Obstructive Sleep Apnea Syndrome Group Research Articles

Effects of sleep-disordered breathing on serum lipid levels in children:a case control study

BackgroundSleep-disordered breathing (SDB) during childhood is common and includes a range of breathing abnormalities that range from primary snoring (PS) to obstructive sleep apnea syndrome (OSAS).Studies have shown that not only OSAS, but also PS, which is originally considered harmless, could cause cardiovascular, cognitive, behavioral, and psychosocial problems. Many researches are focused on the relation of OSA and serum lipid levels. However, little studies are focused on PS and serum lipid levels in children.We evaluated whether serum lipid (total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C)) concentrations were associated with specific components of SDB, including indices of oxygen reduction index, lowest oxygen saturation, mean oxygen saturation. And we explored whether serum lipid levels were associated with different degree sleep disordered (PS and OSA group) and obese.MethodsThis was a cross-sectional study. Children who were complained by their guardians with habitual snoring and(or) mouth breathing were collected in the SDB group. Normal children without sleep problem were matched in the control group. Subjects in the SDB group underwent polysomnography. The serum lipid profiles of all the children included TC, TG, HDL-C and LDL-C concentrations were measured by appropriate enzymatic assays.ResultsA total of 241 with Apnea/Hypopnea Index ≥ 5 (AHI) were assigned to the OSAS group and the remaining 155 with normal AHI were assigned to the PS group. The values of TC, TG, LDL-C and LDL/HDL were significantly higher in the OSAS group than in the PS group, and the values in the PS group were significantly higher than the control group. Multiple regression analysis revealed serum TG only correlated negatively with lowest oxygen saturation. Body mass index-z score has a positive effect on TG in all the 1310 children (P = 0.031) and in SDB 396 children(P = 0.012). The level of serum TG in obese group was significantly higher than that in non-obese group.ConclusionsSDB had a very obvious effect on blood lipids, whereas PS without apnea and hypoxia. Obese only affects the aggregation of TG.Trial registrationChiCTR1900026807(2019.10.23).

Risk of Sarcopenia and Osteoporosis in Elderly Male Patients with Obstructive Sleep Apnea Syndrome: A Multicenter Study

The aim of this study was to assess the risk of sarcopenia and osteoporosis in elderly patients with obstructive sleep apnea syndrome (OSAS). We recruited both OSAS patients and non-OSAS subjects from multiple centers and evaluated their skeletal muscle index (SMI), bone mineral density (BMD), and inflammatory factors. All participants underwent polysomnography (PSG) testing, handgrip strength testing, chest CT, and dual-energy x-ray BMD testing. Based on the PSG diagnosis results, the participants were divided into a control group and an OSAS group. The analysis results revealed a higher incidence of sarcopenia in the OSAS group (χ2 = 22.367; P = 0.000) and osteoporosis (χ2 = 11.730a; P = 0.001). There were statistically significant differences in BMI (P = 0.000), grip strength (P = 0.000), SMI (P = 0.000), bone density (P = 0.000) and vitamin D (P = 0.000). The independent sample t test results showed that there was no statistical difference between IL-6 (P = 0.247) and CRP (P = 0.246). Considering the potential impact of body weight on the observed indicators, we employed covariance analysis to calculate the modified P value for each observation indicator. The findings demonstrated that the grip strength, IL-6, and CRP levels in the OSAS group were significantly higher compared to the control group. Conversely, the SMI, bone density, and Vitamin D levels were found to be significantly lower in the OSAS group than in the control group. These results suggest a higher likelihood of sarcopenia and osteoporosis among OSAS patients. Further studies should be conducted in larger study populations.

Obstructive Sleep Apnea and Its Influence on Intracranial Aneurysm.

Obstructive sleep apnea syndrome (OSAS) is associated with cerebrovascular disease, which can lead to life-threatening outcomes. The purpose of the study was to investigate the relationship between OSAS and comorbid intracranial aneurysms. We retrospectively reviewed 564 patients who underwent a polysomnography and brain magnetic resonance angiography as part of their health checkup. We calculated the prevalence of an intracranial aneurysm and OSAS in patients and measured the size of the intracranial aneurysm if present. The mean patient age was 55.6 ± 8.5 years, and 82.3% of them were men. The prevalence of an intracranial aneurysm in patients with OSAS was 12.1%, which is significantly higher than patients with non-OSAS (5.9%, p = 0.031). Patients with OSAS had a much higher prevalence of intracranial aneurysms, after adjusting all possible confounding factors such as age, sex, smoking status, alcohol drinking, and body mass index (odds ratio: 2.32; 95% confidence interval: 1.07-5.04). Additionally, the OSAS group had noticeably larger aneurysms compared with those of the non-OSAS group (3.2 ± 2.0 mm vs. 2.0 ± 0.4 mm, p = 0.013). We found a significant association between OSAS and intracranial aneurysms. OSAS could be another risk factor for the development of intracranial aneurysms.

Prevalence of Obstructive Sleep Apnea Using Home Sleep Test in Taiwan During the Coronavirus Disease Pandemic.

Obstructive sleep apnea syndrome (OSAS) is a common disorder associated with serious sequelae. The current gold standard diagnostic method, polysomnography, is costly and time consuming and requires patients to stay overnight at a facility. This study aimed to reveal the prevalence of OSAS in general adult population using a home sleep test (HST) during the coronavirus disease 2019 (COVID-19) pandemic. This prospective cohort study was conducted by the Department of Otolaryngology, Taipei City Hospital, Taipei, Taiwan, between January 2020 and December 2021. A total of 1372 patients aged 30-70 years completed an HST using a Type 3 portable sleep monitor (PM). The apnea-hypopnea index (AHI) was analyzed to assess the association of OSAS with age, body mass index (BMI), sex, Epworth Sleepiness Scale (ESS) and the Sleep Apnea Risk Assessment questionnaire (STOP-Bang questionnaire) rating. The mean age of the patients (782 men, 57%; 590 women, 43%) was 49.24 ± 11.04 years. OSAS was detected in 954 (69.5%) patients with 399 (29.1%) mild OSAS; 246 (17.9%) moderate OSAS; and 309 (22.5%) severe OSAS. Among these, the prevalence of moderate-to-severe OSAS was 143 (10.4%) in women and 412 (30.0%) in men. The mean age was the highest (51.29 ± 11.29) in the mild OSAS group and lowest (47.08 ± 10.87) in the healthy group. OSAS severity was greater with increasing BMI, 23.39 ± 3.44 in the healthy group and 29.29 ± 5.01 in the severe OSAS group. A positive correlation was also noted between the ESS/STOP-Bang questionnaire rating and OSAS severity. The prevalence of OSAS in Taiwan was 69.5% in our study. It showed strong evidence that OSAS has important public health consequences and PMs are simple, fast, feasible, and cost-effective tools for OSAS screening in the home environment, especially during the COVID-19 pandemic.

Serum levels of carbohydrate antigen 125 in patients with heart failure and obstructive sleep apnea syndrome: a retrospective analysis.

Obstructive sleep apnea syndrome (OSAS) combined with heart failure (HF) has become a serious disease that threatens human health. Therapeutic interventions targeting OSAS have been shown to improve outcomes in patients with HF, so the identification of severe OSAS in HF is critical. Carbohydrate antigen 125 (CA125) is associated with inflammation and volume overload. The levels of CA125 are elevated in the serum of patients with HF and might be further elevated in patients with HF and OSAS. The aim of this study was to measure CA125 levels in patients with HF with and without OSAS and to analyze affecting factors. In this single-center retrospective cohort study, a total of 95 patients diagnosed with HF hospitalized in Zhongda Hospital from April 2021 to April 2022 were recruited, including 55 patients with OSAS and 40 patients without OSAS. Participants with a history of central sleep apnea syndrome, severe chronic obstructive pulmonary disease, tumors, severe infection, or who were pregnant were excluded. The histories of the participants were recorded, and laboratory examinations were performed. Binary logistic regression analysis was performed to determine the relationship between serum CA125 levels and OSAS in patients with HF. The serum CA125 levels were higher in the HF + OSAS group than in the HF group (29.60 vs. 9.68 U/mL, P<0.001). According to the univariate analysis, CA125 (>35 U/mL) was significantly related to pleural effusion, acute HF, apnea-hypopnea index (AHI), left ventricular ejection fraction (LVEF) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels. Finally, the AHI demonstrated statistical significance in multiple analyses (OR 1.070, 95% CI: 1.019-1.124, P=0.006). Spearman rank correlation coefficient analysis showed that CA125 was positively correlated with AHI, and Ln(CA125) (Ln is the natural logarithm based on e) gradually increased with increasing AHI (r=0.551, P<0.0001). The levels of CA125 were further increased in patients with HF and OSAS, and CA125 (>35 U/mL) was positively correlated with AHI. As a biomarker associated with inflammation and congestion, serum CA125 may have certain value in the diagnosis of patients with HF combined with OSAS.

Evaluation of vestibular functions in patients with obstructive sleep apnea syndrome

Background To determine the anatomical proximity of the vestibular nuclei to the respiratory nuclei and the effect of susceptibility of the posterior labyrinth to a hypoxic state on the vestibular system. Objective It was aimed to evaluate the possible effects of periodic hypoxia on vestibular reflexes and proprioceptive perception in patients with obstructive sleep apnea syndrome (OSAS). Material and methods The study was conducted with 40 patients diagnosed with moderate and severe OSAS and 21 healthy individuals. All individuals were evaluated with Dizziness Handicap Inventory, ocular vestibular evoked myogenic potential (oVEMP), cervical vestibular evoked myogenic potential (cVEMP), video head impulse test (vHIT), videonystagmography (VNG) and sportKAT 3000. Results In the vHIT, a statistically significant difference was found between the groups in terms of anterior and posterior semicircular canal vestibulo-ocular reflex gains (p < .05). A negative correlation was found between the lateral gain asymmetry and RALP gain asymmetry and the awake blood oxygen level in the OSAS groups. There was a statistically significant difference between the groups in terms of wave response rates cVEMP 100 dB nHL and oVEMP 100–110 dB nHL (p < .05). Conclusion and Significance It was concluded that vestibular reflexes and proprioceptive perception were affected due to periodic/chronic hypoxia in patients with moderate and severe OSAS.

Role of Nasal Ventilation Function in Obstructive Sleep Apnea Syndrome in Children.

Background: The association between increased nasal resistance (NR) and obstructive sleep apnea syndrome (OSAS) is controversial. The purpose of this study was to examine nasal ventilation function (NVF) in children with OSAS, with a focus on its pathogenetic role. Methods: Children were recruited and divided into the OSAS group (n = 109) and control group (n = 116). The participants underwent polysomnography (PSG), measurement of NR, and acoustic rhinometry (AR). A combination of intranasal corticosteroids (ICS) and oral montelukast (OM) was administered to 90 children with mild to moderate OSAS for 12 weeks. After excluding participants who dropped out or were lost to follow-up, there were 58 children who responded to the treatment, who were divided into 2 groups-A and B. We compared the size of the tonsil adenoids, the PSG, NR, and AR before and after treatment in the 2 groups. Results: Children aged 6 to 12 years with OSAS had significantly higher NR than the control group (P < .05). The OSAS group had a smaller nasal minimal cross-sectional area (NMCA), nasal cavity volume (NCV) from 0 to 5 cm, and nasopharyngeal volume (NPV) from 6 to 8 cm than the control group, and the difference was statistically significant (P < .05 or P < .01). A total of 58 (84.1%) children responded to the 12-week ICS+OM treatment and 11 (15.9%) children did not respond to the treatment. Effective treatment was achieved in 32 children, as evidenced by a significant reduction in tonsil adenoid size and variations in NR and AR values. There were significant improvements in NR, NMCA, and NCV in the remaining 26 children who were successfully treated, but there was no change in tonsil adenoids and NPV value. Conclusion: NVF may play an important pathogenetic role in children with OSAS.

Study of Haematocrit Level in Obstructive Sleep Apnea Syndrome

Obstructive Sleep Apnea Syndrome can lead to oxyhaemoglobin desaturation and has the possibility of stimulating erythropoiesis, leading to an increased haematocrit. The aim of this study is to identify the level of haematocrit in obstructive sleep apnea syndrome (OSAS) patients and to determine the correlation between haematocrit levels and the severity of obstructive sleep apnea syndrome (OSAS). This is a descriptive cross-sectional study at Hospital Universiti Sains Malaysia. All consented patients were interviewed and underwent a polysomnography (PSG) study. The severity of OSAS was based on the apnea–hypopnea index (AHI) and average oxygen desaturation. The blood haematocrit level was also obtained. Thirty-six OSAS patients were in the study group, and 17 patients were in the control group. The mean haematocrit level in the control group was 41.6 (2.5 SD), whereas in the study group the mean haematocrit level was 44.0 (3.27 SD). Pearson correlation analysis showed there was no significant correlation between AHI and haematocrit level (p-value: 0.392), however, there is a significant correlation between haematocrit levels and average oxygen saturation level (P-value: 0.022). The independent t-test between mean haematocrit level between OSAS group and control group showed that there was a significant difference between the mean haematocrit level among the control and OSAS groups. The increased level of haematocrit is significantly correlated with average oxygen desaturation but not with AHI in OSAS patient. Average oxygen desaturation can be considered as a parameter to assess severity and hypoxic stress in OSA patients.

Cognitive Functions in Patients with Moderate-to-Severe Obstructive Sleep Apnea Syndrome with Emphasis on Executive Functions and Decision-Making.

Patients with obstructive sleep apnea syndrome (OSAS) have cognitive dysfunction in many aspects, however, these patients' decision-making function remains unclear. In this study, the Game of Dice Task (GDT) was used to investigate the function of decision making in patients with OSAS. 30 participants with moderate to severe OSAS and 27 participants with no or mild OSAS diagnosed by sleep breathing monitor were selected from June 2021 to March 2022. Risky decision making was tested through the GDT with known risk probability. General demographic information and background cognitive functions, such as the overall cognitive functioning and executive functioning, were tested to establish baseline data. There were no significant differences in gender, age, and years of education between the two groups. During the GDT, the moderate to severe OSAS group opted for the safety option at a statistically significant lower rate when compared to the no or mild OSAS group (7.53 ± 4.43 vs. 10.26 ± 4.26, p = 0.022). The moderate to severe OSAS group utilized the higher risk option than the group with no or mild OSAS (10.47 ± 4.43 vs. 7.74 ± 4.26, p = 0.022). The utilization rate of negative feedback in the moderate and severe OSAS group was lower than that in the no or mild OSAS group (7.50, 52.50 vs. 28.57, 100.00, p = 0.001). At the end of the GDT, the moderate and severe OSAS group was more likely to have negative total assets than the patients with no or mild OSAS (-1846.67 ± 2587.20 vs. 300.00 ± 1509.97, p < 0.001). Multiple linear regression analysis shows that there is a negative correlation between the selection of risk options and negative feedback utilization in the GDT. Patients with moderate and severe OSAS displayed impaired decision-making throughout the study. Impaired decision-making is related to executive processes and may be caused by diminished prefrontal cortex functioning. However, the functions of memory, attention, language, abstraction, and orientation are relatively retained.

Systemic Inflammatory Status of Patients with Obstructive Sleep Apnea Syndrome and the Predictive Value of Heparin-Binding Protein.

Objective: To investigate the alteration of the systemic inflammatory status of patients with obstructive sleep apnea syndrome (OSAS) and the predictive value of heparin-binding protein (HBP) for OSAS. Methods: Patients with OSAS who were hospitalized in our hospital from 2020 January to 2022 December and diagnosed by polysomnography (PSG) (OSAS group, n = 79) were retrospectively studied and their relevant examination findings and demographic characteristics were recorded. Sex- and age-matched non-OSAS patients hospitalized at the same time were selected as the control group (control group, n = 28). Differences in peripheral blood neutrophil counts, lymphocyte counts, neutrophil-to-lymphocyte ratio (NLR), procalcitonin (PCT), and HBP were compared between the 2 groups. The predictive value of these markers for OSAS was analyzed using the receiver operating characteristic curve, and independent risk factors for OSAS were determined using logistic regression analysis. Peripheral blood was drawn from all patients in the fasting state of the morning. Results: The number of peripheral blood neutrophils, lymphocytes, and HBP was higher in the OSAS group than in the control group, and the differences were statistically significant (P all <.05), while the differences in NLR and PCT between the 2 groups were not statistically significant (P all >.05). Plasma HBP level had an area under the curve (AUC) of 0.79 (P < .0001) in determining OSAS, with a sensitivity of 80.49% and a specificity of 70.83% and the best cutoff value was >10.73 ng/ml. Combining body mass index (BMI), neutrophil, lymphocyte, and HBP improved the predictive value of OSAS with an AUC of 0.89 (P < .0001), a sensitivity of 80.49%, and a specificity of 87.50%. Logistic regression analysis showed that both BMI and HBP were independent risk factors for OSAS (PBMI < .001, PHBP < .01), while neutrophils and lymphocytes were not (P all >.05). Conclusions: This is the first study to objectively examine HBP in OSAS patients, and HBP is an independent risk factor that may serve as a diagnostic biomarker in OSAS. Patients with OSAS have an altered systemic inflammatory state and may be more prone to severe bacterial infections.

Relationships between hypertensive disorders in pregnancy and obstructive sleep apnea syndrome

Objective: To investigate the impact of obstructive sleep apnea syndrome (OSAS) on pregnancy outcomes, especially the relationship between OSAS and hypertensive disorders in pregnancy (HDP). Methods: A total of 228 pregnant women with high risk of OSAS who underwent sleep monitoring during pregnancy in Peking University People's Hospital from January 2021 to April 2022 were collected by reviewing their medical records for retrospective analysis. According to the diagnosis of OSAS, the pregnant women were divided into OSAS group (105 cases) and non-OSAS group (123 cases). The non-parametric Mann-Whitney U test, χ2 test or Fisher's exact test were used to compare the general data and maternal and fetal outcomes between the two groups, and the occurrence of each type of HDP was further compared. Results: (1) Compared with the non-OSAS group, the median pre-pregnancy body mass index (23.6 vs 27.6 kg/m2) and the proportion of snoring [28.9% (33/114) vs 59.2% (61/103)] in the OSAS group were higher, and the differences were both statistically significant (both P<0.001). (2) The incidence of HDP [67.6% (71/105) vs 39.0% (48/123)] and gestational diabetes mellitus [GDM; 40.0% (42/105) vs 26.8% (33/123)] of pregnant women in the OSAS group were higher than those in the non-OSAS group, and the median delivery week was shorter than that in the non-OSAS group (38.4 vs 39.0 weeks). The differences were all statistically significant (all P<0.05). Between-group differences for the delivery way, postpartum hemorrhage, the rate of intensive care unit admission, preterm birth, small for gestational age infants, neonatal asphyxia, the rate of neonatal intensive care unit admission, newborn birth weight and the proportion of umbilical artery blood pH<7.00 were not statistically significant (all P>0.05). (3) Compared with the non-OSAS group, the incidence of chronic hypertension [11.4% (14/123) vs 22.9% (24/105)] and chronic hypertension with superimposed pre-eclampsia [11.4% (14/123) vs 30.5% (32/105)] were higher in the OSAS group, and the differences were both statistically significant (both P<0.01). Conclusion: OSAS is related to HDP (especially chronic hypertension and chronic hypertension with superimposed pre-eclampsia) and GDM, which could provide a practical basis for the screening, diagnosis and treatment of OSAS in pregnant women at high risk.

Alterations of ocular surface parameters in patients with obstructive sleep apnea syndrome.

This study aimed to evaluate changes in ocular surface parameters among obstructive sleep apnea syndrome (OSAS) patients. 44 healthy volunteers (88 eyes) and 27 OSAS patients (54 eyes) were recruited in our cross-sectional study. 14 patients were classified as mild&moderate OSAS, and 13 patients were classified as severe OSAS. For evaluating the ocular surface, the following tests were conducted: the height of tear meniscus (TMH), first non-invasive tear break-up time (FNITBUT), mean non-invasive tear break-up time (MNITBUT), the score of Meibomian gland dropout area (Meiboscore), the tear test of anesthesia-free Schirmer I (SIT), corneal fluorescein staining (CFS), partial blinks rate (PBR), the lipid layer thickness (LLT), ocular surface disease index (OSDI). The results obtained from the study were analyzed and compared among the groups. FNITBUT, MNITBUT, and TMH were lower. OSDI, CFS, Meiboscore and PBR were higher in the OSAS group than those in the control group. The mild&moderate as well as the severe OSAS subgroups had statistically significantly lower TMH, and higher OSDI and PBR than the control group. Meanwhile, we found there were no significant differences between two OSAS subgroups. CFS was higher in the severe OSAS group than the mild&moderate OSAS group. Significantly lower FNITBUT, MNITBUT and higher Meiboscore were observed in the severe OSAS subgroup than in the control group, and MNITBUT was higher in severe OSAS objects than in the mild&moderate OSAS objects. LLT and SIT did not exhibit significant differences among control and OSAS subgroups. FNITBUT and MNITBUT showed significantly negative correlations with BMI, while Meiboscore showed a significant positive correlation with AHI. Patients with OSAS have a tendence of dry eyes, whereas control subjects do not. This indicates us that the OSAS patients should pay more attention to ocular surface care.

Evaluation of the auditory findings of patients with obstructive sleep apnea syndrome

ObjectivesTo investigate the effects of hypoxia occurring in patients with Obstructive Sleep Apnea Syndrome (OSAS) on Auditory evoked late latency, Auditory brainstem response, and the contralateral suppression of otoacoustic emissions. Materials and methods46 patients diagnosed with OSAS were divided into groups as moderate and severe based on their Apnea Hipopnea Index (AHI) values. The control group consisted of 22 healthy individuals. All participants underwent an Auditory Brainstem Response (ABR) test, Auditory Evoked Late Latency Response (LLR), and Contralateral Suppression Otoacoustic Emission (CS-OAE). FindingsThere was no statistical difference between the OSAS group and the control group regarding P1 latency, N1 latency, and P1 and N1 wave amplitude (p > 0.05). In ABR, statistically significant differences were found between the control, moderate OSAS, and severe OSAS groups in wave I in the right and left ear (p < 0.05). In the analyses performed for the otoacoustic emission frequencies with and without contralateral suppression of the right and left ear, suppression was not observed at some frequencies, and this was regarded as statistically significant (p < 0.05). ConclusionIt is considered that OSAS does not have cortical effects but impacts the brainstem region and the cochlea. Bilateral impact, especially observed in wave I of ABR, is prominent on the auditory nerve. Considering that the medial olivo-cochlear (MOC) system is affected in patients with OSAS, it is thought that these patients are inadequate in suppressing noise, and this may cause various problems, particularly the inability to distinguish speech in noisy environments.

Are Sleep Quality, Physical Activity Levels, and Fear of Movement of Obstructive Sleep Apnea Syndrome Patients Different From Healthy People During the Coronavirus Disease 2019 Pandemic?

The sleep quality and physical activity levels of patients with obstructive sleep apnea syndrome during the lockdown period have not yet been investigated. The aim of this study was to evaluate the sleep quality, physical activity level, and fear of movement in patients with obstructive sleep apnea syndrome and healthy individuals during the coronavirus disease 2019 pandemic. Patients with obstructive sleep apnea syndrome (n = 33) and healthy individuals (n = 30) were included in the study. Physical activity levels, sleep quality, and fear of movement were evaluated. The total physical activity amount of patients with obstructive sleep apnea syndrome and healthy individuals was lower than the acceptable levels. The obstructive sleep apnea syndrome group had significantly lower leisure-time physical activity (P = .006) and higher sitting time (P = .008) than the healthy individuals. Patients with obstructive sleep apnea syndrome had significantly more sleep disturbances, daytime dysfunction, and daytime sleepiness than healthy people (P < .001). Fear of movement was negatively correlated with the amount of vigorous (r = -0.395, P = .023) and leisure activities (r = -0.557, P = .001) in the obstructive sleep apnea syndrome group. During the coronavirus disease 2019 pandemic, patients with obstructive sleep apnea syndrome and healthy individuals had lower physical activity levels. Physical activity counseling is an important strategy for increasing the physical activity of patients with obstructive sleep apnea syndrome and healthy individuals during and after the coronavirus disease 2019 pandemic.

Prevalence of bruxism in obstructive sleep apnea syndrome (OSAS) patients: A systematic review conducted according to PRISMA guidelines and the cochrane handbook for systematic reviews of interventions.

Sleep bruxism (SB) and obstructive sleep apnea syndrome (OSAS) are two sleep-related conditions that have been associated with significantly conflicting results in literature. Understanding the prevalence of bruxism among OSA patients is crucial for identifying possible comorbidities and optimising treatment strategies. This systematic review aimed at analysing the prevalence of SB in OSAS sufferers and understanding the association between the two. Five online databases were searched for relevant articles in accordance with the PRISMA guidelines for conduction of systematic reviews. Studies reporting the prevalence of bruxism in OSAS patients and diagnosed through clinical assessments or polysomnography were included. Data extraction and quality assessment were performed independently by two reviewers. Methodological quality of the included studies was assessed using Risk of Bias In Non-randomised Studies of Interventions (ROBINS-I). A thorough search of literature yielded only two studies were eligible for this review. SB was found to be significantly present in the OSAS group. Despite methodological variations, the majority of studies reported higher rates of bruxism in OSAS patients compared to the general population or control groups. The results of this systematic review point to a significant association between bruxism and obstructive sleep apnea. Further research is required to determine a more precise prevalence rate and investigate the potential therapeutic implications of the bruxism-OSAS association that uses a standardised assessment techniques and larger sample sizes.

Correlation between Obstructive Sleep Apnea Syndrome (OSAS) and Cognitive Dysfunction in Elderly Patients with Hypertension.

Obstructive sleep apnea syndrome (OSAS) is a common clinical disease that seriously affects the quality of life and health of patients. This study aimed to explore the correlation between OSAS and cognitive dysfunction in elderly patients with hypertension. A total of 106 elderly hypertensive patients were included and divided into OSAS group (n = 45) and non-OSAS group (n = 61), according to whether they combined with OSAS. OSAS was monitored with a portable polysomnography monitor by monitoring sleep and breathing. The cognitive dysfunction of the patients was evaluated using the Montreal Cognitive Assessment (MoCA). Basic data and MoCA scores of the patients were compared between the OSAS group and non-OSAS group. The correlation between OSAS and cognitive dysfunction in patients was evaluated using Pearson's correlation analysis. The proportion of men (38 vs. 22, p = 0.000), atrial fibrillation (31 vs. 19, p = 0.000), body mass index (27.32 ± 3.85 vs. 21.27 ± 5.90, p = 0.002), systolic pressure (167.76 ± 14.31 vs. 153.22 ± 12.79, p = 0.008), homocysteine (29.71 ± 6.27 vs. 12.50 ± 4.19, p = 0.005), cognitive dysfunction (15 vs. 10, p = 0.042) in patients of the OSAS group were significantly higher compared to patients of the non-OSAS group. Visual space/executive ability (3.12 ± 1.23 vs. 4.75 ± 1.03, p = 0.021), memory (2.48 ± 0.31 vs. 3.71 ± 0.42, p = 0.039), attention (4.15 ± 1.21 vs. 5.12 ± 1.87, p = 0.041), total MoCA scores (20.11 ± 5.09 vs. 25.76 ± 4.31, p = 0.017) in patients in the OSAS group were significantly lower compared to patients in the non-OSAS group. OSAS was positively correlated with cognitive dysfunction in elderly patients with hypertension (r = 0.224, p < 0.05). OSAS was positively correlated with cognitive dysfunction in elderly patients with hypertension, so OSAS could increase the risk of cognitive dysfunction through its own adverse effects or its accompanying disease status.

Impact of Obstructive Sleep Apnea Syndrome on Time to Complete Recovery of Continence After Robot-Assisted Radical Prostatectomy: A Propensity Score Matching Analysis.

Background: Postoperative urinary incontinence after robot-assisted radical prostatectomy (RARP) represents a bothersome side effect, which may permanently affect patient's quality of life. Several studies have demonstrated that obstructive sleep apnea syndrome (OSAS) is associated with urinary symptoms such as urge incontinence, overactive bladder, and nocturia. In this study, we sought to further explore the effect of OSAS on urinary continence after RARP. Methods: We queried our prospectively collected institutional RARP database and identified 82 patients with OSAS and 131 controls, which were matched for age and body mass index (BMI), with available follow-up data for continence. To minimize selection bias, we conducted a propensity score-matched analysis. Patient's characteristics and urinary continence outcomes were compared between the two groups before and after propensity-score matching. Kaplan-Meier curves were constructed to assess the difference in continence between the two groups. Results are presented as means with standard deviations and percentages with 95% confidence intervals (CIs). Results: A total of 213 patients were included in the analysis, of whom 82 with OSAS and 131 with non-OSAS (control group). The mean age of the total cohort was 61.7 ± 6.96 years, the mean BMI was 30.4 ± 5.36, and 52% of the cohort were classified as obese (BMI ≥30). In post-propensity score-matched analyses, there was no significant difference in baseline demographics and tumor characteristics between the two groups (included 82 cases in each group). The median time to continence was 6.6 months for the control group as compared with 13.0 months for the OSAS group (p < 0.001). At 12 months the continence rate for the OSAS group was 41.2% (95% CI: 28.9%-51.4%) as compared with 61.7% (95% CI: 28.5%-71.5%) for the control group. At 24 months the continence rate for the OSAS group was 68.7% (95% CI: 56%-77.7%) as compared with 90.8% (95% CI: 79%-96%) for the control group. Conclusion: On matched analysis, we found that patients with OSAS tended to demonstrate worse urinary continence recovery as compared with patients without OSAS. Additional investigation will be necessary to confirm these initial findings.

Is there link between hypoxemia severity and impaired functional connectivity? electrophysiological evidence from patients with obstructive sleep apnea syndrome

AbstractBackgroundApneas occur more than 30 times per hour in severe obstructive sleep apnea syndrome (OSAS) patients. Each apnea results in decrease of oxygen saturation that leads to recurring intermittent hypoxemia (IH). IH was suggested as a possible factor to contribute cognitive impairment in OSAS. In the present study, we aimed to investigate the functional connectivity in low and high hypoxemia OSAS sub‐groups.MethodThe study included 56 severe OSAS patients and age‐, gender‐ and education matched 33 healthy controls (HC). The OSAS group was divided into two subgroups according to their minimum SO2 level: low‐hypoxemia OSAS (SO2 dropped never below 80%, LHO, n = 29) and high‐hypoxemia OSAS (SO2 dropped below 80%, HHO, n = 27). All participants underwent detailed neuropsychological testing and an EEG recording, using auditory classical oddball paradigm. Imaginary coherency (ICOH) was calculated for intra‐hemispheric, inter‐hemispheric and midline electrode pairs in delta, theta, alpha, beta, and gamma frequency bands.ResultLHO patients did not differ from HC in any frequency band. HHO patients showed reduced intra hemispheric ICOH values at delta, theta and beta frequency bands compared to LHO patients. HHO patients also showed decreased intra hemispheric ICOH values at theta, alpha and beta frequency bands compered to HC. Inter hemispheric group differences were found at beta band indicating decreased ICOH values in HHO patients compared to LHO patients. Midline gamma ICOH values decreased in HHO patients compared to both HC and LHO patients. HHO patients showed decreased memory scores compared to both HC and LHO groups and decreased attention scores compared only to HC.ConclusionAs far as we know, this is the first study to investigate event‐related ICOH changes in OSAS. Above results indicates that decreased connectivity in OSAS may be due to increased IH. Patients with low levels of hypoxemia did not differ from healthy controls, yet patients with high hypoxemia showed diffuse functional connectivity changes. Coherency measures revealed a parallel pattern with the neuropsychological tests underpinning the adverse effect of IH on cognitive functions. Considering OSAS as a modifiable risk factor for developing Alzheimer’s disease, treatment methods to prevent intermittent hypoxemia (i.e., positive airway pressure treatment) gains additional importance.

MP80-11 IMPACT OF OBSTRUCTIVE SLEEP APNEA SYNDROME ON TIME TO COMPLETE RECOVERY OF CONTINENCE AFTER ROBOT-ASSISTED RADICAL PROSTATECTOMY: AN ANALYSIS USING PROPENSITY SCORE MATCHING

You have accessJournal of UrologyCME1 Apr 2023MP80-11 IMPACT OF OBSTRUCTIVE SLEEP APNEA SYNDROME ON TIME TO COMPLETE RECOVERY OF CONTINENCE AFTER ROBOT-ASSISTED RADICAL PROSTATECTOMY: AN ANALYSIS USING PROPENSITY SCORE MATCHING Mohammed Shahait, Tuan Thanh Nguyen, Jose Asmar, Ryan W Dobbs, Jeffrey Walker, Jessica L. Kim, Ayah El-Fahmawi, and David I. Lee Mohammed ShahaitMohammed Shahait More articles by this author , Tuan Thanh NguyenTuan Thanh Nguyen More articles by this author , Jose AsmarJose Asmar More articles by this author , Ryan W DobbsRyan W Dobbs More articles by this author , Jeffrey WalkerJeffrey Walker More articles by this author , Jessica L. KimJessica L. Kim More articles by this author , Ayah El-FahmawiAyah El-Fahmawi More articles by this author , and David I. LeeDavid I. Lee More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003357.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Postoperative urinary incontinence after robot-assisted radical prostatectomy (RARP) represents a bothersome side effect which may permanently affect patient quality of life. The urinary continence rate after RARP depends on several factors, including baseline continence, age, body mass index (BMI), prostate volume, surgeon experience, pre-existing lower urinary tract symptoms, & surgical technique. Several studies have demonstrated that obstructive sleep apnea syndrome (OSAS) is associated with urge incontinence, overactive bladder, & nocturia. In this study, we sought to further explore the effect of OSAS on urinary continence (UC) after RARP. METHODS: We queried our prospectively collected institutional RARP database & identified 84 patients with OSAS & 131 controls, which were matched for age & BMI, with available follow-up data for UC. To minimize selection bias, we conducted a propensity score-matched analysis. Patient characteristics & UC outcomes were compared between the two groups before & after propensity-score matching. Continence was defined as using zero pads. Kaplan-Meier curves were constructed to assess the difference in UC between the two groups. Results are presented as means with standard deviations & percentages with 95% confidence intervals. RESULTS: A total of 213 patients were included in the analysis, of whom 82 with OSAS & 131 with non-OSAS (control group). The mean age of the total cohort was 61.7±6.96 years, the mean BMI was 30.4±5.36, & 52% of the cohort was classified as obese (BMI ≥30). In post-propensity score-matched analyses, there was no significant difference in baseline demographics & laboratory tests between the two groups (included 82 cases in each group). The median time to UC was 6.6 months for the control group as compared to 13.0 months for the OSAS group (p<0.001). At 12 months the UC rate for the OSAS group was 41.2% (95% CI: 28.9%-51.4%) as compared to 61.7% (95% CI: 28.5%-71.5%) for the control group. At 24 months the UC rate for the OSAS group was 68.7% (95% CI: 56%-77.7%) as compared to 90.8% (95% CI: 79%-96%) for the control group. CONCLUSIONS: On matched analysis, we found that patients with OSAS tended to demonstrate worse UC recovery than patients without OSAS. If these findings were confirmed in other cohorts, it might help urologist to counsel these patients pre-operatively. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1156 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mohammed Shahait More articles by this author Tuan Thanh Nguyen More articles by this author Jose Asmar More articles by this author Ryan W Dobbs More articles by this author Jeffrey Walker More articles by this author Jessica L. Kim More articles by this author Ayah El-Fahmawi More articles by this author David I. Lee More articles by this author Expand All Advertisement PDF downloadLoading ...

Agmatine, telomerase and trace minerals levels in patients with obstructive sleep apnea syndrome

Obstructive sleep apnea syndrome (OSAS) is a disease characterized by repetitive, partially or complete upper airway obstructions resulting in hypoxia and bioelectrical wakefulness reactions along with sleep. There is a limited and different information on the biochemical pathways that may determine harmful effects in OSAS patients with different disease severity. Hence, we aimed to estimate the plasma levels of polyamine agmatine, which has many effects on the central nervous system, telomerase and trace minerals in patients with OSAS. The study included 90 volunteer patients diagnosed with OSAS and divided into three groups of 30 people each according to the apnea-hypopnea index (AHI) score: mild, moderate and severe. Nocturnal blood oxygen saturation percentage (SpO2) and body mass index (BMI) were measured. Plasma agmatine level was defined by ultra-high-pressure liquid chromatography (UHPLC), plasma trace elements (Cu, Co, Mg, Mo, Zn, Se) level by inductively coupled plasma mass spectrometer (ICP-MS) and serum telomerase level by enzyme-linked immunosorbent assay (ELISA) method. It was found that SpO2 value decreased as the disease progressed and showed a negative correlation with BMI, Co and Se plasma levels. The levels of agmatine and telomerase were shown to lower in patients with severe OSAS group compared to other groups. Keywords: agmatine, sleep apnea syndrome, SpO2, telomerase, trace minerals