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Objective Obstructive sleep apnea syndrome (OSAS) is closely associated with cardiovascular diseases. Evaluation of simplified OSAS diagnostic methodologies is still new and has not been deeply investigated in the field of cardiology. In this study, we aimed to evaluate the relationship between OSAS and the severity of coronary artery disease in our patients with acute coronary syndrome (ACS), using the SYNTAX score, the Berlin Sleep Questionnaire (BUA) and the Epworth Sleepiness Scale (EUÖ). Material and Methods 200 patients with acute coronary syndrome who underwent coronary angiography were enrolled in the study. SYNTAX scores of the patients were calculated. Patients were administered BUA and EUÖ before discharge. The scales were compared between the two groups and with SYNTAX scores of patients. Results In NSTEMI patients, the rate of high-risk patients in the BUA and ACL was statistically significant compared to the STEMI group (p<0.001, p=0.023). The total score of the BUA and the total score in the EUÖ was statistically significant in NSTEMI patients compared to the STEMI group (p<0.001). Pearson correlation analysis revealed a significant positive correlation between the SYNTAX score and the total score in the BUA and between the SYNTAX score and the EUÖ (r = 0.865, p <0.001 ve r = 0.761, p <0.001) Conclusions In this study, the relationship between OSAS and ACS was evaluated. The results of the BUA and EUÖ scale were higher than those of other countries and a positive correlation was found between SYNTAX score and OSAS risk. [ABSTRACT FROM AUTHOR]

Objective: Numerous studies investigating Vitamin D receptor (VDR) polymorphisms in different populations have been present in current literature. For this reason, we designed a study to investigate the role of three known common VDR genetic polymorphisms (Apa-I/rs7975232, Bsm-I/ rs1544410 and Taq-I/rs731236) in Turkish individuals affected by Obstructive sleep apnea syndrome (OSAS). Methods: The study was carried out on a total of 175 consecutive subjects, including 80 OSAS patients and 95 healthy participants. Single Nucleotide Polymorphism (SNP) Detection was performed with the iPLEX® Assay and the MassARRAY® System for detection of Apa-I (rs7975232), Bsm-I (rs1544410), and Taq-I (rs731236) polymorphisms. Results: Fifty-seven C alleles (71.3%) and 59 T alleles (73.8%) were detected in the group of 80 OSAS patients in terms of rs1544410 polymorphism. When the patient and control groups were evaluated statistically at allelic level, it was observed that the T allele increased the risk of disease and this increase was statistically significant (Odds Ratio (OR) = 1.549 [Confidence Interval (CI): 1.012-2.371], (p=0.043). However, there were no significant differences between other VDR polymorphisms (rs7975232 and rs731236) and OSAS clinical data (p=0.6 and p=0.9, respectively). Discussion: As a conclusion, no statistically significant relationship was found between all three VDR polymorphisms and OSAS patients' clinical features. Further studies should be performed by creating a large sampling group. Finally, population studies should be given importance considering the variability of polymorphism according to ethnic origin. [ABSTRACT FROM AUTHOR]

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Objective: Obstructive Sleep Apnea syndrome (OSAS) is a chronic intermittent hypoxic process. In this study, we aimed to investigate electrophysiologically the changes in number of skeletal muscle motor unit due to chronic intermittent hypoxemia in cases followed up with the diagnosis of OSAS. Materials and Methods: According to the apnea-hypopnea index (AHI), patients divided into two groups (group 1: AHI <15 and group 2: AHI ≥15.0). Fifty-seven patients in group 1 and 62 patients in group 2 were included in the study. Motor and sensory distal latencies, conduction velocities and combined action potential amplitudes of nervus medianus and nervus ulnaris were evaluated in patients. After obtaining maximum M responses by submaximal stimulation in the patients, motor unit numbers (MUNE) were achieved with the program in Keypoint device. Results: There were no statistical differences between the two groups in terms of nervus medianus and nervus ulnaris motor and sensory nerve distal latencies, maximum M response amplitude and mean conduction velocity (p>0.5). Maximum M mean area of nerve medianus was 50.8±20.4 (16.1-121.7) in group 1 and 48.6±20.05 (10.5-111.4) in group 2 (p=0.55). The mean MUNE values were 155.3±41.17 (46.6251.7) in group 1 and 127.7±40.2 (22.8-235) in group 2 (p<0.00). Conclusion: The MUNE method demonstrates that chronic intermittent hypoxemia during sleep causes reduction of the motor unit number in OSAS patients and is an independent risk factor for subclinical polyneuropathy. [ABSTRACT FROM AUTHOR]

Rhythmic movement disorder (RMD) is usually observed in children during drowsiness. However, here we present an adult patient experiencing RMD associated with Obstructive Sleep Apnea syndrome (OSAS) during rapid eye movement (REM) sleep. A 50-year old male was admitted with a complaint of head rocking during sleep for about one year. Video-polysomnography revealed OSAS (43/hour) and RMD. Following positive airway therapy, all the symptoms related to OSAS and head rocking disappeared. Adult-onset RMD occurring in REM sleep is rare; OSAS related arousals, increased cyclic alternating pattern, and possible association with REM sleep without atonia were suggested to be the underlying reasons for the condition. [ABSTRACT FROM AUTHOR]

Objective: Obstructive sleep apnea syndrome (OSAS); is a clinical condition that presented with non-specific symptoms such as snoring, daytime sleepiness, excess weight, apathy and / or lethargy. These symptoms are frequently seen also in hypothyroidism. In this study, we tried to identify the frequency and co-incidence of hypothyroidism in the patients who had clinically OSAS symptoms. Methods: We retrospectively reviewed the data of 309 patients who underwent all night PSG test with pre-diagnosis of sleeping breathing disorders. Demographic data, body mass index, PSG scores and thyroid function test results were evaluated. Results: The data of 309 patients were reviewed. The mean age of all cases was 38.46 ± 12.34 and the body mass index (BMI) was 28.14 ± 4.08. Of all cases 279 (90.3%) were male. 91 (29.45%) cases had AHI <5 and defined as non-OSAS group. Mild, moderate and severe OSAS were determined in 80 (25.89%) patients, 60 (19.42%) patients and 78 (25.24%) patients, respectively. When thyroid function tests were examined for entire group, hypothyroidism was detected in 16 cases (5.59%). Of these 5 were in the group without OSAS and 11 were in the group with OSAS. Hypothyroidism frequency was 6.17% in the non-OSAS group and 5.36% in the OSAS diagnosed group. Conclusion: Our results demonstrated that 50% of the cases with hypothyroidism were in the non-OSAS and mild OSAS group, necessitating the evaluation of thyroid functions. Thyroid function tests, an easily applicable screening method, is clinically important and necessary in patients presenting with OSAS-like symptoms. [ABSTRACT FROM AUTHOR]

Object: Obstructive sleep apnea syndrome is a disease associated with recurrent apnea-hypopneas during sleep. Apnea-hypopnea attacks cause hypoxia by lowering oxygen saturation levels. Oxidative stress induced by hypoxia can lead to inflammation and DNA damage. The aim of this study was to investigate the effects of intermittent hypoxia on oxidative stress, inflammation, and DNA in severe OSAS patients. Methods: A total of 67 individuals were measured by polysomnography during the night. Peripheral ven blood was collected. Cholesterol, triglyceride, HDL, hs-CRP, TAS and TOS values of all subjects were measured in blood serum by calorimetric method. The comet assay method was used to investigate DNA damage. Results: We found a statistically significant increase in oxidative stress and inflammation parameters in severe OSAS patients (p <0.05). Furthermore, we could not detect the effect of severe OSAS disease on DNA damage. (p>0,05). Conclusions: Our results showed that oxidative stress and inflammatory markers changed markedly in severe OSAS patients. However, the absence of DNA damage despite increased oxidative stress has been interpreted as hypoxia, which is not long enough to damage DNA and does not cause DNA damage alone. [ABSTRACT FROM AUTHOR]

Objective: Obstructive Sleep Apnea syndrome (OSAS) is a disease characterized by recurrent complete (apnea) or partial (hypopnea) upper respiratory tract obstructions episodes during sleep and often a decrease in blood oxygen saturation. Night hypoxias and sympathetic activity increase of arousals in OSAS are thought to stimulate that endothelial dysfunction and hypercoagulability. Materials and Methods: In this study, it was aimed to evaluate the relationship between the severity of the disease and the night hypoxia severity with hemogram parameters in patients diagnosed with OSAS who examined in our clinics. A total of 94 cases were included in the study, including 24 controls, 24 mild, 23 moderate, and 23 severe OSAS. Results: The mean and minimum oxygen saturation values in polisomnography with the number of neutrophils and neutrophil/lymphocyte (N/L) ratio were negatively correlated in the mild and severe OSAS groups. A negative correlation was observed between erythrocyte distribution width (EDW) and, mean oxygen saturation and minimum oxygen saturation in moderate and severe OSAS. When the mean and minimum oxygen saturation with regression analysis of EDW and N/L ratio were examined in each three groups; the 1 unit decrease in the minimum oxygen saturation increases the N/L ratio by 0.5-fold (p=0.02) in the mild OSAS, 0.5-fold (p=0.01) in the severe OSAS and it increases the EDW by ratio 0.5-fold (p=0.02) in the moderate OSAS. The 1 unit decrease in the mean oxygen saturation increases the N/L ratio by 0.4- fold (p=0.04) and the EDW by 0.8-fold (p=0.001) in the severe OSAS. Conclusion: As long as the OSAS severity increases, it is determined that the hematocrit values of patients increasing. However, as patients' sleep desaturation increase, we can see that EDW, the number of neutrophils, and N/L ratio also increasing. This situation suggests that the local inflammation caused by both mechanical stress and ischemiareperfusion cycles in the respiratory tract in OSAS is a consequence of spillage into the systemic circulation. [ABSTRACT FROM AUTHOR]

Objective: In the study, it was aimed to investigate the effects of nutrition status of university students on sleepiness and sleep quality. Materials and Methods: The research was conducted between January and April 2017 with 920 students who were studying at three different faculties of a university in İstanbul and were willing to participate in the study. A questionnaire that assessed the students' socio-demographic data, nutritional status, symptoms of Obstructive Sleep Apnea syndrome (OSAS), the Epworth Sleepiness scale (ESS), and the Pittsburgh Sleep Quality index (PSQI) were used in the study. Results: In the study 66.6% of the students were female, 33.4% were male and the average age was 22.66±4.86. The students with higher food consumption such as bread, pasta and rice were found to have higher PSQI and ESS scores and a significant difference was found between them (p<0.05). The study found that the total score of the students' PSQI scale was 7.28±3.56 and the majority of students (88.5%) had poor sleep quality. Nevertheless, when the students ESS scores were assessed, it was determined that there was not OSAS risk in the majority (79.9%) of the students. A weak relationship was found between the PSQI and total score of the ESS in the positive direction; also as long as sleep quality deteriorated the daytime sleepiness was determined increased. Conclusion: University students generally have poor sleep quality, but no risk for OSAS which can be said that the consumption of excess grain food reduces sleep quality and causes daytime sleepiness. [ABSTRACT FROM AUTHOR]

Objective: Obstructive sleep apnea syndrome (OSAS) is a disorder characterized by partial or complete narrowing of the pharyngeal airway during sleep. In this study it was aimed to investigate the relation between OSAS and different variants of the ApoE gene, and to identify other risk factors that may affect the development of the disease. Materials and Methods: Fifty-two patients with OSAS and 50 healthy volunteers were enrolled into the study. After collecting the necessary information associated with OSAS from the individuals, DNA was isolated from blood. ε2, ε3 and ε4 variants of Apolipop'rotein E (ApoE) gene were investigated using real-time polymerase chain reaction. Results: When the groups were compared with each other, age, body mass index, total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein, triglyceride, neck circumference, waist circumference, apnea hypopnea index, Epworth sleepiness scale, smoking, and daytime sleepiness were found statistically significant. The ε2 variant was found statistically high in the control group. Also, waist circumference, triglyceride and LDL levels were found statistically low in individuals with the ε2 genotype. In addition, triglyceride levels were found statistically high in individuals with the ε4 genotype. Conclusion: The presence of the ε2 variant in healthy individuals may have a protective effect against OSAS. In addition, the relation between different variants of ApoE with LDL and triglyceride levels demonstrates the overlap of genotype and phenotype data. [ABSTRACT FROM AUTHOR]

Objective: The purpose of the study is to evaluate the risks of atrial and ventricular tachyarrhythmia and the risk of right atrial dilatation by using P wave amplitude (Pda) measurement, in patients with Obstructive Sleep Apnea syndrome (OSAS) by using the parameters of the P wave dispersion (Pd) and QT interval dispersion (QTc) the accepted noninvasive risk indicators for atrial and ventricular tachyarrhythmia. Materials and Methods: Patients who had applied to our clinic's sleep laboratory with pre-diognosis of OSAS were evaluated. Two hundred twenty five cases were included in the study who met the criteria for acceptance to work. Polysomnographic tests and routine blood tests applied to all patients. In addition, electrocardiography was performed. Pd, QTc and corrected QT dispersion (QTcd) calculated on a 12 lead surface electrocardiographic examination. The difference between patient and control groups were evaluated. Results: After polysomnographic workup, 56 cases with apnea-hypopnea index (AHI) <5 were included as the control group and 169 cases with AHI =5 were included as the patient group. The mean age determined as 48.3±8.9. There was no statistically significant differences between patient and control group with regard to QTcmin, QTcmax, QTd and QTcd parameters (p>0.05). Although QTcd was higher than normal range in patient group, the differences was not significant compared to control group (p>0.05). In the studies made for P wave, although the values in terms of Pmax, Pmin and Pd were found higher in the patient group than in the control group, a significant difference was not determined between the groups. However, P wave amplitude was significantly higher as statistically in the patient group than in the control group (p=0.02). Conclusion: Pd and QTc/QTcd parameters do not seem to be appropriate for the assessment of ventricular and atrial arrhythmia risk in patients with OSAS. However, the increase in Pda may be indicative of an increased risk of right atrial dilatation. There is a need for forward studies involving large case series in order to provide clarity on the subject. [ABSTRACT FROM AUTHOR]

Objective: The primary and secondary consequences which related to obstructive respiration to occur during sleep cause cognitive, emotional and behavioral changes indirectly. Aim of the present study was to evaluate quality of sleep and relationship between quality of sleep and cognitive function at baseline and during treatment in the patients having diagnosis of severe Obstructive Sleep Apnea syndrome (OSAS) being followed in sleep laboratory. Materials and Methods: Pittsburg, Epworth and Stroop tests to assess patient attention; P300 test was applied for the evaluation of memory and attention. Results: When the pre-treatment and post-treatment cognitive functions of the patients were compared; there was a significant decrease in daytime sleepiness after treatment (p=0.000) and a significant improvement in latency of P300 test (p=0.000-p=0.001-p=0.004). In Pittsburgh study; the pre-treatment total sleep quality scores were consistent with poor sleep quality, while the mean value obtained after treatment was found to be related to the healthy sleepiness (p=0.000). In the Stroop test for measuring attention, the rate of error correction obtained after treatment was significantly improved (p=0.010). Conclusion: In patients diagnosed with severe OSAS; the negative effects of disease on attention, alertness, and memory, challenges on maintaining the attention and its negative effects on the structure of sleep has been shown by using Stroop, Pittsburgh, P300 and Epworth tests unlike other publications. As a result of the tests performed after the treatment, the fact that it is an important development in the disease shows us how the treatment is important and necessary. [ABSTRACT FROM AUTHOR]

Objective: Obstructive Sleep Apnea syndrome (OSAS) is a disease commonly seen in the community, causing labor loss and neuropsychiatric symptoms. The aim of the study is to compare the symptoms of depression and anxiety with those of healthy controls in patients with OSAS and to investigate the relationship between OSAS severity with anxiety and depression. Materials and Methods: Two hundred and thirteen patients with OSAS who underwent polysomnographic examination and 116 healthy controls were included in the study. The patient group was classified as mild, moderate and severe OSAS. Beck Anxiety and Beck Depression Scales were administered to the patients and healthy controls. Results: There was a significant difference between the patient group and the control group in the mean scores of Beck Depression and Beck Anxiety Scales. The mean scores of depression of the OSAS group were 11.16±8.87 (mild depression); 6.85±6.15 of the control group (p<0.05). Compared to Beck Anxiety Scores, OSAS group was 14.31±11.29 (mild anxiety); the control group was 6.45±6.08 (p<0.05). When the relationship between anxiety and depression scores and apnea-hypopnea index (AHI) were examined, there was no statistically significant correlation between control and patient group (p>0.05). Conclusion: In our study; although there was a significant difference between depression and anxiety mean scores in patient and control group; there was no significant difference in anxiety and depression mean scores among mild, moderate and severe OSAS patients. Patients with OSAS were found to have mild anxiety and depressive symptoms. In these patients, there was no correlation between AHI values and depression and anxiety scores. [ABSTRACT FROM AUTHOR]

Objective: In Obesity Hypoventilation syndrome (OHS), pulmonary hypertension (PH) is an important morbidity and mortality reason compared to pure Obstructive Sleep Apnea syndrome (OSAS). However, few studies are available in the literature about this subject. For this reason, we evaluated OHS and pure OSAS cases in our study from the point of right heart-related echocardiographic parameters and PH. Materials and Methods: Obese [body mass index (BMI) >30 kg/m²] cases diagnosed by polysomnography were included in the study. The subjects were divided to two groups as OHS and pure OSAS. OHS criteria were defined as obesity (BMI >30 kg/m²) and for another reason unexplained (neuromuscular, chest wall, restrictive or obstructive pulmonary diseases) daytime hypercapnia (PaCO2 >45 mmHg). Patients with severe hypothyroidism, renal and heart insufficiency, cardiac drug anamnesis were not included in the study. Transthoracic echocardiography was performed to all cases and those with left-heart pathology were excluded from the study. Systolic pulmonary artery pressure (PABs) >35 mmHg was accepted as PH. Results: Of the 115 cases studied (mean age: 49.3±10.6/year, female/male: 53/62, BMI: 40.5±6.1 kg/m²), 70 were pure OSAS and 45 were OHS. In the OHS group, PABs, right ventricular diameter and pulmonary velocities were significantly higher than the pure OSAS group (p=0.002, p=0.015, p=0.012, respectively). The frequency of PH in OHS was significantly higher than group with pure OSAS (48.8% vs. 17.1%, p<0.001). In the overall group, there was a positive correlation between PABs value and apnea-hypopnea index, OSAS phase, oxygen desaturation index, SpO2 <90% elapsed time, and OHS presence (r=0.307, p=0.001; r=0.259, p=0.005; r=0.405, p<0.001; r=0.162, p<0.001; r=0.305, p=0.001, respectively). There was negative correlation between PABs and mean and minimum SpO2 (r=-0.404, p<0.001; r=-0.344, p<0.001, respectively). Conclusion: In OHS cases; PAPs, right ventricular diameter and pulmonary velocities, and PH frequency are higher than pure OSAS. Echocardiographic evaluation should be routinely performed for OHS cases. [ABSTRACT FROM AUTHOR]

Aim: Obstructive sleep apnea syndrome (OSAS) is described as repetitive episodes of upper airway obstruction at sleep with frequent decreases of blood oxygen saturation. OSAS is considered as an independent risk factor for cardiovascular disease. Objective of this study is to investigate the relationship between aortic stiffness parameters and severity of OSAS. Material and Methods: Sixty-five patients diagnosed as OSAS with polysomnography were divided into 2 groups as mild-moderate and severe OSAS according to apnea hypopnea index. Hypertension, coronary artery disease, hyperlipidemia and diabetes mellitus were evaluated as comorbid diseases. Two groups were compared in terms of aortic strain and aortic distensibility in this cross sectional study. Results: Median apnea hypopnea index was 15.2 in Mild-Moderate OSAS (n=28), and 56.5 in Severe OSAS group (n=37). Oxygen desaturation index (p<0.001), body mass index (p=0.002) and any comorbid disease presence (p=0.003) was significantly higher in severe OSAS group. In all patients, 49 had comorbid disease; and there was no significant relation between aortic strain, aortic distensibility and comorbid disease presence. There was no statistical difference between mild-moderate OSAS and severe OSAS in terms of aortic strain (p=0.134) and aortic distensibility (p=0.085). Conclusion: Aortic stiffness does not change between mild-moderate and severe OSAS groups in this study. Because multiple factors may affect the measured values, more studies are needed for evaluation of elastic properties of arteries. [ABSTRACT FROM AUTHOR]

Traumatic diaphragmatic hernia (TDH) is a serious, frequently overlooked complication observed secondary to a thoracoabdominal trauma. The treatment of TDH is surgical and diaphragmatic repair, usually performed with a thoracotomy approach. During a thoracotomy, the lung on the operation side is collapsed and single-lung ventilation is employed. This procedure facilitates the work of the surgeon; however, it makes the administration of anesthesia more difficult. Obstructive sleep apnea (OSA) is a disorder characterized by attacks of apnea and hypopnea due to partial or complete obstruction of the upper respiratory tract during sleep. Administration of anesthesia to patients with OSA involves several difficulties with respect to ventilation and intubation, as well as potential respiratory complications during the postoperative period. In this case report, critical issues faced during the administration of anesthesia to a 46-year-old male patient with OSA who was diagnosed with TDH 1 year after a trauma were discussed in the context of the literature. [ABSTRACT FROM AUTHOR]

Aim: REM (Rapid Eye Movement) sleep disordered breathing (REM SDB) is a subgroup of obstructive sleep apnea syndrome (OSAS) in which respiratory events are predominantly seen in REM period.We aimed to determine the characteristics of patients with OSAS associated with Rem by polysomnography test. Recognition of these patients before anesthesia is importance for the regulation of perioperative and postoperative morbidity and treatment. Material and Method: A total of 4,882 patients who underwent polysomnographic (PSG) examinations between December 2006 and January 2009 were included in the study. A total of 80 patients who met the REM SDB definition were included in the study. The accepted criteria for REM SDB are AHI > 5, NREM (Non Rapid Eye Movement) AHI < 15, REMAHI/ NREM-AHI ratio>2 and the percentage of REM sleep being at least 15%. Presence, type and severity of apnea were determined with PSG, which is the golden Standard for sleep apnea, during the night. Results: In our study 48 (60%) of our patients were male and 32 (40%) were female with a meanage of 49.45±10.95 changing between 27 to 75. The prevalance of REM SDB was found to be 1.89%. The PSGs of 20 out of a total of 80 detected REM USB are repeated with control purpose. The polysomnographic findings of the first and second episodes were compared. Of the four cases, four had at least 2.5 years between two polysomnography, eight with at least 1.5 years, and eight with at least 1 year. There was no statistically significant difference in our study between the first and second polysomnograms of 20 cases Conclusion: We found that the incidence of REM-associated SDB is higher in men, and BMI in women with REM-associated USB is significantly higher than that in women.There is no difference between males and females in terms of age distribution.There was no statistically significant difference in the mean values of total AHI, REM-AHI, NREM-AHI, REM-AHI / NREM-AHI between male and female subjects.These events were the result of sleeping respiratory disturbances being less severe than NREM USB events, resulting in fewer days than daytime sleepiness [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effect of continuous positive airway pressure (CPAP) treatment on metabolic syndrome and insuline resistance in patients with obstructive sleep apnea syndrome (OSAS). Materials and Methods: This study evaluated retrospectively with 30 patients who received OSAS diagnosis following polysomnography between the years January 2016 - January 2017, whose Respiratory Disturbance Index were above 15, and who were between the ages of 18-78, having no diabetes, chronic liver and kidney disease, malignancy and mental retardation. The anthropometric measures and blood values of these patients before the CPAP treatment and 3 months afterwards were evaluated in their controls. The effect of CPAP treatment on metabolic syndrome and insulin resistance assessed by homeostatic model assessment index was investigated Results: It has been observed that the body mass index (BMI) decreases significantly following the CPAP treatment. No significant changes were found in the anthropometric measurements including the neck circumference, waist circumference, hip circumference, and waist/hip ratios as well as insulin resistance and metabolic syndrome parameters (before of treatment BMI: 31.33±5.58, post treatment BMI: 30.83±7.13, p=0.03). The ESS evaluating the subjective daytime sleepiness following the CPAP treatment has decreased significantly. Conclusion: Although this study didn't improve insulin resistance with assessed homeostatic model assessment, and metabolic syndrome, a significant improvement in BMI and ESS was demonstrated in post treatment. Long-term studies with more cases and with high compliance are needed to demonstrate the effects of CPAP treatment on metabolic syndrome in OSAS patients. [ABSTRACT FROM AUTHOR]

Amaç: Uyku bozuklukları, kronik havayolu hastalıkları ile sıklıkla birlikte bulunan hem hastalığın gidişatını hem de kişinin hayat kalitesini etkileyen durumlardır. Obstrüktif uyku apne sendromu (OUAS) ise uykuda solunum bozukluklarının en sık rastlanılan grubudur. Çalışmamızda retrospektif olarak uyku kliniğimizde yatarak polisomnografik tetkik yapılmış ve OUAS tanısı almış hastalarda astım ve kronik obstrüktif akciğer hastalığı (KOAH) sıklığını; bu hastalıkların OUAS şiddetine etkisini araştırmayı hedefledik. Gereç ve Yöntem: Hastaların yaş, cinsiyet, vücut kitle indeksi (VKİ), spirometri değerleri, Epworth Uykululuk skalası (EUS) ve polisomnografik bulgularını kaydettik. Bulgular: Çalışmaya 970 OUAS'lı hasta alındı. Hastalar 3 gruba ayrıldı: Yalnız OUAS (%86,8), OUAS+KOAH (%7,6), OUAS+astım (%5,6) idi. KOAH ve astım sıklığı normal popülasyona göre fazla değildi. OUAS ve KOAH birlikteliği olan grupta erkek cinsiyet (p=0,001), ileri yaş (p=0,001), sigara içiciliği (p=0,001), EUS (p=0,04) belirgin şekilde fazla idi. Polisomnografi bulgularından minumum oksijen satürasyonu, yalnız OUAS olan gruba göre düşüktü (p=0,004). OUAS ve astım birlikteliği olan grupta kadın cinsiyet ile VKİ daha fazla idi (p=0,001). Polisomnografi bulgularından minumum oksijen satürasyonu sadece OUAS olan gruba göre düşük idi (p=0,04). Sonuç: KOAH ve astım varlığı OUAS'ı olumsuz yönde etkileyebilir. Erkek cinsiyet, sigara içiciliği, ileri yaş gibi durumlarda KOAH açısından; kadın cinsiyet, orta yaş, atopi varlığı gibi durumlarda astım açısından ileri tetkik yapılabilir. Objective: Sleep disorders are conditions that often interfere with chronic airway diseases and affecting both the course of illness and the quality of life. Obstructive sleep apnea syndrome (OSAS) is the most common group of sleep-disordered breathing. We aimed to investigate the prevalence of asthma and chronic obstructive pulmonary disease (COPD) on OSAS severity in patients who were retrospectively examined by polysomnographic examination in our sleep clinic and who were diagnosed with OSAS. Materials and Methods: We recorded the age, sex, body mass index (BMI), spirometry values, Epworth sleepiness scale (ESS) and polysomnographic findings of the patients. Results: Nine hundred seventy patients with OSAS were included in the study. Patients were divided into 3 groups: only OSAS (86.8%), OSAS with COPD (7.6%) and OSAS with asthma (5.6%). The frequency of COPD and asthma was not higher than in the normal population. The male gender (p=0.001), older age (p=0.001), ESS (p=0.04) and smoking status (p=0.001) were significantly higher in the group with OSAS and COPD. The minimum oxygen saturation which is polysomnography finding was lower than only OSAS group (p=0.004). In the OSAS and asthma association group, female gender and BMI were higher (p=0.001). The polysomnography findings showed that the minimum oxygen saturation was lower than only OSAS group (p=0.04). Conclusion: The presence of COPD and asthma can affect OSAS in negative way. Male gender, smoking status, older age in terms of COPD; female gender, middle age and presence of atopy, further examination can be done in terms of asthma. [ABSTRACT FROM AUTHOR]

Obstructive Sleep Apnea syndrome (OSAS) is a clinical condition accompanied by episodes of respiratory arrest, sleep fragmentation, oxygen desaturation, and excessive daytime sleepiness due to obstructions in the upper airway during sleep. Contrary to popular belief, OSAS is much more common in society. In some patients, we can observe symptoms of OSAS easily; however, some of the patients may not indicate any symptoms. Although the interest and research on the causes of OSAS and the mortality rate associated with cardiovascular disease have increased, this relationship has still not completely understood. The results of several proven trusted clinical trials support the hypothesis that OSAS increases the risk of stroke, arrhythmias (atrial fibrillation, bradyarrhythmia, supraventricular tachycardia, ventricular arrhythmia), coronary artery disease, acute myocardial infarction, and cardiac arrest as much as essential or resistant hypertension. In this case report, we wanted to demonstrate OSAS as a cause of arrhythmia in a young obese patient without OSAS symptoms, and an arrhythmia that improved with OSAS therapy. [ABSTRACT FROM AUTHOR]

Obstructive sleep apnea syndrome (OSAS) can lead to many complications associated with cerebrovascular system. Pathophysiological mechanisms in the development of cerebrovascular pathology include hypoxia, inflammation, oxidative stress and hypercoagulability. Herein, we report a 31-year-old patient with OSAS which was associated with sinus venous thrombosis whose symptoms improved with positive airway pressure therapy. [ABSTRACT FROM AUTHOR]

Objective: Several studies have investigated the association between obstructive sleep apnea syndrome (OSAS) and depression and anxiety; however, the relationship is still not understood very well. In this study we aimed to investigate the association between the hospital anxiety and depression (HAD) scores and the symptoms and polysomnographic (PSG) findings in patients referred with OSAS symptoms. Materials and Methods: Patients who referred with snoring, witnessed apnea and daytime sleepiness symptoms and patients who had full-night PSG were included in this study. Illiterate patients were not included in the study. Epworth sleepiness scale and HAD scores was self-administered by the patients. Patients were compared according to HAD scores for symptoms, comorbidities, and PSG findings. Also, the correlation between HAD and PSG findings, symptoms and Epworth scores (ES) of the patients were analyzed. Results: Out of 149 patients who included in the study mean age was 48±11, mean body mass index (BMI) was 31±5, and 63% were male. Of the patients 127 (85%) had OSAS. Of the patients 32 (21%) had a high likelihood of depression (DS >10) and 24 (16%) of anxiety (AS >10). ESS and asthma rate were significantly higher in DS >7 subjects compared to DS <7 (p=0.019, p=0.015, respectively). Minimum oxygen saturation (minSpO2) in PSG was found significantly lower in AS >10 subjects compared to AS <10 subjects (p=0.005). There were no difference concerning other parameters (p>0.05). There were correlations between DS and age, female gender and mean oxygen saturation; AS and female gender, BMI, ES and excessive daytime sleepiness. Conclusion: We did not find any association between hospital anxiety depression score and presence of OSAS and apnea hypopnea index in our study. Excessive daytime sleepiness was found as the most important factor related to depression and anxiety scores in our patients. [ABSTRACT FROM AUTHOR]

Objective: Uric acid which arises in conditions such as cardiovascular diseases, Chronic kidney failure, metabolic syndrome is a strong and independent marker of morbidity and mortality. Hypoxia-arousalreoxygenation cycles that observed in Obstructive sleep apnea syndrome (OSAS) throughout the night increase adenosine triphosphate degradation and cause uric acid production, an end-product of purine metabolism. We aimed to evaluate the relationship between OSAS and serum uric acid levels. Materials and Methods: Subjects who were evaluated by polysomnography (PSG) in our sleep laboratory were prospectively analysed. Demographic data, detailed history including comorbidities, smoking history of all the patients were recorded. PSG was performed all night and complete blood count and biochemical analysis were done. Results: Total of 449 subjects with a mean age of 47.78 (18-65) were included in the study. The study population consisted of 283 (63%) male and 166 (37%) female. According to PSG data, 43 subjects had apneahypopnea index was <5 and 406 subjects had OSAS. As comorbidities evaluated, hypertension in 135 (30%), diabetes mellitus in 80 (18%), coronary heart disease in 53 (12%), asthma in 53 (12%), dyslipidemia in 14 (3%), chronic obstructive pulmonary disease in 12 (2.7%) patients were found. Serum uric acid level was high in 75 cases; 3 of which was in control group and 72 of which was in OSAS group. Uric acid level was increased in 13 patients with mild OSAS, 25 patients with moderate OSAS and 34 patients with severe OSAS. Serum uric acid level was significantly higher in OSAS group compared to control group. Conclusion: Complete blood count data and serum urea levels were found similar in both groups, whereas creatinine was significantly higher in OSAS patients. Serum uric acid and creatinine levels were increasing significantly as the disease got more severe. When patient uric acid levels were compared by gender, mean uric acid level was 5.29 mg/dL in women and 6.58 mg/dL in men; the difference between genders was statistically significant. [ABSTRACT FROM AUTHOR]

Objective: Obstructive sleep apnea syndrome (OSAS) patients are thought to experience increased resistive load due to both anatomical and functional changes. This can possibly contribute to respiratory muscle dysfunction. We aimed to measure daytime maximal inspiratory and expiratory pressures, in order to find out respiratory muscle functions in OSAS. Materials and Methods: Patients admitted to our sleep laboratory for one-year period were prospectively analysed. All the cases had undergone overnight polysomnography. All cases had pulmonary function tests performed by the same experienced technician in the morning following sleep study. The study population consisted of 51 (37.8%) female and 84 (62.2%) male patients, with a mean age of 47. Results: Apnea hypopnea index (AHI) was found to be correlated with forced expiratory volume in one second (FEV1) and forced volume vital capacity (FVC) values and FVC%. FEV1/FVC, maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) values did not seem to be correlated with AHI. FVC (L), FVC%, FEV1, FEV1%, MIP, MIP% and MEP were similar in patients with and without OSAS. OSAS patients had significantly lower MEP% values. FVC, FEV1 and MEP% showed significant differences in different stages of the disease. Other parameters were similar in all groups. Conclusion: In this study we demonstrated that maximal expiratory muscle strength of awake OSAS patients was lower, whereas inspiratory muscle strength was similar in subjects with and without OSAS. [ABSTRACT FROM AUTHOR]

Objective: Hypoxia, perfusion pressure changes, systemic hypertension, vasospasm, increase in blood viscosity and small vessels’ resistance may cause ischemia in Obstructive sleep apnea syndrome (OSAS). The aim of this study is to assess the effect of hypoxia on the eye (choroidal and corneal thicknesses) in patients with OSAS. Materials and Methods: In this observational study age and gendermatched 20 severe, 17 modarate, 16 mild OSAS patients without any comorbidity and a control group of 16 healthy subjects were examined with spectral-domain optic coherence tomography (OCT). The central corneal thickness (CCT), subfoveal, and temporal and nasal choroidal thicknesses of the patients were measured by OCT. Results: The mean age of OSAS patients was 52.3±10.6 and 48.8±12.1 in control subjects. Female and male patients made up 23.1% and 76.9%, respectively. The mean CCT of OSAS patients was 560.2±31.1/563.5±29.1 μm, whereas the mean CCT was 560.6±30.4/567.1±28.2 μm in control group (p=0.52/p=0.29). There were significant differences (p<0.001) in choroidal thickness (severe: 228.3±16.8/240.5±17.8; moderate: 236.0±21.6/232.4±18.5; mild: 241.3±23.6/242.6±20.9; control: 267.8±18.6/271.6±18,6 μm) between patients and control groups who were separated by their OSAS severity. Conclusion: In our study choroidal thickness became thinner with increasing OSAS severity. On the other hand, corneal thickness did not seem to be affected from OSAS. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the relationship between redcell distrubution width (RDW), platelet distribution width (PDW), mean platelet volume (MPV) parameters and the disease severity in Obstructive sleep apnea syndrome (OSAS) patients; to benefit from the biomarkers to take early measures on disease treatment, follow-up and complications (as thromboembolic events and cardiovascular diseases). Materials and Methods: Our study is a retrospective and a cross-sectional study and we planned to asses polysomnography (PSG) records of the patients. Patients who were diagnosed with OSAS by PSG were grouped as 108 mild patients with [Respiratory Disturbance Index (RDI): 5-14.9]; 69 moderate patients (RDI: 15-30); 66 severe patients (RDI>30) and 117 patients were control group (RDI<5). The age range was between 18 and 78. Inclusion criterions were routine blood count, RDW, MPV and PDW. Results: Three hundred and sixty patients were enrolled in the study. 74.2% of them were male; mean age was 46.5. The average patient O2 saturation was 93.2. When moderate OSAS group was compared with the control group, hematocrit (Htc) (p=0.004) and hemoglobin (Hb) (p=0.002) were found to be significantly increased. When severe OSAS group was compared with the control group, MPV (p=0.017) was decreased significantly, Htc (p=0.006) and Hb (p=0.02) were found to be significantly increased. Conclusion: In our study, when the other groups and the control group were compared, we observed significantly increased Hb and Htc values in moderate and severe OSAS groups, however some other studies gives an increase in MPV we observed a decrease in severe group. Having few number of patients in moderate and severe OSAS groups may have led to such results. Therefore, more extensive and prospective studies are needed. [ABSTRACT FROM AUTHOR]

Objective: Interstitial lung disease (ILD) may create sleep disturbances due to chronic disease-related stress, respiratory abnormalities and adverse effects of treatment. We aimed to determine the quality of sleep in ILD patients, and the incidence of Obstructive sleep apnea syndrome (OSAS) in these patients. Materials and Methods: Taken to this study were 52 patients who were followed up in our center due to ILD. Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI) were applied to the patients. Spirometry and diffusion test were performed. Polysomnography (PSG) was performed to 27 patients whose ESS were more than or equal to 10. Results: Demographic characteristics, body mass index, spirometry and diffusion measurements, PSQI global score and the sub-components of it didn’t show difference according to ESS daytime sleepiness. Sleep quality of 44% of the patients was determined to be poor by PSQI. PSQI global score and sub-components weren’t correlated with apnea-hypopnea index, stage 1 latency, sleep efficiency and nocturnal desaturation (p>0.05) in 27 patients who underwent PSG. We observed increased stage 1 sleep and decreased stage 2-3 and rapid eye movement sleep. As nocturnal hypoxemia was seen arousals (p=0.000, r=0.698) increased. OSAS was diagnosed in 19 (70%) of subjects. Conclusion: Although ILD patients don’t have daytime hypoxemia; they may have nocturnal hypoxemia and OSAS, which may effect their sleep quality. Therefore ILD patients should be evaluated for daytime sleepiness, and sleep-related breathing disorders. [ABSTRACT FROM AUTHOR]

Introduction: An increase in sympathetic activity caused by intermittent hypoxia and reoxygenation that develops an obstruction of the upper respiratory tract in obstructive sleep apnea syndrome (OSAS) results in cardiovascular and metabolic changes. This study aimed to assess the effects of OSAS on serum vitamin D and parathyroid hormone (PTH) levels. Methods: The study population comprised 103 male patients with newly diagnosed OSAS and 58 male non-apnoeic controls matched for age, sex, and body mass index (BMI). Serum calcium, phosphorus, vitamin D, and PTH levels were measured. Results: There were no significant differences between patients with OSAS and the controls in terms of age, sex, BMI, smoking status, hypertension, and hyperlipidemia. Serum vitamin D levels were significantly lower in the OSAS group than in the control group (22.4±7.5 ng/mL vs. 31±7.9 ng/mL, respectively; p<0.001), whereas PTH levels were significantly higher in the OSAS group than in the control group (56.6±18.8 pg/mLvs. 42.3±17.6 pg/mL, respectively; p<0.001). On subgroup analysis, vitamin D levels were significantly lower in patients with severe OSAS than in those with mild/moderate OSAS (p<0.001). Vitamin D levels significantly correlated with theapnea-hypopnea index, oxygen desaturation index, PTH levels, and mean oxygen saturation. Conclusion: These results showed that OSAS is associated with low vitamin D levels and elevated PTH levels, which is related severity of OSAS. [ABSTRACT FROM AUTHOR]

Copyright of Archives of the Turkish Society of Cardiology / Türk Kardiyoloji Derneği Arşivi is the property of KARE Publishing 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.)

Objective: Sleep fragmentation occurs proportionally with the severity of disease in Obstructive sleep apnea syndrome (OSAS) patients. Deep sleep decreases in patients. Depression incidence increases depending on poor sleep, cognitive impairment, and the character and personality changes. Our aim in this study, we examined the relationship between oxygen desaturation and the Beck depression index (BDI) in patients with OSAS. Materials and Methods: Two hundred nineteen patients with polysomnography (PSG) and BDI records were included in this crosssectional and retrospective study. The age range of patients was in 18- 78. In OSAS group, 57 patients were mild [respiratory disturbance index (RDI): 5-15)]; 54 patients were moderate (RDI: 15.1-30); 52 patients were severe (RDI: >30). Fifty-six patients (RDI <5) were control group. Exclusion criterions were major depression, other psychiatric disorders and to receive depression treatment when PSG recordings were made. The results of Beck depression inventory were evaluated according to the criterion that BDI: 0-13 normal; BDI: 14-19 mild depression, BDI: 20-28 moderate depression, BDI: >29 severe depression. Results: The results of Beck Depression Index were observed as normal or mild depression at whole study population. The oxygen desaturation in patients with OSAS was increasing due to the severity of disease. But, between BDI and the oxygen desaturation there was no correlation in OSAS patients as compared with the control group. Conclusion: Depression is common due to chronic insomnia and especially fragmentation of sleep in OSAS. However, in our study, we observed the patients with normal or mild depressive symptoms. Between BDI and the oxygen desaturation there was no correlation. Hypoxemia was not provoked depression, however was suggested in the mood changes that due to insufficient sleep and the reduction of sleep depth. [ABSTRACT FROM AUTHOR]

Objective: We aimed to evaluate pulmonary medicine physicians' attitudes about obstructive sleep apnea syndrome (OSAS) and its treatment in İzmir. Materials and Methods: About 78 of 120 pulmonary medicine physicians in İzmir answered the questionnaire containing 24 items (demographics: 6, education: 4, attitudes: 9, knowledge: 5). Results: 67.9% of the participants were female. Mean age was 41.06±5.63, mean working year was 11.16±6.09. 52.6% worked in training and research hospitals, 32.1% in state hospitals, and the rest in private and university hospitals. Monthly patient number was 714.10±3.24, patients number with OSA symptoms was 14.85±2.15. 64.1% had completed speciality education in hospitals with sleep disorders centers and this ratio was higher in physicians whose working year was less than 10. 24.4% had practiced sleep study during this education. Participation in sleep study courses after speciality education was 48.7%. 26.9% worked as sleep specialist. 67.9% usually asked patients OSA symptoms and 38.5% asked preoperative OSA symptoms. 97.4% usually referred patients to sleep centers. 65.4% had been working in hospitals with sleep disorders centers. The ratio of correct answers in knowledge part of the questionnaire was 95%. Conclusion: OSAS is a major pulmonary disease and it is important in order tofind out the patients with OSA risk. 2.07% of patients in clinics have OSA symptoms. Physicians' confidence in diagnosis is more than managing patients with OSA. Practical part of sleep study is not enough in speciality education. Asking OSA symptoms is not common in preoperative examination. [ABSTRACT FROM AUTHOR]

Objective: Obstructive sleep apnea (OSA) is associated with intermittent hypoxia. OSA leads to increased sympathetic activation, oxidative stress, vascular endothelial dysfunction, coagulation disorders and metabolic dysregulation. These disturbances increase the the risk of inflammation and cardiovascular diseases. The purpose of this article is to review the laboratory parameters of OSA patients without any comorbidities. Materials and Methods: This retrospective study of consecutive 675 patients who had polysomnography, was conducted on one hundred and thirty patients who did not have any comorbidities. Laboratory values of patients were evaluated. Patients were grouped according to apnea-hypopnea index (AHI). Group 1 (n=17) AHI <5; group 2 (n=42) AHI=5-14.9; group 3 (n=31) AHI=15-29.9 and group 4 (n=40) AHI >30. Results: There were 88 men (67.7%) and 42 women (32.3%) in the study. Mean age, body mass index, Epworth score and AHI were 41.6±11.3 (16-75), 29.6±6.3 (17.1-65.7) 9.9±5.5, 6.2±11.34, respectively. Serum glucose, cholesterol and triglyceride levels were higher in group 4 (p=0.03, p=0.04, p=0.02, respectively). Uric acid and fibrinogen levels were higher in patients with higher AHI (p=0.038). Conclusion: Our study indicates that increased blood glucose, uric acid and dyslipidemia are associated with OSA regardless of comorbidities. [ABSTRACT FROM AUTHOR]

Objective: Obstructive sleep apnea syndrome (OSAS) adversely affects school performance by causing learning difficulties, attention deficit, and forgetfulness. Aim of this study is to compare two student groups with different school success levels by symptoms related with OSAS. Methods: First class students from a faculty of our university with relatively higher university entrance examination scores (Group 1) and the ones from another faculty with lower scores (Group 2) were included in study. A questionnaire was applied. Demographic features, information related with smoking, driving, and previous traffic accidents were recorded. Additionally, Epworth Sleepiness Scale and Berlin Questionnaire used in OSAS screening were scored. Findings of two groups were compared. Results: 252 students were included. Group 1 and 2 consisted of 136 and 116 students, respectively. No difference was determined by age, sex, weight, and height. Significantly higher prevalence of snoring (87.1% vs.27.2%), sleep apnea (10.3% vs.5.1%), daytime sleepiness (25.8% vs.13.2%), and frequency of smoking (25.3% vs.18.2%) were determined in Group 2 than in Group 1 (p<0.001, p=0.021, p=0.002,and p<0.001,respectively). Group 2 also had higher Epworth Sleepiness Scales (5.3±3.5 vs.1.8±3.6,p=0.006) and higher prevalence of OSAS risk (45.7% vs.31.6%,p<0.001). Within Group 2, frequencies of snoring and sleep apnea were higher in smokers than in non-smokers [(97.8% vs.20%,p<0.001) and (68.9% vs.6.7%,p=0.047),respectively]. Conclusions: The prevalence of smoking and symptoms related with OSAS were found higher in students with lower school performance. Given that one of the factors affecting school success in young adults is sleep breathing disorders including OSAS, more comprehensive studies in this field are warranted. [ABSTRACT FROM AUTHOR]

Objective: There is limited number of studies conducted on the use of capnography for CO2 monitorization in sleep laboratories. In this study, it was aimed to investigate the correlation between the CO2 value measured by transcutaneous carbon dioxide (tcCO2) monitorization and partial pressure of carbon dioxide (PaCO2) levels measured with arterial blood gas analysis in patients diagnosed with obstructive sleep apnea syndrome (OSAS) and Sleep-related hypoventilation/hypoxemic syndromes (SRHHS). Materials and Methods: Patients with bilevel positive airway pressure (BiPAP) treatment indication who were diagnosed with OSAS and SRHHS via polysomnography (PSG), were prospectively included in the study. Four arterial blood gas analyses were conducted from all participants (preand post-PSG, before and after manual bi-level positive airway pressure titration) in order to find PaCO2 levels against tcCO2 monitorization. Results: Totally 30 patients with sleep-related respiratory disease (SRRD), consisting of 18 patients with OSAS and COPD, and 12 patients with OSAS and obesity hypoventilation syndrome (OHS), were included in the study. A correlation was detected between average tcCO2 level and average PaCO2 level in night PSG (r=0.600; p<0.0001). Similarly, we found a correlation between average tcCO2 level and average PaCO2 level in BiPAP titration night measurements as well (r=0.812; p=0.001). Finally, a correlation was detected between the average PaCO2 value obtained from four blood gas samples measured in both nights and the average tcCO2 value taken from two capnographies (r=0.783; p<0.001). Conclusion: Comparing tcCO2 and PaCO2 values, it was determined that the average CO2 values measured by capnography correlated with the average of simultaneous arterial CO2 values measured before and after BiPAP titration. [ABSTRACT FROM AUTHOR]

In patients with Obstructive sleep apnea syndrome (OSAS), preoperative evaluation should be routinely done in all patients with OSAS undergoing surgery or in all patients suspected to have OSAS to avoid problems during perioperative (pre-intra-post) stages. The detection of OSAS severity, the prediction of perioperative anesthesia risk, preoperative medication and difficult entubation should be taken in account. Preventive measures should be taken. [ABSTRACT FROM AUTHOR]

Objective: In this study, we investigated 304 patients diagnosed with Obstructive sleep apnea syndrome (OSAS) and undergoing standard polysomnography in our sleep laboratory between December, 2013 and January 2015 in terms of anamnesis, drugs used and laboratory test results. Materials and Method: Chronic diseases were detected in patients and their relations between OSAS were investigated. Results: Severity of the disease in all patients was investigated under 3 topics according to Respiratory disturbance index (RDI). According to the results as severity of the OSAS increases, co-occurrence with systemic diseases increases. Conclusion: In this study, co-occurrence of OSAS and chronic systemic diseases, characteristics of OSAS and the relation between OSAS and chronic systemic diseases were investigated. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Physical Medicine & Rehabilitation / Turkiye Fiziksel Tip ve Rehabilitasyon Dergisi is the property of Turkish Society of Physical Medicine & Rehabilitation 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.)

Objective: Obstructive sleep apnea syndrome (OSAS) is characterized by repetitive nocturnal apnea episodes. Periodic limb movements (PLMs) is known as the nocturnal, stereotypic, repetitive movements of the lower extremities. The aim of this study was to investigate the presence of PLMs in patients with OSAS, and the relationship between PLM and OSAS severity. Materials and Methods: One hundred forty-one patients who had a pre-diagnosis of OSAS were enrolled into the study. All subjects' blood pressure, heart rate measurements, and neurologic examinations were performed by the same neurologist. Sociodemographic characteristics were recorded. Overnight polysomnography (PSG) was performed in all patients and results were analyzed. Patients with an apnea-hypopnea index (AHI) of ≥5 were accepted as having OSAS, and a PLM index (PLMI) of ≥5 were accepted as having PLM. Results: One hundred two patients were diagnosed as having OSAS. The control group consisted of 39 patients who had normal polysomnographic findings. The patients with OSAS were older and their body mass indexes (BMI) were higher compared with the control group. Systolic blood pressure was higher in the OSAS group. Alcohol use was found to be a risk factor for OSAS. PLM was more common in the OSAS group than in the control group (30.3-10.2%). PLM frequency was associated with the severity of OSAS. Conclusion: The presence of PLM was associated with OSAS severity, higher systolic and diastolic blood pressure, and REM sleep depletion in OSAS. PLM seen in patients with OSAS may be regarded as an indicator of disease severity, and should alert the physician to increased complications. [ABSTRACT FROM AUTHOR]

Objective: Obstructive Sleep Apnea syndrome (OSAS) is a condition in which ever-repeating obstruction of upper airway during the sleep. In the present study, we aimed to evaluate the autonomic nervous system function in patients with moderate to severe OSAS. Materials and Methods: Totally, 29 patients diagnosed with OSAS by Polysomnography (PSG) and scored moderate to severe based on American Academy of Sleep Medicine (AASM) International Scoring in Eskişehir Osmangazi University Faculty of Medicine, Department of Neurophysiology Sleep Laboratory were included the study. Thırty healthy individuals included as control group. Analyzing protocol of electrophysiological autonomic nervous system functions included Sympathetic Skin Response (SDY) for sympathetic nervous system and RR Interval Variability (RRIV) for parasympathetic nervous system both during rest and after Hyperventilation (HV). Results: Patient group included 29 patients consists of 4 women (14%) and 25 men (86%) and control group included 30 healthy volunteers consists of 18 women (60%) and 12 men (40%). The mean age was 46.6±10.2 years for the patient group and 43.5±12.2 years for the control group. In patient group, 12 patients had moderate OSAS and 17 patients had severe OSAS. No statistically significant difference was found for the values of mean SDY latency, RRIV and HV-RRIV between groups (p>0.05). Conclusion: In our study, significant autonomic dysfunction was not found in patients with OSAS. [ABSTRACT FROM AUTHOR]

Objective: Obstructive Sleep Apnea syndrome (OSAS) is a clinical syndrome characterized by recurrent episodes of upper airway obstruction during sleep, resulting in chronic intermittent hypoxia and causing inflammation. IL-6 and CRP are the most commonly studied inflammation biomarkers in OSAS. Given that IL-6 is an important activator of hepcidin during inflammation. In this study, hepcidin levels in OSAS patients were examined. Materials and Methods: A total of 44 patients undergoing Polysomnography (PSG) for suspected sleep disorder breathing were studied. Patients were classified as having no to mild OSAS (n=15) or moderate to severe OSAS (n=29) based on apnea-hypopnea index (AHI) (AHI <15 vs. AHI ≥15, respectively). Blood samples were obtained at night before PSG and in morning to obtain hepcidin levels. Results: Patients with moderate to severe OSAS had lower evening hepcidin levels (U=-3.91, p<.001) and a greater change in evening to morning hepcidin levels (t=-2.83, p=.007) than patients with no or mild sleep apnea. AHI was negatively correlated with evening hepcidin (Hep E) (rs=-0.48, p =0.001) but was not significantly associated with morning hepcidin (Hep M) or change in evening to morning hepcidin levels. Greater Hep E levels were associated with significantly decreased odds of having moderate to severe sleep apnea even after controlling for covariates. A greater change in Hep E to Hep M levels were associated with a 1.08-fold increase in the odds of having moderate to severe sleep apnea (95% CI 1.02-1.15, p=.02). Conclusion: This is a pioneer study to date to investigate the association between hepcidin and OSAS. Among patients with moderate-severe OSAS, significant increases in Hep E levels and change in Hep E to Hep M levels were found. Hepcidin may be a useful marker for the detection of hypoxia/reoxygenation episodes and inflammation in OSAS. [ABSTRACT FROM AUTHOR]

Adult stem cells are undifferentiated cells that are present particularly in the bone marrow. Several stimuli, such as inflammation and oxidative stress can mobilize these cells from the bone marrow into the circulating blood and stem cells repair tissue, organ and vascular injuries. Obstructive sleep apnea syndrome is a systemic inflammatory disease with severe cardiovascular consequences. The role of stem cells in obstructive sleep apnea is studied in this review. [ABSTRACT FROM AUTHOR]

Objective: Lethargy, apathy, daytime sleepiness are common features of Obstructive sleep apnea syndrome (OSAS). These features are already seen in hypothyroidism. OSAS is more frequent in obese patients and overt hypothyroidism may substantially add to this risk. We aimed to evaluate the incidence of hypothyroidism in cases applying with OSAS symptoms who have no known clinical thyroid disease to evaluate the necessity of thyroid hormone screening in OSAS. Materials and Methods: The study population consisted of patients with no known history of thyroid disease. All patients were screened in the sleep laboratory for one night and polysomnography. Serum thyroidstimulating hormone (TSH) levels were measured by chemiluminescence method in patients referred to our sleep center for an overnight sleep study. Results: Of 1473 subjects, 1406 (95.5%) were diagnosed as OSA (Apnea-hypopnea index (AHI)>5). Elevated TSH levels were detected in 3 cases in the nonapneic group (4.47%) and 54 cases in the OSAS group (3.90%). In mild-moderate OSAS group, the mean TSH value was 2.02 μU /ml and in patients with severe OSAS this value was 2.44 μU/ml, though the difference was not statistically significant (p=0.08). AHI was found to be weakly correlated with TSH values, though the correlation was statistically significant (r=0.05, p=0.04). Mean TSH values were not correlated with oxygen desaturation index (ODI) or lowest oxygen saturation values (r=0.02 and r=-0.02, respectively). Conclusion: The measurement of TSH levels in suspected OSAS cases may help both differential diagnosis between OSAS and hypothyroidism, but subclinical hypothyroidism was not found more common in patients with OSAS. [ABSTRACT FROM AUTHOR]

Objective: We aimed to investigate the relationship between polysomnographic (PSG) findings and sexual functions of men with erectile dysfunction (ED) caused by obstructive sleep apnea (OSA) syndrome, and point out the alteration in the sexual functions after continous positive airway pressure (CPAP) theraphy. Materials and Methods: Patients referred to Yunus Emre State Hospital sleep laboratory between May 2013 and October 2013 with a complaints of snoring and apnea during sleep and have apnea hypopnea index (AHI)>15 were the subjects of this prospective clinical study. All patients were asked to fill IIEF (International Index of Erectile Function) test before and after 12 weeks of CPAP theraphy. Results: As well as total IIEF-15 scores, each score of five questions (erectile function, orgasmic function, sexual desire, intercourse satisfaction, overall satisfaction) were significantly increased after nasal CPAP therapy (p<0.05). Twenty-one (84%) and 10 (40%) patients had ED before and after CPAP treatment respectively and the changing was statistically significant (p=o.003). The correlation analysis was revealed no significant relation between the IIEF-15 (total & five item) scores and PSG findings. Conclusion: Our findings revealed that CPAP therapy improves ED of men with OSAS. Although ED is not a mortal complaint, it has remarkable impact on mens' life and might be improved after CPAP theraphy. [ABSTRACT FROM AUTHOR]

Objective: Oxidative stress is characterized byan imbalance between production and destruction of reactive oxygen species. In our study, we aimed to determine the relationship between the oxidant-antioxidant balance in patients with showing some biochemical factors reflecting the severity of the disease and sleep parameters in patients with Obstructive Sleep Apnea Syndrome (OSAS). Methods: 93 patients were included to the study at the sleep centre, Department of Chest Diseases, Dicle University Hospital. All patients were subjected to all night polysomnography. Serum TOS and TAS levels were measured. Results: The mean age of patients was 47.4±7.2 years. There was not significant between patient and control groups in terms of age, gender, body mass index and frequency of symptoms (p> 0.05).The mean apnea-hypopnea index (AHI) was 25.1units/hour. We found these parameters significant compared with the control group; apnea-hypopnea index, arousal index, oxygen desaturation index, serum total oxidant and serum total antioxidant level (p<0.05). The mean serum levels TOS and TAS in patients with OSAS were found 34.2 mmol/L and 1.18 mmol/L, respectively. The mean serum levels TOS and TAS in control group were found 21.7 mmol/L and 1.54 mmol/L, respectively. Differences between two groups were significant (p<0.05). Conclusion: We observed that increased level of oxidative stress and decreased antioxidant levels in patients with OSAS. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effect of obesity on obstructive sleep apnea syndrome (OSAS) by means of objective and subjective data. Methods: A total of 70 patients were divided into obese (n=38; BMI>35 kg/m2) and non-obese patient groups (n=32; BMI<30 kg/m2). The Epworth sleepiness scale scores, modified Mallampati index scores, levels of obstruction in the oropharynx and soft palate, neck circumference and polysomnography findings between two groups were compared. Results: Obese patients had an average Mallampati score of Class III while the non-obese study participants had an average score of Class II, with a statistically significant intergroup difference. In Muller's maneuver, the levels of obstruction in both the soft palate and oropharynx were higher in the obese patients with a statistically sig-nificant difference between two groups. When polysomnography results were examined, the average apnea-hypopnea index (AHI) score was determined to be 22.5 in the obese and 6.4 in the non-obese groups, respectively. Furthermore, average scores of rapid eye move-ment (REM) AHI in the non-obese and obese patients were 4.6 and 17.2 with a statistically significant difference between the groups. The average lowest oxygen saturation was 75.5% in the obese and 88% in the non-obese group, which represented a statistically signif-icant difference between groups. In the obese group, the number of patients with REM-dependent OSAS was higher than in the non-obese group which attained a level of statistical significance. Conclusion: Our study indicated that obesity increases the severity of OSAS, in part due to significant narrowing of the airway at the level of the soft palate and oropharynx. Additionally, our study has shown that the risk of supine position-dependent OSAS and especially REM-dependent OSAS were notably higher in obese patients. [ABSTRACT FROM AUTHOR]