Application of enhanced recovery after surgery based on multiphase optimization strategy in the nursing management of children with snoring disease day surgery.

AIMS AND OBJECTIVES: This study aimed to investigate the effectiveness of applying a multiphase optimization strategy (MOST) to enhance recovery after surgery (ERAS) protocols within the nursing management of children undergoing day surgery for snoring disease. BACKGROUND: While MOST has been applied to behavioral intervention research in smoking cessation, AIDS management, and weight loss by international scholars, its application in constructing nursing intervention projects remains relatively unexplored. DESIGN: Using convenience sampling, randomised controlled trial. METHODS: A convenience sampling method was employed. The study recruited 200 preschool children diagnosed with snoring who underwent day surgery at a specific hospital between January 2023 and January 2024. The participants were divided into two groups: a control group receiving standard nursing care and an experimental group receiving MOST-guided, integrated high-quality nursing plans specifically designed for children with snoring undergoing day surgery, adhering to established ERAS guidelines. RESULTS: Children in the experimental group exhibited significantly lower anxiety levels compared to the control group, both in the preoperative waiting area and upon returning to the ward (p < 0.01). While the quality of discharge teaching scale (QDTS) scores did not reveal a statistically significant difference between the groups (p > 0.01), the content of discharge instructions and the perceived effectiveness and skill of nurse guidance differed significantly between the control and experimental groups(p < 0.01). Notably, the experimental group experienced a demonstrably lower incidence of thirst, hunger, crying, aspiration, pain, and conversion of day ward to routine hospitalization mode compared to the control group (all p < 0.01). There was no significant difference in the incidence of postoperative nausea and vomiting between the groups after rehydration (p > 0.01). CONCLUSIONS: The implementation of ERAS protocols enhanced by MOST within the nursing management of children with snoring undergoing day surgery demonstrates significant efficacy. This approach can effectively reduce preoperative anxiety in children, improve the quality of discharge guidance provided to parents, and demonstrably decrease the occurrence of postoperative thirst, hunger, crying, aspiration, pain, and the need for unplanned hospitalization transitions within 6 h after surgery. RELEVANCE TO CLINICAL PRACTICE: It is necessary to provide fast rehabilitation nursing for children with snoring during daytime operation. Nurses should adopt the theory of fast rehabilitation based on multi-stage optimization strategy to promote children's fast rehabilitation after operation.

Assessing the Knowledge and Awareness of Obstructive Sleep Apnea among Patient Families in Saudi Arabia: A Qualitative Study.

Background: Obstructive sleep apnea (OSA), if left untreated, can have major negative effects on health, such as an elevated risk of diabetes, heart disease, and stroke. Increasing people's knowledge of this illness might lessen the stigma associated with sleep problems and motivate them to get treatment if they think they might have OSA. Aim of the Study: This study aims to assess the knowledge and awareness of OSA among patients' families in Saudi Arabia. Methods: A phenomenological-oriented study with in-depth interviews was used to collect data from 28 participants. Results: Two themes and subthemes emerged from the interviews, revealing significant knowledge gaps, especially regarding the health risks and management of OSA. Only a few participants were aware of the serious health implications of untreated OSA. Furthermore, many did not know about effective management strategies for OSA. Conclusion: The level of awareness and knowledge among participants was poor, with participants' lifestyles significantly affected by having relatives with OSA. They expressed concerns about challenges with CPAP adherence and recommended various coping techniques to support affected individuals.

Association between sleep bruxism and snoring in adults: An observational study.

OBJECTIVE: This study evaluated the association between sleep bruxism and snoring. Additionally, the associations between sleep bruxism and age, sex, body mass index, sleep structure, sleep quality, and sleepiness were evaluated. METHODS: Adults suspected of having sleep disorders (n = 61) underwent single-night video polysomnography according to the American Academy of Sleep Medicine criteria. Validated questionnaires were used to assess sleepiness and sleep quality, and clinical examinations were performed to document weight and height. Jamovi software was used for statistical analysis. Logistic regression analyses of the different sleep stages-REM sleep, NREM sleep, and total sleep time-were conducted. RESULTS: No association was found between sleep bruxism and snoring (P > 0.31), with a small effect size (V = 0.171). However, the snore index was found to influence the rhythmic masticatory muscle activity index during REM sleep, with an odds ratio of 1.018 (95 % CI: 1.005 to 1.03; P = 0.05). Moreover, logistic regression showed that the desaturation index presented an odds ratio of 5.01 (95 % CI: 0.96 to 26.13; p = 0.056), with a medium effect size (>3.5). Sleep bruxism was not associated with age, sex, body mass index, or other sleep variables. CONCLUSION: Snoring appears to be associated with bruxism during REM sleep. No associations were found between sleep bruxism and sex, age, or body mass index. This lack of association underscores the complexity of sleep bruxism and snoring and highlights the need for further research. Concerning sleep architecture, only desaturation episodes were associated with bruxism during REM sleep. Neither sleep quality nor sleepiness was associated with sleep bruxism.

Gender-specific association between snoring and total sleep duration with type 2 diabetes mellitus in rural adults.

PURPOSE: To investigate the separate and joint association between snoring and total sleep duration with the risk of type 2 diabetes mellitus (T2DM) in both genders within Chinese rural community. METHODS: The Henan Rural Cohort Study included a total of 28093 participants. Data on snoring and total sleep duration were obtained through the Pittsburgh Sleep Quality Index (PSQI). Binary logistic regression was employed to assess the correlation between snoring and total sleep duration with T2DM. RESULTS: The prevalences of T2DM were 8.53% in males and 9.27% in females. Males exhibited a higher prevalence of snoring (34.90%) compared to females (22.42%), and the median of total sleep duration was also longer in males (8.83 h) than in females (8.67 h), respectively (P < 0.001). Females who snored had an adjusted odds ratio (OR) and 95% confidence interval (CI) for T2DM of 1.19 (1.06, 1.35) when contrasted with non-snorers. Compared with optimal total sleep duration (6-8 h), longer total sleep duration (≥ 8 h) increased the prevalence of T2DM by 17% (95%CI: 3%, 32%) in females. Additionally, the participants with shorter total sleep duration (< 6 h) and snoring have the highest risk of T2DM, with an increase of 91% (95%CI: 20%, 204%) than those with optimal total sleep duration and non-snorers in females. These significant associations were not found in males. CONCLUSIONS: Snoring and longer total sleep duration independently elevated the prevalence of T2DM. Meantime, a synergistic relationship was observed between snoring and total sleep duration with a higher prevalence of T2DM. These associations exhibited gender-specific differences.

Association of Snoring and Daytime Sleepiness With Subsequent Incident Hypertension: A Population-Based Cohort Study.

BACKGROUND: There is a strong association between obstructive sleep apnea and hypertension, but the effects of obstructive sleep apnea symptoms on the risk of incident hypertension are not well documented. The aim of this prospective study was to examine whether snoring and sleepiness are associated with incident hypertension. METHODS: Data from the French population-based CONSTANCES cohort were analyzed. Normotensive participants, aged 18 to 69 years, were included between 2012 and 2016 and screened for snoring, morning fatigue, and daytime sleepiness in 2017 using items of the Berlin Questionnaire. We used Cox models, adjusted for multiple potential confounders, including body mass index, baseline blood pressure, sleep duration, and depressive symptoms, to compute hazards ratios of incidentally treated hypertension. RESULTS: Among 34 727 subjects, the prevalence of self-reported habitual snoring, morning fatigue, and excessive daytime sleepiness (≥3× a week for each) was 23.6%, 16.6%, and 19.1%, respectively. During a median follow-up of 3.1 years (interquartile range, 3.0-3.5), the incidence of treated hypertension was 4.1%. The risk of de novo treated hypertension was higher in participants who reported habitual snoring (adjusted hazard ratio, 1.17 [95% CI, 1.03-1.32]) and excessive daytime sleepiness (adjusted hazard ratio, 1.42 [95% CI, 1.24-1.62]), and increased with the weekly frequency of symptoms, with a dose-dependent relationship (Ptrend≤0.02 for all symptoms). CONCLUSIONS: Self-reported snoring and excessive daytime sleepiness are associated with an increased risk of developing hypertension. Identification of snoring and daytime sleepiness may be a useful public health screening tool in primary care for hypertension prevention.

Sleep apnoea symptoms and sleepiness associate with future diet quality: a prospective analysis in the Bogalusa Heart Study.

Sleep apnoea is a known risk factor for cardiometabolic diseases (CMD), but it is unknown whether sleep apnoea or its symptoms contribute to increased CMD through an association with diet quality. This study assessed the association between sleep apnoea symptoms on future diet quality in the Bogalusa Heart Study (BHS). This prospective study included 445 participants who completed a sleep apnoea questionnaire in 2007-2010 and a FFQ in 2013-2016 (mean follow-up: 5·8 years; age 43·5 years; 34 % male; 71 % White/29 % Black persons). Diet quality was measured with the Alternate Healthy Eating Index (AHEI) 2010, the Healthy Eating Index (HEI) 2015 and the alternate Mediterranean diet score. Adjusted mean differences in dietary patterns by sleep apnoea risk, excessive snoring and daytime sleepiness were estimated with multivariable linear regression. Models included multi-level socio-economic factors, lifestyle and health characteristics including BMI, physical activity and depressive symptoms. Those with high sleep apnoea risk, compared with low, had lower diet quality 5·8 years later (percentage difference in AHEI (95 % CI -2·1 % (-3·5 %, -0·7 %)). Daytime sleepiness was associated with lower diet quality. After adjusting for dietary pattern scores from 2001 to 2002, having high sleep apnoea risk and excessive sleepiness were associated with 1·5 % (P < 0·05) and 3·1 % (P < 0·001) lower future AHEI scores, respectively. These findings suggest that individuals with sleep apnea or excessive sleepiness should be monitored for diet quality and targeted for dietary interventions to improve CMD risk.

Evaluation of Dentofacial Angles in Children with Severe Adenoid Hypertrophy.

Introduction: Hypertrophy of adenoids is a common condition in childhood, resulting in obstructive symptoms such as sleep apnea, snoring, and rhinosinusitis. Adenotonsillectomy is recommended to improve prognosis and quality of life. This case-control study compared facial angles and lip position related to dentofacial and mouth growth in symptomatic children with adenoid hypertrophy and asymptomatic control groups. Materials and Methods: The study included children aged 5 to 7 who presented with obstructive symptoms and confirmed severe adenoid hypertrophy in lateral neck radiography. Standard lateral photography was taken. The Nasofacial and Nasomental angles, and upper and lower lip positions and their distance behind the Ricketts line, were measured and compared with the normal control group. Results: This study included 54 children with severe adenoid hypertrophy and 66 normal children. Facial angles were not significantly different between the two groups, but the mean horizontal position of the upper and lower lip in children with adenoid hypertrophy was significantly lower than in the control group (P value = 0.05). The lips were too close to the Ricketts line compared with the control group. Conclusions: This research demonstrates that children with severe adenoid hypertrophy have more dentofacial disorders than others. Adenotonsillectomy surgery is necessary for children with obstructive symptoms caused by tonsil enlargement, and if symptoms like snoring persist post-surgery, complementary orthodontic treatments should be considered.

Consensus Statements among European Sleep Surgery Experts on Snoring and Obstructive Sleep Apnea: Part 3 Palatal Surgery, Outcomes and Follow-Up, Complications, and Post-Operative Management.

Background/Objectives: Exploring and establishing a consensus on palatal surgery, the outcomes and follow-up after the palatal surgery, the complications of palatal surgery, and the post-operative management after palatal surgery for snoring and obstructive sleep apnea (OSA) among sleep surgeons is critical in the surgical management of patients with such conditions. Methods: Using the Delphi method, a set of statements was developed based on the literature and circulated among a panel of eight European experts. Responses included agreeing and disagreeing with each statement, and the comments were used to assess the level of consensus and to develop a revised version. The new version with the level of consensus and anonymized comments was sent to each panel member as the second round. This was repeated over a total of five rounds. Results: The final set included a total of 111 statements, 27 of which were stand-alone questions and 21 of which contained 84 sub-statements. Of the 34 statements regarding palatal surgery, consensus was achieved among all eight, seven, and six panelists for 50%, 35.3%, and 5.9% of the questions, respectively. Of the 43 statements regarding the outcomes and follow-up after the palatal surgery, consensus was achieved among all eight, seven, and six panelists for 53.5%, 23.3%, and 4.7% of the questions, respectively. Of the 24 statements regarding complications after the palatal surgery, consensus was achieved among all eight, seven, and six panelists for 91.7%, 0%, and 4.2% of the questions, respectively. Of the 10 statements regarding post-operative management after palatal surgery, consensus was achieved among all eight, seven, and six panelists for 10%, 30%, and 30% of the papers, respectively. Conclusions: This consensus provides an overview of the work of European sleep surgeons to develop a set of statements on palatal surgery for the treatment of snoring and OSA, the outcomes and follow-up, the complications, and the post-operative management of palatal surgery. We believe that this will be helpful in everyday practice. It also indicates key areas for further studies in sleep surgery.

Associations of sleep with cardiometabolic risk factors and cardiovascular diseases: An umbrella review of observational and mendelian randomization studies.

Two researchers independently assessed studies published up to February 5, 2023, across PubMed, Web of Science, Embase, and Cochrane Library, to investigate the associations of sleep traits with cardiometabolic risk factors, as well as with cardiovascular diseases. Fourteen systematic reviews consisting of 23 meta-analyses, and 11 Mendelian randomization (MR) studies were included in this study. Short sleep duration was associated with a higher risk of obesity, type 2 diabetes (T2D), hypertension, stroke, and coronary heart disease (CHD) in observational studies, while a causal role was only demonstrated in obesity, hypertension, and CHD by MR. Similarly, long sleep duration showed connections with a higher risk of obesity, T2D, hypertension, stroke, and CHD in observational studies, none was supported by MR analysis. Both observational and MR studies indicated heightened risks of hypertension, stroke, and CHD in relation to insomnia. Napping was linked to elevated risks of T2D and CHD in observational studies, with MR analysis confirming a causal role in T2D. Additionally, snoring was correlated with increased risks of stroke and CHD in both observational and MR studies. This work consolidates existing evidence on a causal relationship between sleep characteristics and cardiometabolic risk factors, as well as cardiovascular diseases.

Effects of modified oropharyngeal exercises on individuals with simple snoring: An online randomized controlled trial.

BACKGROUND: Individuals who suffer from simple snoring rarely go to a doctor due to a lack of medical knowledge, but simple snoring can reduce the individual's quality of life and may cause social problems to the bed partner/family members. OBJECTIVES: The aims of the present study are to explore the effects of online modified oropharyngeal exercises on the individuals with simple snoring and to provide a rehabilitation method for individuals with simple snoring. METHODS: This study is a double-blinded, two-arm, randomized controlled trial. Participants were enrolled and randomly assigned to the intervention group (n = 33) or the control group (n = 33). The participants in the control group received health education on snoring, while the participants in the intervention group received the modified oropharyngeal exercise besides health education on snoring. The intervention duration was 4 weeks. The primary outcomes included snoring index, snoring loudness, and snoring quantity. The secondary outcomes included self-reported snoring, sleep quality, daytime sleepiness, anxiety symptoms, depression symptoms, and quality of life. All outcomes were measured at baseline, 4 weeks, and 8 weeks. RESULTS: Generalized estimating equations (GEE) analyses showed significant differences between the intervention group and the control group on snoring index, loudness, and quantity (p < .001). Moreover, modified oropharyngeal exercise had effects on sleep quality, daytime sleepiness, anxiety symptoms, depression symptoms, and quality of life in individuals with simple snoring (p < .001). Self-reported snoring also improved at 8 weeks. CONCLUSION: The modified oropharyngeal exercises were effective in improving simple snoring. It could also improve sleep quality, daytime sleepiness, anxiety symptoms, depression symptoms, and quality of life.

Novel Susceptibility Genes and Biomarkers for Obstructive Sleep Apnea: Insights from Genetic and Inflammatory Proteins.

STUDY OBJECTIVES: Numerous observational studies link obstructive sleep apnea (OSA) to inflammatory proteins, yet the directionality of these associations remains ambiguous. Therefore, we aimed to clarify the potential associations of gene-predicted inflammatory proteins with OSA. METHODS: Based on genome-wide association study data, we applied Mendelian randomization (MR) to explore potential connections between circulating inflammatory proteins and OSA, primarily using the inverse variance weighting method for robustness. Cochran's Q test, MR‒Egger intercept test, MR-PRESSO, and leave-one-out method were used to perform sensitivity tests for pleiotropy and heterogeneity. Replication analyses and meta-analyses were performed using other independent data. Steiger tests and multivariate MR assessed the independent effects of exposure factors, and the functional mapping and annotation (FUMA) platform was used to identify key genes to enhance the understanding of genetics. RESULTS: Our investigation revealed 21 circulating inflammatory proteins significantly associated with OSA-related phenotypes. Notably, IL-10RA, IL-18R1, TNFSF14, CCL23, ADA, and SLAMF1 had significant effects on multiple phenotypes. After FDR correction, IL-18R1, SLAMF1, IL-10RA, and IL-17C were identified as important candidates for OSA, and multivariate MR analysis strengthened the independent heritability of 20 inflammatory factors. The FUMA platform revealed seven overlapping genes: ROBO1, PRIM1, NACA, SHBG, HSD17B6, RBMS2, and WWOX. All reverse MR analyses and sensitivity analyses confirmed the robustness of these associations. CONCLUSIONS: Our results underscore crucial associations between inflammatory proteins and OSA pathogenesis, revealing new correlates and susceptibility genes. These findings advance biomarker identification for OSA risk and highlight the importance of genetic and inflammatory profiles in OSA management.

Sex-specific associations between habitual snoring and cancer prevalence: insights from a US Cohort Study.

Study Objectives: To investigate the sex-specific association between habitual snoring and overall cancer prevalence and subtypes, and to examine the influence of age, body mass index (BMI), and sleep duration on this association. Methods: This study utilized data from the National Health and Nutrition Examination Survey cycles between 2005 and 2020 and included 15 892 participants aged 18 and over. We employed inverse probability of treatment weighting based on propensity scores to adjust for confounders when comparing the prevalence of cancer between habitual snorers and non-habitual snorers for each sex and cancer type. Subgroup analyses were conducted based on sleep duration, age, and BMI categories. Results: The cohort (mean age 48.2 years, 50.4% female, and 30.5% habitual snorers) reported 1385 cancer cases. In men, habitual snoring was linked to 26% lower odds of any cancer (OR 0.74, 95% CI: 0.66 to 0.83), while in women, it showed no significant difference except lower odds of breast cancer (OR 0.77, 95% CI: 0.63 to 0.94) and higher odds of cervix cancer (OR 1.54, 95% CI: 1.18 to 2.01). Age and sleep duration significantly influenced the snoring-cancer relationship, with notable variations by cancer type and sex. Conclusions: Habitual snoring exhibits sex-specific associations with cancer prevalence, showing lower prevalence in men and varied results in women. These findings emphasize the critical need for further research to uncover the biological mechanisms involved. Future investigations should consider integrating sleep characteristics with cancer prevention and screening strategies, focusing on longitudinal research and the integration of genetic and biomarker analyses to fully understand these complex relationships.

Impact of snoring on the risk of stroke in patients with diabetes mellitus.

BACKGROUND: The impact of snoring and diabetes on stroke risk is unclear. This study examined the association between snoring and stroke risk and how it varies with diabetes mellitus (DM) status. METHODS: This research was conducted as a prospective cohort study. A total of 4,352 subjects were included in the analysis, with a mean follow-up time of 13.7 years. The study used snoring history obtained through interviews as the primary exposure variable and DM as the secondary exposure variable. The main outcome measured was the occurrence of stroke. Cox regression analysis was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Additionally, a joint test was conducted to evaluate the combined effect of snoring and diabetes on the occurrence of stroke. RESULTS: In our study of 4,352 subjects, 1,135 (26.1%) had a history of snoring, 233 (5.4%) had diabetes mellitus, and over the 18-year observation period, there were 168 cases of new-onset stroke. Snoring was not associated with an increased risk of stroke (HR: 0.95, 95% CI [0.68-1.33]), but DM significantly elevated the risk of stroke (3.02 [1.96-4.65]). In the interaction analysis of snoring and DM status on stroke risk, snoring was a significant risk factor for stroke only in the population with DM (2.89 [1.07-7.60]). Compared to non-snoring and non-DM, the multivariate HRs for stroke were 1.09 (0.76-1.57) for snoring and non-DM, 1.64 (0.83-2.82) for non-snoring and DM, and 2.95 (1.42-5.45) for snoring and DM. CONCLUSION: Diabetes mellitus was associated with an increased risk of stroke, while a history of snoring was not. In a sub analysis, snoring appeared to be associated with an increased risk of stroke among subjects with diabetes mellitus.

Habitual snoring coexisting with respiratory allergies in children: Prevalence and impact on quality of life extending beyond primary snoring.

Background: Children who have respiratory allergies are more likely to experience sleep disturbances. Persistent sleep-disordered breathing directly contributes to poor symptom control for asthma and allergic rhinitis, including deterioration in quality of life. This study aimed to investigate the prevalence, risk factors of habitual snoring, and the correlation between 18-item obstructive sleep apnea (OSA-18) scores and the level of asthma and allergic rhinitis (AR) symptoms control for habitual snorers with respiratory allergies. Material and methods: A cross-sectional design was conducted on Thai children aged 2 to 15 who were diagnosed with asthma and AR in a respiratory allergy clinic at the Medical Education Center. The Pediatric Sleep Questionnaire was used to determine the prevalence of habitual snoring. Patients with habitual snoring completed the OSA-18 quality of life questionnaire, which was divided into 5 subscales: sleep disturbance, physical symptoms, emotional distress, daytime function, and caregiver concerns. Symptom control for asthma and AR was evaluated according to the Global Initiative for Asthma (GINA) guidelines and the Visual Analog Scales (VAS), respectively. Multivariable logistic regression models and adjusted odds ratios were used to assess associations. Results: A total of 565 participants were enrolled, and 363 (64.2%) were male. Habitual snoring had the highest prevalence of sleep-disordered breathing in 29.6% of patients with respiratory allergies. Patients with poorly controlled symptoms had a significantly higher risk of habitual snoring than well controlled symptoms for AR (52.0% vs 19.1%, adjusted Odds Ratio: aOR 4.39, 95%CI 2.25-8.58, p < 0.001) and for asthma concomitant with AR (54.9% vs. 18.8%, aOR 5.18, 95%CI 2.52-10.68, p < 0.001). Habitual snorers with poorly controlled asthma negatively affected their quality of life more than those with well controlled asthma (37.7% vs 13.3%, p = 0.005), as did patients with underlying AR (46.2% vs 22.9%, p = 0.002). In comparison to habitual snorers with well controlled symptoms, those with poorly controlled symptoms for respiratory allergies had higher mean the OSA-18 scores across all subscales. Conclusion: Nearly one-third of children with respiratory allergies develop habitual snoring. Poorly controlled symptoms of asthma and allergic rhinitis raise the possibility of developing habitual snoring. Their quality of life and caregivers were shown to be affected just as negatively as those with obstructive sleep apnea (OSA) syndrome.

Effect of snoring on pregnant women and fetal outcomes: a cross sectional study.

PURPOSE: Snoring frequently occurs among pregnant women, particularly in the later stages of pregnancy. It often signals obstructive sleep apnea (OSA), which could potentially affect pregnancy outcomes negatively. Hence, our study aimed to investigate how snoring influences the likelihood of pregnancy complications and fetal outcomes in a cohort of expectant mothers. METHODS: We enrolled pregnant women in their second and third trimesters and had them fill out a questionnaire concerning sleep-related symptoms such as snoring, excessive daytime sleepiness, and frequency of nighttime awakenings, along with anthropometric measurements. Subsequently, the participants were divided into snorers and non-snorers, and the occurrence of pregnancy complications and fetal outcomes was monitored. RESULTS: The study enrolled a total of 212 pregnant women, among whom 35 were identified as snorers and 177 as non-snorers during mid to late pregnancy. This indicated a snoring prevalence of 16.5% in our sample. Significant differences were noted between the two groups regarding the occurrence of oligohydramnios (11.43% vs. 2.82%, p = 0.044) and fetal distress (28.57% vs. 8.47%, p = 0.003). Logistic regression analyses revealed that snoring was independently associated with fetal distress (odds ratio [OR] = 4.99, 95% confidence interval [CI] 1.88-13.23, p = 0.001). CONCLUSIONS: Our findings suggest that habitual snoring was the independent risk factor fetal distress after adjusting for potential confounders, indicating that habitual snoring may have a detrimental effect during mid to late pregnancy.

Sleep Quality and Bariatric Surgery-Can We Treat Sleep Disturbances and Insomnia in Patients with Obesity with Laparoscopic Sleeve Gastrectomy?

Introduction: Bariatric surgery is the mainstay of treatment of obesity, with a proven, long-lasting effect on body weight reduction and remission of co-morbidities. Sleep disorders, including insomnia, and deteriorated sleep quality and duration are associated with obesity, and a reduction in body weight can be associated with a reduction in prevalence of sleep disorders. The purpose of this study was to assess the influence of laparoscopic sleeve gastrectomy (LSG) on the prevalence and intensity of different sleep disturbances. Methods: This observational prospective study included 80 patients qualified for bariatric surgery who filled in a questionnaire with a set of structured questions about different sleep disturbances, such as difficulties in falling asleep, night awakenings, early morning awakenings, snoring, and nightmares, as well as eating at night and daytime dysfunction, supplemented with Athens Insomnia Scale (AIS), before and 6 months after bariatric surgery. Results: There was a statistically significant reduction in incidence of night awakenings, with 40.00% of participants reporting night awakenings before surgery and, respectively, 25.00% after surgery. A significant reduction was also observed in the rate of patients who reported snoring, with 60.00% before the surgery and 38.75% after the surgery (p < 0.05). There was a correlation present between estimated weight loss % (EWL%) and reduction in snoring (p < 0.05). The mean total AIS score before surgery was 7.21 and 5.99 after surgery, and the change was statistically significant (p < 0.05). A total AIS score of 8 or more, the cutoff score for insomnia diagnosis according to the Polish validation of the Athens Insomnia Scale, was present in 44.16% of cases before surgery and in 38.00% after surgery (p = 0.52). There was a significant difference in the incidence of awakening during the night score before and after surgery (p < 0.05; CI 0.022-0.341), sleep quality (p < 0.05; CI 0.0105-0.4311), well-being during the day (p < 0.05; CI 0.0273-0.4143), and sleepiness during the day (p < 0.05; CI 0.101-0.444). Conclusions: LSG is observed to have a positive effect on selected sleep disturbances and insomnia remission in patients with obesity, measured by a significant reduction in Athens Insomnia Scale scores in follow-up 6 months after surgery. Additionally, patients after bariatric surgery reported less night awakenings and there was a lower rate of snoring. Therefore, LSG can be considered an effective therapeutic tool for insomnia in patients with obesity.

Causal associations between sleep traits and temporomandibular disorders: a bidirectional mendelian randomization analysis.

Objectives: This study aims to investigate the relationship between five sleep traits (insomnia, sleep duration, getting up in morning, snoring, and daytime nap) and temporomandibular disorders (TMD) using bi-directional Mendelian randomization. Methods: The bi-directional Mendelian randomization study was conducted in two stages. Initially, sleep traits were examined as exposures while TMD was evaluated as an outcome, whereas the second step was reversed. The inverse variance weighted (IVW) method and other Mendelian randomization methods were used for analysis. Furthermore, we performed the MR-Egger intercept, MR-PRESSO, Cochran's Q test, and "Leave-one-out" to assess the levels of pleiotropy and heterogeneity. Results: The IVW method indicates that getting up in the morning reduces the risk of developing TMD (OR = 0.50, 95% CI 0.30-0.81, p = 0.005), while insomnia may increase the risk of TMD (OR = 2.05, 95% CI 1.10-3.85, p = 0.025). However, other sleep traits are not associated with the risk of TMD, and having TMD does not alter an individual's sleep traits. After removing outliers, the results remained robust, with no pleiotropy detected. Conclusion: Genetically determined difficulty in getting up in the morning and insomnia can increase the risk of TMD. By optimizing sleep, the risk of developing TMD can be reduced. This underscores the importance of sleep in preventing TMD.

The Diagnostic Value of CT Scan in Identifying Adenoid Hypertrophy in Adults: A Case Report.

The utility of computed tomography (CT) scan in diagnosing adenoid hyperplasia in adults. A 22-year-old woman presented with persistent bilateral nasal obstruction, anterior nasal discharge, mouth breathing, and snoring over the past three months. Despite attempts with both local and systemic decongestants, there was no improvement, and flexible nasopharyngoscopy could not be conducted. CT scans revealed a heterogeneously enhancing space-occupying mass in the nasopharynx, and a rare diagnosis of adult adenoid hypertrophy was reported. The patient responded to a combination of painkillers, antibiotics, and nasal decongestants. Adenoid hyperplasia in adults is quite rare and inadequate examination by indirect posterior rhinoscopy may lead to misdiagnosis and mismanagement. A CT scan not only provides a clearer view of the nasopharyngeal space and adenoids but also reveals details about the nature of lesions, including their extension and potential bone destruction, suggesting the presence of a malignant tumor. Additionally, a CT scan proves valuable in diagnosing chronic sinusitis.

Sex Differences in the Relationship Between Self-Reporting of Snoring and Cardiovascular Risk:An Analysis of NHANES.

Background: Identifying risk factors for cardiovascular disease (CVD) is critical for effective prevention and management. While classic CVD risk factors have been extensively studied, there is a scarcity of research on the association between snoring and CVD risk, particularly in the context of sex differences. Methods: This study utilized data from the National Health and Nutrition Examination Survey (NHANES) conducted between 2015 and 2020. Participants were initially categorized based on the severity of snoring or the presence of snoring.Within the snoring group, they were further classified by sex. Analysis was carried out using multivariate logistic regression. Results: Our study included 12,681 participants aged 18 years or older. When compared to the non-snoring group, individuals in the moderate snoring group had a higher odds ratio (OR) of 1.418 (95% CI 1.083 to 1.857, p = 0.011), while those in the severe snoring group had a higher OR of 1.882 (95% CI 1.468 to 2.409, p < 0.001). In the snoring group, individuals were further categorized by gender: 4527 males and 4131 females. Importantly, male patients showed a higher OR for atrial fibrillation (4.945, 95% CI 1.187 to 20.598, p = 0.028) compared to females. Additionally, male patients had a higher OR for coronary heart disease (2.002, 95% CI 1.152 to 3.479, p = 0.014) compared to females. Conclusion: Sex plays a significant role in the relationship between snoring and CVD risk. Males with snoring have a higher risk of developing CVD compared to females. In particular, male snorers are nearly five times more likely to develop atrial fibrillation and about twice as likely to experience coronary artery disease in comparison to female snorers. It is recommended that healthcare providers and public health officials prioritize cardiovascular risk assessments for male individuals who exhibit symptoms of snoring.

The Potential Effect of Changing Patient Position on Snoring: A Systematic Review.

Approximately 45% of adults snore occasionally, and 25% snore regularly, with a higher prevalence in men and an increase among postmenopausal women due to hormonal changes. Snoring is a health concern linked to vascular disease and decreased quality of life for both snorers and their bed partners. Effective snoring treatment, which aims to reduce or eliminate the sound, is challenging and depends on factors like age, comorbidities, disease severity, and anatomical features. This review aims to provide a systematic overview of the current literature on the effects of positional therapy (PT) on snoring. Various devices facilitate PT, including anti-snoring pillows and vibration alarms. PT devices maintain head and neck alignment to keep airways open, while head of bed elevation (HOBE) solutions reduce upper airway collapses by elevating the head and trunk. Studies show that PT and HOBE reduce snoring by increasing airway cross-sectional area and decreasing closing pressure. Despite their benefits, these non-surgical treatments have limitations, such as discomfort in certain sleeping positions and intolerance to prolonged head elevation. While reducing snoring intensity is critical for health reasons, further comparative studies between the different devices are needed to enhance snoring management.