuk, Saudi Arabia. Methods This cross-sectional study employed an online questionnaire for the parents of 517 children, assessing sociodemographic variables, medical history, and OSA symptoms. The data analysis used Statistical Product and Service Solutions (SPSS; IBM SPSS Statistics for Windows, Armonk, NY) software, employing descriptive and inferential statistics. Results The children were predominantly male (281, 54.4%) and from Tabuk (405, 78.3%), with 158 (30.6%) classified as obese. Symptoms such as snoring (191, 36.9%), daytime fatigue (195, 37.7%), and impact on daily activities (79, 15.3%) were prevalent. OSA scores significantly correlated with BMI categories (p < 0.001), family history of OSA (p < 0.001), and medical conditions including diabetes, hypertension, and high cholesterol (p < 0.05). Correlations showed weak positive associations of age (ρ = 0.159) and height (ρ = 0.229) with OSA score, whereas a strong correlation existed between weight (ρ = 0.531) and OSA score (p < 0.001). Conclusion Obesity demonstrated a strong association with OSA severity among children in Tabuk. Higher BMI categories, a family history of OSA, and certain medical conditions correlated significantly with increased OSA scores. Although age and height displayed weaker associations, weight emerged as a major contributing factor to OSA severity. These findings emphasize the importance of addressing obesity in managing pediatric OSA, advocating for early interventions to mitigate its impact on children's health and well-being.

NoSAS score predicts cardiovascular disease in patients with obstructive sleep apnea.

The Lausanne NoSAS (Neck circumference, Obesity, Snoring, Age, Sex) score is a new tool for the identification of high-risk patients for obstructive sleep apnea (OSA). Up to now, no study has attempted to determine the role of NoSAS score in cardiovascular morbidity of patients withOSA. We aimed to investigate the relationships between NoSAS scores and CVD and also between severity of OSA, polysomnographic parameters, and NoSAS scores in patients with OSA. Patients with diagnosis of OSA by full-night polysomnography were recruited in the study. Based on apnea-hypopnea index (AHI) scores, the patients were categorized as OSA-negative (AHI < 5), mild OSA (5 ≤ AHI < 15), moderate OSA (15 ≤ AHI < 30), and severe OSA (AHI ≥ 30). The definition of cardiovascular diseases (CVD) included the presence of any of the diseases such as hypertension, coronary artery disease, heart failure, or arrhythmia. A total of 1514 patients including cases with 199 OSA-negative, 391 mild, 342 moderate, and 582 severe OSA were enrolled in the study. NoSAS scores were significantly different between mild, moderate, and severe OSA groups. NoSAS scores were negatively correlated with minimum oxygen saturation values and positively with AHI and ODI (oxygen desaturation index) values (P < 0.001). NoSAS scores were significantly higher in patients with CVD, diabetes mellitus, and cerebrovascular disease compared with those without (P < 0.005). NoSAS cut-off values for hypertension (14), congestive heart failure (8.5), coronary artery disease (9), cerebrovascular event (11), and diabetes mellitus (10) were also determined. NoSAS scores are associated with CVD and the severity of OSA. NoSAS scores may be useful to predict CVD in patients withOSA.

Dysphagia and obstructive sleep apnoea in post-extubated intensive care unit patients.

To determine the relationship between dysphagia and obstructive sleep apnoea and its association with age, gender and Glasgow Coma Scale in post-extubated patients in an intensive care setting. The correlational study was conducted from July 1 to October 31, 2021, at the intensive care unit of Evercare Hospital, Lahore, Pakistan, and comprised post-extubated patients of either ender aged 45-70 years within 72 hours following extubation and having Glasgow comma scale score 11-15. Gugging Swallowing Screen and Obstructive Sleep Apnoea questionnaires were used for data collection. Data was analysed using SPSS 25. Of the 29 patients with a mean age of 57.45±8.74 years, 18(62.1%) were males. There was a significant correlation between dysphagia and obstructive sleep apnoea (p=0.005). The Obstructive Sleep apnoea score had a significant negative correlation with Glasgow Coma Scale score (p=0.01), while dysphagia revealed a significant positive correlation (p<0.001) with Glasgow Coma Scale score. Age and gender had no significant association with either dysphagia or obstructive sleep apnoea (p>0.05). There was a significant correlation between dysphagia and obstructive sleep apnoea in post-extubated patients under intensive care. Both dysphagia and obstructive sleep apnoea had a significant correlation with Glasgow Coma Scale score.

Systemic Lupus Erythematous and Obstructive Sleep Apnea: A Possible Association

Marked fatigue is common in patients with systemic lupus erythematosus (SLE). This study aimed to assess the association of sleep disorders, including obstructive sleep apnea (OSA), with SLE. Forty-two consecutive patients with SLE and 20 healthy controls were recruited and underwent a one-night ambulatory sleep examination. They completed questionnaires, including the Pittsburgh Sleep Quality Index (PSQI) and Functional Assessment of Chronic Illness Therapy (FACIT). SLE disease activity and damage were assessed by the SLE Disease Activity Index 2000 (SLEDAI-2K) and the Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) damage index (SDI). A significantly increased apnea/hypopnea index was noted in the SLE group compared to healthy controls (p = 0.004). SLE patients had higher rates of moderate-to-severe OSA (p = 0.04), PSQI (p = 0.001), and FACIT scores (p = 0.0008). Multivariate analysis revealed that the SDI was associated with OSA (p = 0.03). There was a positive association between SLEDAI-2K and moderate-to-severe OSA (p = 0.03). Patients with SLE had an increased prevalence of OSA and poorer quality of sleep compared to healthy controls. Our findings suggest that active disease and accumulated damage may be associated with OSA. These findings highlight the importance of identifying the presence of OSA in patients with SLE.

Relationship between obstructive sleep apnea, insulin resistance, and metabolic syndrome: a nationwide population-based survey.

We aimed to identify the association between obstructive sleep apnea (OSA), insulin resistance (IR), and metabolic syndrome (MetS) in a nationwide population-based sample. A total of 7,900 adults with information on the STOP-Bang score and MetS (3,341 men and 4,469 women) were identified from the dataset of the Korea National Health and Nutrition Examination Survey 2019-2020. The association between OSA, IR, MetS, and its components was estimated using complex sample logistic regression analysis with adjustments for age, body mass index, residence, smoking status, alcohol consumption, household income, education, and the presence of diabetes. Participants with a high OSA score were more likely to have IR (odds ratio [OR] 2.78, 95% confidence interval [CI] 1.96-3.95 in men and OR 2.64, 95% CI 0.55-12.80 in women), MetS (OR 6.05, 95% CI 4.23-8.69 in men and OR 4.20, 95% CI 1.23-15.70 in women), and components of MetS, compared to individuals with a low OSA score. Compared to premenopausal women, postmenopausal women had a more intense association between OSA and IR (OR 1.78, 95% CI 0.13-24.43 for premenopausal women and OR 3.64, 95% CI 0.60-22.28 for postmenopausal women) and MetS (OR 2.58, 95% CI 0.23-29.55 for premenopausal women and OR 5.36, 95% CI 1.42-20.21 for postmenopausal women). OSA was associated with abdominal obesity and hypertension in premenopausal women, while all components of MetS were associated with OSA in postmenopausal women. Further studies are necessary to elucidate the underlying mechanisms of these findings.

Left atrial appendage dimension predicts elevated brain natriuretic peptide in nonvalvular atrial fibrillation.

BNP elevation in patients with AF is observed in the absence of heart failure; however, prior mechanistic studies have not included direct left atrial pressure measurements. This study sought to understand how emptying function of the left atrial appendage (LAA) and LAA dimension contributes to brain-natriuretic peptide elevations (BNP) in atrial fibrillation (AF) accounting for left atrial pressure (LAP). 132 patients referredfor left atrial appendage occlusion (LAAO) were prospectively enrolled in this study. BNP levels and LAP were measured just before LAAO. Statistical analysis considered BNP, rhythm at time of procedure, LAP, LAA morphology, LAA size (ostial diameter, depth, volume), LAA emptying velocity, CHADS2-VASc score, body mass index (BMI), left ventricular ejection fraction (LVEF), estimated glomerular filtration rate (eGFR), and obstructive sleep apnea (OSA) diagnosis as covariates. Bivariate statistical analysis demonstrated positive associations with age, LAA ostial diameter, depth, and volume, LAP, AF status at time of measurement, OSA, and CHADS2-VASc score. BNP was negatively associated with LVEF, eGFR, LAA emptying velocity and BMI. With multivariate logistic regression including LAP as covariate, significant relationships between BNP and AF/AFL(OR 1.99 [1.03, 3.85]), LAP (OR 1.13 [1.06, 1.20]), LAA diameter (OR 1.14 [1.03, 1.27]), LAA depth (OR 1.14 [1.07, 1.22]), and LAA emptying velocity (OR 0.97 [0.96,0.99]) were observed; however, no significant associations were seen with LAA morphology or CHADS2-VASc score. BNP elevations in AF are associated with LAA size and function, but not CHADS2-VASc score or appendage morphology after accounting for changes in LAP.

Validation of the traditional Chinese version of the Sinus and Nasal Quality of Life Survey (SN-5) for children.

Persistent sinonasal symptoms are common in children with chronic rhinosinusitis. The Sinus and Nasal Quality of Life (QoL) Survey (SN-5) was the first validated questionnaire measuring sinonasal-related QoL in populations aged 2-12 years. No norm has been established for Chinese-speaking countries. We translated the SN-5 into traditional Chinese and evaluated validity and reliability. From December 2016 to December 2017, healthy volunteers and children with persistent sinonasal symptoms were enrolled. Guardians of the participants completed the SN-5, a visual analog scale (VAS) of nasal symptoms, and the Obstructive Sleep Apnea-18 (OSA-18); the responses were used to assess internal consistency, discriminant validity, and treatment responsiveness. A nontreatment group was administered the SN-5 1 week later to assess test-retest reliability. We recruited 31 healthy volunteers and 85 children with rhinosinusitis, 50 and 35 in the treatment and nontreatment groups, respectively. The SN-5 demonstrated good internal consistency (Cronbach's α=0.86) and test-retest reliability (0.74, p<0.01). It exhibited good discriminant validity between the healthy and rhinosinusitis groups (p<0.001). The SN-5 scores were correlated with the VAS scores (0.63, p<0.001). The effect size of the SN-5 scores was 0.51. The total SN-5 and OSA-18 scores changed significantly after 4-week treatment (p<0.05) and demonstrated good responsiveness. The SN-5 and OSA-18 scores were significantly and positively correlated (r2=0.53, p<0.001). Our traditional Chinese version of the SN-5 is reliable and valid for measuring sinonasal-related QoL in children in Chinese-speaking countries. NCT04836403.

Increased Distraction Magnitude Leads to Greater Reduction in the Apnea-Hypopnea Index in Infants With Robin Sequence

Upper airway obstruction seen in Robin Sequence (RS) is commonly treated with mandibular distraction osteogenesis (MDO). The purpose of this study is to evaluate the impact of distraction distance on sleep study outcomes in patients with obstructive sleep apnea (OSA) secondary to RS. A retrospective cohort study was conducted for patients with isolated RS who underwent MDO at Children's Hospital Los Angeles between January 2006-September 2021. The predictor variable was distraction distance (maximal distraction using a 30mm device vs sub-maximal distraction), and the primary outcome variable was OSA scores. Relationships between covariates, including demographic characteristics, preoperative sleep variables, and postoperative OSA outcomes using polysomnography, were also analyzed. Descriptive statistics and tests of statistical significance were performed using the Statistical Package for Social Sciences (SPSS) (version 28.0), including Student's t-test, proportions testing, multiple linear regression, and correlation analysis. Seventy-one patients met inclusion criteria (39.4% female, 60.6% male). Average age at MDO was 3.0±10.2months. Fifty-six patients were distracted maximally with a 30mm distractor, while the remaining 15 patients experienced shorter distraction due to distractor limitations (25mm distractor), persistent infection or family request. Looking at absolute values of postoperative sleep study variables, there were no significant differences between patients who were maximally and sub-maximally distracted across apnea-hypopnea index (AHI), highest carbon dioxide, lowest oxygen saturation, and oxygen requirement. However, both cohorts demonstrated significant improvements in lowest oxygen saturation, AHI, highest carbon dioxide level, and highest oxygen requirement compared to their pre-distraction levels. Compared with patients distracted <30mm, maximal distraction had a significantly greater improvement in AHI when controlling for preoperative sleep study variables (P=.047). Patients with isolated RS who have more severe OSA experienced greater improvements in AHI, oxygen requirement, and oxygen saturation after MDO. Two-thirds of patients no longer had oxygen requirements after MDO. Our results suggest that MDO is helpful in treating patients with RS regardless of distraction distance. However, our study provides evidence that increasing the distraction distance may further improve AHI, which is particularly beneficial to patients with a significant preoperative AHI.

Does the risk of obstructive sleep apnea (OSA) affect erectile function recovery (EFR) after radical prostatectomy (RP)?

ABSTRACT Introduction Obstructive sleep apnea (OSA) affects as many as 7% of adult men in the general population, higher in men with obesity and large neck sizes. OSA is associated with ED. No data to date has assessed EFR after RP in men with OSA. Objective The objective of this study was to define EFR rates 2 years post-RP. Methods Records of men who underwent RP with 24-month post-RP follow-up were reviewed. ADT and radiation therapy were exclusions. Men completed the OSA screening questionnaire, STOP-BANG (SB) pre-RP. Men were divided into OSA risk groups: high, intermediate, and low. EFR was recorded using IIEF-EFD score, with a score of at least 24 indicating recovery. Univariable and multivariable logistic regression analyses assessed predictors of EFR. Results 454 men were analyzed. Mean age 62 ± 7 years. Of the studied population,12% had a history of OSA,10% had diabetes,12% were current smokers, and 37% were former smokers. The median STOP-BANG (SB) score was 2. High, intermediate, and low risk of OSA scores were 8%, 41% and 51% respectively. Mean baseline testosterone (T) was 495 ng/dL, PSA 7.4 ng/mL, and EFD score 22. Most men had a Gleason sum of 7 (87%). 73% of patients had bilateral or unilateral neurovascular bundle preservation. At the 2-year follow up, median EFD score in high, intermediate and low OSA risk groups: were 9, 16, and 18 respectively. The low OSA risk group was significantly more likely to recover (OR = 1.6, 1.1 – 2.4) than the moderate/high group. Younger age (OR = 0.92, 0.89 – 0.95), absence of diabetes (OR = 0.31, 0.14 – 0.72), higher baseline T (OR per 100 units = 1.40, 1.04 – 1.89), higher baseline EFD score (OR = 1.16, 1.11 – 1.22), and lower Gleason score (OR = 0.53, 0.34 – 0.82) were also associated with recovery at 2 years. Conclusions In our cohort, at 2 years post-RP, increasing OSA risk is associated with poorer EFR in men post-RP. Disclosure Work supported by industry: no.

Does the Risk of Obstructive Sleep Apnea (OSA) Affect Erectile Function Recovery (EFR) After Radical Prostatectomy (RP)?

ABSTRACT Introduction Obstructive sleep apnea (OSA) affects as many as 7% of adult men in the general population, higher in men with obesity and large neck sizes. OSA is associated with ED. No data to date has assessed EFR after RP in men with OSA. Objective The objective of this study was to define EFR rates 2 years post-RP. Methods Records of men who underwent RP with 24-month post-RP follow-up were reviewed. ADT and radiation therapy were exclusions. Men completed the OSA screening questionnaire, STOP-BANG (SB) pre-RP. Men were divided into OSA risk groups: high, intermediate, and low. EFR was recorded using IIEF-EFD score, with a score of at least 24 indicating recovery. Univariable and multivariable logistic regression analyses assessed predictors of EFR. Results 454 men were analyzed. Mean age 62 ± 7 years. Of the studied population,12% had a history of OSA,10% had diabetes,12% were current smokers, and 37% were former smokers. The median STOP-BANG (SB) score was 2. High, intermediate, and low risk of OSA scores were 8%, 41% and 51% respectively. Mean baseline testosterone (T) was 495 ng/dL, PSA 7.4 ng/mL, and EFD score 22. Most men had a Gleason sum of 7 (87%). 73% of patients had bilateral or unilateral neurovascular bundle preservation. At the 2-year follow up, median EFD score in high, intermediate and low OSA risk groups: were 9, 16, and 18 respectively. The low OSA risk group was significantly more likely to recover (OR = 1.6, 1.1 – 2.4) than the moderate/high group. Younger age (OR = 0.92, 0.89 – 0.95), absence of diabetes (OR = 0.31, 0.14 – 0.72), higher baseline T (OR per 100 units = 1.40, 1.04 – 1.89), higher baseline EFD score (OR = 1.16, 1.11 – 1.22), and lower Gleason score (OR = 0.53, 0.34 – 0.82) were also associated with recovery at 2 years. Conclusions In our cohort, at 2 years post-RP, increasing OSA risk is associated with poorer EFR in men post-RP. Disclosure No

Impact of soft palate visibility and tongue position on early diagnosis of obstructive sleep apnea among patients with tooth loss - An observational preliminary study.

Obstructive sleep apnea (OSA) was estimated to affect 15% to 30% of males and 5% to 15% of females with prevalence increasing with progressive tooth loss and its early identification can reduce the sequalae of OSA. Apnea-hypopnea index is confirmatory but unsuitable for clinical settings to detect OSA and concise screening tools are required to detect OSA in edentulous patients. To evaluate the impact of soft palate visibility and tongue position on incidence of OSA among edentulous patients. Thirty two edentulous participants aged between 30 and 65 years were grouped as partially edentulous (PE) and completely edentulous (CE). STOP-BANG Questionnaire (SBQ) was used to assess the scores in OSA risk factors. Mallampati score assessed soft palate visibility. Wright's Classification graded tongue position. Spearmann test evaluated the correlation between the soft palate visibility and tongue position on the OSA scores. Mann-Whitney U test evaluated influence of tooth loss and gender on OSA scores. Positive correlation existed between Mallampati scores, Wright's classification and OSA scores (p<.05). CE participants and male participants had more OSA scores at (p<.05) and (p<.01). SBQ and Mallampati score can assist in chairside screening of OSA. Early screening for OSA in edentulous patients will direct for early intervention and prevent unforeseen sequalae.

Sleepiness in obstructive sleep apnea using hypopneas defined by a 3% oxygen desaturation or arousal but not by 4% or greateroxygen desaturation.

This analysis determined the association between obstructive sleep apnea (OSA) with hypopneas defined by a 3% O2 desaturation or arousal (3%A), but not by a hypopnea criterion of ≥ 4% (4%), and subjective sleepiness. Data were analyzed from Sleep Heart Health Study participants who had polysomnography (N = 6307) regarding OSA and subjective sleepiness scores (Epworth Sleepiness Scale, ESS). The apnea hypopnea index (AHI) was classified based on 3% only, 3%A only, and 4% definitions of hypopneas. Of the 3326 participants without 4% OSA, 67.6% (n = 2247) had 3%A only OSA. The ESS score was higher in 3%A only OSA than in those without OSA (7.44 ± 4.2 vs 7.07 ± 4.3, P = 0.02). Of those without 4% OSA, 40.2% (n = 1336) had 3% only OSA. The ESS score was higher in those with 3% only OSA than those with no OSA (7.72 ± 4.3 vs 7.05 ± 4.2, P < 0.001). A linear regression model demonstrated a trend towards significance for the 3%A only AHI as an independent predictor of ESS when controlled for age, BMI, and sex (P = 0.051). The association of 3% only AHI with the ESS was stronger (P = 0.003). However, 23.3% of the participants with hypersomnia would not qualify as having OSA if arousals were excluded from the definition of OSA. The current study found that the presence and severity of OSA is associated with higher ESS scores in persons with 3%A only OSA. Hence, the use of the 4% hypopnea definition will result in the failure to identify and treat a significant number of individuals with OSA who have subjective sleepiness.

Evaluation of sinonasal complaints in obstructive sleep apnea

Background/Aim: Sinonasal complaints are frequently observed in patients with obstructive sleep apnea (OSA). This study aimed to correlate the severity of OSA with sinonasal complaints. Methods: A total of 90 patients, including 30 patients with mild, 30 with moderate, and 30 with severe OSA, were enrolled in this cross-sectional study. None of the patients received any treatment for OSA at the time of enrollment. All participants were asked to complete the SNOT-22 questionnaire. Subdomain scores obtained from the patients with the SNOT-22 questionnaire, total scores, and scores obtained for each complaint were investigated for any correlations with severity of OSA. Also, mild, moderate, and severe OSA groups were compared with each in terms of these scores. Results: A significant, positive correlation was found between AHI values and “nasal obstruction,” “runny nose,” “lack of a good night's sleep” and “waking up tired” items of the SNOT-22 (P=0.008, P=0.022, P=0.037, P=0.005, respectively) and nonrhinologic otolaryngologic subdomain scores (P=0.036). A significant, positive correlation existed between the severity of OSA and sleep subdomain score (P=0.039) and the total score (P=0.047) in addition to all the above-mentioned elements. There was no difference between mild and moderate OSA groups in nasal obstruction and runny nose complaints (P=0.858, P=0.990, respectively) but a difference was noted between mild and severe (P=0.016, P=0.011, respectively), and moderate and severe OSA groups (P=0.015, P=0.011, respectively). While there was no difference between mild and moderate (P=0.268), and moderate and severe OSA groups (P=0.036) in terms of the 'waking up tired' item, the mild and severe OSA groups differed significantly (P=0.009). Conclusion: OSA causes various sinonasal complaints such as nasal obstruction, runny nose, and waking up tired. An increase in OSA severity leads to an increase in these complaints, and treatment may lead to increased quality of life.

MP27-02 DOES THE RISK OF OBSTRUCTIVE SLEEP APNEA (OSA) AFFECT ERECTILE FUNCTION RECOVERY (EFR) AFTER RADICAL PROSTATECTOMY (RP)?

You have accessJournal of UrologySexual Function/Dysfunction: Evaluation I (MP27)1 Sep 2021MP27-02 DOES THE RISK OF OBSTRUCTIVE SLEEP APNEA (OSA) AFFECT ERECTILE FUNCTION RECOVERY (EFR) AFTER RADICAL PROSTATECTOMY (RP)? Jose M. Flores, Carolyn A. Salter, Karin Ruiz, Nicole Benfante, Elizabeth Schofield, Miranda Tan, Vincent Laudone, and John P. Mulhall Jose M. FloresJose M. Flores More articles by this author , Carolyn A. SalterCarolyn A. Salter More articles by this author , Karin RuizKarin Ruiz More articles by this author , Nicole BenfanteNicole Benfante More articles by this author , Elizabeth SchofieldElizabeth Schofield More articles by this author , Miranda TanMiranda Tan More articles by this author , Vincent LaudoneVincent Laudone More articles by this author , and John P. MulhallJohn P. Mulhall More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002024.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Obstructive sleep apnea (OSA) affects as many as 7% of adult men in the general population, higher in men with obesity and large neck sizes. OSA is associated with ED. No data to date has assessed EFR after RP in men with OSA. The objective of this study was to define EFR rates 2 years post-RP. METHODS: Records of men who underwent RP with 24-month post-RP follow-up were reviewed. ADT and radiation therapy were exclusions. Men completed the OSA screening questionnaire, STOP-BANG (SB) pre-RP. Men were divided into OSA risk groups: high, intermediate, and low. EFR was recorded using IIEF-EFD score, with a score of at least 24 indicating recovery. Univariable and multivariable logistic regression analyses assessed predictors of EFR. RESULTS: 454 men were analyzed. Mean age 62±7 years. Of the studied population, 12% had a history of OSA, 10% had diabetes, 12% were current smokers, and 37% were former smokers. The median STOP-BANG (SB) score was 2. High, intermediate, and low risk of OSA scores were 8%, 41% and 51% respectively. Mean baseline testosterone (T) was 495 ng/dL, PSA 7.4 ng/mL, and EFD score 22. Most men had a Gleason sum of 7 (87%). 73% of patients had bilateral or unilateral neurovascular bundle preservation. At the 2-year follow up, median EFD score in high, intermediate and low OSA risk groups: were 9, 16, and 18 respectively. The low OSA risk group was significantly more likely to recover (OR = 1.6, 1.1–2.4) than the moderate/high group. Younger age (OR = 0.92, 0.89–0.95), absence of diabetes (OR = 0.31, 0.14–0.72), higher baseline T (OR per 100 units = 1.40, 1.04–1.89), higher baseline EFD score (OR = 1.16, 1.11–1.22), and lower Gleason score (OR = 0.53, 0.34–0.82) were also associated with recovery at 2 years. CONCLUSIONS: In our cohort, at 2 years post-RP, increasing OSA risk is associated with poorer EFR in men post-RP. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e472-e472 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jose M. Flores More articles by this author Carolyn A. Salter More articles by this author Karin Ruiz More articles by this author Nicole Benfante More articles by this author Elizabeth Schofield More articles by this author Miranda Tan More articles by this author Vincent Laudone More articles by this author John P. Mulhall More articles by this author Expand All Advertisement Loading ...

Effect of High-Risk Obstructive Sleep Apnea on Clinical Outcomes in Adults with Coronavirus Disease 2019: A Multicenter, Prospective, Observational Clinical Trial.

Rationale: Coronavirus disease (COVID-19) is an ongoing pandemic, in which obesity, hypertension, and diabetes have been linked to poor outcomes. Obstructive sleep apnea (OSA) is associated with these conditions and may influence the prognosis of adults with COVID-19.Objectives: To determine the effect of OSA on clinical outcomes in patients with COVID-19.Methods: The current prospective observational study was conducted in three hospitals in Istanbul, Turkey from March 10 to June 22, 2020. The participants were categorized as high-risk or low-risk OSA according to the Berlin questionnaire that was administered in the out-patient clinic, in hospital, or shortly after discharge from hospital blinded to the clinical outcomes. A modified high-risk (mHR)–OSA score based on the snoring patterns (intensity and/or frequency), breathing pauses, and morning/daytime sleepiness, without taking obesity and hypertension into account, were used in the regression models.Results: The primary outcome was the clinical improvement defined as a decline of two categories from admission on a 7-category ordinal scale that ranges from 1 (discharged with normal activity) to 7 (death) on Days 7, 14, 21, and 28, respectively. Secondary outcomes included clinical worsening (an increase of 1 category), need for hospitalization, supplemental oxygen, and intensive care. In total, 320 eligible patients (median [interquartile range] age, 53.2 [41.3–63.0] yr; 45.9% female) were enrolled. In all, 121 (37.8%) were categorized as known (n = 3) or high-risk OSA (n = 118). According to the modified scoring, 70 (21.9%) had mHR-OSA. Among 242 patients requiring hospitalization, clinical improvement within 2 weeks occurred in 75.4% of the mHR-OSA group compared with 88.4% of the modified low-risk–OSA group (P = 0.014). In multivariate regression analyses, mHR-OSA (adjusted odds ratio [OR], 0.42; 95% confidence interval [CI], 0.19–0.92) and male sex (OR, 0.39; 95% CI, 0.17–0.86) predicted the delayed clinical improvement. In the entire study population (n = 320), including the nonhospitalized patients, mHR-OSA was associated with clinical worsening (adjusted hazard ratio, 1.55; 95% CI, 1.00–2.39) and with the need for supplemental oxygen (OR, 1.95; 95% CI, 1.06–3.59). Snoring patterns, especially louder snoring, significantly predicted delayed clinical improvement, worsening, need for hospitalization, supplemental oxygen, and intensive care.Conclusions: Adults with mHR-OSA in our COVID-19 cohort had poorer clinical outcomes than those with modified low-risk OSA independent of age, sex, and comorbidities. Clinical trial registered with www.clinicaltrials.gov (NCT04363333).

Obstructive sleep apnea and sudden unexpected death in epilepsy in unselected patients with epilepsy: are they associated?

We aimed to determine (1) the frequency of high-risk sudden unexpected death in epilepsy (SUDEP) in patients with epilepsy who have had obstructive sleep apnea (OSA) in different stages of sleep using the revised SUDEP risk inventory (rSUDEP-7) score instrument and (2) the factors associated with high risk SUDEP in patients with epilepsy who have had OSA. We conducted a cross-sectional study of consecutive subjects who are more than 15 years old without known sleep disorders, recruited from a single epilepsy clinic in a tertiary care facility. Participants underwent polysomnography. Scoring was performed by two blinded board-certified sleep physicians. The relationships between rSUDEP-7 scores and OSA measures were evaluated using Wilcoxon rank-sum test, chi-squared test, and quantile regression. Our study population consisted of 95 participants. Overall median (IQR) apnea-hypopnea index (AHI) of our populations was 2.3 (0.7,7.5) events rate per hour; 12 (75%) patients had moderate OSA and 4 (25%) patients had severe OSA. Nine patients had a rSUDEP-7 score of 5 to 7. There was no significant difference between total rSUDEP-7 score or rSUDEP-7 score of > 5 or < 5 and total AHI, supine AHI, non-supine AHI, NREM AHI, or REM AHI; similarly, (2) there was no significant difference in total rSUDEP-7 score between AHI of < 15 or > 15. Our study reveals no association between AHI score, OSA, and total rSUDEP-7 score or rSUDEP-7 score of > 5. The pathophysiology underlying SUDEP appears complex. We need further studies on SUDEP to help elucidate the cardiorespiratory mechanisms and predisposing factors.

Obstructive sleep apnea and periodontitis: A cross-sectional study.

(1) To assess the risk of Obstructive Sleep Apnea (OSA) using a pre-designed questionnaire; (2) To assess the periodontal parameters like pocket probing depth (PPD) and clinical attachment loss (CAL) in the study subjects and (3) To determine the association between the shared risk factors of OSA and periodontitis. Periodontitis is a microbially associated, host-mediated inflammatory disease that results in the loss of periodontal attachment. It has multifactorial etiology and has been linked to an array of systemic diseases. Though both periodontitis and obstructive sleep apnoea (OSA) share some common risk factors, the insight into the hypothetical speculative link remains vague. This study intended to probe into the association between periodontitis and OSA. A cross-sectional study was conducted on 250 subjects. The subjects were explained the nature of the study and written informed consent was obtained for participation in the study. The patients were administered a STOP-BANG questionnaire following which the periodontal parameters were recorded. The data obtained was analyzed by descriptive and inferential statistics. A statistically significant increase in PPD and CAL scores were seen with the increase in OSA scores. A significant moderate positive correlation was found between OSA scores and PPD [r = 0.58, P < 0.001] and CAL [r = 0.55, P = 0.001]. Males were at increased risk for OSA and periodontitis. Age, hypertension and BMI which are the risk factors for periodontitis were also significantly higher in subjects at high risk for OSA. This study found a moderate positive association between periodontitis and OSA.

Long-Term Impact of Adenotonsillectomy on Quality of Life in Thai Children with Sleep-Disordered Breathing

Background: Sleep disordered breathing (SDB) is a spectrum of disorders that is characterized by abnormal respiratory patterns during sleep, with symptoms that include snoring, mouth breathing, and pauses in breathing. No previous study has investigated the long-term impact of adenotonsillectomy on the quality of life in Thai children with SDB. Objective: To investigate the long-term impact of adenotonsillectomy on the quality of life in Thai pediatric patients with SDB as measured by Obstructive Sleep Apnea-18 (OSA-18) questionnaire. Materials and Methods: The present study was retrospectively conducted in Thai pediatric SDB that underwent adenotonsillectomy at Siriraj Hospital between January 1997 and December 2010. Caregivers of the present study children completed the OSA-18 questionnaire pre-operatively and at least 6-months post-operatively. Demographic and pre-operative polysomnography (PSG) data were also collected and analyzed. Pre-operative and post-operative OSA-18 total score and OSA-18 scores for all five domains were compared using paired t-test. Results: Forty-nine children with SDB that underwent adenotonsillectomy were included. There were 30 boys (61.2%) and 19 girls (38.8%), with a mean age of 6.1±2.6 years (range 3.0 to 12.1). Pre-operative PSG was performed in 32 children (65.3%), with a mean apnea-hypopnea index of 12.6±12.4. Mean pre-operative and post-operative total OSA-18 score was 69.8±16.1 and 36.0±12.9, respectively. Mean duration from surgery to completion of the OSA-18 questionnaire after adenotonsillectomy was 12.5±4.6 months (range 6 to 28). Total OSA-18 score and the scores for all five OSA-18 domains were significantly improved after adenotonsillectomy (p&lt;0.001 and &lt;0.001, respectively). Conclusion: Long-term quality of life in Thai children with SDB was improved significantly after adenotonsillectomy, as evidenced by the significant improvement in OSA-18 total score and all OSA-18 domains. Based on these findings, the authors encourage adenotonsillectomy as the first-line treatment for SDB in Thai pediatric population. Keywords: Long-term impact, Adenotonsillectomy, Quality of life, Thai children, Sleep-disordered breathing, SDB

Comparison of prevalence rates of restless legs syndrome, self-assessed risks of obstructive sleep apnea, and daytime sleepiness among patients with multiple sclerosis (MS), clinically isolated syndrome (CIS) and Neuromyelitis Optica Spectrum Disorder (NMOSD)

BackgroundPrevalence rates for restless legs syndrome (RLS) and risk of Obstructive Sleep Apnea (OSA) in individuals with Neuromyelitis Optica Spectrum Disorder (NMOSD) and Clinically Isolated Syndrome (CIS) are unknown. The aims of the present study were to assess symptoms of RLS and self-assessed risks of OSA in individuals with NMOSD and CIS, to compare these prevalence rates with those of persons with multiple sclerosis (MS), and to associate RLS and OSA with expanded disability status scale (EDSS) scores, daytime sleepiness, fatigue, paresthesia, and medication. MethodsA total of 495 individuals (mean age = 34.92 years, 84.9% females) were assessed. Of these, 24 had NMOSD, 112 had CIS and 359 had MS. Trained neurologists ascertained individuals’ neurological diagnoses, assessed their EDSS scores, and conducted a clinical interview to assess RLS. Additionally, participants completed questionnaires covering sociodemographic information, risks of snoring and OSA, daytime sleepiness, fatigue, paresthesia and medication. ResultsPrevalence rates of RLS were 45.8% in NMOSD, 41.1% in CIS, and 28.7% in MS. Prevalence rates of self-assessed risks of OSA were 8.3% in NMOSD, 7.7% in CIS, and 7.8% in MS; these rates were not significantly different. Across the entire sample and within the diagnostic groups, RLS and OSA scores were unrelated to EDSS, daytime sleepiness, fatigue or medication. ConclusionsIndividuals with NMOSD, CIS and MS have high prevalence rates for RLS and self-assessed risks of obstructive sleep apnea syndrome (OSAS), which are unrelated to EDSS, daytime sleepiness, fatigue, paresthesia, or medication. Sleep issues should be monitored during routine check-ups for individuals with NMOSD and CIS.

Obstructive sleep apnea in Parkinson's disease: a study in 239 Chinese patients

ObjectiveOur objective was to explore the clinical characteristics of Parkinson's disease (PD) comorbidity with obstructive sleep apnea (OSA), explore the correlation between OSA and PD features and identify factors that are independent predictors of OSA in PD patients. MethodsIn sum, 239 PD patients were divided into two groups according to the presence of OSA (apnea–hypopnea index (AHI) score ≥5) (PD-OSA vs PD-non-OSA). Blinded to sleep apnea status, participants underwent an extensive assessment to determine demographic features, concomitant disease, disease severity, polysomnography (PSG) characteristics and non-motor symptoms (NMSs). ResultsOf the 239 patients, 66 (27.62%) had an AHI score ≥5, including 14.2% (34/239) with mild, 6.7% (16/239) with moderate, and 6.7% (16/239) with severe sleep apnea. The binary logistic regression analyses indicated that age and male gender were risk factors for OSA, while rapid eye movement (REM) sleep disorder (RBD) and higher Levodopa equivalent dose (LED) were protective factors for OSA. PD-OSA patients had higher Epworth Sleepiness Scale (ESS) scores than those of PD-non-OSA patients. No differences were found for other NMSs between groups. ConclusionOur data suggest that OSA in PD was lower in patients with RBD and higher LED. RBD and higher LDEs were significant protective factors for OSA in PD. OSA in PD was increased with age and male gender. Age and male gender were risk factors for OSA in PD. OSA can aggravate excessive daytime somnolence in PD patients but is not associated with other NMSs.