Search

Abstract Recent empirical investigations reinforce the understanding of a profound interconnection between metabolic functions and Obstructive Sleep Apnea-hypopnea Syndrome (OSAHS). This study identifies distinctive miRNA signatures in OSAHS with Metabolic Syndrome (Mets) patients from healthy subjects, that could serve as diagnostic biomarkers or describe differential molecular mechanisms with potential therapeutic implications. In this study, OSAHS with MetS patients showed significantly higher Apnea Hyponea Index(AHI), but lower oxygen desaturation index(ODI 4/h) and minimum pulse oxygen saturation(SpO2). A total of 33 differentially expressed miRNAs by Limma method, and 31 differentially expressed miRNAs by DEseq2 method were screened. In addition, GO enrichment analysis of target genes associated with differentially expressed miRNAs revealed significant enrichment in metabolic processes, suggesting that the differential expression of OSAHS-induced miRNAs may contribute to the progression of metabolic disorders through the regulation of metabolic pathways. Furthermore, KEGG pathway enrichment analysis revealed significant enrichment in the p53 signaling pathway and several other pathways. Notably, the Wnt signaling pathway, PI3K-Akt signaling pathway, cAMP signaling pathway, and AMPK signaling pathway are implicated in the metabolic processes of glucose dysregulation and lipid homeostasis, as well as the pathogenesis of hypertension associated with OSAHS. We identified IKBKB, PIK3R1, and MAP2K1 as the target genes most associated with Mets pathogenesis in OSAHS, regulated by miR-503-5p, miR-497-5p, and miR-497-5p, respectively. Additionally, the target genes of differentially expressed miRNAs between Tibetan OSAHS patients with MetS and healthy individuals are regulated by transcription factors such as NR2C1, STAT3, STAT5a, HIF1a, ETV4, NANOG, RELA, SP1, E2F1, NFKB1, AR, and MYC. In conlusion, we found differentially expressed miRNAs in Tibetan OSAHS patients with Metabolic Syndrome for the first time. Enrichment analysis results suggest that differentially expressed miRNAs may involved in the development of OSAHS-related metabolic disorders by regulating metabolic pathways. We also revealed that IKBKB, PIK3R1, and MAP2K1 are mostly associated with metabolic disorder in OSAHS, and miR-503-5p and miR-497-5p may regulate the development of MetS associated with OSAHS by modulating IKBKB, PIK3R1, and MAP2K1.

Kai-li Liu,&ast; Shen-jie Xu,&ast; Si-wen Chen, Min-jie Zhang, Ni Ye, Jie Li Department of General Medicine, The First Affiliated Hospital of Soochow University, Suzhou, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Jie Li; Ni Ye, Department of General Medicine, The First Affiliated Hospital of Soochow University, No. 899 of Pinghai Road, Gusu District, Suzhou, 215006, People’s Republic of China, Tel: +86 139 6211 6580 ; +86 151 6246 0064, Email lijie_Li01@126.com; yeni0328@126.comObjective: The aim of this study was to analyze the relationship between the characteristics of the intestinal microbiota and cytokine levels in individuals with different degrees of obstructive sleep apnea-hypopnea syndrome (OSAHS) as well as to investigate intestinal microbiota imbalances in patients with OSAHS and the associated mechanisms.Methods: Based on their sleep apnea hypopnea index (AHI), a total of 37 adults were assigned to a control group, a mild OSAHS group, or a moderate-to-severe OSAHS group. Fecal samples were collected to characterize the intestinal microbiota using metagenomic next-generation sequencing (mNGS), while blood samples were collected to detect levels of interleukin-17a (IL-17a), interleukin-10 (IL-10), tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6) in each group.Results: 1. There was no significant difference in the Shannon index among the three groups (P > 0.05). The three groups showed significant difference in the relative abundance of Faecalibacterium prausnitzii and Bifidobacterium adolescentis (with F values of 3.955 and 7.24, respectively, P < 0.05), while showed no significant difference in the relative abundance of B. pseudocatenulatum, Bifidobacterium longum, Klebsiella pneumoniae, and Haemophilus parainfluenzae (P > 0.05). 2. The three groups showed significant difference in the expression of serum IL-17A and TNF-α levels (with F values of 18.119 and 10.691, respectively, P < 0.05), while showed no significant difference in the expression of IL-10, IL-6, and CRP levels (P > 0.05). 3. Multiple linear regression analysis revealed that the relative abundance of F. prausnitzii was correlated with changes in BMI and AHI (with β values of 2.585 and − 0.157, respectively, P < 0.05), while the relative abundance of B. adolescentis was correlated with changes in IL-17a (with β value of − 0.161, P < 0.05).Conclusion: The study revealed a significant correlation between intestinal microbiota abundance and cytokine levels, suggesting that gut microbiota disruption in OSAHS patients may be linked to systemic chronic inflammation.Keywords: chronic inflammation, chronic intermittent hypoxia, cytokines, intestinal microbiota, OSAHS

Background: Obstructive sleep apnea-hypopnea syndrome (OSAHS) is correlated with metabolic deterioration in patients experiencing polycystic ovary syndrome (PCOS). Women diagnosed with PCOS exhibit a heightened prevalence of OSAHS. This meta-analysis aims to assess the morbidity of OSAHS in women affected by PCOS and to examine the differences in metabolismrelated indicators between OSAHS-positive and OSAHS-negative in women with PCOS. Methods: A comprehensive literature analysis of OSAHS morbidity in women with PCOS was conducted, utilizing databases such as CNKI, EMBASE, PubMed, Web of Science, and Wanfang. A comparison was carried out between patients with OSAHS-positive and those with OSAHS-negative in terms of their clinical characteristics and metabolic differences. The search language included English and Chinese. The acquired data were analyzed by employing RevMan 5.2 and Stata 11.0. Continuous variables with the same units were combined and analyzed through weighted mean differences (WMDs) as effect sizes, while continuous variables with different units were combined and analyzed through standardized mean differences (SMDs) as effect sizes. A conjoint analysis was performed on the basis of I² value, using either a fixed effect model (I² = 50%) or a random effect model (I² > 50%). Results: A total of 21 articles met the inclusion criteria for this study. The findings indicated that 20.8% of women with PCOS were found to have comorbid OSAHS. The subjects were categorized into various subgroups for meta-analysis on the basis of race, age, disease severity, body mass index (BMI), and diagnostic criteria of PCOS. The results revealed high morbidity of OSAHS in all subgroups. In addition, most metabolic indicators and parameters of metabolic syndrome were notably worse in women suffering from both PCOS and OSAHS in comparison to their counterparts solely diagnosed with PCOS. Conclusion: The current literature indicates higher morbidity of OSAHS among women with PCOS, linking OSAHS with worse metabolic status and obesity in this population. Consequently, clinicians are advised to prioritize the detection and management of OSAHS in women with PCOS. [ABSTRACT FROM AUTHOR]

Background: The aim of this research is to achieve the early detection of facial characteristics in patients diagnosed with neurodevelopmental deficits and obstructive sleep apnoea–hypopnea syndrome (OSAHS) through the analysis of the VERT index and Ricketts' cephalometry to minimise the neurocognitive morbidity associated with these disorders. Methods: This clinical study was conducted on 44 patients aged 4 to 15 years. Participants completed an initial questionnaire about sleep disturbances, followed by a polysomnography, a radiographic study, and an oral examination. Results: The maximum variability in the data was obtained in the mandibular plane angle, where we observed that the measurement was higher in patients diagnosed with OSAHS. The relative and normalised indices of facial depth and the mandibular plane showed variations between patients with a clinical picture compatible with OSAHS and the control group without pathology. Conclusions: Our findings indicate that Ricketts' VERT index by itself is unable to provide evidence of a diagnosis compatible with OSAHS in patients with early neurodevelopmental deficits, but, after analysing the results obtained, we observed that for the cephalometric measurements of the mandibular plane angle and facial depth relative to the patient's age, there are sufficiently strong variations for creating a solid method of differential diagnosis, thus preventing complications at the neurocognitive level. [ABSTRACT FROM AUTHOR]

Objective: This study used latent profile analysis to explore the level of depression among US adults with obstructive sleep apnea hypopnea syndrome (OSAHS) symptoms and to identify different latent categories of depression to gain insight into the characteristic differences between these categories. Methods: The data of this study were obtained from the National Health and Nutrition Examination Survey (NHANES) database, and the subjects with OSAHS symptoms were aged 18 years and older. The latent profile analysis (LPA) method was used to fit the latent depression categories in subjects with OSAHS symptoms. The chi-square test, rank sum test, and binary logistic regression were used to analyze the influencing factors of depression subgroups in subjects with OSAHS symptoms. Results: Three latent profiles were identified: low-level (83.7%), moderate-level (14.5%) and high-level (1.8%) depression. The scores of 9 items in the high-level depression group were higher than those in the other two groups. Among them, item 4 "feeling tired or lack of energy" had the highest score in all categories. Conclusion: Depression in subjects with OSAHS symptoms can be divided into low-level, moderate-level and high-level depression. There are significant differences among different levels of depression in gender, marital status, PIR, BMI, smoking, general health condition, sleep duration and OSAHS symptom severity. [ABSTRACT FROM AUTHOR]

Copyright of Revista Médica Clínica Las Condes is the property of Editorial Sanchez y Barcelo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

ObjectiveDepression is very common and harmful in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). It is necessary to screen OSAHS patients for depression early. However, there are no validated tools to assess the likelihood of depression in patients with OSAHS. This study used data from the National Health and Nutrition Examination Survey (NHANES) database and machine learning (ML) methods to construct a risk prediction model for depression, aiming to predict the probability of depression in the OSAHS population. Relevant features were analyzed and a nomogram was drawn to visually predict and easily estimate the risk of depression according to the best performing model.Study designThis is a cross-sectional study.MethodsData from three cycles (2005–2006, 2007–2008, and 2015–2016) were selected from the NHANES database, and 16 influencing factors were screened and included. Three prediction models were established by the logistic regression algorithm, least absolute shrinkage and selection operator (LASSO) algorithm, and random forest algorithm, respectively. The receiver operating characteristic (ROC) area under the curve (AUC), specificity, sensitivity, and decision curve analysis (DCA) were used to assess evaluate and compare the different ML models.ResultsThe logistic regression model had lower sensitivity than the lasso model, while the specificity and AUC area were higher than the random forest and lasso models. Moreover, when the threshold probability range was 0.19–0.25 and 0.45–0.82, the net benefit of the logistic regression model was the largest. The logistic regression model clarified the factors contributing to depression, including gender, general health condition, body mass index (BMI), smoking, OSAHS severity, age, education level, ratio of family income to poverty (PIR), and asthma.ConclusionThis study developed three machine learning (ML) models (logistic regression model, lasso model, and random forest model) using the NHANES database to predict depression and identify influencing factors among OSAHS patients. Among them, the logistic regression model was superior to the lasso and random forest models in overall prediction performance. By drawing the nomogram and applying it to the sleep testing center or sleep clinic, sleep technicians and medical staff can quickly and easily identify whether OSAHS patients have depression to carry out the necessary referral and psychological treatment.

Obstructive Sleep Apnea–Hypopnea Syndrome (OSAHS), a severe respiratory sleep disorder, presents a significant threat to human health and even endangers life. As snoring is the most noticeable symptom of OSAHS, identifying OSAHS via snoring sound analysis is vital. This study aims to analyze the time-domain and frequency-domain characteristics of snoring sounds to detect OSAHS and its severity. The snoring sounds are extracted and scrutinized from nighttime acoustic signals, with spectral energy ratio features being applied, calculated via the snore detection frequency division method. A variety of time and frequency-domain features are derived from the snoring sounds. A novel Snore Detection Cepstral Coefficient (SDCC) is proposed, based on Mel Frequency Cepstral Coefficients (MFCCs) and snore detection frequency division. Relief-F feature screening is then applied to SDCC and MFCC. Canonical Correlation Analysis (CCA) is utilized on the fusion features obtained as a result, and the results indicate the highest accuracy (97.8%) with Subspace KNN. The optimal classifier with feature combination is used for the snore model of OSASH early warnings all night, effectively recognizing and assessing OSAHS and reflecting the severity of its disease. This result, achieving high accuracy and low computational complexity, shows that the proposed method holds significant promise for developing portable sleep health detection devices. [ABSTRACT FROM AUTHOR]

The obstructive sleep apnea-hypopnea syndrome(OSAHS) is a sleep disorder caused by upper airway stenosis, and the main clinical manifestations were apnea, hypopnea, and arousal. In recent years, the incidence of OSAHS shows increasing trend, while its clinical diagnosis method is still relatively simple, and the early accurate diagnosis cannot be achieved. Metabolomics has played an important role in many disciplines such as medicine, pharmacy, and toxicology as an emerging subject, even if its research develops relatively short time. In this paper, we systematically reviewed the studies and applications of metabolomics on OSAHS biomarkers and found that OSAHS could cause changes in some special metabolites, including amino acids, lipids, acylcarnitines, intestinal flora, phospholipids, aromatic hydrocarbons, saturated hydrocarbons, acetone and isoprene. These metabolites involved in various metabolic pathways and mechanisms such as amino acid metabolism, lipid metabolism, oxidative stress pathway, phospholipid metabolism and endocannabinoids. The differential metabolites existed in a variety of biological samples in patients, including blood, urine, feces, saliva, and tonsil tissue, and some metabolites could be used in the early diagnosis and differential diagnosis of OSAHS and as the reference for further research on the biomarkers and pathogenesis of OSAHS.

Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a disease marked by apnea, hypopnea, decreased oxygen saturation, and disordered sleep structure, which is a major risk for cardiovascular disease. Recent studies have found that OSAHS patients have an increased risk of hypertension, coronary atherosclerotic heart disease, insulin resistance, type 2 diabetes, metabolic syndrome, non-alcoholic fatty liver disease, etc. And these patients have a high prevalence of obvious glucolipid metabolism disorder (GMD) , which plays an important role in cardiovascular morbidity and mortality in OSAHS. We reviewed the latest advances in the association of GMD and OSAHS, and the potential pathogenesis of OSAHS-induced GMD and insulin resistance, aiming at providing new ideas for clinical treatment of GMD in OSAHS.

Obstructive Sleep Apnea/Hypopnea Syndrome (OSAHS) has commonly occured in Down syndrome children caused by the abnormalities in upper respiratory tract anatomy and obesity. This study aims to identify the correlation between Mallampati score and obesity and the risk of OSAHS in Down syndrome children. This was an analytical descriptive cross-sectional study. This study was conducted in children with Down syndrome from September until November 2017. All parents filled the Indonesian Pediatric Sleep Questionnaire (PSQ), then all of the children were examined for Mallampati score and BMI. The correlation was analyzed by the Pearson Chi-Square model. Thirty-six subjects were included in this study. The number of male subjects were slightly more (61.1%), the mean age of the subjects was 8.42±4,449 years, with 52.8% (19 subjects) having OSAHS. There were 23 subjects (63.9%) who had Mallampati scores of 3 and 4, with 13 subjects (36.1%) were obese. This study concluded a statistically significant correlation between Mallampati score and obesity and the risk of OSAHS in Down syndrome children (p-value 0.001 and 0.029). Mallampati score and obesity had a significant correlation with the risk of OSAHS in Down syndrome children.

Obstructive sleep apnea hypoventilation syndrome (OSAHS) is a common sleep breathing disorder closely associated with cardiovascular disease. However, the respiratory sleep and related cardiovascular parameters on the apnea and hypopnea index (AHI) and life quality of primary snoring are unclear. We launched a cohort study focused on the association between respiratory sleep and cardiovascular-related parameters and apnea and hypopnea index, incorporating data from 218 patients with primary snoring in our medical center between Jun 1, 2015, and Apr 1, 2016. Thirty patients from Sichuan Cancer Hospital were used for validation. Patients with longer apnea time were more likely to progress to higher AHI (> 30) than controls (OR = 5.66, 95% CI = [2.79, 11.97], p < 0.001). Similarly, if patients have a higher value of diastolic blood pressure, they will also have a higher AHI (> 30) (HR [95% CI] = 3.42 [1.14, 13.65], p = 0.043). According to multivariate analysis, longest apnea time, the mean percentage of SaO2, and neckline length were independent risk factors of overall survival. A predictive model developed based on these factors above yielded a favorable agreement (C-index = 0.872) on the calibration curve. Thirty patients conducted external validation from Sichuan Cancer Hospital, displaying an AUC of 0.833 (0.782–0.884). Increased diastolic blood pressure and apnea time affect AHI level. An AHI prediction model based on these factors above can help clinicians predict the risk of high AHI events. [ABSTRACT FROM AUTHOR]

Background: The purpose of this single-centre prospective clinical study was to evaluate the correction of severe facial deformity and Obstructive sleep apnoea hypopnoea syndrome (OSAHS) in 22 patients aged from 9 to 42 years (mean 20.09) of bilateral Temporomandibular joint ankylosis. Materials and Methodology: Patients underwent multisegment distraction using external bilateral bidirectional distractors. Facial deformity was evaluated clinically in terms of mouth opening and neck chin angle and cephalometrically in terms of corpus length (gonion-pogonion), ramal height (articulare-gonion), chin deficiency (N perpendicular to Pog and SNB). OSAHS was evaluated through Epworth sleepiness scale, Berlin's questionnaire, pharyngeal airway space, apnoeic hypoapnoeic index, oxygen desaturation index, average arterial oxygen saturation and minimal fall in O2 saturation. Patients were followed up for a period of 13–74 months (mean 28.68). Results: Statistically highly significant results were obtained in all parameters. Complications encountered were pin infection (13.63%), loosening of pins (4.5%), wound dehiscence (9.09%), tooth fracture (4.5%) and parotid fistula (9.09%). Intermediate segment necrosis and vector loss were not observed. Conclusion: This study is a large case series using two corticotomy cuts for external bilateral bidirectional distracters with concomitant neo callous moulding in patients both pre- and post-ankylosis release. It is extremely efficient in correcting mandibular corpal and ramal deficiency as well as improving OSAHS. [ABSTRACT FROM AUTHOR]

Background: Obstructive Sleep Apnoea Hypoapnoea Syndrome (OSAHS) is known to be associated with impairment in neuro-cognitive functions. This impairment in cognition is associated with daytime sleepiness that results in occupational deficits and an increased risk of automobile accidents. Objectives: The aim of the study was to assess Neuro-cognition in patients of Obstructive Sleep Apnoea Hypoapnoea Syndrome (OSAHS) Material and methods: Our study was an observational cross-sectional study. Eligible patients (n=205) undergoing polysomnography were categorized into Snoring (n=105), Mild OSA (n=70), Moderate OSA (n=17) and Severe OSA (n=13) groups, based on Apnoea Hypoapnoea Index (AHI). The Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE) Questionnaires were administered to assess their cognitive functions and the correlation between Questionnaire scores and severity of OSAS was determined. Results: MMSE Questionnaire detected overall cognitive impairment in 22% of OSA patients while as MoCA Questionnaire detected overall cognitive impairment in 33% of the same OSA patients. The frequency of mild neurocognitive impairment as detected by MMSE Questionnaire increased progressively as the severity of OSA increased from Snoring(6.7%) to Mild OSA(17.1%), Moderate OSA(29.4%) and severe OSA(38.4%). MoCA Questionnaire demonstrated the same pattern except that it was more sensitive. It detected cognitive impairment of 12.4% in Snoring group, 27.1% in Mild OSA group, 41.2% in Moderate OSA group and 53.9% in Severe OSA group. Conclusion: Neurocognitive impairment is common in patients with OSAHS. The MoCA is a more sensitive tool than MMSE for the assessment of mild cognitive impairment in OSAHS patients, whose performance on the MMSE is in the normal range.

Purpose: The aim of this study was to explore the clinical characteristics of different sleep perception types of obstructive sleep apnea–hypopnea syndrome (OSAHS) patients and to analyze the correlation between sleep perception and polysomnography (PSG) indicators in OSAHS patients.Methods: We retrospectively analyzed 355 patients diagnosed with OSAHS by PSG at the Sleep Medicine Center of Shengjing Hospital of China Medical University. Patients saw a doctor due to snoring and daytime sleepiness from March 2017 to March 2018. We excluded the patients who are

Abstract Background Obstructive sleep apnea-hypopnea syndrome (OSAHS) is prone to being complicated with various cardiovascular, cerebrovascular and metabolic conditions. OSAHS, due to its multifactorial nature, entails individualized and comprehensive treatment. So far, no well-established diagnostic criteria for the disease are available. In recent years, miRNA has been shown to be a sensitive biomarker suggestive of the progression and prognosis of many diseases. In this study, we examined some serum miRNAs in healthy OSAHS (OSAHS patients without complication) and OSAHS with arterial hypertension, with an attempt to understand the potential effects on the disease, improve the diagnosis of OSAHS and find OSAHS-related diagnostic markers. Methods Against various diagnostic criteria, participants were divided into three groups: healthy OSAHS, OSAHS with arterial hypertension and healthy controls. Their serum miRNA profiles were assessed by microarray technology, and then differentially expressed miRNAs were verified by quantitative real-time PCR (qRT-PCR). The receiver operating characteristic (ROC) curves of miRNAs were constructed and the areas under the curve (AUC) were calculated. Meanwhile, the miRNAs were subjected to logistic regression analysis. The target genes were bioinformatically assessed, their functions and signaling pathways further determined and eventually an miRNA-gene network was established. Results Analysis with the miRNA array exhibited that, compared with the control group, 12 differentially expressed miRNAs were found in healthy OSAHS, and 33 were found in OSAHS with arterial hypertension. The expression of miR-126-3p, let-7d-5p, miR-7641 and miR-1233-5p, miR-320b, miR-145-5p, miR-107, miR-26a-5p were validated by using qRT-PCR. Bioinformatics analysis predicted that the potential target genes of these miRNAs might be involved in metabolism, and the regulation of endothelial cells and nervous system. Moreover, the ROC analysis showed that the using miR-145-5p and let-7d-5p in combination can identify the healthy OSAHS, presence of miR-126-3p, miR-26a-5p and miR-107 was well indicative of OSAHS with arterial hypertension. Conclusions A cluster of dysregulation miRNAs have been found to be involved in the development of OSAHS patients. Moreover, these miRNAs might be used to be potential diagnostic and early warning markers.

Abstract Background To assess the retinal sensitivity in obstructive sleep apnea hypopnea syndrome (OSAHS) patients evaluated with standard automated perimetry (SAP). And to correlate the functional SAP results with structural parameters obtained with optical coherence tomography (OCT). Methods This prospective, observational, case-control study consisted of 63 eyes of 63 OSAHS patients (mean age 51.7 ± 12.7 years, best corrected visual acuity ≥20/25, refractive error less than three spherical or two cylindrical diopters, and intraocular pressure

Purpose: The aim of this study was to explore the clinical characteristics of different sleep perception types of obstructive sleep apnea–hypopnea syndrome (OSAHS) patients and to analyze the correlation between sleep perception and polysomnography (PSG) indicators in OSAHS patients. Methods: We retrospectively analyzed 355 patients diagnosed with OSAHS by PSG at the Sleep Medicine Center of Shengjing Hospital of China Medical University. Patients saw a doctor due to snoring and daytime sleepiness from March 2017 to March 2018. We excluded the patients who are <18 years old, had a history of OSAHS treatment, had other sleep and psychiatric disorders, and could not provide complete data. According to the patients' explanation, medical history, PSG indicators, and morning questionnaire after PSG, the patients were divided into normal sleep perception (NSP), positive sleep perception abnormality (PSPA), and negative sleep perception abnormality (NSPA). We analyze the demographic characteristics and PSG of the three groups with ANOVA and non-parametric tests. In addition, we conducted correlation analysis between sleep perception and PSG indicators. Results: Of OSAHS patient, 55.5% had sleep perception abnormalities, of which 35.5% were positive-perception abnormalities and 20% were negative-perception abnormalities. From the analysis of PSG indicators, the sleep perception abnormality was related to the frequency of spontaneous arousal of the patient (P = 0.003) and was not related to the slight arousal caused by respiratory events, oxygen desaturations, and limb movement events. OSAHS patients with PSPA had a higher oxygen desaturation index (P = 0.046) but no significant difference in post hoc test. PSPA group had significantly lower rapid eye movement (REM) latency and sleep efficiency and more wake after sleep onset (WASO) than had the other sleep perception groups. Multivariate linear regression analyses after adjusting for age and sex revealed that sleep perception was related to lowest oxygen saturation (LSaO2), TS90%, sleep efficiency, and WASO. Conclusion: Sleep perception abnormality is common in OSAHS patients. OSAHS patients with different sleep perception types have different PSG profiles. The OSAHS patients with PSPA have more severe hypoxia levels at night that require timely personalized treatment. [ABSTRACT FROM AUTHOR]

The aim of this investigation was to define the volume and area of the airway in subjects with Class II and Class III skeletal deformity. A cross-sectional study was designed including subjects with facial deformity defined by Steiner's analysis in subjects with indication of orthognathic surgery who presented diagnosis by cone beam computerised tomography. We determined the measurements of maximum area, minimum area and volume of the airway. The data were compared using Spearman's test, with statistical significance defined as p<0.05. 115 subjects were included: 61.7 % Class II and 38.3 % Class III, mean age 27.8 years (± 11.6). A significant difference was observed in the area and volume measurements in the groups studied, with significantly smaller measurements found in Class II (p=0.034). The minimum area was 10.4 mm2 smaller in Class II patients than in Class III, while the general volume of the airway was 4.1 mm3 smaller in Class II than in Class III. We may conclude that Class II subjects present a smaller airway volume than Class III subjects. [ABSTRACT FROM AUTHOR]

Background: Obstructive sleep apnea/hypopnea syndrome (OSAHS) is a prevalent condition affecting a substantial portion of the global population, with its prevalence increasing over the past 2 decades. OSAHS is characterized by recurrent upper airway (UA) closure during sleep, leading to significant impacts on quality of life and heightened cardiovascular and metabolic morbidity. Despite continuous positive airway pressure (CPAP) being the gold standard treatment, patient adherence remains suboptimal due to various factors, such as discomfort, side effects, and treatment unacceptability., Objective: Considering the challenges associated with CPAP adherence, an alternative approach targeting the UA muscles through myofunctional therapy was explored. This noninvasive intervention involves exercises of the lips, tongue, or both to improve oropharyngeal functions and mitigate the severity of OSAHS. With the goal of developing a portable device for home-based myofunctional therapy with continuous monitoring of exercise performance and adherence, the primary outcome of this study was the degree of completion and adherence to a 4-week training session., Methods: This proof-of-concept study focused on a portable device that was designed to facilitate tongue and lip myofunctional therapy and enable precise monitoring of exercise performance and adherence. A clinical study was conducted to assess the effectiveness of this program in improving sleep-disordered breathing. Participants were instructed to perform tongue protrusion, lip pressure, and controlled breathing as part of various tasks 6 times a week for 4 weeks, with each session lasting approximately 35 minutes., Results: Ten participants were enrolled in the study (n=8 male; mean age 48, SD 22 years; mean BMI 29.3, SD 3.5 kg/m 2 ; mean apnea-hypopnea index [AHI] 20.7, SD 17.8/hour). Among the 8 participants who completed the 4-week program, the overall compliance rate was 91% (175/192 sessions). For the tongue exercise, the success rate increased from 66% (211/320 exercises; SD 18%) on the first day to 85% (272/320 exercises; SD 17%) on the last day (P=.05). AHI did not change significantly after completion of training but a noteworthy correlation between successful lip exercise improvement and AHI reduction in the supine position was observed (R s =-0.76; P=.03). These findings demonstrate the potential of the device for accurately monitoring participants' performance in lip and tongue pressure exercises during myofunctional therapy. The diversity of the training program (it mixed exercises mixed training games), its ability to provide direct feedback for each exercise to the participants, and the easy measurement of treatment adherence are major strengths of our training program., Conclusions: The study's portable device for home-based myofunctional therapy shows promise as a noninvasive alternative for reducing the severity of OSAHS, with a notable correlation between successful lip exercise improvement and AHI reduction, warranting further development and investigation., (©Patrice Roberge, Jean Ruel, André Bégin-Drolet, Jean Lemay, Simon Gakwaya, Jean-François Masse, Frédéric Sériès. Originally published in JMIR Biomedical Engineering (http://biomsedeng.jmir.org), 15.04.2024.)

Abstract: Computational Fluid Dynamic simulations are performed in real patient individual pharynx geometries of an Obstructive Sleep Apnea patient. The Navier-Stokes equations as well as the Reynolds Averaged Navier-Stokes equations and k − ∊ and k −ω turbulence models are used. The velocity profile and pressure distribution of the patient without any treatment and the patient wearing a mandibular advancement appliance are compared to each other. The simulation results for the different model conditions all lead to similar results showing the robustness of the numerical solutions. The pressure loss along the pharynx is lower in the presence of a mandibular appliance, which can indicate the reduction of OSAHS severity.

Background and Aim: The obstructive sleep apnea-hypopnea syndrome (OSAHS) is a common chronic respiratory disease, characterized by repetitive complete or partial collapse of the upper airway during sleep. The clinical spectrum extends between stoppage of breathing, snoring, daytime somnolence, and fatigue, to serious cardiovascular disease, stroke, metabolic syndrome, increased morbidity, and mortality. We aim to evaluate the short-term use of nasal continuous positive airway pressure (nCPAP) therapy for the clinical profile and exercise capacity of patients with OSAHS. Patient Selection: Twenty patients diagnosed with moderate-to-severe OSAHS were enrolled in the study (study group - 15; clinically and PSG-matched control group - 5). Materials and Methods: Each patient was clinically evaluated for sleep-related symptoms, and also assessed with spirometry, the six-minute walk test (6MWT), and a symptom-limited incremental cardiopulmonary exercise test (CPET). The study group patients were administered nCPAP therapy for eight hours each night for four weeks, while the control group patients were just observed. They were re-assessed after four weeks and the data were statistically analyzed between the two groups. Results: The study group patients showed a significant (P- < 0.05) improvement in the OSAHS symptoms-the Epworth sleepiness score, six-minute walk distance; duration of exercise, power output, peak oxygen uptake, anaerobic threshold, diastolic blood pressure, dyspnea, and fatigue-in comparison with the control group patients. The improvement in exercise capacity following nCPAP therapy was attributed to the relief of disabling the OSAHS symptoms and improved cardiovascular, ventilator, and musculoskeletal functions. Conclusion: All OSAHS patients must be treated with nCPAP.

Background and Objectives: Obstructive sleep apnoea (OSA) is associated with heightened systemic inflammation and a hypercoagulation state. Soluble urokinase-type plasminogen activator receptor (suPAR) plays a role in fibrinolysis and systemic inflammation. However, suPAR has not been investigated in OSA. Materials and Methods: A total of 53 patients with OSA and 15 control volunteers participated in the study. Medical history was taken and in-hospital sleep studies were performed. Plasma suPAR levels were determined by ELISA. Results: There was no difference in plasma suPAR values between patients with OSA (2.198 ± 0.675 ng/mL) and control subjects (2.088 ± 0.976 ng/mL, p = 0.62). Neither was there any difference when patients with OSA were divided into mild (2.134 ± 0.799 ng/mL), moderate (2.274 ± 0.597 ng/mL) and severe groups (2.128 ± 0.744 ng/mL, p = 0.84). There was no significant correlation between plasma suPAR and indices of OSA severity, blood results or comorbidities, such as hypertension, diabetes, dyslipidaemia or cardiovascular disease. Plasma suPAR levels were higher in women when all subjects were analysed together (2.487 ± 0.683 vs. 1.895 ± 0.692 ng/mL, p < 0.01), and also separately in controls (2.539 ± 0.956 vs. 1.411 ± 0.534 ng/mL, p = 0.02) and patients (2.467 ± 0.568 vs. 1.991 ± 0.686 ng/mL, p < 0.01). Conclusions: Our results suggest that suPAR does not play a significant role in the pathophysiology of OSA. The significant gender difference needs to be considered when conducting studies on circulating suPAR.

Introduction: Obstructive sleep apnea hypopnea syndrome (OSAHS) is caused by an obstruction in the upper airway during sleep. Obesity and advanced age are main risk factors for OSAHS. The classic symptoms of OSAHS include snoring, apneas and choking during sleep. On the other hand, some scientific literature describes that the consumption of benzodiazepines may worsen the snoring and the severity and duration of OSAHS. Case report: A 74-year-old female reported on her appointment to have mood alterations. When asked about other sleep disorders, she said that she snored loudly, with pauses on her breathing. Therefore, a split night polysomnography was performed which revealed a diagnosis of severe OSAHS. Discussion: Old people are frequent consumers of benzodiazepines. The woman of this study had been taking 1.5 mg of clonazepam per day for the last eight years. This may have worsened the OSAHS. Conclusion: The patient presented risk factors that could lead to OSAHS. It is important to study the relationship between benzodiazepines and the severity of OSAHS. [ABSTRACT FROM AUTHOR]

Copyright of Revista Mexicana de Endocrinología, Metabolismo y Nutrición is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and Aim: The obstructive sleep apnea-hypopnea syndrome (OSAHS) is a common chronic respiratory disease, characterized by repetitive complete or partial collapse of the upper airway during sleep. The clinical spectrum extends between stoppage of breathing, snoring, daytime somnolence, and fatigue, to serious cardiovascular disease, stroke, metabolic syndrome, increased morbidity, and mortality. We aim to evaluate the short-term use of nasal continuous positive airway pressure (nCPAP) therapy for the clinical profile and exercise capacity of patients with OSAHS. Patient Selection: Twenty patients diagnosed with moderate-to-severe OSAHS were enrolled in the study (study group -- 15; clinically and PSG-matched control group -- 5). Materials and Methods: Each patient was clinically evaluated for sleep-related symptoms, and also assessed with spirometry, the six-minute walk test (6MWT), and a symptom-limited incremental cardiopulmonary exercise test (CPET). The study group patients were administered nCPAP therapy for eight hours each night for four weeks, while the control group patients were just observed. They were re-assessed after four weeks and the data were statistically analyzed between the two groups. Results: The study group patients showed a significant (P- < 0.05) improvement in the OSAHS symptoms--the Epworth sleepiness score, six-minute walk distance; duration of exercise, power output, peak oxygen uptake, anaerobic threshold, diastolic blood pressure, dyspnea, and fatigue--in comparison with the control group patients. The improvement in exercise capacity following nCPAP therapy was attributed to the relief of disabling the OSAHS symptoms and improved cardiovascular, ventilator, and musculoskeletal functions. Conclusion: All OSAHS patients must be treated with nCPAP. [ABSTRACT FROM AUTHOR]

Obstructive sleep apnea - hypopnea syndrome (OSAHS) is a frequent pathology, affecting an increasing percent of adult population in modern times. The pathophysiology is represented by repetitive episodes of apnea and hypopnea occurring during sleep. The signs and symptoms of OSAHS include increased daytime sleepiness, lack of concentration, morning headaches and a general decreased quality of life. Conservative treatment using Continuous Positive Airway Pressure (CPAP) or its variations is the standard procedure for OSAHS, with good results generally. There are still some cases in which the treatment cannot be used, it is not accepted by patients, or it is not enough for a favorable outcome. In these cases, there are a series of surgical therapies that can be used for treatment, or which can ease the use of CPAP. The goal of this paper is to underline the advantages of surgical treatment for obstructive sleep apnea. [ABSTRACT FROM AUTHOR]

Snore related signals (SRS) have been found to carry important information about the snore source and obstruction site in the upper airway of an Obstructive Sleep Apnea/Hypopnea Syndrome (OSAHS) patient. An overnight audio recording of an individual subject is the preliminary and essential material for further study and diagnosis. Automatic detection, segmentation and classification of SRS from overnight audio recordings are significant in establishing a personal health database and in researching the area on a large scale. In this study, the authors focused on how to implement this intelligent method by combining acoustic signal processing with machine learning techniques. The authors proposed a systematic solution includes SRS events detection, classifier training, automatic segmentation and classification. An overnight audio recording of a severe OSAHS patient is taken as an example to demonstrate the feasibility of their method. Both the experimental data testing and subjective testing of 25 volunteers (17 males and 8 females) demonstrated that their method could be effective in automatic detection, segmentation and classification of the SRS from original audio recordings. [ABSTRACT FROM AUTHOR]

Background: Obstructive sleep apnea and hypopnea syndrome (OSAHS) is a disorder that causes clinical symptoms (e.g. snoring, excessive daytime sleepiness and impaired concentration) that may increase the risk of traffic accidents, cardiovascular disease, type 2 diabetes and reduce the quality of life. A recently developed device (Somnolter®) detects apneas and hypopneas in a home setting, allowing to detect OSAHS in a more comfortable environment compared to the gold standard polysomnography. The aim of our study was to investigate whether the Somnolter® is useful in family practice to identify patients with OSAHS. Methods: Questionnaires were offered to patients in five general practitioner (GP) practices. Based on the questionnaire and body mass index, patients with an increased risk of OSAHS were contacted to collaborate in the study. In this convenience sample, 18 patients were successfully tested with the Somnolter® measuring SaO2, mandibular movements, body position, heart rate, nasal air flow and thoracic and abdominal breathing movements. The Somnolter® automatically analyses the data and different parameters to detect OSAHS. Afterwards, the data were manually revised by the researchers. Results: Out of 365 subjects, 31 met the inclusion criteria and 18 were successfully tested at home. Sixteen out of 18 patients had an Apnea Hypopnea Index (AHI) ≥ 5, ten of them had mild OSAHS, 3 were categorized as moderate OSAHS and finally 3 matched the criteria of severe OSAHS. Conclusion: The proposed case-finding strategy still needs optimization, but is considered helpful in selecting patients at high risk of OSAHS. OSAHS was detected in 14 out of 18 patients tested with the Somnolter®. In the future the Somnolter® might be a feasible alternative to diagnose OSAHS. [ABSTRACT FROM AUTHOR]

Introduction: Lesch-Nyhan Syndrome is a congenital recessive disorder that occurs due to a mutation in the HGPRT1 gene.1,2 It manifests as dysfunction in purine metabolism and overproduction of uric acid. In the classic form, severe motor impairment, intellectual disability and self-injurious behaviors are observed.1-4 Complications include nephrolithiasis and gout.1 Variant forms have attenuated phenotypes, in which patients may be cognitively healthy and have a variable degree of motor impairment. Diagnosis is made by estimating HPRT enzyme activity or molecular testing. Treatment is based on the administration of allopurinol. Objectives: Alerting for the realization of differential diagnoses in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and suspected genetic syndromes. To demonstrate the differential diagnosis between Prader-Willi syndrome and Lesch-Nyhan syndrome. Resume report: 24-year-old male, with maxillomandibular discrepancy (Angle III) and a history of cognitive deficit. It was reported snoring since childhood associated with self-mutilation and recurrent monoarthritis attacks. In polysomnography, OSAHS was confirmed. Due to the diagnosis of OSAHS, cognitive deficit and selfmutilation behavior, the hypothesis of Prader-Willi syndrome and Lesch-Nyham Syndrome were raised as differential diagnosis. In molecular testing, the analysis suggested the possibility of the presence of a duplication of 416 bp in exons of the HPRT1 gene, but without the minimum quality to confirm that it was a real event. This variant form with attenuated phenotype was considered pathogenic. Conclusion: It is important to recognize Lesch-Nyhan syndrome as a differential diagnosis of genetic syndromes associated with OSAHS aiming at early diagnosis. [ABSTRACT FROM AUTHOR]