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Background: Management of OSA during the COVID-19 pandemic has changed and telemedicine was used to continue diagnosing and treating these patients. However, there are no studies till now evaluating OSA patients’ attitudes and PAP adherence during the initial phase of the COVID-19 pandemic in Greece. Aims and Objectives: To analyse the impact of the national lockdown in Crete on PAP adherence, patients attitudes regarding COVID-19 pandemic and the potential influence of telemedicine. Methods: 167 OSA patients under PAP treatment were included with adherence data available in the 12- months prior and in the 3 months after the lockdown. Telemedicine was used for patient’s follow-up. We analysed the impact of COVID-19 lockdown on objective PAP adherence and patients concerns regarding COVID-19 infection and associated complications due to OSA diagnosis. Results: All patients continued to use their PAP during the COVID-19 outbreak. Comparing data from the pre-COVID-19 period to data post-lockdown we found no significant difference in PAP adherence, measured by hours of use (6.1 vs 5.7, p=0.15); however, the proportion of patients with good compliance (≥6 hours of PAP use/night) increased by 18% (pl0.001). 23% of patients reported concerns about getting COVID-19 due to OSA diagnosis, but only 3% reported decreased sleep duration and 9% were concerned that the presence of OSA would make them more likely to have greater medical complications in case of COVID-19 infection. Conclusions: Our results suggest that until now COVID-19 pandemic had no impact on PAP adherence or reported sleep duration, pointing out the potential role of digital health in Sleep field.

Background: Obstructive sleep apnea (OSA) and diabetes type 2 are high prevalent diseases with major public health impact, sharing a complex relationship. Aims and Objectives: Τo evaluate the influence of OSA severity on prevalent diabetes in a large clinical population of patients. Methods: We identified a sample of 2,279 patients (mean age 55 years, 74% men) who undergone a diagnostic polysomnography and completed the Epworth sleepiness scale (ESS). We investigated the prevalence of diabetes type 2 in patients with newly diagnosed OSA and analyzed the risk of severe OSA for prevalent diabetes after adjustment for relevant confounding factors including gender, age, smoking, obesity, daytime sleepiness and comorbidities. Results: The prevalence of Diabetes in OSA patients was 19.8%, which was 4.4 times higher than that in patients without OSA (4.5%). Diabetes was more prevalent in severe (26%) and moderate (12%) OSA compared to mild OSA (5%, pl0.001 among all). Following multivariable adjustment, severe OSA remained a significant predictor for diabetes [odds ratio (95% CI) 2.922 (1.346–6343), p=0.007]. Further analysis demonstrated[s1] that severe OSA predicted prevalent diabetes mainly in younger (l60 years) [OR (95% CI) 5.246 (1.523–18.070), p=0.009] and sleepy (ESS≥10) patients [OR (95% CI) 5.726 (1.298–25.264), p=0.021]. Conclusion: Our results showed that severe OSA associated with an independent 3-time risk increase for type 2 diabetes in this large clinical patient cohort. These data suggest that there is value in systematic screening for diabetes in severe OSA patients, especially in younger and sleepy patients.

Scientific data about the effects of positive airway pressure (PAP) treatment on blood pressure (BP) control are continuously increasing; however, they are controversial. We aimed to determine the long-term effects of compliance with PAP therapy on BP in both hypertensive and normotensive patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). One thousand one hundred sixty eight consecutive patients with newly diagnosed OSAHS, who had been recommended PAP therapy, were followed up for a minimum of 2 years. Patients with previous cardiovascular disease were excluded. BP was measured at baseline and after 2 years of PAP treatment. In addition, the correlation between the changes in BP with different levels of PAP compliance was assessed. At the end of the follow-up period, in the hypertensive group of patients (n=586), a significant decrease was shown in systolic (-11.2 mm Hg, P0.001) and diastolic BP (-4.2 mm Hg, P0.001). Furthermore, in the patients without hypertension (n=528), a significant decrease was noted both in systolic and diastolic BP (-3.6, P0.001 and -2.4, P0.001, respectively). A correlation between the magnitude of change in systolic and diastolic BP and hours of use of PAP (r=0.14, P=0.002 and r=0.1, P=0.025, respectively) was observed in all patients. Long-term use of PAP treatment, as well as increased hours of PAP in patients with OSAHS use showed significant reductions in BP not only in patients with hypertension, but also in normotensive patients. Therefore a significant potential reduction in cardiovascular mortality and morbidity should be expected in these patients.

European-Respiratory-Society (ERS) International Congress -- SEP 28-OCT 02, 2019 -- Madrid, SPAIN, WOS: 000507372400192, [No abstract available], European Respiratory Soc

Background: Gender affects the clinical presentation of obstructive sleep apnea (OSA). The classic OSA symptoms, such as sleepiness, snoring, and apnea, are not so frequent in women. Objectives: To evaluate possible gender differences in questionnaires used for OSA prediction, such as the Epworth Sleepiness Scale (ESS), STOP, STOP Bang (SB), Berlin Questionnaire (BQ), Athens Insomnia Scale (AIS), and Fatigue Scale (FS). Methods: 350 males were matched with 350 women referred to a sleep clinic, according to OSA severity. All responded to the questionnaires and underwent a sleep study. Cardiovascular disease (CVD) patients were separately analyzed. Results: ESS did not differ between genders. SB was higher in males, whereas STOP, BQ, AIS, and FS were higher in females. BQ presented the highest sensitivity in both genders, whereas STOP exhibited the highest specificity in males and ESS in females. AIS and FS were more sensitive and SB more specific in females, whereas BQ was more specific in males. For severe OSA, the predictive values of SB and BQ were almost similar for both genders, however AIS and FS were higher in women. CVD patients presented higher scores, independent of gender, except for AIS, which was higher in females. Conclusion: Gender-specific evaluation of questionnaires is necessary to prevent OSA under-diagnosis.

Circulating KL6 has been recognized as a biomarker of subclinical lung injury induced by oxidative stress in idiopathic pulmonary fibrosis (IPF) and in obstructive sleep apnoea (OSA). The proportion of coexistence of OSA and IPF is remarkable and IPF guidelines recently recognize OSA as a serious problem affected survival. The aim of this study was to investigate potential additive effects in serum and BALF KL6 levels, of the coexistence of OSA in IPF patients. 25 patients with IPF (Group A) and 22 patients with IPF-OSA(Group B) were included in the study. BALF KL6 was available in 13 patients from group A and in 10 patients from group B. We investigated the correlation of KL6 levels with several parameters from the sleep study, such as apnoea-hypopnoea index (AHI), REM apnoea-hypopnoea index (REM-AHI) and desaturation indexes. Both serum and BALF KL6 levels were non-significantly between two groups. However, a negative correlation was found between KL6 serum levels and severity of IPF, assessed by DLCO (r=-0.504, p=0.017) and KCO (r=-0.548, p=0.01), only in group with IPF plus OSAS. Our preliminary findings showed a negative association of serum KL6 and lung diffusion parameters only in IPF-OSA subgroup of patients. This evidence could support the hypothesis that KL6 levels probably reflect the additional oxidative stress OSA provides in IPF patients. Further studies are needed to clarify this observation.