Obstructive Sleep Apnea Syndrome Screening Research Articles

Diagnostic value of the Berlin questionnaire in the treatment of snoring and obstructive sleep apnea syndrome

Snoring and obstructive sleep apnea syndrome (OSAS) are common pathologies. Sleep disorders cause a daytime sleepiness, impaired concentration, and other cognitive impairments. All this can lead to fatal consequences. Unfortunately, only about 20 % of patients suffering from this pathology are identified. As a rule, patients do not know about the presence of OSAS, on the one hand, and on the other hand, they do not know which specialist they need to seek help from. Given the fact that impaired upper airway patency is one of the main causes of OSAS, most patients should be treated by an otolaryngologist. This work is aimed at improving the diagnosis of snoring and obstructive sleep apnea syndrome in screening studies. Screening for snoring and OSAS using the Berlin questionnaire as a result of this study allowed identifying 60 % more patients suffering from snoring and OSAS than in self-referral. The use of the Berlin questionnaire in all patients seeking medical care will help identify a hidden pathology and further conduct a more complete diagnosis of snoring and sleep apnea, as well as prescribe appropriate treatment.

Application value of questionnaires in the screening obstructive sleep apnea syndrome in pregnancy across trimesters

Objective: To evaluate the clinical utility value of questionnaires of Berlin, STOP, STOP-Bang (SBQ), Epworth Sleepiness Scale (ESS) in screening obstructive sleep apnea syndrome (OSAS) in pregnant women of different trimesters. Methods: Consecutive pregnant women at high risk for OSAS were enrolled from January, 2021 to April, 2022 at the obstetric clinic of Peking University People's Hospital. They completed questionnaires of Berlin, STOP, SBQ, ESS and also underwent an overnight polysomnography (PSG). To evaluate the accuracy of questionnaires of Berlin, STOP, SBQ, ESS, sensitivity, specificity, positive predictive values, negative predictive values and the area under the receiver operating characteristics (ROC) curve of these questionnaires in pregnancy across trimesters (Pregnancy 1-15 weeks was the first stage, pregnancy 16-27 weeks was the second stage, and pregnancy 28-40 weeks was the third stage) were calculated. Results: A total of 100 pregnant women [(34.5±4.3) years old (26-46 years old)] were included in this study, including 20, 35 and 45 pregnant women in the first, second and third trimester of pregnancy, respectively. Based on PSG results, 45 (45%) of 100 pregnant women were diagnosed with OSAS. The overall predictive values of the four questionnaires were not good, area under[AUC(95%CI)] the ROC curve ESS, Berlin questionnaire STOP and SBQ were 0.54(0.43, 0.66), 0.59 (0.47, 0.70), 0.62(0.51, 0.73) and 0.61 (0.49, 0.72), respectively, sensitivity was 35.6%, 65.9%, 48.9%, 28.9%, specificity was 71.7%, 52.5%, 73.6%, 92.5%. When categorized according to trimesters, the predicted values of the four questionnaires increased in the first trimester, the AUC (95%CI) of STOP questionnaire was 0.81 (0.61, 1.00), sensitivity was 75.0%, specificity was 87.5%. Conclusion: The overall predictive power of the four screening questionnaires is limited in pregnant women. But predictive value of STOP questionnaire is acceptable in the first trimester.

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.

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.

Stop-bang questionnaire for screening obstructive sleep apnea syndrome among hypertensive patients in Kenya

IntroductionObstructive sleep apnea (OSA) is a type of breathing problem during sleep caused by the blockage of the upper airway, which can cause cessation of airflow. There is limited research on the prevalence of OSA in hypertensive patients in sub-Saharan Africa (SSA). The study aimed to describe the prevalence and clinical characteristics of OSA among hypertensive patients at a tertiary hospital in Nairobi, Kenya.MethodsThis cross-sectional study was conducted at the Aga Khan University Hospital in Nairobi, Kenya. Two hundred and fifty-one hypertensive patients were screened for OSA risk using the STOP-Bang questionnaire (SBQ). Patients with a SBQ score of ≥ 4 were categorized as high risk for OSA. Descriptive statistics were employed to describe both categorical and continuous variables and binary logistic regression to assess factors associated with the high risk of OSA.ResultsThe study reported that 78.5% of the participants had high-risk OSA. The median age and body mass index (BMI) were 57.0 years (IQR: 50.0–64.0) and 28.3 kg/m2, respectively. Age, neck circumference, gender, and BMI were significantly higher in the high-risk OSA group as compared to the low-risk group.ConclusionThe study highlights the importance of screening hypertensive patients for OSA using the SBQ in clinical settings, particularly in low-and middle-income countries (LMICs). Healthcare providers can use patient characteristics such as age, gender, neck circumference, and BMI to identify those at greater risk of developing OSA. Further research could focus on developing effective OSA prevention and treatment interventions in hypertensive patients.

Application of the STOP-BANG questionnaire for screening obstructive sleep apnea syndrome in patients with atrial fibrillation.

Application of the STOP-BANG questionnaire for screening obstructive sleep apnea syndrome in patients with atrial fibrillation.

Upper Airway Assessment in Cone-Beam Computed Tomography for Screening of Obstructive Sleep Apnea Syndrome: Development of an Evaluation Protocol in Dentistry

The upper airways are formed by the nasal cavities, pharynx, and larynx. There are several radiographic methods that allow evaluation of the craniofacial structure. Upper airway analysis in cone-beam computed tomography (CBCT) may be useful in diagnosing some pathologies such as obstructive sleep apnea syndrome (OSAS). OSAS prevalence has increased significantly in recent decades, justified by increased obesity and average life expectancy. It can be associated with cardiovascular, respiratory, and neurovascular diseases, diabetes, and hypertension. In some individuals with OSAS, the upper airway is compromised and narrowed. Nowadays, CBCT is widely used in dentistry by clinicians. Its use for upper airway assessment would be an advantage for screening some abnormalities related to an increased risk of pathologies such as OSAS. CBCT helps to calculate the total volume of the airways and their area in different anatomical planes (sagittal, coronal, and transverse). It also helps identify regions with the highest anteroposterior and laterolateral constriction of the airways. Despite its undoubted advantages, airway assessment is not routinely performed in dentistry. There is no protocol that allows comparisons between studies, which makes it difficult to obtain scientific evidence in this area. Hence, there is an urgent need to standardize the protocol for upper airway measurement to help clinicians identify at-risk patients. Our main aim is to develop a standard protocol for upper airway evaluation in CBCT for OSAS screening in dentistry. To measure and evaluate the upper airways, data are obtained using Planmeca ProMax 3D (Planmeca). Patient orientation is performed in accordance with the manufacturer's indications at the time of image acquisition. The exposure corresponds to 90 kV, 8 mA, and 13,713 seconds. The software used for upper airway analysis is Romexis (version 5.1.O.R; Planmeca). The images are exhibited in accordance with the field of view of 20.1×17.4 cm, size of 502×502×436 mm, and voxel size of 400 μm. The protocol described and illustrated here allows for automatic calculation of the total volume of the pharyngeal airspace, its area of greatest narrowing, its location, and the smallest anteroposterior and laterolateral dimensions of the pharynx. These measurements are carried out automatically by the imaging software whose reliability is proven by the existing literature. Thus, we could reduce the possible bias of manual measurement, aiming at data collection. The use of this protocol by dentists will allow for standardization of the measurements and constitutes a valuable screening tool for OSAS. This protocol may also be suitable for other imaging software. The anatomical points used as reference are most relevant for standardizing studies in this field. RR1-10.2196/41049.

Manuscript Title: A 4-miRNAs Serum Panel for Obstructive Sleep Apnea Syndrome Screening.

Obstructive sleep apnea syndrome (OSAS) is a common chronic sleep disorder. OSAS is closely related to cardiovascular disease, metabolic disorders, cancer risk, and sudden death. This association has special significance in young people. Although it is known that OSAS has a great impact on physical health, it is estimated that 70-80% of patients with moderate-to-severe OSAS remain undiagnosed. Therefore, a new method for early diagnosis of the disease, the therapeutic effect of OSAS and prevention of complications to important. A total of 110 patients with moderate-to-severe OSAS diagnosed in the Sleep Disorders Diagnosis and Treatment Center of Peking University Shenzhen Hospital were selected. After excluding other diseases, 59 patients were finally selected as the OSAS group. In addition, 60 healthy people were selected as the control group. Serum RNA was then extracted. Eight RNA samples were randomly selected from the two groups for high-throughput miRNA sequencing. The 10 miRNAs with the greatest differences were selected as preselected markers from the results. Then, qRT-PCR was performed on the remaining RNA samples of the two groups to extract and verify the 10 miRNAs, and statistical analysis was performed between groups. A diagnostic panel was constructed by a stepwise logistic regression model combined with the expression data of miRNAs in the validation phase. A four-miRNA panel was identified to better predict OSAS, and the model was calculated using the following formula: Logit (P)= 0.77-1.65 × miR-486-5p - 4.56 × miR-148a-3p + 1.79 × miR-744-5p + 1.13 × let-7d-3p. The AUC for the four-miRNA panel was 0.955 (95% CI: 0.899 to 0.985; sensitivity = 91.38%, specificity = 91.38%). Gene Ontology (GO) annotation and Kyoto encyclopedia of genes and genomes (KEGG) pathway analysis was included in bioinformatic analysis. A 4-miRNAs panel as a diagnostic biomarker for OSAS screening is feasible.

Prevalence of obstructive sleep apnea syndrome in hospitalized patients with type 2 diabetes in Beijing, China.

To estimate the prevalence, and patient clinical and demographic profile, as well as risk factors associated with obstructive sleep apnea syndrome (OSAS) in hospitalized patients with type 2 diabetes mellitus in Beijing, China. Hospitalized adult patients with type 2 diabetes mellitus were consecutively screened and invited for an overnight polysomnography from four hospitals in Beijing, China, from May 2016 to February 2017. We used the American Academy of Sleep Medicine 2012 polysomnography recording techniques and scoring criteria to identify the type of apnea and the severity of OSAS. The χ2 -test was used to evaluate differences between groups regarding the prevalence, and demographic and other clinical parameters. A total of 735 patients were found eligible for the study, of whom 309 patients completed the overnight polysomnography. The mean age of the patients was 58.2 ± 10.9 years, and most (67.3%) were men. The prevalence of overall (apnea hypopnea index ≥5/h), moderate-to-severe (apnea hypopnea index ≥15/h) and severe (apnea hypopnea index ≥30/h) OSAS was 66.3% (95% confidence interval 60.8-71.6%), 35.6% (95% confidence interval 30.3-41.2%) and 16.5% (95% confidence interval 12.5-21.1%), respectively. Central and mixed apnea contributed 12% to all sleep-disordered breathing. With the aggravation of OSAS, the combined prevalence for central, mixed and obstructive apnea increased from 57% to 70%. We found OSAS to be associated with older age, obesity, self-reported snoring and apnea, and diabetes complications. Guidelines on screening and treatment of OSAS among hospitalized patients with diabetes are needed to direct the routine practice for diabetes endocrinologists for optimal clinical care of such patients.

Academic cardiac electrophysiologists' perspectives on sleep apnea care.

Obstructive sleep apnea syndrome (OSAS) is an important, modifiable risk factor in the pathophysiology of arrhythmias including atrial fibrillation (AF). The purpose of the study was to evaluate cardiac electrophysiologists' (EPs) perception of OSAS. We designed a 27-item online Likert scale-based survey instrument entailing several domains: (1) relevance of OSAS in EP practice, (2) OSAS screening and diagnosis, (3) perception on treatments for OSAS, (4) opinion on the OSAS care model. The survey was distributed to 89 academic EP programs in the USA and Canada. While the survey instrument questions refer to the term sleep apnea (SA), our discussion of the diagnosis, management, and research on the sleep disorder is more accurately described with the term OSAS. A total of 105 cardiac electrophysiologists from 49 institutions responded over a 9-month period. The majority of respondents agreed that sleep apnea (SA) is a major concern in their practice (94%). However, 42% reported insufficient education on SA during training. Many (58%) agreed that they would be comfortable managing SA themselves with proper training and education and 66% agreed cardiac electrophysiologists should become more involved in management. Half of EPs (53%) were not satisfied with the sleep specialist referral process. Additionally, a majority (86%) agreed that trained advanced practice providers should be able to assess and manage SA. Time constraints, lack of knowledge, and the referral process are identified as major barriers to EPs becoming more involved in SA care. We found that OSAS is widely recognized as a major concern for EP. However, incorporation of OSAS care in training and routine practice lags. Barriers to increased involvement include time constraints and education. This study can serve as an impetus for innovation in the cardiology OSAS care model.

Obstructive Sleep Apnoea Syndrome Screening Through Wrist-Worn Smartbands: A Machine-Learning Approach.

PurposeA large portion of the adult population is thought to suffer from obstructive sleep apnoea syndrome (OSAS), a sleep-related breathing disorder associated with increased morbidity and mortality. International guidelines include the polysomnography and the cardiorespiratory monitoring (CRM) as diagnostic tools for OSAS, but they are unfit for a large-scale screening, given their invasiveness, high cost and lengthy process of scoring. Current screening methods are based on self-reported questionnaires that suffer from lack of objectivity. On the contrary, commercial smartbands are wearable devices capable of collecting accelerometric and photoplethysmographic data in a user-friendly and objective way. We questioned whether machine-learning (ML) classifiers trained on data collected through these wearable devices would help predict OSAS severity.Patients and MethodsEach of the patients (n = 78, mean age ± SD: 57.2 ± 12.9 years; 30 females) underwent CRM and concurrently wore a commercial wrist smartband. CRM’s traces were scored, and OSAS severity was reported as apnoea hypopnoea index (AHI). We trained three pairs of classifiers to make the following prediction: AHI <5 vs AHI ≥5, AHI <15 vs AHI ≥15, and AHI <30 vs AHI ≥30.ResultsAccording to the Matthews correlation coefficient (MCC), the proposed algorithms reached an overall good correlation with the ground truth (CRM) for AHI <5 vs AHI ≥5 (MCC: 0.4) and AHI <30 vs AHI ≥30 (MCC: 0.3) classifications. AHI <5 vs AHI ≥5 and AHI <30 vs AHI ≥30 classifiers’ sensitivity, specificity, positive predictive values (PPV), negative predictive values (NPV) and diagnostic odds ratio (DOR) are comparable with the STOP-Bang questionnaire, an established OSAS screening tool.ConclusionMachine learning algorithms showed an overall good performance. Unlike questionnaires, these are based on objectively collected data. Furthermore, these commercial devices are widely distributed in the general population. The aforementioned advantages of machine-learning algorithms applied to smartbands’ data over questionnaires lead to the conclusion that they could serve a population-scale screening for OSAS.

Auditory Property-Based Features and Artificial Neural Network Classifiers for the Automatic Detection of Low-Intensity Snoring/Breathing Episodes

The definitive diagnosis of obstructive sleep apnea syndrome (OSAS) is made using an overnight polysomnography (PSG) test. This test requires that a patient wears multiple measurement sensors during an overnight hospitalization. However, this setup imposes physical constraints and a heavy burden on the patient. Recent studies have reported on another technique for conducting OSAS screening based on snoring/breathing episodes (SBEs) extracted from recorded data acquired by a noncontact microphone. However, SBEs have a high dynamic range and are barely audible at intensities &gt;90 dB. A method is needed to detect SBEs even in low-signal-to-noise-ratio (SNR) environments. Therefore, we developed a method for the automatic detection of low-intensity SBEs using an artificial neural network (ANN). However, when considering its practical use, this method required further improvement in terms of detection accuracy and speed. To accomplish this, we propose in this study a new method to detect low SBEs based on neural activity pattern (NAP)-based cepstral coefficients (NAPCC) and ANN classifiers. Comparison results of the leave-one-out cross-validation demonstrated that our proposed method is superior to previous methods for the classification of SBEs and non-SBEs, even in low-SNR conditions (accuracy: 85.99 ± 5.69% vs. 75.64 ± 18.8%).

Obstrüktif Uyku Apne Sendromlu Hastalarda Plazma Ghrelin, Omentin-1 Düzeyleri ve İnsülin Dirençlerinin Değerlendirilmesi

Objective: Available studies support the occurrence of a bidirectional association between obstructive sleep apnea syndrome (OSAS) and cardiovascular disorders. In this study, we aimed to evaluate the plasma ghrelin, omentin–1 levels, insulin resistance (IR) in patients with OSAS, and its cardiovascular consequences. Methods: This study was performed on 150 individuals who applied to the sleep laboratory with complaints such as snoring and sleep-breathing pause. Polysomnographic (PSG) evaluation was applied to every patient. Seventy-five individuals with Apnea-Hypopnea Index (AHI) ≥5 were diagnosed as OSAS and seventy-five individuals with AHI&amp;lt;5 were included as the without OSAS. Results: The median omentin-1 level was 59.0 ng/mL in the OSAS group and 105.0 ng/mL in without OSAS (p&amp;lt;0.001). The median ghrelin level in the OSAS group was 229.0 pg/ml and 180.0 pg/ml in the without OSAS group (p&amp;lt;0.001). The prevalence of OSAS was 2.667 times higher in males than females (OR=2.667). HOMA-IR scores were not different between OSAS and without OSAS groups (p=0.218). Patients with OSAS had higher BMI, neck circumference, and median ESS values compared to those without OSAS group (p&amp;lt;0.001). In obese, the risk of OSAS was found 3.058 times higher (OR= 3.058) (p&amp;lt;0.001). Conclusions: Median omentin-1 level was lower in the OSAS group than the without OSAS group, whereas median ghrelin level was higher in the OSAS and obese individuals. Due to the high prevalence of OSAS in hypertensive and obese individuals, effective screening, diagnosis, and treatment of OSAS are required to reduce cardiovascular risk.

Obstructive Sleep Apnoea Syndrome Screening Through Wrist-Worn Smartbands: A Machine-Learning Approach

Background. A large portion of the adult population is thought to suffer from Obstructive Sleep Apnoea Syndrome (OSAS). Screening the general population for this syndrome is therefore crucial since this pathology has been associated with increased morbidity and mortality. However, current screening methods are based on questionnaires that intrinsically lack of objectivity. On the other hand, wrist-worn smartbands are non-invasive and economically convenient devices, which allow for prolonged monitoring of physiological parameters. Methods. We used accelerometric and photoplethysmographic data collected via commercial smartbands to train a machine-learning (ML) classifier assessing the presence and severity of OSAS. Each of the 78 patients who participated in this study underwent cardiorespiratory monitoring (CRM), a diagnostic method used to assess OSAS and its severity according to the Apnoea-Hypopnoea Index (AHI). Findings. According to the Matthews Correlation Coefficients (MCC), the proposed algorithms reached an overall good correlation with the ground truth (CRM) for AHI<5 vs AHI≥5 (MCC: 0.4) and AHI<30 vs AHI≥30 (MCC: 0.3) classifications. AHI<5 vs AHI≥5 and AHI<30 vs AHI≥30 classifiers’ sensitivity, specificity, positive predictive values (PPV), negative predictive values (NPV) and diagnostic odds ratio (DOR) are in line with the ones of the STOP-Bang questionnaire, a OSAS screening tool widely adopted in the clinical practise. Interpretation. The consumer accelerometric and photoplethysmographic data, continuously collected and stored, could guide OSAS large scale screening also in a retroactive way, ideally triggering an alert for those users in need of further diagnostic investigation of the risk of OSAS.Funding. Arpa Foundation. Declaration of Interest: Ugo Faraguna and Umberto Olcese are co-founders of sleepActa S.r.l, a spin-off company of the University of Pisa operating in the field of sleep medicine. All other authors declare no competing interests. Ethical Approval: This study was approved by the Pisa University Hospital Bioethical Committee (CEAVNO protocol No: 42714). Participants provided written informed consent to take part in the study.

0450 Screening Method for Obstructive Sleep Apnea Syndrome by Patients’ Exhalant with TD-GC-MS System

Abstract Introduction Human exhaled breath test is getting more important for non-invasive health monitoring and detecting method nowadays. The diagnosis of obstructive sleep apnea syndrome (OSAS) is often difficult to be confirmed from the daytime presentation and usually need the overnight polysomnography. The methods for OSAS screening are therefore potentials for the clinical practice in the near future. Methods In this research, a method of thermal desorption (TD) tendon with gas chromatography-mass spectrometry (GC-MS) system has been developed for screeing of OSAS patients. We detected the volatile organic compounds (VOCs) from the special designed experimental bags which collected exhaled gas. Then we compared the VOCs from normal control and OSAS group in order to find out the biomarkers which could be used to screen OSAS patients. Furthermore, the Reliable Number(N) was used to see how often the VOC identified in all the experients in OSAS group and was defined as the times of a single VOC identified devided by the times of total experiment in a single OSAS patient. Results While the reliable number been set as &amp;#8805;50%, we found 8 VOC markers, including Pentane and Cyclopentyl acetylene, appeared more often in OSAS patients. When we raise N to &amp;#8805;70%, we have only 3 markers remaining. Conclusion Based on this result, we utilize the artificial intelligence method, deep learning, to figure out whether the peak intensity of different biomarkers are related to the severity of OSAS. Support Thanks for Da-Jeng Yao Lab’s support

The STOPBANG score is effective for obstructive sleep apnea syndrome screening and correlates with its features, in a sub-Saharan African population.

Introductionthe STOPBANG score is an easy-to-use screening tool for obstructive sleep apnea (OSA), which has not been validated in sub-Saharan Africa (SSA). We sought to evaluate its diagnostic performance in Cameroun.Methodsthis community-based study took place in a sub-urban area, from November 2015 to April 2016. Adults aged ≥19 years underwent a clinical assessment, including the STOPBANG and the Epworth sleepiness scale (ESS) questionnaires. A respiratory polygraph (RP) was performed on a randomly selected sample. Diagnosis performance included sensitivity (Se), specificity (Sp), and positive and negative predictive values (PPV and NPV). An association was sought between STOPBANG and OSA features.Resultsa total of 3033 were interviewed, of whom 102 had a RP. Their mean age was 49.1±17.9 years, the sex ratio was 1 and the mean body mass index 29.1±6.1 kg/m2. For OSA screening (apnea-hypopnea index (AHI) ≥5), the STOPBANG score at threshold 3 obtained: Se=82.9%, Sp=34.4%, PPV=45.9% and NPV=75.0%. For moderate-to-severe OSA (IAH ≥15), these values were 93.3%, 31.1%, 18.9% and 96.4% respectively. Furthermore, STOPBANG-based high risk of OSA correlated with AHI (9.1±10.7/hr vs 3.8±3.5/hr, p=0.0003) and oxygen desaturation index (6.4±7.9/hr vs 2.6±2.1/hr, p=0.0004). There was a non-significant association with ESS (6.3±5.3 vs 4.5±3.5, p=0.06).Conclusionin this Cameroonian population, the STOPBANG diagnostic performance did not differ from the original Caucasian one. It could therefore be proposed on a larger scale, since obesity and other OSA risk factors are increasing in SSA.

Performance of sleep questionnaires for the diagnosis of obstructive sleep apnea syndrome

Background The diagnosis of obstructive sleep apnea syndrome (OSAS) is based on nocturnal records: polysomnography or respiratory polygraphy. However, their high costs limit their use. Aim To examine the predictive value of three sleep questionnaires (STOP, STOP-Bang, Epworth Sleepiness Scale (ESS) in the screening of OSAS in Chilean adults. Material and Methods During the National Health Survey 2016/17, 205 adults aged 50.7 ± 15.0 years (46% males) living in the Metropolitan Region answered sleep questionnaires and underwent an ambulatory respiratory polygraphy. The sensitivity, specificity, positive and negative predictive values and receiver operating characteristic curves of sleep questionnaires were calculated. Results Fifty nine percent of participants had OSAS which was moderate to severe in 26%. The clinical variables associated with OSAS were age, male gender, hypertension, dyslipidemia, overweight, cervical and waist circumferences, history of regular snoring and witnessed apneas. Daytime somnolence, insomnia and unrefreshing sleep were not associated to OSAS risk. STOP, STOP-Bang and ESS questionnaires classified 64%, 71% and 12% of cases as high risk for OSAS, respectively. The STOP and STOP-Bang questionnaires had the highest sensitivity to predict OSAS (76% and 89%, respectively) while the ESS had the highest specificity (91%). Conclusions The sleep questionnaires allowed to identify the subjects at high risk for OSAS in this sample of adults from the Metropolitan Region.

Obstructive sleep apnea syndrome and neuropsychological function in pediatric stroke.

To assess the prevalence of obstructive sleep apnea syndrome (OSAS) in children with arterial ischemic stroke (AIS) and to evaluate its association with neuropsychological outcomes. We conducted a cross-sectional study of sleep health and neuropsychological outcome in children with AIS. A consecutive cohort of children attending a stroke clinic were assessed using a standardized pediatric sleep questionnaire (PSQ) and standardized measures of pediatric stroke outcome and intellectual, executive and adaptive function. High risk for OSAS was defined as PSQ score ≥0.33. Overall, 102 children were included (55% males, median age: 9 years [interquartile-range [IQR]: 6-14]). The prevalence of OSAS in children with AIS was significantly higher compared to published normative prevalence rate (25.5% vs 5%, p<0.001). Children with OSAS were more likely to have infarcts affecting both the anterior and posterior circulation (37.5% vs 9.5%, p=0.021). In addition, children with OSAS had significantly higher median Pediatric Stroke Outcome Measure (PSOM) scores (2 [IQR: 0-2] vs 1 [IQR: 1-3.5], p=0.01) and were more likely to be prescribed concomitant medications affecting sleep architecture (50% vs 22.4%, p=0.007). OSAS was associated with significantly lower scores on intellectual, memory, cognitive, behavioral, attention, executive and adaptive function scales. The association between PSQ and intellectual ability and working memory remained statistically significant upon controlling for potential confounding factors including stroke related characteristics (neurologic impairment and arterial territory). The prevalence of OSAS in children with AIS compared to healthy controls is significantly elevated and is associated with poor neuropsychological outcomes. We highlight the importance of regular screening for OSAS - a modifiable risk factor - in children with AIS. The specific risk factors for OSAS and the potential benefits of therapeutic interventions in this patient population warrant further investigation.

Pediatric sleep questionnaires for screening of obstructive sleep apnea syndrome

Obstructive sleep apnea syndrome (OSAS) is the most severe form of obstructive sleep-disordered breathing. It can produce cardio vascular problems, growth retardation, cognitive deficits, and behavioral problems such as attention deficit/hyperactivity symp toms in children. The diagnostic gold standard for OSAS is overnight polysomnography, but it is expensive, time-consuming, and la bor intensive, and is conducted by specialized centers which have trained personnel. Therefore, sleep questionnaires as screening tools for OSAS was developed. The benefits of sleep questionnaires are easy/quick application and low cost. The objective of this re view is to describe several available pediatric sleep questionnaires which are helpful in screening OSAS. (Allergy Asthma Respir Dis 2019;7:122-128)

Sleep-disordered breathing in paediatric setting: existing and upcoming of the genetic disorders.

Childhood obstructive sleep apnea syndrome (OSAS) is characterized by anatomical and functional upper airway abnormalities as pathophysiological determinants, and clinical symptoms are frequently clear. OSAS is widely described in rare genetic disorders, such as achondroplasia, Down syndrome, Prader-Willi syndrome, Pierre Robin sequence, and mucopolysaccharidosis. Craniofacial and upper airway involvement is frequently morbid conditions. In children with genetic diseases, the clinical symptoms of OSAS are often slight or absent, and related morbidities are usually more severe and can be observed at any age. The present review is aimed to updating the discoveries regarding OSAS on Achondroplasia, Down syndrome, Prader-Willi syndrome, Pierre Robin sequence, Sickle cell disease, or encountered in our clinical practice (Ehlers-Danlos syndrome, Ellis-van Creveld syndrome, Noonan syndrome). Two additional groups of genetic disorders will be focused (mucopolysaccharidoses and osteogenesis imperfecta). The flowing items are covered for each disease: (I) what is the pathophysiology of OSAS? (II) What is the incidence/prevalence of OSAS? (III) What result from the management and prognosis? (IV) What are the recommendations? Considering the worries of OSAS, such as inattention and behavioural problems, daytime sleepiness, failure to thrive, cardiological and metabolic complications, the benefit of a widespread screening and the treatment in children with genetic diseases is undoubtful. The goals of the further efforts can be the inclusion of various genetic diseases into guidelines for the screening of OSAS, updating the shreds of evidence based on the research progression.