Breathing Pauses Research Articles

Pediatric Obstructive Sleep Apnea: Clinical Manifestations and Consequences

Obstructive sleep apnea (OSA) significantly impacts the quality of life in children, affecting their physical and mental health. The pathophysiology involves a complex interaction between anatomical factors (such as enlarged tonsils, adenoids, and structural abnormalities) and obesity, along with neuromuscular compensations. Clinical manifestations include loud snoring, breathing pauses, restless sleep, unusual sleeping positions, and frequent awakenings. OSA can lead to enuresis, growth impairment, poor academic performance, and neurocognitive and behavioral difficulties. Long-term consequences are cardiovascular morbidity, metabolic dysfunction, and neurocognitive impairment. Many studies have explored these associations and the impact of adenotonsillectomy. This review provides an overview of clinical manifestations and consequences of OSA, aiming to enhance diagnosis and treatment strategies for pediatric OSA.

B - 25 Documenting the Prevalence of Sleep Disturbances among TBI Survivors: a FITBIR Study

Abstract Objective The objective of this study is to utilize data from the Federal Interagency Traumatic Brain Injury Research (FITBIR) database to document the short-term prevalence of sleep disorders among a sample of mild Traumatic Brain Injury (mTBI) survivors. Method Data was extracted from the FITBIR website. Adult individuals who sustained an mTBI (Rivermead Post Concussion Symptoms Questionnaire; RPQ6) and had a data collection timepoint within 10 days of the injury were included. Measures of demographic characteristics and sleep problems (Pittsburgh Sleep Quality Index; PSQI) were utilized. A total of 74 participants (97% male, 73% white, mean age = 22.49 SD = 11.25) were included. Descriptive analysis were conducted to document the prevalence of sleep problems among this sample. Results Across our sample, broad sleep difficulties were common (PSQI Mean = 7.014, Median = 5, SD = 7.56). 47.29% of participants reported severe sleep difficulties (PSQI >5). 14(23.3%) individuals met criteria for insomnia based on their component 5 scores. Among individuals with a bed partner, only 3(7%) endorsed long breathing pauses, suggestive of Central Sleep Apnea (CSA), 16(40%) endorsed snoring, suggestive of Obstructive Sleep Apnea, and 16(22%) endorsed leg twitching, possibly indicative of Restless Leg Syndrome. Conclusion This study highlights the prevalence of sleep problems as a salient issue among mTBI patients. The FITBIR is a valuable tool to further TBI research. Future studies should examine the temporal trajectory of sleep problems and its relationship to other outcomes and include more diverse samples.

Apnoea suppresses brain activity in infants

Abstract Apnoea—the cessation of breathing—is commonly observed in premature infants. These events can reduce cerebral oxygenation and are associated with poorer neurodevelopmental outcomes. However, relatively little is known about how apnoea and shorter pauses in breathing impact brain function in infants, which will provide greater mechanistic understanding of how apnoea affects brain development. We analysed simultaneous recordings of respiration, electroencephalography (EEG), heart rate, and peripheral oxygen saturation in 124 recordings from 118 infants (post-menstrual age: 38.6 ± 2.7 weeks [mean ± standard deviation]) during apnoeas (pauses in breathing greater than 15 seconds) and shorter breathing pauses between 5 and 15 seconds. EEG amplitude significantly decreased during both apnoeas and short breathing pauses compared with normal breathing periods. Change in EEG amplitude was significantly associated with change in heart rate during apnoea and short breathing pauses and, during apnoeas only, with oxygen saturation change. No associations were found between EEG amplitude changes and apnoea/pause duration, post-menstrual age, or sleep state. As apnoeas often occur in premature infants, frequent disruption to brain activity may impact neural development and result in long-term neurodevelopmental consequences.

The Effect of Static Apnea Diving Training on the Physiological Parameters of People with a Sports Orientation and Sedentary Participants: A Pilot Study.

Diver training improves physical and mental fitness, which can also benefit other sports. This study investigates the effect of eight weeks of static apnea training on maximum apnea time, and on the physiological parameters of runners, swimmers, and sedentary participants, such as forced vital capacity (FVC), minimum heart rate (HR), and oxygen saturation (SpO2). The study followed 19 participants, including five runners, swimmers, sedentary participants, and four competitive divers for reference values. The minimum value of SpO2, HR, maximum duration of apnea, and FVC were measured. Apnea training occurred four times weekly, consisting of six apneas with 60 s breathing pauses. Apnea duration was gradually increased by 30 s. The measurement started with a 30 s apnea and ended with maximal apnea. There was a change in SpO2 decreased by 6.8%, maximum apnea length increased by 15.8%, HR decreased by 9.1%, and FVC increased by 12.4% for the groups (p < 0.05). There were intra-groups changes, but no significant inter-groups difference was observed. Eight weeks of apnea training improved the maximum duration of apnea, FVC values and reduced the minimum values of SpO2 and HR in all groups. No differences were noted between groups after training. This training may benefit cardiorespiratory parameters in the population.

Persistent and symptomatic periodic breathing beyond the neonatal period in full-term infants: A case series

IntroductionPeriodic breathing (PB) is considered physiological in the neonatal period and usually disappears in the first months of life. There are few data available on persistent PB after the neonatal period. The objective of this study was to characterize infants born at term with persistent PB after the age of 1 month through polysomnography (PSG) performed during symptoms. MethodsThis retrospective case series included infants born at term between 2012 and 2021, without an underlying disease, who presented with symptoms of persistent PB during a PSG. Persistent PB was defined as more than 1 % of total sleep time (TST) of PB after 1 month of life, and PB was defined as a succession of at least three episodes of central apnea lasting more than 3 s and separated by less than 20 s of normal breathing. ResultsA total of 10 infants born at term were included. They underwent PSG for brief resolved unexplained events, desaturation, pauses in breathing, cyanosis, and/or signs of respiratory distress. The percentage of TST spent with PB was 18.1 % before 3 months of age (n = 7), and 4.7 % between 3 and 6 months of age (n = 10). During the first PSG, ≥3 % of desaturation events were observed in 77–100 % of the PB episodes. At the first PSG, nine of the 10 infants had an obstructive apnea–hypopnea index of >10/h and five of 10 infants had a central apnea index of >5/h. Gastroesophageal reflux (GER) was suspected in eight infants. All infants showed improvement in the initial symptoms during the first year of life. ConclusionThis study presents cases of persistent and symptomatic PB after 1 month of life in infants born at term. The interesting finding was the presence of obstructive sleep apnea syndrome and/or central apnea syndrome in the majority of children, along with GER.

Urdu fillers used by English teachers in ESL classrooms

Pakistan is a bilingual country with nine major and 68 minor languages. It is quite common for English language teachers to use their first language (L1) in their second language (L2) classrooms which is called code switching. This predominant practice of code switching can serve as a filler to ensure the continuity of an interaction or fill a communication gap. Hence, this paper aims to describe the different kinds and purposes of Urdu fillers that three English as a second language (ESL) teachers from Pakistan use when teaching students in ESL courses at the university level. The data consists of four classroom recordings of each teacher’s lectures which have been transcribed for qualitative analysis. The overall findings showed that ESL teachers produced more lexicalized filled pauses than non-lexicalized filled ones in Urdu. The lexicalized filled pauses served as an editing tool, a response marker, an opening frame marker, an empathizer, a time-creating device or a positive reaction. On the other hand, the non-lexicalized filled pauses were used as reaction marker, hesitation marker, device for keeping the floor, device while searching for a word or breathing pause. Hence, this study suggests the importance of fillers as a language teaching and learning tool.

A Prospective Study of Role of Functional MRI in Suspects of Obstructive Sleep Apnea.

Obstructive sleep apnea (OSA) syndrome, characterized by daytime impairment, affects approximately 1 in 20 adults and can lead to a range of behavioral and cardiovascular abnormalities. Understanding the underlying causes and identifying the specific obstructions within the upper airway is crucial for effective management of this condition. Sleep MRI has emerged as a valuable tool in accurately diagnosing OSA by providing detailed insights into the level, magnitude, and type of obstruction present in affected individuals. One of the key observations made through sleep MRI studies is the increased collapsibility of the velopharynx in apneic patients, particularly during sleep. This heightened collapsibility predisposes the airway to occlusion, contributing to the repetitive breathing pauses characteristic of OSA. By visualizing the dimensions and configurations of the upper airway during both wakefulness and sleep, sleep MRI enables clinicians to pinpoint structural and dynamic factors that play a role in the development and progression of OSA. Moreover, the information gleaned from sleep MRI scans can inform the development of personalized treatment strategies for OSA patients. By identifying specific anatomical abnormalities and dynamic changes in the upper airway, clinicians can tailor interventions such as continuous positive airway pressure (CPAP), oral appliances, or surgical procedures to address the underlying causes of obstruction more effectively. Sleep MRI serves as a powerful diagnostic tool in the management of OSA, offering detailed anatomical and functional insights that guide treatment planning and optimization. Its ability to uncover structural and dynamic factors contributing to airway obstruction enhances our understanding of OSA pathophysiology and facilitates targeted therapeutic interventions aimed at improving patient outcomes and quality of life.

Automatic detection of obstructive sleep apnea based on speech or snoring sounds: a narrative review.

Obstructive sleep apnea (OSA) is a common chronic disorder characterized by repeated breathing pauses during sleep caused by upper airway narrowing or collapse. The gold standard for OSA diagnosis is the polysomnography test, which is time consuming, expensive, and invasive. In recent years, more cost-effective approaches for OSA detection based in predictive value of speech and snoring has emerged. In this paper, we offer a comprehensive summary of current research progress on the applications of speech or snoring sounds for the automatic detection of OSA and discuss the key challenges that need to be overcome for future research into this novel approach. PubMed, IEEE Xplore, and Web of Science databases were searched with related keywords. Literature published between 1989 and 2022 examining the potential of using speech or snoring sounds for automated OSA detection was reviewed. Speech and snoring sounds contain a large amount of information about OSA, and they have been extensively studied in the automatic screening of OSA. By importing features extracted from speech and snoring sounds into artificial intelligence models, clinicians can automatically screen for OSA. Features such as formant, linear prediction cepstral coefficients, mel-frequency cepstral coefficients, and artificial intelligence algorithms including support vector machines, Gaussian mixture model, and hidden Markov models have been extensively studied for the detection of OSA. Due to the significant advantages of noninvasive, low-cost, and contactless data collection, an automatic approach based on speech or snoring sounds seems to be a promising tool for the detection of OSA.

The Effectiveness of Continuous Positive Airway Pressure for Treating Obstructive Sleep Apnoea in Pregnancy: A Systematic Review

(Aust N Z J Obstet Gynaecol 2023. 2023;63(3):290–300) Obstructive sleep apnea (OSA) is characterized by recurrent pauses in breathing during sleep due to upper airway collapse, resulting in decreased oxygen levels. OSA affects around 10.5% of parturients during early pregnancy and up to 30% at term. In pregnancy, OSA is associated with an increased risk for gestational hypertension, pre-eclampsia, and gestational diabetes. Infants born to mothers with OSA may have a lower birth weight and are at increased risk for premature delivery and neonatal intensive care unit admission. Baseline obesity increases the risk of OSA during pregnancy, with lifestyle modifications being the standard treatment, though their influence on maternal outcomes is limited. Continuous positive airway pressure (CPAP) is an effective OSA treatment; however, little research exists on the impact of CPAP on either maternal or fetal outcomes. This systematic review sought to investigate if the use of CPAP improved outcomes for pregnant women with or at risk of OSA.

Challenging Case: A Multidisciplinary Approach to Demystifying Chronic Sleep Impairment in an Infant with a Complex Medical and Behavioral Profile.

Challenging Case: A Multidisciplinary Approach to Demystifying Chronic Sleep Impairment in an Infant with a Complex Medical and Behavioral Profile.

Principles and Techniques of Apnoea Resuscitation: The Critical Importance of Prompt and Effective Intervention in Managing Respiratory Distress in Neonates - A Review

Neonatal apnea, characterized by pauses in breathing lasting more than 20 seconds, is common in preterm infants due to immature respiratory control mechanisms, posing risks such as hypoxemia and bradycardia, which can impact neurological development. This review underscores the critical need for prompt and effective intervention, ranging from non-invasive techniques like tactile stimulation to advanced methods such as positive pressure ventilation and endotracheal intubation. Despite progress, research gaps remain in optimizing non-pharmacological and pharmacological treatments, highlighting the necessity for standardized training, updated guidelines, and multidisciplinary approaches. Continuous monitoring, post-event reflection, and ongoing research are essential to improve outcomes for these vulnerable patients.

Validation of Trøndelag Apnoea Score Proxy for Obstructive Sleep Apnoea in the General Population of Norway: The HUNT Study.

The aim was to validate a new seven-item "TASC" (Trøndelag Apnoea Score) proxy for obstructive sleep apnoea (OSA) against polysomnography in the general population. Objectives included validation against different polysomnographic criteria, stratification by age and gender, and estimation of OSA prevalence. From the fourth wave of the Trøndelag Health Study (HUNT4), 1,201 participants were randomly invited to a substudy focusing on sleep and headaches, of whom 232 accepted and 84 (64% women, mean age 55.0 years, and standard deviation 11.5 years) underwent polysomnography. The TASC proxy sums seven binary items for snoring, observed breathing pauses, restricted daytime activities, hypertension, body mass index (≥30 kg/m2), age (≥50 years), and gender (male). A single night of ambulatory (home) polysomnography was analysed using both the recommended and optional hypopnoea criteria of the American Academy of Sleep Medicine (AASM). We found 65% sensitivity and 87% specificity (Cohen's κ = 0.53, 95% confidence interval 0.34-0.72) for TASC ≥ 3 against AHI ≥ 15 (recommended AASM criteria). Validity was similar against AHI ≥ 30 but lower against AHI ≥ 5 and against the optional AASM criteria. Sensitivity and overall validity were higher among men and those above 50 years of age. The prevalence of an apnoea-hypopnoea index (AHI) of at least 5, 15, or 30 using the recommended (and optional) AASM criteria was 73% (46%), 37% (18%), or 15% (5%). A seven-item TASC proxy for OSA showed good validity and may be useful in screening and epidemiological settings. Sensitivity, specificity, and validity vary considerably by cut-off, by polysomnographic scoring criteria, and by gender and age strata.

Proportion and Factors Associated Obstructive Sleep Apnoea (OSA) Risk Among Adults in Sepang: A Cross-sectional Study

Introduction: Sleep is often viewed by the general public as a “perceptual hole in time” where it is the period in which nothing productive occurs. However, sleep is an important part of health which affects mental and physical health. Sleep-disordered breathing (SDB) encompasses a range of respiratory disorders that are distinguished by intermittent pauses in breathing during the sleep cycle. This includes obstructive sleep apnoea (OSA), a global disease with a rising incidence along with its comorbidity. OSA creates an impact on the quality of life as it is associated with multiple negative implications which include neurocognitive problems and increases the risk of cardiometabolic diseases. This article illustrates the importance to determine the proportion of patients in the district of Sepang who are at high risk of obstructive sleep apnoea (OSA) and its determinants. Method: A cross-sectional study was carried out among individuals aged 18 years and above in Sepang district Malaysia. Using systematic random sampling, 521 participants were recruited. The questionnaire given gathered respondents information regarding their socio-demography, clinical profiles, and the STOP-BANG questionnaire was used to screen for OSA. Result: Almost a third of the participants (30.3%) were at risk of having OSA. It is found that the predictors for having OSA are menopausal women (AOR: 2.46; 95% CI: 1.22, 4.93; p = 0.011) and having large waist circumference measurement (AOR: 1.07; 95% CI: 1.04,1.10; p &lt;0.001). Conclusion: The findings in this study will help healthcare workers to detect early patients at risk of OSA with the aid of STOP-BANG questionnaire.

Advancements in Home-Based Devices for Detecting Obstructive Sleep Apnea: A Comprehensive Study

Obstructive Sleep Apnea (OSA) is a respiratory disorder characterized by frequent breathing pauses during sleep. The apnea–hypopnea index is a measure used to assess the severity of sleep apnea and the hourly rate of respiratory events. Despite numerous commercial devices available for apnea diagnosis and early detection, accessibility remains challenging for the general population, leading to lengthy wait times in sleep clinics. Consequently, research on monitoring and predicting OSA has surged. This comprehensive paper reviews devices, emphasizing distinctions among representative apnea devices and technologies for home detection of OSA. The collected articles are analyzed to present a clear discussion. Each article is evaluated according to diagnostic elements, the implemented automation level, and the derived level of evidence and quality rating. The findings indicate that the critical variables for monitoring sleep behavior include oxygen saturation (oximetry), body position, respiratory effort, and respiratory flow. Also, the prevalent trend is the development of level IV devices, measuring one or two signals and supported by prediction software. Noteworthy methods showcasing optimal results involve neural networks, deep learning, and regression modeling, achieving an accuracy of approximately 99%.

Predictive Power of XGBoost_BiLSTM Model: A Machine-Learning Approach for Accurate Sleep Apnea Detection Using Electronic Health Data

Sleep apnea is a common disorder that can cause pauses in breathing and can last from a few seconds to several minutes, as well as shallow breathing or complete cessation of breathing. Obstructive sleep apnea is strongly associated with the risk of developing several heart diseases, including coronary heart disease, heart attack, heart failure, and stroke. In addition, obstructive sleep apnea increases the risk of developing irregular heartbeats (arrhythmias), which can lead to low blood pressure. To prevent these conditions, this study presents a novel machine-learning (ML) model for predicting sleep apnea based on electronic health data that provides accurate predictions and helps in identifying the risk factors that contribute to the development of sleep apnea. The dataset used in the study includes 75 features and 10,765 samples from the Swedish National Study on Aging and Care (SNAC). The proposed model is based on two modules: the XGBoost module assesses the most important features from feature space, while the Bidirectional Long Short-Term Memory Networks (BiLSTM) module classifies the probability of sleep apnea. Using a cross-validation scheme, the proposed XGBoost_BiLSTM algorithm achieves an accuracy of 97% while using only the six most significant features from the dataset. The model’s performance is also compared with conventional long-short-term memory networks (LSTM) and other state-of-the-art ML models. The results of the study suggest that the proposed model improved the diagnosis and treatment of sleep apnea by identifying the risk factors.

Differences in the swallowing process of newborns and healthy preterm infants: first results with a non-invasive bioimpedance and electromyography measurement system

PurposePreterm infants (PI) have difficulty coordinating sucking, swallowing and breathing, and there is a risk of aspiration. The causes of this are not yet sufficiently understood. The aim of this study was to test a novel measurement device to measure breathing and pharyngeal processes involved in swallowing externally in everyday life to identify possible differences in neonates (NB) and PI.MethodsForty healthy NB were studied at 4–8 weeks of age (mean: 6.7 weeks) and 20 healthy PI (mean gestational age 30.5 weeks) at postmenstrual age (PMA) 34/35 weeks (mean PMA 35.1 weeks) during a single feeding. Surface electrodes were used to measure bioimpedance and electromyography reflecting swallow-related changes in the pharynx and muscle activation of the tongue and submental muscles. A respiratory belt was combined with recording of the depth of chest movements and the occurrence of pauses in breathing.ResultsVelocity and extent of pharyngeal closure did not differ significantly across the feeding period (velocity: p=0.09, closure: p=0.17), but during the first two suck–swallow bursts PI had greater velocity (p<0.001*) and extent of pharyngeal closure (p=0.004*) than NB. The duration of swallowing phases was significantly longer in PIs (p<0.001*), their muscle activation decreased faster (p<0.001*), and they had more pauses in breathing than NBs.ConclusionsThe novel measurement device allowed, for the first time in everyday life, the measurement of factors influencing swallowing and breath–swallow coordination in NBs and PIs. PIs showed differences from NBs most likely due to differences in muscle strength and condition.

Association of Birthplace for Sleep Duration, Sleep Quality, and Sleep Disorder Symptoms, at the US–Mexico Border

ABSTRACT Objectives The present study investigated the roles birthplace and acculturation play in sleep estimates among Hispanic/Latino population at the US–Mexico border. Measures Data were collected in 2016, from N = 100 adults of Mexican descent from the city of Nogales, AZ, at the US–Mexico border. Sleep was assessed with the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index categorized as none, mild, moderate, and severe, and Multivariable Apnea Prediction Index (MAP) categorized as never, infrequently, and frequently. Acculturation was measured with the Acculturation Rating Scale for Mexican-Americans II (ARSMA-II). Results The sample consisted of majority Mexican-born (66%, vs. born in the USA 38.2%). Being born in the USA was associated with 55 fewer minutes of nighttime sleep (p = .011), and 1.65 greater PSQI score (p = .031). Compared to no symptoms, being born in the USA was associated with greater likelihood of severe difficulty falling asleep (OR = 8.3, p = .030) and severe difficulty staying asleep (OR = 11.2, p = .050), as well as decreased likelihood of breathing pauses during sleep (OR = 0.18, P = .020). These relationships remained significant after Mexican acculturation was entered in these models. However, greater Anglo acculturation appears to mediate one fewer hour of sleep per night, poorer sleep quality, and reporting of severe difficulty falling asleep and staying asleep. Conclusions Among individuals of Mexican descent, being born in the USA (vs Mexico) is associated with about 1 hour less sleep per night, worse sleep quality, more insomnia symptoms, and less mild sleep apnea symptoms. These relationships are influenced by acculturation, primarily the degree of Anglo rather than the degree of Mexican acculturation.

Sleep apnea syndrome associated with gonadal hormone imbalance (Review).

Patients with obstructive sleep apnea exhibit an increased risk of developing gonadal disorders. Because a notable number of people worldwide have sleep respiratory and reproductive disorders, it is essential to recognize the association between local upper airway dysfunction and its gonadal effects. Repeated breathing pauses cause sleep fragmentation, disorganization of sleep cycles and stages, sympathetic activation, intermittent hypoxemia and systemic inflammation. Nocturnal intermittent hypoxemia has a direct central effect on neurotransmitters, with disturbances in the normal production of hypothalamic-pituitary hormones. Awakenings and micro-awakenings at the end of apneic episodes produce a central stress responsible for hormonal changes and subsequent endocrine imbalances. The aim of the present study was to investigate the impact of obstructive sleep apnea syndrome (OSAS) on gonadal hormonal homeostasis and its consequences. Recognizing and understanding how local upper airway dysfunction causes gonadal imbalance may facilitate better care for patients with OSAS. Although there may be a direct relationship between sleep-disordered breathing and gonadal function mediated by hormones via the hypothalamic-pituitary-gonadal axis, to date, current therapies have not been effective.

STUDY ON SOME ANTHROPOMETRIC CHARACTERISTICS AND LEARNING OUTCOMES OF THE SECOND YEAR MEDICAL STUDENTS WITH OBSTRUCTIVE SLEEP APNEA RISK AT CAN THO UNIVERSITY OF MEDICINE AND PHARMACY

Background: Obstructive sleep apnea (OSA) is a condition characterized by repeated pauses in breathing during sleep, which is frequently accompanied by snoring, daytime sleepiness, and decreased concentration. Several scales, including the STOP-BANG and EPWORTH scores, have been developed to screen people at high risk for OSA. There have been few studies on both OSA risk and anthropometric characteristics, academic performance in student populations, particularly medical students. Objectives: (1) Determine the proportion of medical students at risk of OSA based on STOP-BANG score, EPWORTH score, and their academic performance; and (2) Survey the association between some anthropometric characteristics, STOP-BANG score, daytime sleepiness, and poor academic performance of second-year medical students. Materials and method: A descriptive cross-sectional study was conducted on 565 second-year medical students at Can Tho University of Medicine and Pharmacy. Results: Our study included 565 students, 44.4% of whom were male. The average BMI was 21.0 kg/m2, the mean neck circumference was 32.9 cm, the mean waist circumference was 73.2 cm, the mean waist/hip ratio was 0.80, the mean systolic blood pressure was 116.2 mmHg, the mean diastolic blood pressure was 67.8 mmHg. The percentage of students at risk of OSA based on STOP-BANG scores was 13.5%, and 58.4% based on EPWORTH scores. Smoking affects 0.9% of students, hypertension affects 2.7%, snoring affects 16.6%, average sleep time is 6.59 hours, and poor academic performance affects 4.4%. According to the STOP-BANG transcript, the percentage of students with poor academic performance (&lt;2.5) in the group at risk of OSA was higher than in the group without the risk of OSA (10.5% versus 3.5%, χ2=7.730, p=0.012). According to the EPWORTH score, the proportion of students with poor academic performance (&lt;2.5) in the group at risk of OSA was lower than in the group without the risk of OSA (χ2=5.406, p=0.02). In multivariable logistic regression analysis, BMI ≥ 23kg/m2 was a risk factor for poor academic results (OR=2.5, p=0.043), while daytime sleepiness was a protective factor for poor academic results (OR = 0.384, p = 0.024). Conclusions: The percentage of students at risk of OSA based on STOP-BANG scores was 13.5%, and 58.4% based on EPWORTH scores. Second-year medical students at Can Tho University of Medicine and Pharmacy who are at risk of OSA according to STOP-BANG score have lower academic performance. Poor academic results were associated with BMI ≥ 23kg/m2.

Positional Therapy for Obstructive Sleep Apnea: Therapeutic Modalities and Clinical Effects

Obstructive sleep apnea (OSA) is characterized by recurrent occurrences of partial or complete collapse of the upper airway during sleep, leading to shallow breathing or breathing pauses. These repeated breathing disruptions can result in intermittent hypoxia, hypercapnia, hyperactivity of the sympathetic nervous system, and fragmented sleep patterns. Left untreated, OSA can have significant health implications, including various symptoms and serious consequences. Positional OSA is a subtype of OSA where during sleep, the severity of apnea events is significantly higher in the supine position. This condition can worsen respiratory parameters, such as apnea/hypopnea events, oxygen desaturation and arousals, and cardiovascular burdens. Positional therapy is a treatment approach used for patients with positional OSA. Typically, positional therapy involves encouraging the patient to avoid sleeping on their back, and instead sleep in a lateral position. Various modalities for positional therapy exist, including positional training using a tennis ball, alarm, or vest, and sleep positioning pillows. Novel electric-operated postural devices have also been developed. Positional therapy has shown promise in improving apneic events and lowest oxygen saturation in patients with position-dependent sleep apnea. In comparison to positive airway pressure treatment, positional therapy has been reported to demonstrate non-inferior effects, while achieving better compliance. Consequently, positional therapy can be a cost-effective and non-invasive therapeutic alternative for managing positional OSA.