Risk Of Apnea Research Articles

Obstructive sleep apnea syndrome and cardiovascular risk factors in the antihypertensive therapy "escape" phenomenon

To assess the role of obstructive sleep apnea and other cardiovascular (CV) risk factors in the development of the antihypertensive therapy (AHT) efficacy "escape" phenomenon in patients with arterial hypertension (AH). The data of 75 patients with AH stage I-II, grades 1-3 were proceeded. All patients included in the study underwent night respiratory monitoring. After AHT prescription, blood pressure (BP) was monitored by three measurement methods (office, daily monitoring and self-control of blood pressure) - initially, in 1, 3 and 6 months after the inclusion - in order to confirm the initial therapy efficacy and to identify or exclude the "escape" phenomenon. In 36.0% of patients, the "escape" phenomenon was diagnosed in 1 or 3 months of observation. When comparing the group with the "escape" phenomenon, an initially higher level of systolic BP was revealed according to office measurements, 24-hour monitoring and self-control BP monitoring (134.0±4.7 mmHg vs 126.0±8.5 mmHg; 129.0±2.3 mmHg vs 121.0±7.7 mmHg; 131.0±8.2 mmHg vs 121.5±6.2 mmHg resp.; р<0,05). There were no differences in sleep apnea and CV risk factors between the groups. However in patients with a minimal SpO2≤85% during sleep, there were a higher levels of office systolic BP both before the AHT prescription, and during its use (157.6±10.4 mmHg vs 152.4±8.1 mmHg resp., р<0,05; 132.0±6.8 vs 127.1±8.9 mmHg resp.; р<0,05), and mean 24-hour systolic BP (125.7±5.9 vs 121.6±8.2 mmHg resp.; р<0,05) - compared with patients with a minimum SpO2>85%. The higher BP level in patients with lover nocturnal hypoxemia does not allow us to exclude the delayed negative impact of obstructive sleep apnea, especially severe, on the BP profile in case of initially successful AH control.

Obstructive sleep apnoea and long-term risk of incident diabetes in the middle-aged and older general population.

Obstructive sleep apnoea (OSA) is associated with increased risk of type 2 diabetes. However, results from large population-based prospective cohort studies are rare. The main aim of the present study was to investigate the relative risk of 8-year incident type 2 diabetes in relation to OSA severity in a prospective cohort study of middle-aged and older adults. A total of 2918 participants (mean age 59 years) of the Korean Genome and Epidemiology Study (KoGES), who underwent home-based overnight polysomnography at baseline examination between 2011 and 2014, were followed up 4-yearly between 2015-2018 and 2019-2021. A total of 1697 participants were present in both follow-ups. After excluding participants who had diabetes at baseline (n=481), a total of 1216 participants were eligible for the analyses. OSA at baseline was categorised by apnoea-hypopnoea index levels as non-OSA (0-4.9 events·h-1), mild OSA (5.0-14.9 events·h-1) and moderate-severe OSA (≥15.0 events·h-1). Incident type 2 diabetes was identified at each follow-up. Compared with non-OSA, participants with moderate-severe OSA had 1.5 times higher risk of developing type 2 diabetes at the end of the 8-year follow-up after adjusting for potential covariates (relative risk 1.50, 95% CI 1.02-2.21). In the same analytical models for 4-year relative risk of incident type 2 diabetes, none of the OSA groups were at significantly higher risk compared with the non-OSA group. Moderate-severe OSA, a modifiable risk factor, poses a higher risk of incident type 2 diabetes compared with non-OSA over an 8-year period in general middle-aged and older adults.

The efficacy of STOP-BANG questionnaire in screening of benign snoring and mild obstructive sleep apnea

Polysomnography is the gold standard for diagnosing sleep-related breathing disorders. Respiratory pulse oximetry can be used for screening, and several pre-screening questionnaires are available to assess the risk of obstructive sleep apnea. STOP-BANG questionnaire is simple and effective according to the literature. Investigating the effectiveness of the STOP-BANG questionnaire for screening benign snoring and mild obstructive sleep apnea. We analyzed the data of patients examined in our department for suspected sleep-related breathing disorder between 20. 06. 2021 and 19. 03. 2022. We compared the subsequently calculated STOP-BANG scores to the respiratory pulsoximetry results. Due to the lack of information regarding the intensity of snoring, the analysis was performed both with positive and negative results for this criterion. Sensitivity, specificity, positive and negative predictive values were calculated. We analyzed the data of 36 patients, one of them was examined twice due to weight loss. Benign snoring was confirmed by 19 patients, mild obstructive sleep apnea in 9, moderate in 4, and severe in 5 cases. Assuming loud snoring, the sensitivity was 100%, the specificity 21%, the positive predictive value 29%, and the negative predictive value 100%. Assuming no loud snoring, the sensitivity was 100%, the specificity 54%, the positive predictive value 41%, and the negative predictive value 100%. STOP-BANG questionnaire is effective, and can also be used in primary care to screen benign snoring and mild obstructive sleep apnea. Unnecessary device tests can be reduced by using it, resulting in significantly shorter waiting times for the sleep tests for high-risk patients. Orv Hetil. 2023; 164(7): 265-272.

Adult-onset obstructive sleep apnea and pediatric pharyngoplasty in 22q11.2 deletion syndrome

Objective/backgroundWe aimed to evaluate adult-onset obstructive sleep apnea (OSA) and related risk factors, including history of pediatric palatal/pharyngeal surgery to remediate velopharyngeal dysfunction, in 22q11.2 deletion syndrome (22q11.2DS). Patients/methodsUsing a retrospective cohort design and standard sleep study-based criteria, we determined presence of adult-onset OSA (age ≥16 years) and relevant variables through comprehensive chart review in a well-characterized cohort of 387 adults with typical 22q11.2 microdeletions (51.4% female, median age 32.3, interquartile range 25.0–42.5, years). We used multivariate logistic regression to identify independent risk factors for OSA. ResultsOf the 73 adults with sleep study data, 39 (53.4%) met criteria for OSA at median age 33.6 (interquartile range 24.0–40.7) years, indicating a minimum OSA prevalence of 10.1% in this 22q11.2DS cohort. History of pediatric pharyngoplasty (odds ratio 2.56, 95% confidence interval 1.15–5.70) was a significant independent predictor of adult-onset OSA, while accounting for other significant independent predictors (asthma, higher body mass index, older age), and for male sex. An estimated 65.5% of those prescribed continuous positive airway pressure therapy were reported as adherent. ConclusionsIn addition to factors of known importance in the general population, delayed effects of pediatric pharyngoplasty may contribute to risk of adult-onset OSA in individuals with 22q11.2DS. The results support increased index of suspicion for OSA in adults with a 22q11.2 microdeletion. Future research with this and other homogeneous genetic models may help to improve outcomes and to better understand genetic and modifiable risk factors for OSA.

Facial and Intraoral Photographic Traits Related to Sleep Apnea in a Clinical Sample with Genetic Ancestry Analysis.

Rationale: Craniofacial and pharyngeal morphology influences risk for obstructive sleep apnea (OSA). Quantitative photography provides phenotypic information about these anatomical factors and is feasible in large samples. However, whether associations between morphology and OSA severity differ among populations is unknown. Objectives: The aim of this study was to examine this question in a large sample encompassing people from different ancestral backgrounds. Methods: Participants in SAGIC (Sleep Apnea Global Interdisciplinary Consortium) with genotyping data were included (N = 2,393). Associations between photography-based measures and OSA severity were assessed using linear regression, controlling for age, sex, body mass index, and genetic ancestry. Subgroups (on the basis of 1000 Genomes reference populations) were identified: European (EUR), East Asian, American, South Asian, and African (AFR). Interaction tests were used to assess if genetically determined ancestry group modified these relationships. Results: Cluster analysis of genetic ancestry proportions identified four ancestrally defined groups: East Asia (48.3%), EUR (33.6%), admixed (11.7%; 46% EUR, 27% Americas, and 22% AFR), and AFR (6.4%). Multiple anatomical traits were associated with more severe OSA independent of ancestry, including larger cervicomental angle (standardized β [95% confidence interval (CI)] = 0.11 [0.06-0.16]; P < 0.001), mandibular width (standardized β [95% CI] = 0.15 [0.10-0.20]; P < 0.001), and tongue thickness (standardized β [95% CI] = 0.06 [0.02-0.10]; P = 0.001) and smaller airway width (standardized β [95% CI] = -0.08 [-0.15 to -0.002]; P = 0.043). Other traits, including maxillary and mandibular depth angles and lower face height, demonstrated different associations with OSA severity on the basis of ancestrally defined subgroups. Conclusions: We confirm that multiple facial and intraoral photographic measurements are associated with OSA severity independent of ancestral background, whereas others differ in their associations among the ancestrally defined subgroups.

High Risk of Obstructive Sleep Apnea in Hemorrhagic Stroke Patient

Background: Stroke is one of the biggest causes of mortality and morbidity in the world, about 10% - 20% are caused by hemorrhagic strokes. Obstructive Sleep Apnea (OSA) is a sleep disorder that is often found in 5-15% of the general population and has a high prevalence in patients with cerebrovascular disease. Case summary: A 51 year old female with a sudden loss of consciousness since 1 day ago, while working. The patient has a history of hypertension since 2014. On computerized tomography scan (CT scan) of the head without contrast shows bleeding. During hospitalization, it appears that the patient snoring, easily falls asleep during the day and there are periods of apnea when the patient sleeps. The blood gas analysis was normal. The patient's sleep score shows high risk of OSA. Discussion: Patient with a hemorrhagic stroke and high risk OSA. There are several risk factors that influence the emergence of OSA in this case, obesity and hypertension. The therapy is to prohibit positioning, sleep hygiene, and losing weight. Conclusion: We have reported a case of hemorrhagic stroke with a high risk of OSA that was experienced long before. The high risk of OSA in these patients can be a risk factor for hemorrhagic stroke. Polysomnography examination needs to be done in patients with a high risk of OSA, as the gold standard. Management of these patients apart from giving pharmacological therapy combined with behavioral and positional therapy to treat OSA symptoms. Mandibular enhancement devices and continuous positive airway pressure (CPAP) have not been given to this patient because polysomnography has not been performed and cost constraints. Keywords: hypertension; hemorrhagic stroke; obesity; OSA

A Three-dimensional Analysis of Nasopharyngeal Airway Characteristics in Subjects with Cleidocranial Dysplasia: A CBCT Study.

Children with congenital or acquired craniofacial abnormalities exhibit an array of dental abnormalities like supernumerary teeth, failure of permanent teeth eruption, decreased alveolar bone height, etc. These subjects undergo complex corrective surgeries to improve esthetics and functional derangements, predisposing them to risks of obstructive sleep apnea due to airway obstruction. The various corrective or therapeutic procedures done might lead to airway complications in these children. The study designed was for retrospective evaluation and comparison of the nasopharyngeal (NP) characteristics and assessment of the airway volume three-dimensionally in normal vs cleidocranial subjects. Cone-beam computed tomography (CBCT) scans of nine subjects with cleidocranial dysplasia (CCD) were compared with the control sample, and matched for age and sex. A 3D-DOCTOR software by Able Software Corporation was used to calculate the volumetric measurements. The correlation and differences among the values were assessed using an independent t-test and Pearson analysis. The values of lower airway width, upper adenoid width, McNamara upper pharynx, retroglossal area, and total pharyngeal area were found to be reduced in the cleidocranial subjects. The NP airway volume and total airway volume also significantly decreased. Cleidocranial dysplasia (CCD) being a rare genetic disorder, we could find only nine established cases. Hence our study can be called a pilot study but may work to establish a database of any sort of skeletal and dental anomaly with possible specific respiratory characteristics affecting airway. Chaturvedi S, Chaturvedi Y, Chowdhary S, et al. A Three-dimensional Analysis of Nasopharyngeal Airway Characteristics in Subjects with Cleidocranial Dysplasia: A CBCT Study. Int J Clin Pediatr Dent 2022;15(5):520-524.

Sleep Disorders Among Individuals With Rheumatoid Arthritis.

Self-reported sleep problems are common in rheumatoid arthritis (RA), with potential negative health implications, yet relatively little research has focused on sleep in RA. We examined the prevalence of obstructive sleep apnea (OSA) risk, restless legs syndrome (RLS) symptoms, and short sleep (SS) in a large RA cohort (n=4,200) and factors associated with each. Data are from FORWARD, The National Databank for Rheumatic Diseases. Validated screening measures assessed OSA risk and RLS symptoms. SS was based on self-reported average sleep time (<6 hours). The Medical Outcomes Study Sleep Problems Index I measured self-reported sleep quality. Multivariable logistic regression models identified independent predictors of sleep disorders and sleep quality and the independent association of OSA risk, RLS symptoms, and SS with self-reported poor sleep quality. Twenty-one percent (n=899) had OSA diagnosis or risk, 30% (n=1,272) had RLS symptoms or diagnosis, and 43% (n=1,737) reported SS, and RA disease activity was associated with each sleep disorder. Abatacept use was associated with lower odds of RLS and SS. Use of conventional disease-modifying antirheumatic drugs or abatacept was less frequent in the SS group. No medications were associated with OSA in multivariable analyses. Both RLS and SS was associated with worse perceived sleep quality. Almost two-thirds met criteria for at least one sleep disorder. RA disease activity and pain were significantly associated with each sleep condition. Additional research is needed to identify the causal pathway between sleep disorders and RA disease activity and pain and the long-term consequences of sleep disorders in RA.

Use of Swedish smokeless tobacco during pregnancy: A systematic review of pregnancy and early life health risk.

Smokeless tobacco is a heterogeneous product group with diverse composition and prevalence globally. Tobacco use during pregnancy is concerning due to the risk of adverse pregnancy outcomes and effects on child health. Nicotine may mediate several of these effects. This systematic review measured health outcomes from Swedish smokeless tobacco (snus) use during pregnancy. Literature search was conducted by an information specialist in May 2022. We included human studies of snus use during pregnancy compared with no tobacco use, assessed risk of bias, conducted a meta-analysis and assessed confidence in effect-estimates using Gradingof Recommendations, Assessment, Development and Evaluations (GRADE). We included 18 cohort studies (42 to 1 006 398 participants). Snus use during pregnancy probably (moderate confidence in risk estimates) increase the risk of neonatal apnea, adjusted odds ratio 95% confidence interval [aOR (95% CI)] 1.96 (1.30 to 2.96). Snus use during pregnancy possibly (low confidence in risk estimates) increase the risk of stillbirths aOR 1.43 (1.02 to 1.99), extremely premature births aOR 1.69 (1.17 to 2.45), moderately premature birth aOR 1.26 (1.15 to 1.38), SGA aOR 1.26 (1.09 to 1.46), reduced birth weight mean difference of 72.47 g (110.58 g to 34.35 g reduction) and oral cleft malformations aOR 1.48 (1.00 to 2.21). It is uncertain (low confidence in risk estimates, CI crossing 1) whether snus use during pregnancy affects risk of preeclampsia aOR 1.11 (0.97 to 1.28), antenatal bleeding aOR 1.15 (0.92 to 1.44) and very premature birth aOR 1.26 (0.95 to 1.66). Risk of early neonatal mortality and altered heart rate variability is uncertain, very low confidence. Snus using mothers had increased prevalence of caesarean sections, low confidence. This systematic review reveals that use of smokeless tobacco (snus) during pregnancy may adversely impact the developing child.

Association of Obstructive Sleep Apnoea Risk and Severity of Psoriasis Vulgaris in Adults

Introduction: Psoriasis vulgaris has a significant association with obstructive sleep apnoea (OSA). The study intended to explore the relation between the severity of psoriasis vulgaris and OSA risk, and to identify the factors that are attributed to increased risk of OSA. Methods: A cross sectional, observational study was carried out from October 2020 until April 2021 at the dermatology clinic of Hospital Tengku Ampuan Rahimah, Malaysia. All study participants were evaluated for OSA risk using the STOP-Bang and Epworth Sleepiness Scale questionnaires. Results: Our study recruited 237 participants and the results revealed a higher percentage of moderate to severe psoriasis participants with intermediate to high risk of OSA than participants with mild psoriasis (35.3% versus 17.7%, respectively). There was also a 2.3 times higher incidence of daytime sleepiness among participants with moderate to severe psoriasis as opposed to participants with mild psoriasis (44.1% versus 19.2%, respectively). We have also detected a significantly higher probability for OSA in psoriasis patients with diabetes mellitus versus those without (odds ratio: 2.09). We also noticed that for every unit rise in body mass index (BMI), there seemed to be a 1.06 times higher risk of OSA. Furthermore, patients with moderate to severe psoriasis were found to possess 3.32 times increased odds to have OSA. Conclusion: Our results suggest that psoriasis severity and the existence of comorbidities i.e. diabetes mellitus and high BMI are linked with an enhanced risk of OSA in adults with psoriasis.

Inter-hospital cardiorespiratory telemonitoring of newborns and infants: a wellworking example of a hub and spoke network

BackgroundPatients who experience cardiorespiratory events usually have to be moved to specialized centers to perform cardiorespiratory studies. To avoid the transfer of these patients to specialized centers, a network has been created based on an interchange system, where the recordings were uploaded in unspecialized centers (spokes) and downloaded by the Sleep Disorders Breathing (SDB) Center (hub) to be analyzed.MethodsThe inter-hospital network was established in November 2008. Initially only 3 non-tertiary hospitals in the Tuscany Region joined the network. Currently, 12 Tuscany hospitals are included.ResultsFrom November 2008 to December 2020, 625 recordings were collected belonging to 422 infants.No recurrent life-threatening episode or infant death occurred in the study population and none of the infants needed to be readmitted or be moved to a tertiary center, except infants who underwent home monitoring.The discharge diagnoses belong to the following categories: apnoea, respiratory problem of the newborn, syncope, gastroesophageal reflux, altered consciousness, transient loss of consciousness and cyanosis.ConclusionsThis study shows that the inter-hospital network is an efficient system that allows accurate and safe management of infants at risk for apnoea, bradycardia, and hypoxemia to remain in unspecialized centers, avoiding unnecessary transfers of patients and over – hospitalizations.

Poor quality sleep is associated with greater carotid intima media thickness among otherwise healthy resident doctors.

Sleep is important for maintaining the metabolic processes in the body, and hence, disruption in sleep leads to metabolic derangement and accelerated atherosclerosis. The effect of sleep duration on subclinical atherosclerosis has been examined in several studies; however, data regarding sleep quality is lacking. The study aimed to assess the association between sleep quality and carotid intima-media thickness among healthy young doctors. This was an observational cross-sectional study among 110 healthy young resident doctors. Anthropometric data were recorded and morning fasting venous blood samples were collected to assess fasting blood sugar, lipid profile and glycosylated haemoglobin (HbA1c). Pittsburgh Sleep Quality Index and Berlin questionnaire assessed subjective sleep quality and risk for obstructive sleep apnea, respectively. Carotid ultrasonography was done to detect the intima-media thickness. Average age of the participants was 26.45 (±1.43) years, and 51.8% were male. Self-reported poor sleep quality was found in 54.5%. Carotid intima-media thickness (CIMT) was increased among 44.5% of participants. In the multivariate analysis, only poor sleep quality appeared to be associated with higher CIMT (P < 0.001, OR = 7.4; 95% CI = 2.70-20.32). When different components of sleep quality was analyzed through multivariate logistic regression, subjective sleep onset latency (>30 min), sleep efficiency (<85%) and sleep disturbance was found to be associated with the increased CIMT. Poor sleep quality, especially prolonged sleep onset latency, poor sleep efficiency, and sleep disturbance are associated with increased carotid intima-media thickness among healthy young adults.

Putting the pieces together to understand anger in combat veterans and service members: Psychological and physical contributors

Dysregulated anger can result in devastating health and interpersonal consequences for individuals, families, and communities. Compared to civilians, combat veterans and service members (C–V/SM) report higher levels of anger and often have risk factors for anger including posttraumatic stress disorder (PTSD), traumatic brain injury (TBI), pain, alcohol use, and impaired sleep. The current study examined the relative contributions of established variables associated with anger (e.g., combat exposure, current PTSD symptoms, history of TBI, pain interference, and hazardous alcohol use) in 1263 C–V/SM. Sleep impairments, represented by poor sleep quality and obstructive sleep apnea (OSA) risk, were also evaluated as potential mediators of the relationships between established risk factors and anger, and therefore potential modifiable treatment targets. Multiple regression model results revealed that PTSD symptoms (β = 0.517, p < .001), OSA risk (β = 0.057, p = .016), pain interference (β = 0.214, p < .001), and hazardous alcohol use (β = 0.054, p = .009) were significantly associated with anger. Results of the mediation models revealed that OSA risk accounted for the association between PTSD and anger, in addition to the association between pain interference and anger. The current study extends previous literature by simultaneously examining factors associated with anger using a multivariable model in a large sample of C–V/SM. Additionally, treating OSA may be a novel way to reduce anger in C–V/SM who have PTSD and/or pain interference.

Risk of Sleep Apnea Is Associated with Abdominal Obesity Among Asian Americans: Comparing Waist-to-Hip Ratio and Body Mass Index.

This study examines associations between the risk of sleep apnea and abdominal obesity (assessed by waist-to-hip ratio (WHR)) and general obesity (assessed by body mass index (BMI)) in a sample of Chinese and Korean American immigrants. The dataset included Chinese and Korean participants aged 50-75 who were recruited from primary care physicians' clinics from April 2018 to June 2020 in the Baltimore-Washington D.C. Metropolitan area (n = 394). Abdominal obesity was determined if WHR ≥ 0.9 in men and WHR ≥ 0.85 in women. General obesity was determined if BMI ≥ 30. The risk of sleep apnea was determined by using the Berlin questionnaire. Poisson regression models examined associations between sleep apnea risk and obesity. Models controlled for socio-demographic risk factors. Twelve percent of the study participants were classified as a high risk for sleep apnea, and 75% had abdominal obesity whereas 6.4% had general obesity. High risk of sleep apnea was positively associated with abdominal obesity (PR = 1.31, 95% CI: 1.17-1.47) and general obesity (PR = 2.19, 95% CI: 0.90-5.32), marginally significant at p < 0.1). Chinese and Korean immigrants living in the USA who are at high risk of sleep apnea have higher abdominal obesity, even after accounting for sociodemographic characteristics. Abdominal obesity may be a better indicator than general obesity when examining the risk of sleep apnea among Asian Americans. Name: Screening To Prevent ColoRectal Cancer (STOP CRC) among At-Risk Asian American Primary Care Patients NCT Number: NCT03481296; Date of registration: March 29, 2018 URL: https://clinicaltrials.gov/ct2/show/NCT03481296?term=Sunmin+Lee&draw=2&rank=1.

Symptoms and Risk of Obstructive Sleep Apnea in Patients Attending Primary Health Care Clinics in Riyadh, Saudi Arabia.

Background Obstructive sleep apnea (OSA) is a breathing disorder that occurs while sleeping, characterized by periods of partial or complete airway collapse associated with a drop in oxygen saturation or arousal from sleep. OSA is associated with significant health consequences, including hypertension, obesity, coronary artery disease, metabolic dysfunction, cognitive decline, and cancer progression. Methods A cross-sectional study was conducted at the four primary healthcare centers in the Ministry of National Guards Health Affairs (MNGHA) in Riyadh, Saudi Arabia. The study included every adult 18- 65 years old. After informed consent was obtained, interviews were conducted using the Berlin questionnaire (BQ) to assess participants' prevalence and risk (OSA). SAS software version 9.4 was used to enter and analyze the data. Results A total of 400 primary care attendants were approached. The overall prevalence of high-risk apnea was 21%. There was a significant difference in the high risk of apnea between a BMI greater than 30 and a BMI lower than 30 (p< 0.0001). There was a significant difference in the high risk of apnea between hypertension and normal blood pressure (p< 0.0001). Conclusion The BQ assessed the predictive factors related to the development and prevalence of OSA and showed a predominance in those with a BMI over 30 Kg/m2 or with a previous diagnosis of hypertension with no significant related risk among gender and age factors.

Eating habit of adding salt to foods and incident sleep apnea: a prospective cohort study

BackgroundPrevious studies have revealed that sodium-restricted diet intervention significantly decreased apnea frequency among patients with sleep apnea. However, the longitudinal association between the habit of adding salt to foods and sleep apnea in general populations is uncertain.MethodsThe UK Biobank cohort study includes more than 500,000 participants aged 40 to 69 across the United Kingdom from 2006 to 2010. The frequency of adding salt to foods was collected through a touch screen questionnaire. Incident sleep apnea was ascertained by hospital inpatient records, death registries, primary care, and self-reported diagnosis. The association between the habit of adding salt to foods and incident sleep apnea was estimated using Cox proportional hazard regression models.ResultsAmong the 488,196 participants (mean age 56.5 years; 55.0% female) in this study. During a median follow-up of 12.3 years, 6394 sleep apnea events occurred. Compared to participants who never/rarely added salt to foods, those who sometimes, usually, and always added salt to foods had an 11% (hazard ratio [HR] 1.11, 95% confidence interval [CI]: 1.04 to 1.17), 15% (HR 1.15, 95% CI: 1.07 to 1.24), and 24% (HR 1.24, 95% CI: 1.12 to 1.37) higher risk for incident sleep apnea, respectively.ConclusionsIn this large prospective study, the habit of adding salt to foods was associated with a higher risk of incident sleep apnea. The findings support the benefits of a salt reduction program in preventing sleep apnea.

Risk of pre-term birth as a function of sleep quality and obesity: prospective analysis in a large Prematurity Research Cohort.

To investigate whether poor sleep quality is associated with pre-term birth (PTB) risk, overall and independent of sleep apnea and habitual snoring. We used longitudinal data from the Washington University Prematurity Research Cohort to investigate the association between poor sleep quality (defined as a Pittsburgh Sleep Quality Index > 5) and PTB, overall and independent of sleep apnea and snoring (defined by the Berlin questionnaire and prior sleep clinic attendance). Associations were investigated for sleep quality early and throughout pregnancy. Stratified analyses were performed by factors previously shown to modify associations between sleep and PTB (race, pre-pregnancy obesity). Of the 976 eligible participants, 50.1% experienced poor sleep quality early in pregnancy (<20 completed weeks) and 14.2% delivered pre-term (n = 50 without and 89 with poor sleep quality). In multivariable-adjusted analyses, poor sleep quality early in pregnancy was associated with increased PTB risk (hazard ratio [HR] = 1.48, 95% confidence interval [CI] = 1.02-2.14). This association persisted after further adjustment for sleep apnea and snoring (HR = 1.50, 95% CI = 1.02-2.20) and in analyses stratified by race. It varied, however, by pre-pregnancy obesity. Among individuals without obesity, no association was observed between poor sleep and PTB (HR = 1.08, 95% CI = 0.65-1.79), whereas among those with obesity, a positive association was observed (HR = 2.94, 95% CI = 1.52-5.69, p-interaction = .05). This association was limited to individuals with obesity who experienced poor sleep both earlier and later in pregnancy (HR = 3.94, 95% CI = 1.56-9.99). Our findings suggest that improving sleep quality early in pregnancy may be important for PTB prevention, particularly among individuals with obesity.

Screening the risk of obstructive sleep apnea by utilizing supervised learning techniques based on anthropometric features and snoring events.

Obstructive sleep apnea (OSA) is typically diagnosed by polysomnography (PSG). However, PSG is time-consuming and has some clinical limitations. This study thus aimed to establish machine learning models to screen for the risk of having moderate-to-severe and severe OSA based on easily acquired features. We collected PSG data on 3529 patients from Taiwan and further derived the number of snoring events. Their baseline characteristics and anthropometric measures were obtained, and correlations among the collected variables were investigated. Next, six common supervised machine learning techniques were utilized, including random forest (RF), extreme gradient boosting (XGBoost), k-nearest neighbor (kNN), support vector machine (SVM), logistic regression (LR), and naïve Bayes (NB). First, data were independently separated into a training and validation dataset (80%) and a test dataset (20%). The approach with the highest accuracy in the training and validation phase was employed to classify the test dataset. Next, feature importance was investigated by calculating the Shapley value of every factor, which represented the impact on OSA risk screening. The RF produced the highest accuracy (of >70%) in the training and validation phase in screening for both OSA severities. Hence, we employed the RF to classify the test dataset, and results showed a 79.32% accuracy for moderate-to-severe OSA and 74.37% accuracy for severe OSA. Snoring events and the visceral fat level were the most and second most essential features of screening for OSA risk. The established model can be considered for screening for the risk of having moderate-to-severe or severe OSA.

Study on behavioral risk for aging based on smart mattress monitoring data

With an aging population and a gap in demand for professional caregivers, China's elderly care system is facing severe challenges. Using data mining to expand the smart senior care scenario can effectively improve elderly care services. Based on smart mattress datasets, this paper uses machine learning classification and unsupervised anomaly detection models to analyze the possible risks in the daily behavior of older people from the perspectives of both sleep apnea problems and abnormal physiological information. The model results show that the Stacking algorithm based on data fusion can effectively identify the risk of sleep apnea. In contrast, the Prophet and DBSCAN models can carry out anomaly mining of physiological information of single and combined variables, respectively. Ultimately, based on the research, this paper provides targeted recommendations regarding data collection and integration applications.

A Study to Assess the Relationship of Anthropometric Indices to Risk of Obstructive Sleep Apnea among Patients Attending Pulmonology Outpatient Department at GKNM Hospital, Coimbatore

A Study to Assess the Relationship of Anthropometric Indices to Risk of Obstructive Sleep Apnea among Patients Attending Pulmonology Outpatient Department at GKNM Hospital, Coimbatore