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1.
Medicine (Baltimore) ; 99(36): e22023, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32899056

RESUMO

BACKGROUND: Traditional Chinese medicine (TCM) or combined with western medicine in the treatment of pediatric adenoidal hypertrophy has been widely used in clinical practice, but the overall efficacy and safety is still unclear. This paper aims to evaluate the efficacy and safety analysis of TCM or combined with western medicine for pediatric adenoidal hypertrophy. METHODS: PubMed, EMbase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), WanFang, the Chongqing VIP Chinese Science and Technology Periodical Database, and China biomedical literature database (CBM) were searched for randomized controlled trials of TCM or combined with western medicine for pediatric adenoidal hypertrophy from the date of establishment to July 2020, and Baidu Scholar, Google Scholar, International Clinical Trials Registry Platform (ICTRP), and Chinese Clinical Trials Registry (ChiCTR) were searched for unpublished grey literature. Two researchers independently applied RevMan 5.3 software for data extraction and risk assessment of bias. RESULTS: The effectiveness and safety of TCM or combined with western medicine for pediatric adenoidal hypertrophy is evaluated by means of the Adenoid (A) /(Nasopharyngeal (N) ratio, clinical efficacy, integral score of TCM syndromes, clinical single symptom score, disease specific quality of life for children with obstructive sleep apnea 18 items survey (OSA-18), Interleukin 4 (IL-4) and adverse reaction incidence. CONCLUSION: This study will provide theoretical support for the clinical application of TCM or combined with western medicine for pediatric adenoidal hypertrophy. OSF REGISTRATION NUMBER: DOI 10.17605/OSF.IO/J76AG.


Assuntos
Tonsila Faríngea/patologia , Medicamentos de Ervas Chinesas/uso terapêutico , Hipertrofia/terapia , Medicina Tradicional Chinesa/métodos , Criança , China/epidemiologia , Terapia Combinada , Prescrições de Medicamentos/normas , Prescrições de Medicamentos/estatística & dados numéricos , Feminino , Humanos , Interleucina-4/sangue , Masculino , Qualidade de Vida , Segurança , Apneia Obstrutiva do Sono/epidemiologia , Apneia Obstrutiva do Sono/psicologia , Resultado do Tratamento
2.
Tuberk Toraks ; 68(2): 135-140, 2020 Jul.
Artigo em Turco | MEDLINE | ID: mdl-32755113

RESUMO

Coronavirus disease 2019 (COVID-19) is an infectious disease that causes important mortality and morbidity all over the world caused by SARS-CoV-2 (Severe acute respiratory syndrome coronavirus 2), which started in China at the end of 2019. It spreads rapidly, mainly through droplets, and especially for all healthcare workers involved in aerosol producing procedures are at high risk. During COVID-19 pandemic , the health systems worldwide, along with the practice of chest diseases daily were affected. In our article, we aimed to give some clinical suggestions related to sleep practices according to current data.


Assuntos
Infecções por Coronavirus/terapia , Pessoal de Saúde/estatística & dados numéricos , Pneumonia Viral/terapia , Apneia Obstrutiva do Sono/terapia , Atitude do Pessoal de Saúde , Comorbidade , Infecções por Coronavirus/epidemiologia , Saúde Global , Humanos , Pandemias , Pneumonia Viral/epidemiologia , Síndrome Respiratória Aguda Grave/epidemiologia , Síndrome Respiratória Aguda Grave/terapia , Apneia Obstrutiva do Sono/epidemiologia
3.
Zhonghua Jie He He Hu Xi Za Zhi ; 43(7): 553-556, 2020 Jul 12.
Artigo em Chinês | MEDLINE | ID: mdl-32629553

RESUMO

Objective: To investigate the awareness of snoring hazard and prevalence of obstructive sleep apnea (OSA) among civil servants. Methods: A cross-sectional survey was conducted to investigate the awareness of snoring hazards among in-service civil servants who had annual medical examination in a Guangdong provincial institution from September to November 2017. The high-risk group for OSA was screened and diagnosed by sleep monitoring. Results: 1 036 of 1 241 civil servants were enrolled in the study for integral data. 60.1% (623/1 036) of the subjects realized that snoring was harmful to health. The most common source to develop OSA awareness was network (59.6%, 371/623), followed by television (48.0%), relatives and friends (46.6%), newspaper (44.5%) and radio (18.9%). The awareness rate of snoring consequences was as follows: decreased sleep quality (71.9%, 448/623), sudden death (52.2%), daytime sleepiness (44.3%), cardiovascular and cerebrovascular diseases (42.9%), hypertension (24.4%) and sexual dysfunction (16.7%). 22.0% (228 / 1 036) of the cases were classified into high-risk OSA. The prevalence of OSA among high-risk group was 46.05%(105/228)and only 0.9% (2/228) of them had been diagnosed with OSA. Conclusion: Civil servants had awareness of snoring hazard to a certain extent. Among civil servants classified into high-risk OSA, the OSA perveance was high but the rate of diagnosis and treatment was very low.


Assuntos
Apneia Obstrutiva do Sono/epidemiologia , Ronco/epidemiologia , China/epidemiologia , Estudos Transversais , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Prevalência , Fatores de Risco , Apneia Obstrutiva do Sono/complicações , Ronco/etiologia
4.
PLoS One ; 15(7): e0235463, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32609758

RESUMO

INTRODUCTION: Sleepiness is the main clinical expression of obstructive sleep apnea (OSA) syndrome resulting from upper airway collapse. Recent studies have discussed the fact that the presence of T. gondii cysts in the brain and the resulting biochemical and immunological mechanisms could be linked to neurobehavioral disorders. The aim of the present study was to explore the potential impact of chronic toxoplasmosis on sleepiness and on obstructive sleep apnea (OSA) severity in OSA obese patients. MATERIALS AND METHODS: A case control study on obese patients screened for OSA was performed. According to the sleep disorder and matched based on gender, age and body mass index (BMI), two groups of obese patients were selected from our sample collection database. All patients were tested for toxoplasmosis serological status measuring anti-Toxoplasma IgG and IgM levels. Univariable and multivariable logistic regression models were performed to assess the impact of chronic toxoplasmosis on sleepiness and OSA severity. RESULTS: 107 obese patients suffering from OSA were included in the study (median age: 53.3 years Interquartile range (IQR): [41.9-59.9]; median BMI: 39.4 kg/m2 IQR: [35.5-44.1], apnea-hypopnea index = 27.5 events/h [10.7-49.9]). Chronic toxoplasmosis was present in 63.4% and 70.7% of patients with or without sleepiness (p = 0.48), respectively and was not associated either to sleepiness (OR: 0.76, 95% CI: [0.52; 2.33], p = 0.64) or OSA severity (OR = 1.75, 95% CI: [0.51; 5.98] p = 0.37). CONCLUSION: Although chronic Toxoplasma infection in immunocompetent humans has been associated to several behavioral disorders or pathologies in recent literature, we demonstrate here that chronic toxoplasmosis is not associated to sleepiness and to sleep apnea syndrome severity in obese patients suspected of sleep apnea syndrome.


Assuntos
Doença Crônica/epidemiologia , Obesidade/epidemiologia , Apneia Obstrutiva do Sono/epidemiologia , Toxoplasmose Cerebral/epidemiologia , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Masculino , Pessoa de Meia-Idade , Sonolência , Toxoplasma/imunologia , Toxoplasmose Cerebral/imunologia
5.
PLoS One ; 15(7): e0236284, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32687512

RESUMO

OBJECTIVE: To investigate the frequency distribution of various craniofacial skeletal patterns in a large Korean adult obstructive sleep apnea (OSA) population, and to find a relationship between craniofacial risks and respiratory and sleep characteristics. METHODS: A total of 1226 OSA patients (mean age of 44.9±13.3 years) were included in this retrospective cross-sectional study. All subjects were evaluated for gender and age using fourteen polysomnographic, five cephalometric, two comorbid variables, and three self-reported indexes. Frequency analysis was used to screen the distribution of main skeletal patterns and subtypes. Intergroup comparisons were performed using independent t-test, chi-square test or analysis of variance. Univariable regression analysis was done to find a relationship between skeletal risks and OSA characteristics. RESULTS: The frequency distribution of skeletal patterns was as follows: sagittally 57.2%, 32.3%, and 10.5% of Class II, Class I, and Cass III; vertically 54.0%, 26.7%, and 19.3% of hyperdivergent, normodivergent, and hypodivergent type, respectively. Polysomnographic, symptomatic, and comorbid variables showed no differences among patients with different skeletal patterns. Conversely, skeletal variables showed no differences according to OSA severity. The prevalence of highly risky skeletal pattern of hyperdivergent Class II was more likely to be females (OR 4.52, P < .01) and less obese (OR 3.21, P < .01), irrelevant to OSA and sleep characteristics. CONCLUSION: Characteristic frequency distributions of skeletal patterns and subtypes were observed in adult OSA patients however, no statistical association was found between the skeletal patterns and OSA characteristics due to the large interindividual variation.


Assuntos
Cefalometria/estatística & dados numéricos , Cabeça/anatomia & histologia , Obesidade/epidemiologia , Testes de Função Respiratória/estatística & dados numéricos , Apneia Obstrutiva do Sono/epidemiologia , Adulto , Grupo com Ancestrais do Continente Asiático , Variação Biológica da População , Comorbidade , Estudos Transversais , Feminino , Cabeça/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/fisiopatologia , Polissonografia , República da Coreia/epidemiologia , Fenômenos Fisiológicos Respiratórios , Estudos Retrospectivos , Fatores de Risco , Autorrelato , Índice de Gravidade de Doença , Apneia Obstrutiva do Sono/diagnóstico , Apneia Obstrutiva do Sono/fisiopatologia
6.
Pneumologie ; 74(8): 509-514, 2020 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-32492719

RESUMO

INTRODUCTION: Snoring was monitored in patients with obstructive sleep apnea (OSA) using the LEOSound-Monitor and simultaneously polysomnographic (PSG) recording. In obstructive apneas snoring is normally apparent after apnea termination and the beginning of ventilation. We wanted to know how often obstructive apneas are terminated by ventilation in combination with snoring. METHODS AND INTENTION: In 40 patients with OSA (AHI > 15/h) simultaneous polysomnographic recordings were performed amongst long-term respiratory sound monitoring using the LEOSound monitor. Patients' average age was 57 ±â€Š11 years. Average weight was 100 ±â€Š19 kg by a mean body  mass  index (BMI) of 33 ±â€Š7 kg/m2. 12 out of 40 recordings had to be rejected for further analysis because of artifacts. Snoring recorded by polysomnography was compared with snoring monitored by LEOSound. RESULTS: 3778 obstructive apnea episodes were monitored. LEOSound identified snoring in 1921 (51,0 %), polysomnography in 2229 (58,8 %) obstructive apneas. Only in one patient there was a higher difference in snoring episodes between PSG and LEOSound. DISCUSSION: In nearly 60 % of obstructive apnea events we found snoring during apnea-terminating hyperpnoea. LEOSound is a good diagnostic tool to monitor snoring. It is necessary to clarify why only 60 % of all obstructive events/hyperpnoea develop snoring. From a pathophysiological point of view opening of collapsed upper airway should lead in a very high percentage to turbulences in airstream and committed snoring.


Assuntos
Obstrução das Vias Respiratórias/etiologia , Polissonografia/métodos , Apneia Obstrutiva do Sono/fisiopatologia , Ronco/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Humanos , Pessoa de Meia-Idade , Respiração , Apneia Obstrutiva do Sono/diagnóstico , Apneia Obstrutiva do Sono/epidemiologia , Ronco/etiologia
8.
PLoS One ; 15(5): e0231528, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32413035

RESUMO

The objective of our study was to characterize and analyze the associations between OSA (obstructive sleep apnea) and other clinical variables in adult patients referred for sleep evaluation by polysomnography at a referral center in Beirut, Lebanon, in terms of sociodemographic features, symptoms presentation and comorbidities, and evaluate the burden of comorbidities associated with this disease. All individuals with suspected Sleep Apnea referred (January 2010-September 2017) for a one-night polysomnography were included. Demographics, self-reported symptoms and comorbidities were documented. The relationship between OSA severity and the presence of symptoms and comorbidities were evaluated using multivariate logistic regression. Overall, 663 subjects were assessed. Of these, 57.3% were referred from chest physicians, and sleep test results were abnormal in 589 subjects (88.8%) of whom 526 patients (89.3%) fulfilled diagnostic criteria for OSA; 76.3% were men and women were on average older. OSA was severe in 43.2% and more severe in men. Almost all patients were symptomatic with ~2-4 symptoms per patient and women presented with symptoms that are more atypical. Comorbidities were significantly higher in women. In the multivariate analysis, age, male sex, obesity, symptoms of snoring, excessive daytime somnolence and witnessed apneas were associated with OSA severity. Only age and obesity were associated with self-reported diagnosis of hypertension and diabetes. This is the first study in Lebanon to explore the characteristics of patients with polysomnography-diagnosed OSA. High prevalence of severe OSA and low referral rates in the medical community support promoting awareness for an earlier diagnosis and more personalized approach in this country.


Assuntos
Hipertensão/fisiopatologia , Obesidade/fisiopatologia , Índice de Gravidade de Doença , Apneia Obstrutiva do Sono/epidemiologia , Ronco/fisiopatologia , Adulto , Idoso , Feminino , Humanos , Líbano/epidemiologia , Masculino , Anamnese , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Fatores de Risco , Apneia Obstrutiva do Sono/diagnóstico , Adulto Jovem
11.
Nutr Metab Cardiovasc Dis ; 30(7): 1115-1120, 2020 06 25.
Artigo em Inglês | MEDLINE | ID: mdl-32446869

RESUMO

BACKGROUND AND AIMS: Obstructive sleep apnea (OSA) is a global disease that is a manifestation of metabolic syndrome. Epicardial adipose tissue (EAT), a special type of visceral adipose tissue, has been proposed to be an independent predictor of visceral adiposity. Both OSA and EAT have a close association with diabetes and coronary artery disease. Whether EAT thickness is associated with OSA is controversial. METHODS AND RESULTS: Several databases were searched from their inception to October 13, 2019. We estimated the summarized weighted mean difference (WMD) with 95% confidence intervals (CIs) for EAT thickness in the OSA and non-OSA groups. Then, we conducted a meta-analysis to evaluate the association between EAT thickness and OSA. The relationship between EAT thickness and OSA severity was also assessed. Nine studies with a total of 1178 participants were included. Globally, patients with OSA had a higher EAT thickness than patients without OSA (WMD = 0.95, 95% CI: 0.73-1.16, P < 0.001). Compared to the non-OSA patients, those with mild, moderate, and severe OSA had a progressively higher EAT thickness (WMD = 0.62, 95% CI: 0.41-0.83; WMD = 0.83, 95% CI: 0.50-1.15; and WMD = 1.06, 95% CI: 0.70-1.43, respectively; all P < 0.001). CONCLUSION: EAT thickness was shown to be higher in patients with OSA than in patients with non-OSA measured by echocardiography. The increase in the EAT thickness was associated with OSA severity.


Assuntos
Tecido Adiposo/diagnóstico por imagem , Ecocardiografia , Pericárdio/diagnóstico por imagem , Apneia Obstrutiva do Sono/diagnóstico por imagem , Tecido Adiposo/fisiopatologia , Adiposidade , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pericárdio/fisiopatologia , Valor Preditivo dos Testes , Prognóstico , Medição de Risco , Fatores de Risco , Índice de Gravidade de Doença , Apneia Obstrutiva do Sono/epidemiologia , Apneia Obstrutiva do Sono/fisiopatologia
13.
Ann Otol Rhinol Laryngol ; 129(8): 772-780, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32172600

RESUMO

OBJECTIVE: To evaluate treatment outcomes of upper airway stimulation (UAS) in obstructive sleep apnea (OSA) patients based on patient age, gender, and preoperative disease severity. METHODS: Retrospective chart review of patients undergoing UAS from 2014 to 2018 at a tertiary care center. Data collected included demographic information, implantation records, and pre- and postoperative polysomnography (PSG) results. Profound OSA was defined as AHI >65 and age ≥65 was considered advanced age. The primary outcome measured was initial treatment response, defined as a post-operative AHI <20 with a >50% reduction from baseline. RESULTS: 145 patients underwent UAS at our institution including 98 males and 47 females with a mean age of 61.7 ± 11.5 years, mean BMI of 29.1 ± 3.9 kg/m2, and mean preoperative AHI of 34.1 ± 18.2 events/hour. After surgery, patients had a significantly lower mean AHI of 8.6 ± 15.0 events/hour (<0.001). Older patients had a lower initial treatment response rate (78%) when compared to their younger counterparts (94%) (P = 0.005). Male gender and profound disease status did not significantly impact treatment response rates; young age was the only variable found to predict early treatment response on multivariate analysis (P = 0.003). CONCLUSION: Although the overall OSA population showed significant postoperative AHI reduction with UAS, patients age ≥65 years were less likely to have an initial response to treatment, when compared to their younger counterparts. A larger proportion of elderly patients and patients with profound OSA had residual moderate disease (AHI > 15) after UAS. LEVEL OF EVIDENCE: 4.


Assuntos
Terapia por Estimulação Elétrica/métodos , Eletrodos Implantados , Apneia Obstrutiva do Sono/terapia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Polissonografia/métodos , Estudos Retrospectivos , Fatores Sexuais , Apneia Obstrutiva do Sono/epidemiologia , Apneia Obstrutiva do Sono/fisiopatologia , Resultado do Tratamento , Estados Unidos/epidemiologia
14.
Medicine (Baltimore) ; 99(13): e19468, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32221069

RESUMO

This study characterized and evaluated normal tension glaucoma (NTG) in obstructive sleep apnea syndrome (OSAS).In this retrospective, cross-sectional study, all participants were examined with polysomnography (PSG). Functional parameters of standard automated perimetry (SAP) were recorded. Structural parameters in optical coherence tomography angiography (OCTA) included peripapillary superficial vessel density (VD RPC), peripapillary whole-layer (VD NH), and superficial and deep macular area VD. Participants were categorized into perimetric and nonperimetric groups by SAP result. Low reliability of SAP and signal strength index <50 in OCTA were excluded.Severity of OSAS was graded by apnea-hypopnea index (AHI) in PSG. Those with moderate/severe OSAS (AHI ≥ 15, n = 39) had longer neck circumference and shorter ocular axial length than mild OSAS (AHI < 15, n = 14). Furthermore, there was significantly higher AHI and larger neck circumference in the NTG perimetric group (n = 27) than in the control group (n = 26; p < 0.001 and p = 0.047, respectively). Superficial and deep-layer peripapillary and macular area VD significantly decreased in the perimetric group. Overall, structural and functional parameters show that VF PSD was negatively correlated with VD NH and VD RPC (p = 0.007, p = 0.015); and VF MD was positively correlated with VD NH (p = 0.029), but not significantly to VD RPC (p = 0.106).OSAS is a risk factor of NTG. With aid of OCTA, whole-layer retinal capillary dropout supports that the vascular dysregulation of OSAS leads to NTG.


Assuntos
Glaucoma de Baixa Tensão/epidemiologia , Apneia Obstrutiva do Sono/epidemiologia , Adulto , Idoso , Pesos e Medidas Corporais , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polissonografia , Estudos Retrospectivos , Índice de Gravidade de Doença , Fatores Socioeconômicos , Tomografia de Coerência Óptica , Testes de Campo Visual
15.
Thorax ; 75(5): 422-431, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32209641

RESUMO

BACKGROUND: Current literature supports cross-sectional association between childhood obstructive sleep apnoea (OSA) and elevated blood pressure (BP). However, long-term cardiovascular outcomes in children with OSA remain unexplored. OBJECTIVE: To evaluate the associations of childhood OSA with BP parameters in a prospective 10 year follow-up study. METHODS: Participants were recruited from a cohort established for our previous OSA epidemiological study. They were invited to undergo clinical examination, overnight polysomnography and 24-hour ambulatory BP monitoring. Multivariate linear regression was used to assess the associations of baseline childhood OSA with BP outcomes at follow-up. Multivariable log-binomial regression was used with inverse probability weighting to assess the adjusted associations of childhood OSA with hypertension and non-dipping of nocturnal BP in adulthood. RESULTS: 243 participants (59% male) attended the follow-up visit. The mean age was 9.8 (SD ±1.8) and 20.2 (SD ±1.9) years at baseline and follow-up respectively, with a mean follow-up duration of 10.4 (SD ±1.1) years. Childhood moderate-to-severe OSA was associated with higher nocturnal systolic blood pressure (SBP) (difference from normal controls: 6.5 mm Hg, 95% CI 2.9 to 10.1) and reduced nocturnal dipping of SBP (-4.1%, 95% CI -6.3% to 1.8%) at follow-up, adjusted for age, sex, Body Mass Index and height at baseline, regardless of the presence of OSA at follow-up. Childhood moderate-to-severe OSA was also associated with higher risk of hypertension (relative risk (RR) 2.5, 95% CI 1.2 to 5.3) and non-dipping of nocturnal SBP (RR 1.3, 95% CI 1.0 to 1.7) at follow-up. CONCLUSION: Childhood OSA was found to be an independent risk factor for adverse BP outcomes in adulthood.


Assuntos
Pressão Sanguínea , Hipertensão/epidemiologia , Apneia Obstrutiva do Sono/epidemiologia , Apneia Obstrutiva do Sono/fisiopatologia , Adolescente , Monitorização Ambulatorial da Pressão Arterial , Criança , Feminino , Seguimentos , Hong Kong/epidemiologia , Humanos , Hipertensão/fisiopatologia , Estudos Longitudinais , Masculino , Polissonografia , Estudos Prospectivos , Fatores de Risco , Índice de Gravidade de Doença , Sístole , Adulto Jovem
16.
PLoS One ; 15(2): e0228533, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32053609

RESUMO

This systematic review and meta-analysis examines the associations of allergic rhinitis with sleep duration and sleep impairment. Observational studies published before August 2019 were obtained through English language literature searches in the PubMed, Embase, and CINAHL databases. Mean differences and odds ratios with 95% confidence intervals were extracted and used for meta-analysis. Heterogeneity was confirmed by the I2-heterogeneity test. Subgroup analysis was conducted to evaluate the influence of study design. The Grading of Recommendations Assessment, Development, and Evaluation approach was used to determine the level of evidence. In total, 2544 records were identified through database searches; 914 duplicate records were excluded, 1452 records were removed after screening of titles and abstracts, 151 records were excluded after full-text screening, and 27 articles were included in the final meta-analyses. A total of 240,706,026 patients (19,444,043 with allergic rhinitis) were considered. No significant difference in sleep duration between the allergic rhinitis and the control groups was found. Patients with allergic rhinitis presented with significantly higher sleep quality scores, sleep disturbances scores, and sleep latency scores; more frequent use of sleep medications; and lower sleep efficiency as measured by the Pittsburgh Sleep Quality Index and polysomnography. Meta-analyses for adjusted odds ratios showed that allergic rhinitis was also associated with higher risks of nocturnal dysfunctions, including insomnia, nocturnal enuresis, restless sleep, sleep-disordered breathing, obstructive sleep apnea, and snoring. Meta-analysis for adjusted odds ratio also showed that allergic rhinitis was associated with daytime dysfunction, including difficulty waking up, daytime sleepiness, morning headache, and the use of sleep medications. The overall quality of evidence ranged from low to very low, indicating that caution is required when interpreting these results. This study demonstrates that there is a significant association of AR with sleep characteristics.


Assuntos
Rinite Alérgica/epidemiologia , Rinite Alérgica/fisiopatologia , Transtornos do Sono-Vigília/epidemiologia , Sono/fisiologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Humanos , Pessoa de Meia-Idade , Estudos Observacionais como Assunto/estatística & dados numéricos , Polissonografia , Qualidade de Vida , Rinite Alérgica/complicações , Síndromes da Apneia do Sono/diagnóstico , Síndromes da Apneia do Sono/epidemiologia , Síndromes da Apneia do Sono/etiologia , Apneia Obstrutiva do Sono/diagnóstico , Apneia Obstrutiva do Sono/epidemiologia , Apneia Obstrutiva do Sono/etiologia , Transtornos do Sono-Vigília/diagnóstico , Transtornos do Sono-Vigília/etiologia , Ronco/diagnóstico , Ronco/epidemiologia , Ronco/etiologia , Adulto Jovem
17.
Diabetes Res Clin Pract ; 161: 108035, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32006640

RESUMO

AIM: This study aimed to systematically review the prevalence of diagnosed sleep disorders in people with diabetes and to determine the association between sleep disorders and blood glucose levels and diabetes outcomes. METHODS: We conducted a literature search in the following databases: MEDLINE (Pubmed), EMBASE, CINAHL, PsychInfo and Web of Science Citation Index. Meta-analysis (random-effects models) was conducted to estimate the prevalence of sleep disorders in people with diabetes. RESULTS: Forty-one articles measured the prevalence of sleep disorders in adults with diabetes. The estimated pooled prevalence of sleep disorders in diabetes was estimated to be 52% (95% CI 42-63%). The highest pooled prevalence was observed for unspecified sleep apnea (69%; 95% CI: 59-78%), followed by obstructive sleep apnea (60%; 95% CI 39-80%), and restless leg syndrome (27%; 95% CI 20-34%). Eleven studies examined the association between sleep disorders and diabetes control and complications. The presence of comorbid sleep disorders was associated with increased diabetes outcomes. CONCLUSIONS: Diagnosed sleep disorders are highly prevalent in people with diabetes. Sleep disorders are associated with diabetes outcomes, though there was considerable heterogeneity across studies.


Assuntos
Complicações do Diabetes/epidemiologia , Diabetes Mellitus/epidemiologia , Transtornos do Sono-Vigília/epidemiologia , Adulto , Complicações do Diabetes/diagnóstico , Diabetes Mellitus/diagnóstico , Humanos , Avaliação de Resultados em Cuidados de Saúde , Prevalência , Prognóstico , Apneia Obstrutiva do Sono/complicações , Apneia Obstrutiva do Sono/epidemiologia , Transtornos do Sono-Vigília/complicações
18.
Pediatr Cardiol ; 41(4): 724-728, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32002577

RESUMO

The objective of our study was to determine the prevalence, risk factors, and the impact of obstructive sleep apnea (OSA) in the adult with congenital heart disease (ACHD). One hundred forty-nine consecutive patients seen in our ACHD program were screened for OSA using the Berlin Questionnaire. Demographic and clinical details on subjects were collected through a chart review. Clinical variables were analyzed to determine risk factors for positive OSA screen, as well as associated outcomes. Seventy-seven (52%) of our cohort were females. The median age of the cohort was 33 years (range = 18-74) and median weight was 79 kg (range = 50-145 kg). Overall, 47 (31%) of our cohort were found to have a positive OSA screen using the Berlin questionnaire. Median age of the patients whom tested positive was 34 years. Compared to patients with a negative screen, patients with a positive OSA screen were more likely to be heavier with a median weight of 99 kg vs 71 kg (p < 0.01) and a larger BMI (31 vs 25 kg/m2, p < 0.01). Overall, 55% of patients whom screened positive were obese (defined as a BMI > 30) compared to 15% in the negative group (p < 0.02). Patients with a positive screen were more likely to have other co-morbidities including diabetes (p < 0.04), hypertension (p < 0.05), depression (p < 0.002), and were more likely to have decreased exercise capacity (p < 0.01) and a defibrillator (p < 0.007). Our data demonstrates that OSA is common in the ACHD patient and is associated with increasing weight and BMI. Patients with a positive screen are at increased risk for multiple co morbidities including diabetes, hypertension, and depression. We believe our data supports the use of screening protocols for OSA in the ACHD population in effort to identify early, treat, and potentially prevent late complications.


Assuntos
Cardiopatias Congênitas/epidemiologia , Apneia Obstrutiva do Sono/epidemiologia , Adolescente , Adulto , Idoso , Comorbidade , Feminino , Cardiopatias Congênitas/diagnóstico , Humanos , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Prevalência , Estudos Retrospectivos , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
19.
J Womens Health (Larchmt) ; 29(3): 435-442, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32096683

RESUMO

While essential for health and wellness, the various dimensions of sleep health are generally not equitably distributed across the population, and reasons for racial/ethnic sleep disparities are not fully understood. In this review, we describe racial/ethnic sleep disparities and subsequent implications for health from prior and recently conducted epidemiological and clinical studies as well as the potential sleep interventions presented at the 2018 Research Conference on Sleep and the Health of Women at the National Institutes of Health. Given the clear connection between sleep and poor health outcomes such as cardiovascular disease, we concluded that future studies are needed to focus on sleep health in general, sleep disorders such as insomnia and obstructive sleep apnea in particular, and disparities in both sleep health and sleep disorders among women using an intersectional framework. Future research should also integrate sleep into interventional research focused on women's health as these results could address health disparities by informing, for example, future mobile health (mHealth) interventions prioritizing women beyond the clinical setting.


Assuntos
Doenças Cardiovasculares/epidemiologia , Grupos de Populações Continentais/estatística & dados numéricos , Grupos Étnicos/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Transtornos do Sono-Vigília/epidemiologia , Feminino , Humanos , Caracteres Sexuais , Fatores Sexuais , Sono , Apneia Obstrutiva do Sono/epidemiologia , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Determinantes Sociais da Saúde , Fatores Socioeconômicos , Estados Unidos/epidemiologia
20.
Ann Otol Rhinol Laryngol ; 129(6): 556-564, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31920116

RESUMO

OBJECTIVES: Analyze the differences in length of stay, cost, disposition, and demographics between syndromic and non-syndromic children undergoing multi-level sleep surgery. METHODS: Children with sleep disordered breathing or obstructive sleep apnea that had undergone sleep surgeries were isolated from the 1997 to 2012 editions of the Kids' Inpatient Database, Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality. Children were then classified as syndromic or non-syndromic and stratified by level of sleep surgery (tonsillectomy & adenoidectomy, tonsillectomy & adenoidectomy plus other site surgery, other site surgery). Length of stay and cost were reported with Kruskal-Wallis one-way analysis of variance, disposition with binomial logistic regression, and demographics with chi-square. RESULTS: Syndromic children compared to non-syndromic children were more likely to have surgery beyond just tonsillectomy & adenoidectomy and also had a longer length of stay, higher total cost and non-routine disposition (all P < .001). Syndromic children undergoing tonsillectomy and adenoidectomy plus other site surgery had a longer length of stay compared to syndromic children undergoing tonsillectomy & adenoidectomy (6.00 days vs 3.63 days, P < .001). However, no similar statistically significant difference in length of stay was found in non-syndromic children (2.01 days vs 2.87 days, P > .05). CONCLUSION: The potential risks/benefits need to be weighed carefully before undertaking sleep surgery in syndromic children. They experience a longer length of stay, higher cost, and non-routine disposition when compared to non-syndromic children. This is especially true when considering the transition from tonsillectomy & adenoidectomy to tonsillectomy & adenoidectomy plus other site surgery, as syndromic children experience a longer length of stay and non-syndromic children do not.


Assuntos
Adenoidectomia/estatística & dados numéricos , Transtornos Cromossômicos/epidemiologia , Anormalidades Congênitas/epidemiologia , Custos de Cuidados de Saúde/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos , Apneia Obstrutiva do Sono/cirurgia , Tonsilectomia/estatística & dados numéricos , Adenoidectomia/economia , Criança , Pré-Escolar , Comorbidade , Anormalidades Craniofaciais/epidemiologia , Feminino , Cardiopatias Congênitas/epidemiologia , Humanos , Lactente , Masculino , Procedimentos Cirúrgicos Otorrinolaringológicos/economia , Procedimentos Cirúrgicos Otorrinolaringológicos/estatística & dados numéricos , Avaliação de Resultados em Cuidados de Saúde , Alta do Paciente/estatística & dados numéricos , Obesidade Pediátrica/epidemiologia , Síndromes da Apneia do Sono/epidemiologia , Síndromes da Apneia do Sono/cirurgia , Apneia Obstrutiva do Sono/epidemiologia , Tonsilectomia/economia
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