Risk Factor For Obstructive Sleep Apnea Research Articles

Screening for obstructive sleep apnoea in overweight and obese children in Southern Sri Lanka

Introduction: One of the main risk factors of obstructive sleep apnoea (OSA) is childhood obesity which account for about 60% incidence in obese children. Although polysomnography is the gold standard, it is costly and difficult to be used in children. The objective of this study was to use a prediction tool called a “Modified STOP bang tool” in the assessment of OSA in overweight and obese children in Southern Sri Lanka. Methods: A descriptive cross-sectional study was conducted on ninety seven children (57 boys) aged 5 – 15 years with BMI >85th percentile for age and gender based on CDC 2000 growth charts recruited from the nutrition clinic at the Teaching Hospital, Karapitiya, Sri Lanka. Modified STOP bang questionnaire which assessed snoring, tiredness, observed apnea, blood pressure 95th percentile, BMI >95th percentile, academic problems, neck circumference >95th percentile for age, and male gender was considered on all study participants and a score was generated. Results: Out of 97 children participated, 27.8% children had a higher risk of OSA and 49.5% had an intermediate risk of OSA. According to this study, significant risk factors for OSA in overweight and obese children included, being a male, BMI greater than 95th percentile for age, obesity for age and sex, circumference greater than 95th percentile for age, neck/ height ratio and waist/hip ratio. Conclusion: In the community setting, modified STOP bang questionnaire is useful in the screening of overweight and obese children for OSA and for further follow-up.

Obstructive sleep apnea syndrome in children as a multi-disciplinary problem (a review)

Aim. To analyze the data of modern scientific literature about the etiology, risk factors, pathogenesis, diagnosis and treatment of obstructive sleep apnea (OSA) in children. Results. The prevalence of OSA in children is about 1–5 %, with a peak incidence between the ages of 2 and 6 years. The main risk factors for OSA include adenotonsillar hypertrophy, obesity, and craniofacial anomalies. Nocturnal and daytime symptoms are clinically distinguished. Nocturnal ones include snoring, mouth breathing, pauses in breathing, restless sleep, enuresis and sweating; daytime symptoms are nasal obstruction, mouth breathing, morning headache, drowsiness, violation in attention concentration and hyperactivity. Nocturnal polysomnography is the gold standard for the diagnosis of OSA, in the absence of which the use of screening systems is possible, in particular – cardiorespiratory monitoring. The apnea/hypopnea index ≥1 per hour is considered a diagnostic criterion for mild OSA in children and differs from that in adults ≥5. Among the most effective treatments for OSA are adenoidectomy, CPAP therapy, intranasal corticosteroids, leukotriene receptor antagonists, and lifestyle modification in obesity is obvious. Conclusions. The problem of OSA syndrome is underestimated, and the vigilance of physicians as well as diagnostic opportunities of treatment and prevention facilities in Ukraine are quite low. Nocturnal polysomnography or screening diagnostic methods (cardiorespiratory monitoring) should be used in case of suspected OSA. Therapeutic measures for apnea are primarily aimed at eliminating etiological and risk factors. The presence of OSA in children with adenoids is an absolute indication for their removal.

Mediating Effect of Self-Cognitive Oral Health Status on the Effect of Obstructive Sleep Apnea Risk Factors on Quality of Life (HINT-8) in Middle-Aged Korean Women: The Korea National Health and Nutrition Examination Survey.

Background: Obstructive sleep apnea and oral health are highly correlated with quality of life. The purpose of this study is to determine the mediating effect of self-cognitive oral health status on the effect of obstructive sleep apnea (OSA) risk factors on quality of life in middle-aged Korean women using the 2019 National Health and Nutrition Examination Survey data. Methods: A hierarchical regression analysis was performed on the mediating effect of self-cognitive oral health status on the effects of OSA risk factors on health-related quality of life (Korean health-related quality of life instrument with 8 items; HINT-8). Results: Self-cognitive oral health status as a parameter had a significant effect on quality of life (β = 0.713, p < 0.001). Compared to the effect of the OSA risk factor of the second stage on the quality of life (β = −1.329, p < 0.001), the input of the third stage of self-cognitive oral health was partially mediated (β = −1.280, p <0.001). Conclusions: Therefore, if middle-aged women have OSA risk factors, they should try to improve their quality of life by managing oral health as well as OSA treatment.

INTERMITTENT HEART BLOCK IN OSA

INTERMITTENT HEART BLOCK IN OSA

Age Adjusted Sex Differences in Clinical Features of Korean Patients With Snoring or Sleep Apnea: A Single-Center Study

Background and Objectives Female are less likely to be diagnosed with obstructive sleep apnea (OSA) than male are and their symptoms are more likely to be overlooked because female usually show less typical classic symptoms of OSA, such as snoring, witnessed apnea, and daytime sleepiness. In this study, we identified sex effects among patients who complained of snoring or sleep apnea with adjusting for age.Subjects and Method This study design was retrospectively conducted to compare sex and age differences in 255 Korean patients complaining of snoring or sleep apnea by evaluating medical history, rhinomanometry, physical examination, and polysomnography.Results The sex difference in the apnea-hypopnea index decreased after 50 years of age. Female OSA patients complained of mild-to-moderate OSA with atypical symptoms. Male OSA patients showed Berlin questionnaire scores, retropalatal Muller maneuver grade, and high body mass index (BMI) as significant risk factors for OSA after adjusting for age. Female OSA patients showed retropalatal Muller maneuver grade and high BMI as significant risk factors. Berlin score was a typical risk factor in old male OSA patients.Conclusion Anatomical and hormonal factors were thought to be risk factors for OSA especially in females, but contrary to expectations, there were no risk factors in old females when adjusted for age. A careful approach should be taken to avoid overlooking sleep apnea in female.

Assessment of Anatomic Airway Changes in Obstructive Sleep Apnea Patients Post Bariatric Surgery

Obstructive sleep apnea (OSA) is known to cause adverse health-related effects, reduce quality of life, and is the most common sleep disordered respiratory disease. Obesity is a main risk factor for OSA and several studies have investigated the effect of surgical weight loss on OSA. Some of these studies have shown an improvement in the apnea-hypopnea index (AHI) in OSA patients following bariatric surgery; however, the extent to which OSA improves is unclear. In their 2009 systematic review, Greenburg et al concluded that despite an improvement in AHI, most OSA patients still had moderately severe OSA and should not expect a cure from bariatric surgery.

The prevalence of obstructive sleep apnoea risk factors in individuals with cognitive impairment: south London cross-sectional study.

We aimed to determine the prevalence of risk factors for obstructive sleep apnoea (OSA) in patients with mild cognitive impairment (MCI) or dementia. Using patient records across a 5 year period, we identified 16 855 patients with dementia or MCI. We gave scores for keywords relating to each modified STOP BANG parameter in patient progress notes. Based on individual scores, we stratified the population into groups with low, intermediate and high risk of OSA. Our population had a high prevalence of risk factors and consequently high risk scores for OSA (18.21% high risk). Parameters directly related to sleep had a low prevalence. The risk of developing or having OSA is high among patients with MCI and dementia. Low sleep parameter frequency probably suggests poor documentation of sleep rather than true prevalence. Our findings support the implementation of the STOP BANG or a similar screening tool as a standardised method to identify OSA risk in memory clinics.

Clinician Awareness of Obstructive Sleep Apnoea risk factors and confidence in referral

Clinician Awareness of Obstructive Sleep Apnoea risk factors and confidence in referral

The prevalence of obstructive sleep apnea in sarcoidosis and its impact on sleepiness, fatigue, and sleep-associated quality of life: a cross-sectional study with matched controls (the OSASA study).

Patients with sarcoidosis experience fatigue and excessive daytime sleepiness (EDS). However, the underlying pathomechanism is unclear. Studies suggested undiagnosed obstructive sleep apnea (OSA) to be an important contributor, but reliable data on prevalence and impact of OSA in sarcoidosis are scarce. 71 adult patients with sarcoidosis, 1-to-1 matched to 71 adult controls according to sex, age, and body mass index were included. Participants underwent structured interviews (including Epworth Sleepiness Scale [ESS], Fatigue Assessment Scale [FAS], and Functional Outcome of Sleep Questionnaire [FOSQ-30]) and level-3 respiratory polygraphy. OSA was defined as apnea-hypopnea index ≥ 5 events/h. Prevalence of OSA was assessed and possible risk factors for OSA in sarcoidosis were investigated. Mild OSA (AHI ≥ 5 events/h) was prevalent in 32 (45%) sarcoidosis patients vs 22 (31%) controls (P = .040). Sarcoidosis patients presented higher ESS compared with matched controls (P = .037). FAS scores (median [quartile] of 21.5 [16, 27.5]) indicated fatigue in sarcoidosis patients. Patients with EDS (ESS ≥ 11) presented reduced FOSQ-30 results (median [quartile] of 16.7 [15.2, 17.8]). ESS, FAS, and FOSQ were not associated with AHI in sarcoidosis patients. Body mass index, sex, neck circumference, and NoSAS score were predictors for OSA in sarcoidosis. The risk for mild OSA is 2.5-fold higher in sarcoidosis patients compared with matched controls. OSA seems not to be the reason for increased sleepiness or fatigue in sarcoidosis. Risk factors such as body mass index, sex, neck circumference, and NoSAS score can be used to screen for OSA in sarcoidosis patients. Registry: ClinicalTrials.gov; Name: Obstructive Sleep Apnoea in Sarcoidosis (OSASA); URL: https://clinicaltrials.gov/ct2/history/NCT04156789?V_2=View; Identifier: NCT04156789. Roeder M, Sievi NA, Schneider A, etal. The prevalence of obstructive sleep apnea in sarcoidosis and its impact on sleepiness, fatigue, and sleep-associated quality of life: a cross-sectional study with matched controls (the OSASA study). J Clin Sleep Med. 2022;18(10):2415-2422.

Prevalence of Obstructive Sleep Apnea Is Increased in Patients With Inflammatory Bowel Disease: A Large, Multi-Network Study.

Crohn's disease (CD) and ulcerative colitis (UC) involve an inflammatory state where sleep dysregulation is common. Little is known about implications, if any, of inflammatory bowel disease (IBD) on the development of obstructive sleep apnea (OSA). This study aims to investigate if IBD patients are at higher risk for OSA. This retrospective multivariate analysis utilized a commercial database named Explorys (IBM Watson). We identified patients from 1/2015 to 1/2020 with UC and CD. Cohorts of these patients with and without OSA were then created and prevalence values were obtained. A multivariate analysis was used to correct for several potential confounding variables. The overall prevalence of OSA was 7.8% in UC and 7.2% in CD, as compared with a prevalence of 4.3% in non-IBD patients (odds ratio [OR] for UC: 1.9 [95% CI 1.86-1.94, P < .0001], OR for CD: 1.72 [95% CI 1.69-1.76, P < .0001]). In multivariate analysis, age above 65, Caucasian race, male sex, obesity, smoking, hypertension, and diabetes were all independent risk factors for the development of OSA, with obesity being the most significant. After controlling for the listed variables in the multivariate analysis, IBD was an independent risk factor associated with OSA (OR 1.46, 95% CI 1.43-1.48). In this large population-based study, IBD was independently associated with increased prevalence of OSA. This has implications for screening for OSA in IBD, as well as management of other risk factors for OSA in IBD.

OBSTRUCTIVE SLEEP APNEA AND CARDIOVASCULAR RISK FACTORS IN THE PATIENTS WITH TYPE 2 DIABETES MELLITUS

The aim of this study is to determine the risk factors of obstructive sleep apnea (OSA) and cardiovascular diseases (CVD) in adult patients with Type 2 diabetes. In this cross-sectional study, the data have been collected from 228 type 2 diabetes patients by using the "Patient Information Form," "Berlin Survey," and "Framingham Risk Score" between March 3 and July 15, 2016. The OSA risk level and factors affecting patients were assessed in this study. Gender, Framingham risk score, BMI, waist/hip ratio, and waist circumference were found to statistically significantly increase the risk of OSA in patients with diabetes. Our data suggest that sleep disturbance is common in patients with Type 2 diabetes, and individuals at high risk for OSA are also at higher risk for CVD. OSA appears to increase the risk of CVD in patients with Type 2 diabetes. When healthcare professionals care for diabetic patients, symptoms of sleep disorders should be evaluated. Sleep disorder symptoms and management should be included in the education programs of diabetic patients.

The impact of obstructive sleep apnea on quality of life in children with asthma

Background In children with asthma, obstructive sleep apnea (OSA) is a comorbidity of concern. The presence of OSA has been associated with asthma exacerbations and decreased quality of life. Leukotriene played a role in tonsil hypertrophy which is one of the risk factors for OSA.&#x0D; Objective To evaluate the influence of OSA on quality of life in children with asthma.&#x0D; Methods This cross-sectional study in asthmatic children aged 7?15 years was conducted from August 2020 to June 2021 at government elementary and primary high schools in Bandung, West Java, Indonesia. Asthma was diagnosed by peak expiratory flow rate (PEFR) and OSA was diagnosed by polysomnography. Leukotriene was examined by an ELISA method and quality of life assessed by the Pediatric Asthma Quality of Life Questionnaire (PAQLQ).&#x0D; Results Using the ISAAC questionnaire distributed through teachers to parents, 206 (6.9%) of 2,964 children stated that they had been diagnosed with asthma, 80 of whom were included in our study. Subjects’ mean age was 12 (SD 2) years and most were male. Intermittent asthma and history of allergy was dominant. Thirty-two children had OSA, mostly mild OSA. The mean level of leukotriene was not different between asthmatic children with and without OSA. The percentage of PEFR in asthmatic children with OSA was significantly lower than in those without OSA. The total PAQLQ score in asthmatic children with OSA and all PAQLQ domains were significantly lower than in those without OSA.&#x0D; Conclusion Obstructive sleep apnea in children with asthma is significantly associated with decreased peak expiratory flow rate and lower quality of life.

0514 Risk Factors for Symptoms and Signs of Sleep Apnea Impacting Quality of Life in an Urban Pediatric Community-Based Sample

Abstract Introduction Pediatric obstructive sleep apnea (OSA) disproportionately affects children from minority groups and children living in disadvantaged neighborhoods, but the risk factors that drive this risk are not well understood. We investigated the relationship between minority race/ethnicity, household risk factors (smoking, socio-economic status [SES]), and neighborhood disadvantage with OSA-related quality of life (QOL) scores in participants in the Environmental Assessment of Sleep Youth (EASY) observational study. Methods Families of children 5-12 years old recruited from largely low-income Boston-area neighborhoods participated in an extensive in-home evaluation of OSA risk factors. OSA-related QOL was assessed with parent-reported OSA-18 questionnaire (values &amp;gt;37 indicative of negative impact of symptoms and signs of OSA on QOL). Secondhand smoking (SHS) was defined by parent-report of smoking in the home. Neighborhood disadvantage was characterized using geocoded addresses, calculating the Neighborhood Socioeconomic (NSES) index. We performed logistic regression with OSA-18 &amp;gt;37 as the dependent variable and age, gender, race/ethnicity, BMI, household smoking, household measures of SES and NSES index as independent variables. Results The sample included 256 children (40%-Hispanic ethnicity, 31%-Black, 20%-White, 9%-Other; 56% were female), with a mean age 9.1±1.9 and BMI percentile 69.9±29.8. 33% and 40% of children were from households with income &amp;lt;$25,000 and $25,000-$75,000, respectively, and 10% had SHS exposure. Mean NSES index was 47.9±15.4 (national average of 50). An elevated OSA-18 was reported for 35% of participants and significantly associated with Hispanic ethnicity and smoking exposure (OR=2.16, CI 1.01-4.62 and OR=2.71, CI 1.2-6.3) after adjusting for age, gender, and BMI percentile. Further adjustment for family income attenuated the association of OSA-18 with Hispanic ethnicity, but a significant association with household smoking persisted. NSES index and BMI percentile were not associated with OSA-18. Conclusion High symptoms and signs of OSA impacting QOL were associated with Hispanic ethnicity, household smoking and SES in this diverse cohort of children living in urban and predominantly low-income communities. The study points to the need for strategies to reduce household smoking as one strategy for decreasing sleep health disparities, and the further need to understand other factors associated with low SES that increase risk for poor sleep health. Support (If Any) NIH-NHLBI/T32HL007901, R35HL1358181, P30ES000002, K24AI106822, R01Hl137192, K23ES031663

Automatic Segmentation and Quantification of Upper Airway Anatomic Risk Factors for Obstructive Sleep Apnea on Unprocessed Magnetic Resonance Images

Accurate segmentation of the upper airway lumen and surrounding soft tissue anatomy, especially tongue fat, using magnetic resonance images is crucial for evaluating the role of anatomic risk factors in the pathogenesis of obstructive sleep apnea (OSA). We present a convolutional neural network to automatically segment and quantify upper airway structures that are known OSA risk factors from unprocessed magnetic resonance images. Four datasets (n=[31, 35, 64, 76]) with T1-weighted scans and manually delineated labels of 10 regions of interest were used for model training and validations. We investigated a modified U-Net architecture that uses multiple convolution filter sizes to achieve multi-scale feature extraction. Validations included four-fold cross-validation and leave-study-out validations to measure generalization ability of the trained models. Automatic segmentations were also used to calculate the tongue fat ratio, a biomarker of OSA. Dice coefficient, Pearson's correlation, agreement analyses, and expert-derived clinical parameters were used to evaluate segmentations and tongue fat ratio values. Cross-validated mean Dice coefficient across all regions of interests and scans was 0.70 ± 0.10 with highest mean Dice coefficient in the tongue (0.89) and mandible (0.81). The accuracy was consistent across all four folds. Also, leave-study-out validations obtained comparable accuracy across uniquely acquired datasets. Segmented volumes and the derived tongue fat ratio values showed high correlation with manual measurements, with differences that were not statistically significant (p < 0.05). High accuracy of automated segmentations indicate translational potential of the proposed method to replace time consuming manual segmentation tasks in clinical settings and large-scale research studies.

Role of Adenotonsillectomy and Tonsillectomy in Children with Down Syndrome Who Develop Obstructive Sleep Apnea by Obesity as a Risk Factor.

Down syndrome (DS) or trisomy 21 is caused due to the presence of additional chromosome 21 in humans. DS can exist either as free trisomy 21 (nondisjunction), Robertsonian translocated DS, or as mosaic DS. Obstructive sleep apnea (OSA) is a complex condition with serious health implications for pediatric individuals with DS. OSA is common in DS, and when it is present, it appears to be extreme. Obesity and snoring are some of the OSA risk factors for children associated with DS and OSA. Adenotonsillectomy is one of the surgical protocols applied in children, which is useful in lowering the OSA in which obesity is commonly connected within normal and DS children. Tonsillectomy is the alternative procedure of surgery connected with postoperative respiratory complications, and adenotonsillectomy was found to be a safe surgical method in children and improves the quality of life. The main aim of this review is to bridge the gap between the role of OSA in normal children (46, XX/XY) and DS children (47, XX/XY+21) characterized by the presence of chromosomes and exactly what is the involvement with adenotonsillectomy and tonsillectomy when obesity is a risk factor. The treatment for OSA and obesity is rehabilitative and reversible; however, DS can be managed but not resolved because the disorder occurs from the existence of an extra chromosome during the failure of homologous chromosomal pairing separation during maternal meiosis I. This review concludes that there is a treatment for OSA and obesity and that DS children can be prevented from being obese or experiencing OSA but cannot be turned to normal chromosomes due to an extra trisomy 21. According to this review, children with DS and OSA/OSAS, as well as concomitant complications, can be treated.

Prevalence and Risk Factors for Rapid Eye Movement-Related Obstructive Sleep Apnea in Children.

ObjectivesDifferent pathophysiological mechanisms and the distribution of respiratory events among rapid eye movement (REM) and non-rapid eye movement (NREM) sleep modulate the effect of obstructive sleep apnea (OSA). We aimed to study the prevalence and risk factors for REM-related OSA in children.Study DesignRetrospective, cross-sectional study.MethodsWe recruited 366 children with OSA confirmed by polysomnography (PSG) over a 5-year period. REM-related OSA is defined by an obstructive apnea-hypopnea index (OAHI) in the REM sleep ≥2× than during NREM sleep.ResultsThe prevalence of REM-related OSA in children was 50.3%. Children with REM-related OSA were more likely to be female (P = 0.042), and had lower prevalence of adenotonsillar hypertrophy (P = 0.043) compared with children with other OSA subtypes. Children with REM-related OSA slept longer in the supine position (P = 0.003), had shorter duration of NREM1 sleep (P = 0.018), lower nadir SpO2 (P = 0.005), and a higher oxygen desaturation index 3% (ODI3%) (P = 0.014), and lower arousal index (P = 0.034) compared with other OSA subtypes. Female gender and supine sleep was the independent risk factors for REM-related OSA.ConclusionThe prevalence of REM-related OSA was 50.3%. OAHIREM should be considered as an important parameter in future clinical research studies done in children with OSA.

Factors Associated With Undiagnosed Obstructive Sleep Apnea in Overweight and Obese High-Tech Employees: A Multisite Cross-Sectional Study.

Background: Being overweight or obese is regarded as crucial risk factors for obstructive sleep apnea (OSA). Objectives: This study aimed to determine the influencing factors of overweight and obese employees with OSA in high-tech workplaces. Methods: A cross-sectional study design was employed. A total of 491 overweight and obese participants were recruited from a large-scale electronics industry. The Chinese version of Pittsburgh Sleep Quality Index, the Epworth Sleep Scale, and a portable sleep monitoring device were used for data collection. Logistic regression analysis was conducted to identify the factors affecting overweight and obese employees with OSA. This study was conducted from August 2019 to July 2020. Results: 60.5% of the overweight and obese participants were found to have OSA, of which 58.9% had mild and 18.5% had severe OSA, respectively. The results showed that age, neck circumference, snoring, and habitual drinking were the crucial factors affecting OSA. Remarkably, age and snoring times showed a significant correlation in predicting OSA of different severities. Neck circumference was an independent risk factor for moderate and severe OSA. Conclusion: More than 60% of the overweight and obese high-tech workplace employees were found to have OSA. We found that the older the age, the larger the neck circumference, a higher number of snoring instances, and drinking were important risk factors for predicting OSA in overweight high-tech employees. The healthcare providers should actively educate OSA-related information for employees in the workplace, and promote high-risk OSA groups to adopt screening based on at-home sleep apparatus.

Prevalence and clinical characteristics of sleep-disordered breathing in patients with heart failure of different left ventricular ejection fractions.

The prevalence of sleep-disordered breathing (SDB) is high in patients with heart failure (HF), while the prevalence of SDB in HF with different left ventricular ejection fractions (LVEF) has rarely been reported. We aimed to explore the prevalence and clinical characteristics of SDB in patients withHF having different LVEF. Patients with stable HF were consecutively enrolled. All patients underwent portable overnight cardiorespiratory polygraphy and echocardiography. According to their LVEF, the patients were divided into the HFrEF (HF with reduced EF, EF < 40%), HFmrEF (HF with mid-range EF, 40 ≤ EF < 50), and HFpEF groups (HF with preserved EF, EF ≥ 50%). The prevalence and clinical data of SDB among the 3 groups were then compared. A total of 252 patients, including 134 men, were enrolled in the study. The prevalence of SDB inpatients with HF was 70%. Obstructive sleep apnea (OSA) was diagnosed in48% and central sleep apnea (CSA) in 22%. The prevalence of SDB in the HFrEE, HFmrEF, and HFpEF groups was 86%, 86%, and 62%, respectively (P = 0.001). The prevalence of OSA among the 3 groups was 42%, 47%, and 49%, respectively (P = 0.708), while the prevalence of CSA among the 3 groups was 44%, 40%, and 13% (P < 0.001). Logistic regression analysis revealed that age and BMI were independent risk factors for OSA in patientswith HF, while LVEF and smoking were independent risk factors for CSA in patientswith HF. Correlational analyses revealed that LVEF was negatively correlated with apnea-hypopnea index (AHI) (r = -0.309, P < 0.001) and central apnea index (CAI) ( r = -0.558, P < 0.001), while there was no significant correlation with obstructive apnea index (OAI). The ROC curve revealed that LVEF could predict the occurrence of CSA and SDB, with AUC = 0.683 (95%CI 0.600-0.767, P < 0.001) and AUC = 0.630 (95%CI 0.559-0.702, P = 0.001), but not of OSA. SDB was highly common in HF, and the prevalence of SDB was different in HF with different LVEF, mainly due to the difference in cardiac functions. The prevalence and severity of SDB in HFrEF and HFmrEF were significantly higher than those in HFpEF, which was mainly related to the increase in CSA. When HFmrEF was similar to HFrEF in cardiac functions, the prevalence, type, and severity of SDB were similar between the two groups. Changes in LVEF had a significant impact on CAI, but not on OAI. LVEF can predict the occurrence of CSA and SDB to a certain extent.

A portrait of obstructive sleep apnea risk factors in 27,210 middle-aged and older adults in the Canadian Longitudinal Study on Aging

Determining the prevalence and characteristics of individuals susceptible to present with obstructive sleep apnea (OSA) is essential for developing targeted and efficient prevention and screening strategies. We included 27,210 participants aged ≥45 years old (50.3% women) from the Canadian Longitudinal Study on Aging. Using the STOP questionnaire combined to the percentage of body fat (%BF), we estimated the prevalence of individuals at high-risk for OSA in a sex and age-specific manner, and tested the relation with comorbidities, menopause and systemic inflammation. The prevalence was 17.5%, and was lower in women (13.1%) than in men (21.9%). A high level of high-sensitivity C-reactive protein was the strongest factor associated with OSA risk and this association was 1.3–2.3 times higher in women than in men. OSA risk increased with age, cardiovascular diseases, diabetes mellitus, anxio-depressive symptoms, asthma and arthritis. In women, post-menopausal status was associated with a high OSA risk. Nearly 1 adult out of 5 older than 45 is at risk for OSA in Canada. Comorbidities, menopause and systemic inflammation, more than age, explain increased OSA prevalence. Considering this high prevalence and associations with medical and mental comorbidities, health care practitioners should incorporate systematic OSA screening in their clinical procedures.

What are the Soft Tissue Risk Factors for Obstructive Sleep Apnea in Patients with Down's Syndrome?

To determine the risk factors and their respective magnitudes for developing Obstructive Sleep Apnea (OSA) in Down syndrome (DS) patients. Retrospective cohort study. The 2016 Kids' Inpatient Database (KID) was queried to identify all patients diagnosed with DS. The primary predictor variables were tonsillar hypertrophy (TH), adenoidal hypertrophy (AH), Hypertrophy of Tonsils & Adenoids (HTA), Laryngeal Stenosis (LS), Hypotonia, Glossoptosis, Congenital Laryngomalacia (CL), and Overweight & Obesity (OO). The primary outcome variable was OSA. The final sample consisted of 18,181 patients with a diagnosis of DS. Relative to patients aged 0-5, patients aged 6-10 (OR 3.5, P < 0.01), 11-5 (OR 3.4, P < 0.01), and 16 & above (OR 3.6, P < 0.01) were each independently associated with increased odds of OSA. Further, TH (OR 23.2, P < 0.01), AH (OR 20.3, P < 0.01), HTA (OR 64.2, P < 0.01), glossoptosis (OR 5.0, P < 0.01), CL (OR 4.3, P < 0.01), and OO (OR 3.7, P < 0.01) were all independent risk factors for OSA. The presence of hypertrophied tonsils and adenoids together was the strongest risk factor for OSA. DS patients aged six and above were at risk for OSA development relative to younger patients. Patients with DS should be tested for OSA, which otherwise will deteriorate their existing comorbidities.