Impact of obstructive sleep apnea on neuromuscular transmission- a descriptive study.

Objective: Obstructive sleep apnea (OSA) is a sleep disorder accompanied by intermittent hypoxia. Neuromuscular transmission (NT) is known to be disturbed under chronic hypoxia. In this descriptive study, it has been aimed to test NT under intermittent hypoxia in OSA. Methods: Thirty-nine newly diagnosed OSA patients without any comorbidities or conditions that alter NT were included in the study. Jitter analysis was performed using a concentric needle electrode. Results: The mean jitter value of 39 OSA patients was 25.9 ± 3.7 µs. When compared to the mean reference jitter values, patients in the present study had significantly higher jitter (p < 0.001). Seven (17.9%) patients met the electrophysiological criteria for NT failure. Conclusion: The authors propose that intermittent hypoxia can be the trigger for NT failure in OSA. The interaction between increased oxidative stress and disturbed mitochondrial functions may also contribute.

Mortality analysis of obstructive sleep apnea syndrome cohort receiving positive airway pressure treatment: a 6-year follow-up.

OBJECTIVES: Obstructive Sleep apne syndrome is a disease with high morbidity and mortality. The aim of this study was to investigate the conditions affecting the mortality of patients diagnosed with OSAS at six year follow up. METHODS: 970 patients who admitted to Sleep laboratory between 2011-2013 were evaluated retrospectively. 74 patients whose mortality data could not be accessed through the system were excluded. The patients who died until April 2019 were compared with the surviving group in terms of demographic, clinical, comorbidities and polysomnographic findings. RESULTS: Total 47 patients who died were older, had higher BMI, AHI and ODI values, lower minimum oxygen saturations compared with the survival group (p < .001). In the Cox-hazard regression analysis, BMI (hazard ratio (HR), 1.08; 95% CI, 1.04-1.12), age (1.12, 1.08-1.15), accompanying COPD (2.19, 1.08-4.43), accompanying CAD (2.76, 1.34-5.67) and AHI of >50/h (2.19, 1.19-1.4.05) were reported. CONCLUSION: This study showed that OSAS increases the risk of death accompanied by CAD and COPD. It has also been shown that patients with higher AHI (AHI > 50/h) values die more. Therefore, it may be useful to classify the AHI> 50/h group as very severe OSAS instead of severe OSAS.

Carpal Tunnel Syndrome in Obstructive Sleep Apnea Patients.

INTRODUCTION: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy of the upper extremity. It is usually associated with the compression of the median nerve in the median groove. Because the main symptoms of CTS pain and numbness worsen at night, sleep disorders in CTS patients and the impact of preferred sleeping position on CTS development have been formerly studied. However, to the best of our knowledge, this is the first study assessing the frequency of CTS in obstructive sleep apnea (OSA) patients. This study aimed to determine the frequency of CTS in OSA patients and evaluate the causative relation between the two diseases. METHODS: Records of individuals who were admitted to our sleep laboratory were retrospectively scanned. Eighty patients who were diagnosed with OSA and did not have comorbidities that might cause OSA (e.g., diabetes mellitus, hypothyroiditis, rheumatic diseases, and cervical radiculopathy) were included in the study along with 80 healthy controls who matched for age, sex, and BMI of OSA patients. To maintain observer blindness, patients were not questioned regarding their symptoms or the clinical data that would be used in the study. All participants underwent nerve conduction studies. Those who were diagnosed with CTS were questioned regarding CTS symptoms and the preferred sleeping position. Subsequently, patients were given the Boston CTS questionnaire. RESULTS: CTS frequency in OSA patients was found to be 27.5%. There was no significant relation between preferred sleeping position or being a manual worker and having CTS. CONCLUSION: CTS frequency in OSA patients is significantly higher than that in healthy individuals. In contrast to previous studies that have been performed in the absence of polysomnographic and electrophysiological data, in our study biomechanical factors were not associated with CTS presence. Therefore, we conclude that intermittent hypoxemia is the main etiological factor for CTS in OSA patients. Inflammation may be a common factor for etiopathogenesis for both diseases, but this hypothesis needs further investigation.

Executive functions in sarcoidosis: a neurocognitive assessment study.

Not available.