Predictors Of Obstructive Sleep Apnea Research Articles

Correlation between obstructive sleep apnea and weight-adjusted-waist index: a cross-sectional study

BackgroundObesity is recognized as a prominent factor in the pathogenesis of obstructive sleep apnea (OSA). The weight-adjusted-waist index (WWI) has emerged as a novel metric for assessing adiposity. The study aimed to investigate the potential correlation between WWI and OSA.MethodsIn this study, a cross-sectional analysis was conducted on the data from the National Health and Nutrition Examination Survey (NHANES) during the period from 2013 to 2020. To examine the correlation between WWI and OSA, multivariate logistic regression, smooth curve fitting, subgroup analysis and receiver operating characteristic (ROC) curve were employed.ResultsAmong the total 18,080 participants, 9,050 were categorized as having OSA. It was observed that as the quartile range of WWI increased, there was a gradual rise in the prevalence of OSA (37.4% vs. 50.3% vs. 55.1% vs. 57.5%, p < 0.001). Logistic regression analyses demonstrated a significant positive correlation between WWI and the risk of OSA, even after accounting for potential confounders (OR = 1.314, 95% = 1.223, 1.411). Subgroup analysis further revealed a stronger correlation between OSA and WWI among individuals with normal weight, those under 50 years old, and those engaging in moderate physical activities. Smooth curve fitting identified a positive non-linear correlation, with an inflection point at 11.678. ROC analysis indicated that WWI (AUC = 0.664) can serve as a more robust predictor for OSA compared to BMI and waist circumference.ConclusionThis study provides evidence that elevated levels of WWI are correlated with an increased risk of OSA, indicating the potential utility as predictive indicators for OSA.

P196 UNVEILING THE LINK BETWEEN ISOLATED NOCTURNAL ARTERIAL HYPERTENSION AND OBSTRUCTIVE SLEEP APNEA

Background and Objective: Isolated nocturnal hypertension (INH), characterized by elevated nighttime blood pressure alongside normal daytime readings, often correlates with obstructive sleep apnea (OSA). However, understanding this association remains limited. This study aims to elucidate the relationship between OSA and INH, facilitating early interventions and optimizing patient outcomes. Methods: A convenience sample of patients diagnosed with INH via ambulatory blood pressure monitoring (ABPM), regardless of prior hypertension diagnosis, was included. Polysomnography assessed the presence of OSA. Patient demographics were analyzed, and OSA patterns within this cohort were described. Results: Forty-three participants with an average age of 60.6±13.54 were enrolled, comprising 30 individuals with hypertension and 13 without hypertension, with 24 males and 19 females included in the analysis. Polysomnography findings revealed obstructive sleep apnea (OSA) in 97.64% of participants (n=42) across all severity levels. Specifically, severe OSA was observed in 10 subjects, moderate in 20, and mild in 12. Interestingly, the distribution of OSA severity was similar between hypertensive and non-hypertensive subjects. Conclusions: This study found a close correlation between nocturnal arterial hypertension and the presence of obstructive sleep apnea in both hypertensive and non-hypertensive subjects. Therefore, INH is a strong predictor of OSA, and it could be better than other predictive tests.

Clinical predictors of obstructive sleep apnea among residents of Sagamu local government area of Ogun State

BackgroundObstructive sleep apnea (OSA) is the most commonly diagnosed sleep-associated pulmonary disorder in the world. So many risk factors have been attributed to OSA; however, conflicting results exist on how these factors contribute to OSA.PurposeThis study hypothesized that increasing the number of risk factors for OSA, as reflected in the STOP-BANG questionnaire, increases the probability of having OSA but also increases the likelihood of having other severe diseases such as hypertension in a Nigerian population and that the severity of OSA might be dependent on specific anthropometric indices.MethodsThis study involved 110 male and female residents of Sagamu Local Government Area of Ogun State. Data was collected using a standardized instrument and the STOP-BANG questionnaire. Analysis involved descriptive statistics, parametric test of independent t-test to characterize data based on gender, and multinomial regressions to determine predictive factors of the various parameters of study on the severity of OSA.ResultsThe association of the male gender with higher risk of OSA was confirmed by this study. Diastolic blood pressure (DBP) and heart rate (HR) predicted the risk of OSA, with an increase in DBP and HR implying higher risk of OSA. Of the anthropometric tests examined in this study, body mass index (BMI), neck circumference (NC), and neck height ratio (NHtR) predicted the risk of OSA in comparing low risk and medium risk to high risk, an increase in BMI and NC implying a higher risk of OSA while an increase in NHtR implying a lower risk of OSA.

Association between the triglyceride glucose index and obstructive sleep apnea and its symptoms: results from the NHANES

BackgroundCertain studies have indicated a link between obstructive sleep apnea and insulin resistance in specific populations. To gain more clarity, extensive research involving a broad sample of the overall population is essential. The primary objective of this study was to investigate this correlation by utilizing data from the National Health and Nutrition Examination Survey database.MethodsThe analysis incorporated data from the National Health and Nutrition Examination Survey database spanning the time periods from 2005 to 2008 and from 2015 to 2018, with a focus on American adults aged 18 years and older after applying weight adjustments. Key variables such as obstructive sleep apnea, triglyceride glucose index, and various confounding factors were considered. A generalized linear logistic regression model was used to investigate the association between obstructive sleep apnea and the triglyceride glucose index, with additional exploration of the consistency of the results through hierarchical analysis and other techniques.ResultsThe study included participants aged between 18 and 90 years, with an average age of 46.75 years. Among the total sample, 50.76% were male. The triglyceride glucose index demonstrated a diagnostic capability for obstructive sleep apnea, with an AUC of 0.701 (95% CI: 0.6619–0.688). According to the fully adjusted model, individuals in the fourth quartile of the triglyceride glucose index showed an increased likelihood of having obstructive sleep apnea compared to those in the first quartile (OR: 1.45; 95% CI: 1.02–2.06; P < 0.05). Subgroup analysis indicated that male sex (OR: 2.09; 95% CI: 1.76–2.45; P < 0.05), younger age (OR: 2.83; 95% CI: 2.02–3.96; P < 0.05), white ethnicity (OR: 2.29; 95% CI: 1.93–2.73; P < 0.05), and obesity (OR: 1.54; 95% CI: 1.28–1.85; P < 0.05) were correlated with an elevated risk of OSA.ConclusionsThis study demonstrated a strong association between an elevated TG index and OSA. Additionally, the triglyceride glucose index could serve as an independent predictor of obstructive sleep apnea.

A Machine Learning Prediction Model of Adult Obstructive Sleep Apnea Based on Systematically Evaluated Common Clinical Biochemical Indicators.

Obstructive sleep apnea (OSA) is a common and potentially fatal sleep disorder. The purpose of this study was to construct an objective and easy-to-promote model based on common clinical biochemical indicators and demographic data for OSA screening. The study collected the clinical data of patients who were referred to the Sleep Medicine Center of the Second Affiliated Hospital of Fujian Medical University from December 1, 2020, to July 31, 2023, including data for demographics, polysomnography (PSG), and 30 biochemical indicators. Univariate and multivariate analyses were performed to compare the differences between groups, and the Boruta method was used to analyze the importance of the predictors. We selected and compared 10 predictors using 4 machine learning algorithms which were "Gaussian Naive Bayes (GNB)", "Support Vector Machine (SVM)", "K Neighbors Classifier (KNN)", and "Logistic Regression (LR)". Finally, the optimal algorithm was selected to construct the final prediction model. Among all the predictors of OSA, body mass index (BMI) showed the best predictive efficacy with an area under the receiver operating characteristic curve (AUC) = 0.699; among the predictors of biochemical indicators, triglyceride-glucose (TyG) index represented the best predictive performance (AUC = 0.656). The LR algorithm outperformed the 4 established machine learning (ML) algorithms, with an AUC (F1 score) of 0.794 (0.841), 0.777 (0.827), and 0.732 (0.788) in the training, validation, and testing cohorts, respectively. We have constructed an efficient OSA screening tool. The introduction of biochemical indicators in ML-based prediction models can provide a reference for clinicians in determining whether patients with suspected OSA need PSG.

Early life predictors of obstructive sleep apnoea in young adults: Insights from a longitudinal community cohort (Raine Study)

Early life predictors of obstructive sleep apnoea in young adults: Insights from a longitudinal community cohort (Raine Study)

Cheeks appearance as a novel predictor of obstructive sleep apnea: the CASA score study.

Four well-established predictors of obstructive sleep apnea (OSA) risk are body mass index, age, sex, and neck circumference. We have previously reported cheeks appearance as an OSA predictor, which may represent a combination of such predictors in a single, readily available feature. This study sought to answer the question: Is cheeks appearance an OSA risk predictor? This was a prospective cross-sectional diagnostic accuracy study based on STARD (standards for reporting diagnostic accuracy studies). Patients undergoing polysomnography to investigate sleep complaints at a sleep clinic affiliated with a university hospital were assessed using cheeks appearance scored 0-3 for volume and 0-3 for flaccidity to create the Cheeks Appearance for Sleep Apnea (CASA) score ranging from 0 to 6. Appearance was judged by 3 blinded and independent evaluators. Among 265 patients evaluated, 248 were included. Fifty-seven patients had a CASA score of 0 and 191 had a CASA score between 1 and 6. Polysomnography diagnosed 177 of the individuals with OSA; of these, 167 had an altered CASA score. Sensitivity was 87%, specificity was 82%, positive-predictive value was 94%, negative-predictive value was 66%, and accuracy was 86%. Our results suggest that combining volume and flaccidity of cheeks appearance in a single index may constitute a reliable OSA predictor. CASA score is a novel predictor of OSA with internal validity in a sleep laboratory adult population. Our findings support further studies to confirm the external validity of this practical diagnostic tool. Registry: ClinicalTrials.gov; Name: Cheeks Appearance as a Novel Predictor of Obstructive Sleep Apnea: The CASA Score Study (CASA); URL: https://clinicaltrials.gov/study/NCT04980586; Identifier: NCT04980586. Prikladnicki A, Gomes E, Sousa LCCR, Gonçalves SC, Martinez D. Cheeks appearance as a novel predictor of obstructive sleep apnea: the CASA score study. J Clin Sleep Med. 2024;20(6):879-885.

Cut-off points of neck and waist circumference as predictors of obstructive sleep apnea in the Colombian population: a comparison with polysomnography.

Neck circumference (NC) is a useful anthropometric measure for predicting obstructive sleep apnea (OSA). Ethnicity and sex also influence obesity phenotypes. NC cut-offs for defining OSA have not been established for the Latin American population. To evaluate NC, waist circumference (WC), and body mass index (BMI) as predictors of OSA in the Colombian population and to determine optimal cut-off points. Diagnostic tests were conducted at the Javeriana University, Bogota. Adults from three cities in Colombia were included. NC, WC, and BMI were measured, and a polysomnogram provided the reference standard. The discrimination capacity and best cut-off points for diagnosing OSA were calculated. 964 patients were included (57.7% men; median age, 58 years) and 43.4% had OSA. The discrimination capacity of NC was similar for men and women (area under curve, AUC 0.63 versus 0.66, P=0.39) but better for women under 60 years old (AUC 0.69 versus 0.57, P<0.05). WC had better discrimination capacity for women (AUC 0.69 versus 0.57, P<0.001). There were no significant differences in BMI. Optimal NC cut-off points were 36.5cm for women (sensitivity [S]: 71.7%, specificity [E]: 55.3%) and 41 cm for men (S: 56%, E: 62%); and for WC, 97 cm for women (S: 65%, E: 69%) and 99 cm for men (S: 53%, E: 58%). NC and WC have moderate discrimination capacities for diagnosing OSA. The cut-off values suggest differences between Latin- and North American as well as Asian populations.

Predictors of obstructive sleep apnea in patients with chronic obstructive pulmonary disease

BackgroundThe co-existence of chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) is known as overlap syndrome, and both conditions share common risk factors and are associated with co-morbidities and poor outcomes.MethodologySixty stable COPD patients were included in the study. We assessed body measurements, pulmonary functions to diagnose and assess COPD severity, arterial blood gases, STOB-BANG questionnaire (SBQ), Epworth sleepiness scale (ESS), and polysomnography (PSG) for diagnosis and classification of OSA severity. The aim of the study is to assess predictors of OSA among COPD patients.ResultsThe prevalence of overlap syndrome was 70% among studied stable COPD patients, with a male-to-female ratio of 2:1, and SBQ and ESS were statistically higher in overlap syndrome with p values < 0.001 and 0.002, respectively. Oxygen desaturation index (ODI) was 42.72 ± 30.02 for overlap in comparison to 13.18 ± 5.80 for COPD with a significant p value of < 0.001, and T90 was significantly increased in the overlap group (26.75 ± 10.37) than the COPD-only group (1.8 ± 0.98, p value ≤ 0.001). We found a direct correlation between the GOLD stage and severity of OSA in overlap syndrome. The best cutoff value for the detection of overlap syndrome was ESS = 9 (sensitivity = 88.6% and specificity = 62.5%) and SBQ = 5 (sensitivity = 63.6% and specificity = 93.8%).ConclusionOverlap syndrome represents 70% of stable COPD patients. A direct relation was found between the GOLD stage and OSA severity in overlap syndrome. ESS and SBQ can be used for screening for OSA in COPD patients but with a lower cutoff value than those used for the general population.Trial registrationRetrospectively registered, registration number is NCT05605431, date of registration October 29, 2022.

Long-term outcomes of sphincter pharyngoplasty in patients with cleft palate

The purpose of this study was to evaluate long-term outcomes of sphincter pharyngoplasties, including speech outcomes, revision surgeries, and postoperative incidence of obstructive sleep apnea (OSA). Retrospective matched-cohort study SETTING: Two craniofacial centers in Los Angeles, CA PATIENTS: Patients (n=166) with cleft lip and palate (CLP) or isolated cleft palate (iCP) who underwent sphincter pharyngoplasty from 1992 to 2022 were identified. An age- and diagnosis-matched control group of 67 patients with CLP/iCP without velopharyngeal insufficiency (VPI) was also identified. The pharyngoplasty group underwent sphincter pharyngoplasty, whereas the non-VPI group had no history of VPI surgery or sphincter pharyngoplasty. Postoperative speech outcomes, revision surgeries, and incidence of OSA were evaluated. Multivariable regression was used to evaluate independent predictors of OSA. Among the patients in the pharyngoplasty cohort, 63.9% demonstrated improved and sustained speech outcomes after a single pharyngoplasty, with a median postoperative follow-up of 8.8 years (interquartile range [IQR], 3.6-12.0 years). One-third of the patients who underwent pharyngoplasty required a revision surgery, with a median time to primary revision of 3.9 years (IQR, 1.9-7.0 years). OSA rates increased significantly among the pharyngoplasty cohort, from 3% before surgery to 14.5% after surgery (p<0.001). The average time from sphincter pharyngoplasty to OSA diagnosis was 4.4±2.4 years. Multivariable analysis results indicated that sphincter pharyngoplasty surgery was independently associated with a fourfold increase in OSA (p=0.03). Although sphincter pharyngoplasty remains successful in improving long-term speech outcomes, persistent OSA is a sequela that should be monitored beyond the immediate postoperative period.

A nationwide study on the prevalence and contributing factors of obstructive sleep apnea in Iran

Reliable obstructive sleep apnea (OSA) prevalence information in Iran is lacking due to inconsistent local study results. To estimate OSA prevalence and identify clinical phenotypes, we conducted a nationally representative study using multi-stage random cluster sampling. We recruited 3198 individuals and extrapolated the results to the entire Iranian population using complex sample survey analyses. We identified 3 clinical phenotypes as “sleepy,” “insomnia,” and “restless legs syndrome (RLS).” The prevalence of OSA was 28.7% (95%CI: 26.8–30.6). The prevalence of “sleepy,” “insomnia,” and “RLS” phenotypes were 82.3%, 77.8%, and 36.5% in women, and 64.8%, 67.5%, and 17.9% in men, respectively. “Sleepy” and “insomnia” phenotypes overlapped the most. Age (OR: 1.9), male sex (OR: 3.8), BMI (OR: 1.13), neck circumference (OR: 1.3), RLS (OR: 2.0), and insomnia (OR: 2.3) were significant OSA predictors (p-values: 0.001). In men, “sleepy” phenotype was associated with youth and unmarried status but not in women. The “insomnia” phenotype was associated with shorter sleep duration in women; cardiovascular diseases (CVD), urban residency, and shorter sleep duration in men. “RLS” phenotype was associated with shorter sleep duration and CVD in women and older age, lower educational level, CVD, and hypertension in men. The findings point to the need for funding of OSA screening in Iran, for a different assessment of men and women, and for future sleep research to consider overlapping phenotypes.

Rethinking the distribution of sleep services: discrepancy of obstructive sleep apnoea in rural compared with metropolitan men in Australia - a large national survey.

Geographical location is increasingly recognised as a contributor to health inequity, with barriers including travel distances and a shortage of healthcare services. Individuals living in rural areas are known to have increased illness and comorbidities. Obstructive sleep apnoea (OSA) is one such illness. OSA is a condition where a person repeatedly pauses breathing while asleep due to their airways becoming wholly or partially blocked, and it is associated with various chronic diseases. Exploration into the effects of these barriers on OSA is limited. This study explores the proportion of diagnosed and undiagnosed OSA in men living in rural compared to metropolitan areas. This was a cross-sectional, secondary analysis of the Australian Ten to Men dataset. The present study looked at men aged over 18 years diagnosed with OSA in their lifetime from wave 2 (n=10 513) and wave 3 (n=7262) of the dataset. Wave 2 data were collected between November 2015 and May 2016, and wave 3 between July 2020 and February 2021. In wave 2, a higher proportion of rural men were diagnosed with OSA than metropolitan men (OR, 1.47, 95%CI 1.22-1.78, p<0.001), but not regional men. In addition, a significantly higher proportion of men in rural areas were at risk for OSA than metropolitan men (37.7% v 32.6%, p<0.0001). However, men living rurally were older, had higher BMI and lower socioeconomic status. Location was no longer a significant predictor of OSA after controlling for age, BMI and socioeconomic status. In wave 3, rate of diagnosis of OSA during the lifetime was no longer significantly associated with location (p=0.057) or being diagnosed with OSA in the previous 12 months (p=0.062). This study highlights the need to ensure adequate services in rural areas, given the higher proportion of men diagnosed with, or at risk of, OSA in rural areas. OSA is also associated with an increase risk of comorbidities such as heart disease, hypertension and diabetes, which are diseases also seen more prevalently in rural men. Rethinking the distribution of healthcare services will go some way to addressing this problem.

Identification of Patients at Risk of Obstructive Sleep Apnea in Dental Settings.

Objectives This study aims to assess the risk of obstructive sleep apnea (OSA) in the Saudi Arabian population at a dental hospital using the Berlin Questionnaire (BQ) and investigate the association of gender, age, neck circumference, systolic blood pressure (SBP), diastolic blood pressure (DBP), and smoking habits with the risk of OSA. Methodology Participants were recruited through random selection from walk-in patients aged between 18 and 80 years. BQ was used to screen for OSA. In addition, age, gender, smoking habits, neck circumference, and blood pressure were collected. Data were analyzed using descriptive statistics, Student's t-test, and chi-square test. Results In this study, 55 participants were screened for OSA using BQ. Of the participants, 44 (80%) were considered to be at low risk of OSA. Age, neck circumference, BMI, SBP, and DBP were statistically significantly associated with high risk of OSA (P < 0.05). Age and neck circumference were found to be statistically significant predictors of OSA, even after controlling for gender and smoking status (P < 0.05). Conclusions BQ is a reliable tool for assessing the risk of OSA in the Saudi Arabian population. Age, neck circumference, BMI, SBP, and DBP are all significant factors of OSA, while age and neck circumference are significant predictors of OSA. Dental practitioners can play a valuable role in the early detection and referral of patients at high risk of OSA.

Early life predictors of obstructive sleep apnoea in young adults: Insights from a longitudinal community cohort (Raine study)

ObjectiveEarly-life obstructive sleep apnoea (OSA) predictors are unavailable for young adults. This study identifies early-life factors predisposing young adults to OSA. MethodsThis retrospective study included 923 young adults and their mothers from the Western Australian Pregnancy Raine Study Cohort. OSA at 22 years was determined from in-laboratory polysomnography. Logistic regression was used to identify maternal and neonatal factors associated with OSA in young adulthood. ResultsOSA was observed in 20.8% (192) participants. Maternal predictors of OSA included gestational diabetes mellitus (odds ratio (OR) 9.54, 95% confidence interval (CI) 1.7, 58.5, P = 0.011), preterm delivery (OR 3.18, 95%CI 1.1,10.5, P = 0.043), preeclampsia (OR 2.95, 95%CI 1.1,8.0, P = 0.034), premature rupture of membranes (OR 2.46, 95%CI 1.2, 5.2, P = 0.015), age ≥35 years (OR 2.28, 95%CI 1.2,4.4, P = 0.011), overweight and obesity (pregnancy BMI≥25 kg/m2) (OR 2.00, 95%CI 1.2,3.2, P = 0.004), pregnancy-induced hypertension (OR 1.89, 95%CI 1.1,3.2, P = 0.019), and Chinese ethnicity (OR 2.36,95%CI 1.01,5.5, P = 0.047). Neonatal predictors included male child (OR 2.10, 95%CI 1.5,3.0, P < 0.0001), presence of meconium-stained liquor during delivery (OR 1.60, 95%CI 1.0,2.5, P = 0.044) and admission to special care nursery (OR 1.51 95%CI 1.0,2.2, P = 0.040). Higher birth lengths reduced OSA odds by 7% for each centimetre (OR 0.93, 95%CI 0.87, 0.99, P = 0.033). ConclusionsA range of maternal and neonatal factors predict OSA in young adults, including those related to poor maternal metabolic health, high-risk pregnancy and stressful perinatal events. This information could assist in the early identification and management of at-risk individuals and indicates that better maternal health may reduce the likelihood of young adults developing OSA.

Reliability of Friedman Staging System and Modified Mallampati Scoring as clinical assessment methods for Obstructive Sleep Apnea – A cross sectional study

ABSTRACT Objective To assess the utility of oropharyngeal crowding indicators as predictors of Obstructive Sleep Apnea (OSA). Methods STOP-BANG Questionnaire was administered to 145 adults. Of the 95 with high OSA risk, 42 underwent polysomnography. Intraoral space was assessed using modified Mallampati (MMP) and Friedman Scoring (FS) System. Results Twenty-four were found to have OSA by polysomnography. Most with low risk (86%) had only Class I MMP. Whereas Class III and IV were seen in 37.9% and 17.9% patients with high risk (p < .001) and 50% and 20.8% patients with OSA (p < .831), respectively. All with low risk had Stage 1 FS. Stages 3 and 4 were observed in 27.4% and 1.1% in the high-risk group (p < .001) and in 29.2% and 4.2% with OSA (p < .092), respectively. Conclusion In limited settings, either MMP or FS scores along with the STOP-BANG questionnaire can be used to diagnose OSA.

Self-helped detection of obstructive sleep apnea based on automated facial recognition and machine learning.

The diagnosis of obstructive sleep apnea (OSA) relies on time-consuming and complicated procedures which are not always readily available and may delay diagnosis. With the widespread use of artificial intelligence, we presumed that the combination of simple clinical information and imaging recognition based on facial photos may be a useful toolto screen for OSA. We recruited consecutivesubjects suspected of OSA who had received sleep examination and photographing. Sixty-eight points from 2-dimensional facial photos were labelled by automated identification. An optimized model with facial features and basic clinical information was established and tenfold cross-validation was performed. Area under the receiver operating characteristic curve (AUC) indicated the model's performance using sleep monitoring as the reference standard. A total of 653 subjects (77.2% males, 55.3% OSA) were analyzed. CATBOOST was the most suitable algorithm for OSA classification with a sensitivity, specificity, accuracy, and AUC of 0.75, 0.66, 0.71, and 0.76 respectively (P < 0.05), which was better than STOP-Bang questionnaire, NoSAS scores, and Epworth scale. Witnessed apnea by sleep partner was the most powerful variable, followed by body mass index, neck circumference, facial parameters, and hypertension. The model's performance became more robust with a sensitivity of 0.94, for patients with frequent supine sleep apnea. Thefindings suggest that craniofacial features extracted from 2-dimensional frontal photos, especially in the mandibular segment, have the potential to become predictors of OSA in the Chinese population. Machine learning-derived automatic recognition may facilitate the self-help screening for OSA in a quick, radiation-free, and repeatable manner.

Investigation of serum endocan and serglycin levels in obstructive sleep apnea.

Apnea-related hypoxia, hypercapnia, and blood pressure fluctuations cause production of various proinflammatory cytokines and trigger a vicious cycle that results in vascular endothelial damage and systemic inflammation in obstructive sleep apnea (OSA). Endothelial function is frequently impaired in OSA even in the absence of significant cardiac or vascular disorders. This study aimed to investigate the serum endocan and serglycin levels in OSA patients. This prospective study included 78 consecutive patients who admitted to the sleep laboratory of a tertiary referral center with the complaints of daytime sleepiness, witnessed sleep apnea, and/or snoring and who underwent all-night polysomnography (PSG). After PSG, the patients were divided into four groups in relation with their apnea-hypopnea indexes. The groups were compared for endocan and serglycin levels and their correlations with OSA severity. The correlations with demographic data and PSG findings were also investigated. The OSA and the control groups had significantly different endocan and serglycin levels ([Formula: see text], for both). On univariate logistic regression analysis, it was found that serglycin and endocan levels and BMI were predictors of OSA. Multiple logistic regression analysis showed that endocan and serglycin levels were independent predictors for OSA ([Formula: see text] and [Formula: see text], respectively). We have demonstrated that elevated endocan and serglycin levels are predictors for OSA. Furthermore, we have showed for the first time in literature that serglycin is correlated with OSA and is an independent predictor for OSA.

Obstructive sleep apnea risk and determinant factors among type 2 diabetes mellitus patients at the chronic illness clinic of the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia.

Obstructive sleep apnea is a sleep complaint among type 2 diabetes mellitus patients that has a deleterious effect on health with immediate and long-term impacts. Despite its impacts, data on the magnitude and predictors of obstructive sleep apnea among type 2 diabetes mellitus patients in Ethiopia is still limited. Thus, this study was conducted to determine how common a high risk of obstructive sleep apnea is and its predictors among type 2 diabetes mellitus patients receiving follow-up care at the chronic illness follow-up clinic at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia, 2022. An institution-based cross-sectional study was conducted. Interviewer-administered questionnaires and physical measurements with standard instruments were used to collect the required data. The collected data were entered into EpiData 4.6 and exported into STATA 14. Both Bivariable and multivariable binary logistic regression analyses were done to identify factors associated with a high risk of obstructive sleep apnea. Variables with a p-value ≤0.05 in the multivariable logistic regression analysis were declared as significantly associated with a high risk of obstructive sleep apnea. A total of 319 type 2 diabetes mellitus patients with a median age of 58 years participated in our current study. The overall prevalence of a high risk of obstructive sleep apnea among the study participants was 31.97% (95%CI: 27.06, 37.32). On multivariable logistic analysis, a neck circumference of ≥40 cm (AOR=4.33, 95%CI 1.37, 13.72), physical inactivity (AOR=2.29, 95%CI 1.15, 4.53), comorbid hypertension (AOR=4.52, 95%CI 2.30, 9.18), and male sex (AOR=8.01, 95%CI 3.02, 21.24) were associated with a high risk of obstructive sleep apnea. The prevalence of a high risk of obstructive sleep apnea among type 2 diabetes mellitus patients remains high. A neck circumference of ≥40 cm, physical inactivity, comorbid hypertension, and male sex were significantly associated with a high risk of obstructive sleep apnea among type 2 diabetes mellitus patients. Screening and evaluation of type 2 diabetes mellitus patients for obstructive sleep apnea are recommended to avoid the negative impacts.

Association of Obstructive Sleep Apnea and Atrial Fibrillation in Acute Ischemic Stroke: A Cross-Sectional Study

Background: There is a growing body of evidence suggesting a link between obstructive sleep apnea (OSA) and atrial fibrillation (AF). The primary objective of this study is to evaluate the association between OSA and AF in acute ischemic stroke. The secondary objective is to describe the clinical features of patients with acute ischemic stroke and concomitant OSA. Methods: We enrolled consecutive patients with acute ischemic stroke. All patients underwent full-night cardiorespiratory polygraphy. To determine if there is an association between AF and OSA, we compared the observed frequency of this association with the expected frequency from a random co-occurrence of the two conditions. Subsequently, patients with and without OSA were compared. Results: A total of 174 patients were enrolled (mean age 67.3 ± 11.6 years; 95 males). OSA and AF were present in 89 and 55 patients, respectively. The association OSA + AF was observed in 33/174 cases, which was not statistically different compared to the expected co-occurrence of the two conditions. Patients with OSA showed a higher neck circumference and body mass index, a higher prevalence of hypertension and dysphagia, and a higher number of central apneas/hypoapneas. In the multivariate analysis, dysphagia and hypertension were independent predictors of OSA. A positive correlation was observed between OSA severity, BMI, and neck circumference. The number of central apneas/hypoapneas was positively correlated with stroke severity. Conclusions: Our data suggest that OSA and AF are highly prevalent but not associated in acute stroke. Our findings support the hypothesis that OSA acts as an independent risk factor for stroke.

Is meteorin-like (Metrnl) a novel biomarker to distinguish patients with obstructive sleep apnea (OSA) and patients withOSA at vascular risk.

Metrnl, a newly discovered adipokine with significant expression in white adipose tissue, promotes energy expenditure and contributes to the development of cardiovascular disorders. Endocan is a surrogate marker for endothelial dysfunction and is linked to cardiovascular risk factors. Higher cardiovascular morbidity and mortality have been linked to obstructive sleep apnea (OSA). In this study, we investigated the potential of serum Metrnl and endocan as biomarkers to identify patients with OSA who are at increased cardiovascular risk and differentiate them from healthy controls. The study included the evaluation of serum levels of endocan and Metrnl in individuals with OSA and healthy controls. All participants underwent full polysomnography to evaluate their sleep, and carotid intima-media thickness (CIMT) was measured in each of them. Patients with OSA(n = 117) had considerably lower levels of Metrnl and significantly higher levels of endocanthan controls (n = 59). Once confounding factors were taken into account, both Metrnl and endocan were effective predictors of OSA. Additionally, the severity of OSA, as determined by the apnea-hypopnea index (AHI), was linked to Metrnl and endocan levels. The study also found a significant and independent inverse association between CIMT and Metrnl, along with a positive association with endocan after making multiple adjustments. Furthermore, there was a significant and independent connection between CIMT and AHI. Based on these findings, Metrnl and endocan have the potential to be valuable markers for identifying patients with OSA who are at increased risk of early vascular damage.