Prevalence Of Sleep Apnea Research Articles

ASSOCIATIONS BETWEEN THE GERIATRIC DEPRESSION SCALE AND APNEA-HYPOPNEA INDEX IN OLDER ADULTS

Abstract The prevalence of sleep apnea increases with age and depression. Sleep plays an important role in memory consolidation, therefore, changes in sleep quality may play a contributing factor to neurodegenerative diseases such as Alzheimer’s. Findings from a retrospective analysis of a randomized control sleep study are presented for healthy participants (N=33) with no self-reported mental health conditions between 11/7/2022-6/7/2023. As part of a larger study, this sub-study occurred in The Villages in a partnership between the UFHealth PHRC and Applied Cognition. Participants completed the Geriatric Depression Scale (GDS-15), and Polysomnography (PSG), with the Apnea-Hypopnea Index (AHI) extracted from the PSG data. The relationship between sleep apnea and depression was examined using descriptive statistics and linear regression. The mean age of participants was 61.9, with 55% being male. GDS-15 scores showed a strong negative correlation with AHI (p<.001), indicating that as GDS scores increased, AHI decreased. The R2 value (0.06) indicates little variation in the data and is a good fit for the model. Limited data due to the small sample size may contribute to the observed relationship. Although the effect size was small, symptoms related to depression could contribute to decreased AHI. A sample from The Villages may be biased towards a higher social cohesion lifestyle than other communities, showing how elements of depression may differently impact sleep apnea. Further studies are needed to identify further associations and implement appropriate interventions.

Analysis of Obstructive Sleep Apnoea in Craniofacial Microsomia Based on Polysomnography

Objective This study aimed to investigate the prevalence of obstructive sleep apnoea (OSA) in patients with craniofacial microsomia (CFM) through polysomnography (PSG) and the relationship with the severity of CFM. Methods This study reviewed patients of CFM with pre-operative PSG data between January 2005 and September 2023. Patients were grouped according to the Pruzansky-Kaban classification. OSA was diagnosed and severity was assessed by the obstructive apnea-hypopnea index. The Pediatric Sleep Questionnaire was used to investigate OSA-related signs and symptoms. The χ 2 test and Fisher's exact test were used to compare between groups. Univariate logistic regression was used to identify risk factors associated with OSA. A p-value less than 0.05 was considered statistically significant. Results A total of 121 patients with CFM were included in the study with 3 bilateral and 118 unilateral patients. In total, 86 patients (71.07%) were diagnosed with OSA. The prevalence of OSA in type IIa, type IIb and type III was 72.97%, 78.33%, and 47.62%. There was no statistically significant difference in the prevalence of OSA between type IIa and type IIb ( p > .05). The difference in the prevalence of OSA between type III and type II was statistically significant ( p < .05). Snoring was the most common symptom among the patients of CFM with OSA. Conclusions Patients with CFM have a higher incidence of OSA based on PSG in type II and type III patients. The incidence of OSA did not correlate positively with the severity of CFM, with type III patients having certain particularities.

Heart Failure, Investigator-Reported Sleep Apnea and Dapagliflozin: A Patient-Level Pooled Meta-Analysis of DAPA-HF and DELIVER

Sleep apnea is more common in patients with heart failure (HF) than in the general population, but little is known about its association with clinical outcomes in various HF phenotypes or how it might modify the effect of HF therapy. To examine the prevalence of sleep apnea, its association with outcomes and the effects of dapagliflozin in patients with HF with and without sleep apnea in a pooled analysis of 2 trials comparing dapagliflozin to placebo in HFrEF (DAPA-HF trial) and HFmrEF/HFpEF (DELIVER trial). A history of sleep apnea was investigator-reported. The primary outcome was a composite of worsening HF or cardiovascular death. The prevalence of sleep apnea was 5.7% and 7.8% in patients with HFrEF and HFmrEF/HFpEF, respectively. The primary outcome occurred at a rate of 16.0 in participants with sleep apnea compared to 10.6 per 100 person-years in those without (adjusted HR 1.29 [95%CI, 1.10-1.52]). Compared with placebo, dapagliflozin reduced the risk of the primary endpoint to the same extent in patients with (HR 0.78 [95% CI, 0.59-1.03]) and without sleep apnea (HR 0.79 [0.72-0.87]) [Pinteraction = 0.93]. The beneficial effects of dapagliflozin on other clinical outcomes and symptom burden, physical function, and quality of life were consistent in participants with and without sleep apnea. In DAPA-HF and DELIVER, the true prevalence of sleep apnea was likely underestimated. An investigator-reported history of sleep apnea was associated with higher rates of worsening HF events. The benefits of dapagliflozin on clinical outcomes were consistent in patients with and without sleep apnea. Unique identifiers: NCT01920711 CONDENSED ABSTRACT: In a pooled analysis of the DAPA-HF and DELIVER trials of more than 11,000 patients with heart failure (HF) across the range of ejection fractions, an investigator-reported history of sleep apnea was associated with higher rates of worsening HF events but not mortality. The beneficial effects of dapagliflozin on clinical outcomes were consistent in patients with and without sleep apnea. These findings provide further evidence for dapagliflozin as a new treatment option for patients with heart failure across the range of ejection fractions.

A Correlational Study Elevated Risk of Cardiometabolic Illness and the Prevalence of Obstructive Sleep Apnea Among the Population of Tebing Tinggi, North Sumatra, Indonesia

A Correlational Study Elevated Risk of Cardiometabolic Illness and the Prevalence of Obstructive Sleep Apnea Among the Population of Tebing Tinggi, North Sumatra, Indonesia

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.

SEX EFFECTS ON THE QUALITY OF SLEEP IN DOWN SYNDROME

AbstractBackgroundSex differences in biological factors, such as sleep, might contribute to sex differences in dementia risk. Down’s syndrome (DS) is a genetically determined form of Alzheimer’s disease (AD), with disrupted sleep and a high prevalence of obstructive sleep apnea (OSA). However, sex differences in nocturnal sleep in adults with DS have not been yet investigated. Thus, we aimed to evaluate the sex effect on polysomnographic sleep measures in adults with DS.MethodCross‐sectional study of 187 adults with DS from the Down‐Alzheimer Barcelona Neuroimaging Initiative (DABNI) that underwent a nocturnal polysomnography study. Sleep macrostructure parameters of i)sleep continuity [Total sleep time(TST), Sleep efficiency(SE), Wake after sleep onset(WASO), Sleep latency and latency to REM sleep], ii) NREM (phase N1, N2, N3) and REM stages, in minutes and percentages, and iii) respiratory parameters to determine the presence of OSA were evaluated. Chi‐squared and Mann‐Whitney tests were used to test differences between categorical data, and continuous variables, respectively. To evaluate the sex effects on sleep parameters, we performed ANCOVAs using sleep measurements as dependent variables, the sex, presence of dementia, and OSA as fixed effects, and age as a covariate. Interactions between subjects effects were aso calculatedResultOur cohort includes 187 adults with DS (57,2% females and 42.8% males). OSA was present in 76,2% of the subjects, and 22% of the subjects had symptomatic AD (prodomal/demented) without significant differences in both prevalences between sexes(p = 0.23, p = 0.08 respectively) (table 1). Females presented significant longer TST, WASO, NREM (m), N2(m), N3(m), with higher SE and N3(%), and decreased N1(%) compare to males. These sex differences were maintained after age correction. Results remain essentially similar when including dementia and OSA in the statistical models. No significant interactions between sex and OSA and sex and dementia were observed(Table2).ConclusionAs in general euploid population, females with DS presented a better objective sleep quality with more deep sleep than men. Further work is needed to investigate how sex differences in sleep parameters can influence clinical and biomarker profiles of AD in adults with Down syndrome.

Prevalence and Incidence of Co-Morbid Insomnia and Sleep Apnea (Comisa) in São Paulo, Brazil

Prevalence and Incidence of Co-Morbid Insomnia and Sleep Apnea (Comisa) in São Paulo, Brazil

Third time's a charm: band to sleeve to bypass.

Adjustable gastric bands (AGB) are frequently converted to sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) due to weight recurrence or band complications. Such conversions carry a higher-risk than primary procedures. Some patients undergo two conversions-from AGB to SG, and subsequently from SG to RYGB. This presents a unique situation with limited literature on indications and complication rates associated with these double conversions. We examined the 2020-2021 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) Participant Use File to evaluate conversions from AGB to SG and then to RYGB. Patient and operative characteristics, along with outcomes, were evaluated. Descriptive statistics were applied. We identified 276 patients who underwent a conversion from AGB to SG and then to RYGB. The primary reason for the second conversion (SG to RYGB) was gastroesophageal reflux disease (GERD) at 55.1%, followed by inadequate weight loss or weight regain (IWL/WR) at 36.9%. The remaining reasons included dysphagia, nausea, vomiting, or others. Patients converted for IWL/WR demonstrated a higher baseline body mass index and prevalence of sleep apnea compared to other cohorts (both p < 0.001). Meanwhile, patients in the "other reasons" group had the highest rate of open surgical approaches (9.1%) and concurrent lysis of adhesions (p = 0.001 and p = 0.022), with correspondingly higher rates of anastomotic leak, reoperations, serious complications, and mortality. Patients undergoing double conversions (AGB to SG to RYGB) do so primarily for GERD or IWL/WR. Further research is required to better define the optimal primary operation for each patient, aiming to reduce the necessity for multiple conversions.

Sleep apnoea syndrome prevalence in chronic kidney disease and end-stage kidney disease patients: a systematic review and meta-analysis.

Several studies have examined the frequency of sleep apnoea (SA) in patients with chronic kidney disease (CKD), reporting different prevalence rates. Our systematic review and meta-analysis aimed to define the clinical penetrance of SA in CKD and end-stage kidney disease (ESKD) patients. Ovid-MEDLINE and PubMed databases were explored up to 5 June 2023 to identify studies providing SA prevalence in CKD and ESKD patients assessed by different diagnostic methods, either sleep questionnaires or respiration monitoring equipment [such as polysomnography (PSG), type III portable monitors or other diagnostic tools]. Single-study data were pooled using the random-effects model. The Chi2 and Cochrane-I2 tests were used to assess the presence of heterogeneity, which was explored performing sensitivity and/or subgroup analyses. A cumulative analysis from 32 single-study data revealed a prevalence of SA of 57% [95% confidence interval (CI) 42%-71%] in the CKD population, whereas a prevalence of 49% (95% CI 47%-52%) was found pooling data from 91 studies in ESKD individuals. The prevalence of SA using instrumental sleep monitoring devices, including classical PSG and type III portable sleep monitors, was 62% (95% CI 52%-72%) and 56% (95% CI 42%-69%) in CKD and ESKD populations, respectively. Sleep questionnaires revealed a prevalence of 33% (95% CI 16%-49%) and 39% (95% CI 30%-49%). SA is commonly seen in both non-dialysis CKD and ESKD patients. Sleep-related questionnaires underestimated the presence of SA in this population. This emphasizes the need to use objective diagnostic tools to identify such a syndrome in kidney disease.

Heart failure with preserved ejection fraction risk is associated with prevalence and severity of obstructive sleep apnea.

While heart failure with preserved ejection fraction (HFpEF) is associated with the presence of obstructive sleep apnea (OSA), few studies have examined the association between scoring systems used to predict HFpEF risk, such as the H2FPEF and HFA-PEFF scores, and OSA prevalence and severity. We performed chart review on all patients who underwent both an echocardiogram and sleep study at the University of Pennsylvania between July 1, 2020, and June 30, 2022. There were 277 patients in the final cohort after excluding patients with relevant comorbidities. Associations between echocardiographic parameters and OSA severity, as well as between H2FPEF score and OSA severity, were examined using linear tests of trend. The association between H2FPEF score and prevalent OSA was examined with logistic regression. OSA severity was associated with echocardiographic markers, including left atrial volume index (P = .03) and left ventricular relative thickness (P = .008). Patients with high H2FPEF risk scores had over 17-fold higher odds of prevalent OSA compared with those with low-risk scores (17.7; 95% CI 4.3, 120.7; P < .001). Higher H2FPEF scores were strongly correlated with OSA severity (P < .001). After controlling for body mass index, H2FPEF scores were not associated with prevalence or severity of OSA. In an ambulatory population referred for sleep study and echocardiogram, markers of diastolic dysfunction were associated with OSA severity. OSA prevalence and severity were associated with increased H2FPEF scores, although these associations were largely explained by obesity. Clinicians should have low thresholds for referring patients with OSA for cardiac workup and patients with HFpEF for sleep study. Connolly JE, Genuardi MV, Mora JI, Prenner SB. Heart failure with preserved ejection fraction risk is associated with prevalence and severity of obstructive sleep apnea. J Clin Sleep Med. 2024;20(3):381-387.

Gender differences in association between expiratory dynamic airway collapse and severity of obstructive sleep apnea

ObjectivesRepetitive unbalances and tensions generated by inspiratory efforts against an obstructive upper airway during sleep predispose the development of expiratory central airway collapse. In addition, structures of the upper airway between men and women have differences and could be the reasons for differences in obstructive sleep apnea (OSA) prevalence between genders. The present study aimed to evaluate the association between parameters of expiratory dynamic tracheal collapse measured using chest multidetector CT and objectively measured OSA severity between men and women.Materials and methodsA total of 901 participants who underwent chest CT and overnight in-home polysomnography from the Korean Genome and Epidemiology Study were cross-sectionally analyzed (women: 46.2%). The participants were divided into three groups based on OSA severity by apnea–hypopnea index (AHI). Multivariate linear regression analysis was performed to determine the effects of central airway collapse after adjustment for cardiovascular-related covariates.ResultsIn a multivariate analysis, percentages of expiratory lumen structure reductions involving area, diameter, and perimeter were associated with AHI (all p values < 0.05) and with OSA severity (moderate-to-severe OSA than no OSA: β = 3.30%, p = 0.03; β = 2.05%, p = 0.02; β = 1.97%, p = 0.02, respectively) in women, whereas men had only a greater percentage of expiratory wall thickness reduction in moderate-to-severe OSA than no OSA (β = 0.72%, p = 0.003). In addition, women with both mild OSA and moderate-to-severe OSA had higher expiratory tracheal collapse than men without OSA, and a moderate effect of sex was observed (p for interaction = 0.007).ConclusionThe expiratory dynamic tracheal collapse was independently associated with severity of OSA in women than in men.Clinical relevance statementDifferences of pharyngeal structures and inherent features of airways by genders may affect the dissimilarities in vulnerability to sleep apnea between men and women.Key Points• The expiratory dynamic tracheal collapse was independently associated with severity of OSA in women than in men.• Women with over mild OSA had higher expiratory tracheal collapse than men without OSA, and moderate effect of sex was observed.• Structural differences of airway may affect differences in susceptibility of sleep apnea between genders.

Prevalence of sleep apnea by a home diagnostic device in patients with atrial fibrillation

Abstract Background Sleep apnea (SA), a modifiable risk factor in atrial fibrillation (AF), is associated with worse outcomes in AF hence diagnosing SA in patients with AF is clinically important. The gold standard to detect presence of SA is polysomnography which requires an in-patient, overnight stay in a specialized sleep laboratory. The procedure is time-consuming and inconvenient for patients and not widely available. As such, new and more conveniently assessment tools are needed for optimal screening of SA in patients with AF. Purpose We aimed to assess the prevalence and severity of SA in patients with AF, and, subsequently, to assess the positive predictive value (PPV) of moderate to severe and only severe SA by home-monitoring in comparison to cardio-respiratory monitoring (CRM) in consecutive patients with AF. Methods This cross-sectional study recruited unselected patients with AF without known SA from an out-patient clinic at our University Hospital. Participants underwent four consecutive nights of sleep-recording with the home-monitoring device NightOwl™ (NO). Moderate to severe SA was defined as an Apnea-Hypopnea Index≥15 per hour of sleep. Participants with moderate to severe SA was offered CRM for validation of the diagnosis. Prevalence of SA was calculated by the proportion of participants with moderate to severe SA out of all study participants, and the PPV was calculated as the proportion of moderate to severe and only severe AHI by NO confirmed by CRM. Results We included 126 patients with AF with a median age of 68 (interquartile range: 60-75) years, 42 (33%) women, 70 (56%) hypertension, 61 (48%) hyperlipidemia and 49 (39%) heart failure. NO detected severe SA in 36 (29%) of patients with AF, moderate SA in 35 (28%), mild SA in 45 (36%) and no SA in 10 (8%). Of the 71 patients with moderate to severe SA by NO, 38 patients underwent CRM and the PPV of NO was 0.82 (31/38) to diagnose moderate and severe SA and 0.92 (22/24) to diagnose severe SA by CRM. Conclusion Moderate to severe SA by NO was highly prevalent in patients with AF without known SA. A home-monitoring device such as NO could be an easy and feasible SA screening tool in patients with AF.Figure 1:PrevalenceTable 1:Baseline Characteristics

Abstract 14281: Association of Sleep Apnea Prevalence and Severity With H 2 FPEF Score and Echocardiographic Markers of Heart Failure With Preserved Ejection Fraction

Background: While heart failure with preserved ejection fraction (HFpEF) is highly associated with the presence of sleep apnea, few studies have examined the association between diagnostic scoring systems used to predict HFpEF risk, such as the H 2 FPEF score, and OSA prevalence and severity. Methods: We performed a retrospective chart review on all patients (N = 434) who underwent both an echocardiogram and a sleep study at the University of Pennsylvania between July 1, 2020, and June 30, 2022. Associations between echocardiographic parameters and OSA severity, as well as between H 2 FPEF score and OSA severity, were examined using linear tests of trend. The association between H 2 FPEF score categorization and odds of prevalent OSA was examined with logistic regression. Results: OSA severity was associated with echocardiographic markers of diastolic dysfunction including greater LV mass index (p = 0.04), left atrial volume index (p = 0.03), and LV relative thickness (p = 0.008). Patients with intermediate H 2 FPEF risk scores had 4.3 times greater odds of prevalent OSA compared with those patients with low risk H 2 FPEF scores (95% CI 2.2, 8.7, p &lt; 0.001). Patients with high H2FPEF risk scores had over 17-fold higher odds of prevalent OSA compared to those with low-risk scores (17.7, 95% CI 4.3, 120.7, p &lt; 0.001) (Figure 1). Increasing risk of HFpEF according to H 2 FPEF categorization was strongly correlated with OSA severity as measured by apnea-hypopnea index (p &lt; 0.001) and oxygen desaturation index (p = 0.002). Conclusions: In an ambulatory population referred for both sleep study and echocardiogram, markers of diastolic dysfunction were associated with OSA severity. OSA prevalence and severity were strongly associated with increased H 2 FPEF scores. Clinicians should have a low threshold for referring OSA patients with dyspnea for cardiac workup, as well as a low threshold for referring HFpEF patients for sleep study.

Comorbidities and Laryngeal Cancer in Patients with Obstructive Sleep Apnea: A Review.

Introductions: The global prevalence of obstructive sleep apnea shows that this disease appears in 1 billion people, with the prevalence exceeding 50% in some countries. Treatment is necessary to minimize negative health impacts. Obstructive sleep apnea (OSA) is defined as a cause of daytime sleepiness, as well as a clinical manifestation of sleep-disordered breathing. In the literature, there are numerous controversial studies regarding the etiology of this condition, but it is universally accepted that reduced activity in the upper airway muscles plays a significant role in its onset. Additionally, OSA has been associated with a series of comorbidities, such as type II diabetes, metabolic syndrome, and cardiovascular and pulmonary conditions, as well as head and neck tumors, especially oropharyngeal and laryngeal tumors. This is a review of the subject of OSA that considers several aspects: an analysis of the comorbidities associated with OSA, the involvement of tumor pathology in the onset of OSA, and the association of OSA with various types of laryngeal cancers. Additionally, it includes an evaluation of postoperative and medical outcomes for patients with OSA and laryngeal tumors treated surgically and medically, including chemotherapy. Relevant Sections: By taking into consideration the stated objective, a systematic analysis of the available literature was conducted, encompassing the PubMed, Medline, and Scopus databases. The evaluation was based on several keywords, including head and neck cancer, diabetes, diabetic, overlap syndrome, cardiovascular conditions, laryngeal neoplasm, radiotherapy, and chemotherapy, as well as the concept of quality of life in laryngectomized patients and patients with OSA. Discussions: The review evaluates the involvement of OSA in the presence of comorbidities, as well as the increased incidence of OSA in patients with laryngeal cancer. It is important to note that surgical and post-surgical treatment can play a significant role in triggering OSA in these patients. Conclusions: The studies regarding the correlations between OSA, comorbidities, and head and neck tumors indicate a significantly increased risk of OSA in association with conditions such as diabetes, metabolic syndrome, cardiovascular diseases, and head and neck tumors, particularly laryngeal tumors. This association has a physio-pathological basis. The various surgical methods followed by radiation and chemotherapy for tumor treatment do not exclude an increased risk of developing OSA after treatment. This significantly influences the quality of life of patients who survive these types of tumors. Future directions: Due to the multiple comorbidities associated with OSA, the extension of polysomnography associated with investigations during sleep, such as drug-induced sleep endoscopy, represents a tendency for the early diagnosis of this pathology, which affects the quality of life of these patients. Patients with head and neck cancer are at high risk of developing obstructive sleep apnea; this is why it is necessary to expand the polysomnographic investigation of these patients after surgical procedures or after radiotherapy and chemotherapy.

Prevalence and clinical aspects of obstructive sleep apnea in Parkinson disease: A meta-analysis.

Obstructive sleep apnea (OSA) frequently occurs in Parkinson Disease (PD), probably caused by upper airway dysfunctions or shared pathogenetic mechanisms. OSA may precede PD diagnosis or worsen throughout its course, but its relationship with clinical features and dopaminergic medication remains unclear. This meta-analysis aimed to provide a reliable estimate of OSA prevalence in the PD population (PD-OSA) and to clarify its clinical associated factors to help clinicians in understanding the underlying pathophysiological mechanisms. A systematic literature search was performed up to April 2023 using the PubMed, Scopus, and PsycINFO databases. Articles were included if they provided data on PD patients with and without OSA. Pooled prevalence for PD-OSA was calculated using the proportions of PD participants diagnosed with OSA. Demographic and clinical features associated with PD-OSA were explored by comparing PD patients with and without OSA. Seventeen studies were included in the meta-analysis. Pooled OSA prevalence was 45% of a total sample of 1448 PD patients and was associated with older age, male sex, higher body mass index (BMI), more severe motor disturbances and periodic limb movements, reduced risk of rapid eye movement sleep behavior disorder, intake of dopamine agonists, and worse excessive daytime sleepiness. No relationship emerged with cognitive functioning and neuropsychiatric manifestations. OSA affects nearly half of PD patients as a secondary outcome of predisposing factors such as older age and higher BMI in addition to PD-related motor impairment. Future studies should focus on determining the impact of both clinical features and dopaminergic medication on the development of PD-OSA.

Sleep Apnea and Dental Implications -A Review

Obstructive sleep apnea (OSA) is an increasingly common, chronic, sleep-related breathing disorder.The prevalence of obstructive sleep apnea (OSA) continues to rise due to change in life patterns.The most common presenting symptom of OSA is excessive sleepiness and is associated with a 2- to 3-fold increased risk of cardiovascular and metabolic disease. The key contributors to OSA pathogenesis include a narrow, crowded, or collapsible upper airway “anatomical compromise” and “non-anatomical” contributors such as ineffective pharyngeal dilator muscle function during sleep, a low threshold for arousal to airway narrowing during sleep, and unstable control of breathing. Effective treatments include weight loss and exercise, positive airway pressure, oral appliances that hold the jaw forward during sleep, and surgical modification of the pharyngeal soft tissues or facial skeleton to enlarge the upper airway. This review summarizes the latest knowledge ondifferent contributors to OSA with a focus on emerging clinical tools.

Prevalence and Risk Factors of Obstructive Sleep Apnea among Patients Attending Tertiary Care Teaching Hospital in Odisha, India: A Retrospective Observational Study

Background: Although obstructive sleep apnea is the most common sleep-disordered breathing, there are fewer studies estimating the prevalence of OSA and its risk factors in urban and rural populations in Odisha. Objective: To estimate the prevalence and risk factors of obstructive sleep apnea in a tertiary care teaching hospital in Odisha, India. Method: It is an observational, retrospective study that was conducted in a sleep study lab for a duration of 4 years (January 2016 to December 2019) by the Department of Physiology and Department of Pulmonology of a tertiary care teaching hospital in Odisha. Patients were first screened for high-risk sleep apnea disorder by the Berlin questionnaire, and then they underwent a level 1 sleep study. Results: Total study patients were 1423, of whom 718 and 705 were from urban and rural areas. The mean age of urban and rural patients was 50.81±12.5 years and 51.63±15.3 years, respectively. The prevalence of OSA in urban areas by AHI criteria was 5.9%, and in rural areas it was 4.9%. The mean AHI of urban OSA patients was 37.86±23.46 and that of rural patients was 16.96±13.8. Conclusion: The prevalence of OSA was higher in urban areas than in rural areas. Both BMI and NC were higher for urban patients than for rural patients. The risk factors were mainly diabetes mellitus and hypertension.

Improving the screening process for obstructive sleep apnea in the primary care setting.

There is a high prevalence of obstructive sleep apnea (OSA) in the primary care setting that is underdiagnosed and underreported in 75-80% of the population. If untreated, OSA has implications for long-term cardiovascular, cerebrovascular, and metabolic health. At a primary care clinic in New Jersey, patients at high risk for OSA were not being routinely screened for the condition. This project intended to address the administration of the STOP-Bang Questionnaire among asymptomatic high-risk patient populations with hypertension and/or obesity. In addition to determining each participant's level of risk for OSA, and in turn, facilitating referrals and diagnostic testing per a provider's discretion. The STOP-Bang Questionnaire, a validated screening tool for OSA, was implemented in a primary care practice to measure levels of risk for OSA among eligible participants. A total of 32 out of the 100 patients assessed were identified as high risk for OSA. After screening, 36 participants were referred for confirmatory testing. The STOP-Bang Questionnaire, a validated screening tool for OSA, is recommended for all asymptomatic high-risk patients, specifically for those with obesity and/or hypertension, at least annually. The use of a screening tool evaluates a level of risk, promotes detection of disease in the primary stages, delays disease progression, and improves treatment initiatives.

Prevalence of Obstructive Sleep Apnea and it’s Association with Depression and Cognitive Dementia: A Systematic Review

Background: Obstructive sleep apnea (OSA) and depression can be simultaneously present in a patient. The aim of this article is to summarize the prevalence of OSA in different countries across the world and demonstrate the association between OSA and depression along with other cognitive disorders. Methods: PubMed/ Medline and Goggle Scholar was searched for relevant articles between 2001 and May 2023. Among the selected literature some article were excluded based on the exclusion criteria. The results of the remaining article was studied and summarized to derive a conclusion. Result: The prevalence of OSA ranges between 3.57% to 26.94% in different countries. The study predicts that a significantly high prevalence of depression is seen in subjects with OSA (21.8%) compare to those without OSA (9.43%). Link between OSA and cognitive dementia has also been identified. Conclusion: Prevalence of both OSA and depression is high in the community. Primary care physician should be able to detect these early and ensure proper treatment.

O070 Prevalence of central sleep apnoea in people with tetraplegic spinal cord injury: a retrospective analysis of research and clinical data

Abstract Study Objectives Over 80% of people with tetraplegia have sleep disordered breathing, but whether this is predominantly obstructive or central is unclear. This study aimed to estimate the prevalence of central sleep apnoea (CSA) in tetraplegia and the contributions of central, obstructive and hypopnoea respiratory events to sleep disordered breathing summary indices in tetraplegia. Methods Research and clinical data from 606 individuals with tetraplegia and full overnight polysomnography were collated. The proportions of different respiratory event types were calculated; overall and for mild, moderate, and severe disease. The prevalence of Predominant CSA (central apnoea index 5 and more central than obstructive apnoeas) and Any CSA (central apnoea index  5) was estimated. Prevalence of sleep-related hypoventilation was estimated in a clinical sub-cohort. Results Respiratory events were primarily hypopnoeas (71%), followed by obstructive (23%), central (4%) and mixed apnoeas (2%). As severity increased, the relative contribution of hypopnoeas and central apnoeas decreased, while that of obstructive apnoeas increased. The prevalence of Predominant CSA and Any CSA were 4.3% (26/606) and 8.4% (51/606) respectively. Being male, on opiates and having a high tetraplegic spinal cord injury were associated with CSA. Sleep-related hypoventilation was identified in 26% (26/113) of the clinical sub-cohort. Conclusions This is the largest study to characterize sleep disordered breathing in tetraplegia. It provides strong evidence that obstructive sleep apnoea is the predominant sleep disordered breathing type; 9-18 times more prevalent than CSA. The prevalence of CSA was estimated to be 4-8%, significantly lower than previously reported.