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1.
Medicine (Baltimore) ; 99(10): e19329, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32150069

RESUMO

Sleep-disordered breathing symptoms may recur in some children after successful adenoidectomy. A potential etiology that warrants consideration is torus tubarius hypertrophy (TTH) as well as residual or recurrent adenoid hypertrophy. Here, we report our experience and the treatment outcomes with microscopic coblator-assisted partial resection of TTH.Seven children who had undergone coblator-assisted partial resection of TTH under microscopy from April 2000 through January 2017 were retrospectively reviewed. The patient age at the time of initial adenotonsillectomy and the interval between the first operation and partial resection of TTH were identified. Lateral cephalometry and scores on the Korean version of the obstructive sleep apnea-18 (KOSA-18) questionnaire were reviewed.The median age at the time of the first operation was 3.0 years and the average time interval between the first operation and subsequent tubal tonsillectomy was 44.0 months. The average width between the torus tubarius was 2.1 mm preoperatively. Symptoms of sleep-disordered breathing were relieved in all patients after operation. Preoperative and postoperative KOSA-18 scores were 73.5 and 35.5, respectively (P = .024). On polysomnography, the preoperative and postoperative apnea-hypopnea index scores were 22.9 and 4.7, respectively (P = .068). The patients were followed up for an average of 1.3 years. One patient developed a recurrence of symptoms and underwent a revision operation. Complications such as bleeding and nasopharyngeal stenosis were not observed.Otorhinolaryngologists should keep TTH in mind as one of the differential diagnoses for recurrent upper airway obstruction symptoms after adenoidectomy. Microscopic coblator-assisted partial resection of TTH is likely to be safe and effective.


Assuntos
Tonsila Faríngea/cirurgia , Ronco/cirurgia , Resultado do Tratamento , Estudos de Casos e Controles , Pré-Escolar , Humanos , Hipertrofia , Lactente , Masculino , República da Coreia , Estudos Retrospectivos , Síndromes da Apneia do Sono/etiologia , Síndromes da Apneia do Sono/cirurgia , Ronco/etiologia , Inquéritos e Questionários
2.
Zhonghua Er Ke Za Zhi ; 58(1): 13-18, 2020 Jan 02.
Artigo em Chinês | MEDLINE | ID: mdl-31905470

RESUMO

Objective: To evaluate the endothelial function in obstructive sleep apnea syndrome(OSAS) children and to identify related factors of endothelial dysfunction. Methods: This was a cross-sectional study. Children with habitual snoring (snoring ≥3 nights per week) admitted to the ward of otolaryngology, head and neck surgery, Beijing Children's Hospital were recruited to this study between 1(st) June 2015 and 1(st) March 2016. All children aged 3 to 11 years and of them 245 were boys and 110 were girls. All subjects underwent an overnight polysomnography (PSG), as well as endothelial function testing. All subjects were grouped into primary snoring (PS) and OSAS group according to the obstructive apnea hypopnea index (OAHI). T test or Wilcoxon test were used to compare the differences in PSG results between the two groups, and univariate and multivariate correlation analyses were used to explore the relevant factors affecting the endothelial function. Results: A total of 355 subjects were enrolled and 248 had OSAS, and 107 had PS. There were no significant differences in age, gender and body mass index (BMI) Z-score between the two groups (all P>0.05). OSAS group had higher OAHI, oxgen desaturation index and respiratory related arousal index (5.2 (2.2, 13.2) vs. 0.4 (0.1, 0.7), 4.1 (2.0, 13.1) vs. 0.5 (0.1, 1.0), 2.5 (1.0, 4.8) vs. 0.4 (0.1, 0.9), Z=-14.957, -11.790, -10.378, all P<0.01), and lower minimum oxygen saturation and reactive hyperemia index (RHI) than those of PS (0.89 (0.85, 0.92) vs. 0.94 (0.91, 0.95), 1.2±0.2 vs. 1.1±0.1, Z=-9.337, t=5.354, P<0.01). Univariate regression analysis showed that RHI was linearly correlated with age (parameter estimate=0.017, P<0.01), gender (parameter estimate=0.065, P<0.01), OAHI (parameter estimate=-0.023, P<0.01), oxygen desaturation index (parameter estimate=-0.019, P<0.01), respiratory related arousal index (parameter estimate=-0.031, P<0.01), and oxygen saturation nadir (parameter estimate=0.067, P=0.045). The relationship between BMI Z-score and RHI was quadratic. Multivariate regression analysis showed that age (parameter estimate=0.015, P<0.01), BMI Z-score (parameter estimate=0.040, P<0.01), BMI Z-score quadratic form (parameter estimate=-0.010, P<0.01), respiratory related arousal index (parameter estimate=-0.020, P<0.01) were independently correlated with RHI. Conclusions: Children with OSAS have significant endothelial dysfunction compared with PS. Frequent arousals due to obstructive respiratory events during sleep may be a candidate risk factor for endothelial dysfunction in children with OSAS.


Assuntos
Endotélio Vascular/fisiopatologia , Apneia Obstrutiva do Sono/fisiopatologia , Ronco/fisiopatologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Masculino , Polissonografia , Sono
3.
Am J Orthod Dentofacial Orthop ; 157(1): 91-97, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31901287

RESUMO

INTRODUCTION: This 10-year prospective cephalometric study evaluates the influence of a mandibular protruding device (MPD) in people with obstructive sleep apnea and snoring. METHODS: A baseline study population of 77 people was followed biennially. After 10 years, 65 people (45 MPD users and 20 stopped-MPD users) were reexamined. At baseline and after 10 years, a lateral cephalogram was taken in the upright position. RESULTS: MPD users showed significant changes in all cephalometric variables except for maxillary protrusion. The maxillary incisors were retroclined by a mean -4.2° (standard deviation [SD] 3.95; P <0.001), mandibular incisors were proclined by a mean 3.2° (SD, 5.02; P <0.001), and SNB was reduced by a mean -0.6° (SD 1.41; P = 0.01). In those who had stopped MPD use, these initial cephalometric values were retained. Significant changes in decreased overjet and overbite were seen in the MPD group but not in the MPD-stopped group. The length of the mandible (Cd-Pg) increased by a mean of 5.1 mm (SD 6.78; P <0.001) and 6.1 mm (SD 5.99; P <0.001) in MPD and MPD-stopped groups, respectively. The hyoid bone-mandibular plane distance (hy-ML) increased by a mean of 3.3 mm (SD, 2.90; P <0.001) and 3.8 mm (SD 3.67; P = 0.001) in MPD and MPD-stopped groups, respectively. CONCLUSIONS: Long-term nocturnal MPD use causes retroclination of the maxillary incisors and proclination of the mandibular incisors with consequent decreased overjet and overbite. Both MPD and MPD-stopped users obtained increased mandibular length and lower position of the hyoid bone, which can be a normal physiological change with age.


Assuntos
Apneia Obstrutiva do Sono , Ronco , Seguimentos , Humanos , Mandíbula , Avanço Mandibular , Estudos Prospectivos
5.
Int J Med Inform ; 133: 104000, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31731221

RESUMO

PURPOSE: To evaluate quality and readability of online information on dental treatment for snoring and obstructive sleep apnea. METHODS: An Internet search was done using three engines (Bing, Google, and Yahoo) with the combination of terms, "snoring sleep apnea dental treatment". The first 100 sites from the search of each engine were screened. Subject sites were evaluated with Health on the Net(HON) criteria, Journal of American Medical Association(JAMA) benchmarks, DISCERN, Ensuring Quality Information for Patients(EQIP), Flesch-Kincaid Grade level and Flesch Reading Ease(FRE) score. RESULTS: One hundred and thirty websites were evaluated. The HON, DISCERN, EQIP, and FRE score were each 39.4%, 47.3%, 49.7%, and 51.6% of the maximum possible score, respectively. According to JAMA benchmarks fewer than 50% of the sites displayed attribution and currency. There was only one site displaying the HON seal. HON score, DISCERN score and EQIP score showed significant inter-correlation. CONCLUSION: Based on this study, the current quality and readability of searchable websites on dental treatment for snoring and sleep apnea are low and poorly maintained on average. Clinicians should be able to evaluate and give accurate online information on this issue to patients.


Assuntos
Apneia Obstrutiva do Sono/terapia , Ronco/terapia , Compreensão , Informação de Saúde ao Consumidor , Humanos , Internet
6.
Am J Orthod Dentofacial Orthop ; 156(6): 840-845, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31784018

RESUMO

INTRODUCTION: The aim was to study the association between snoring and development of occlusion, maxillary dental arch, and soft tissue profile in children with newly completed deciduous dentition. METHODS: Thirty-two (18 female, 14 male) parent-reported snorers (snoring ≥3 nights/week) and 19 (14 female, 6 male) nonsnorers were recruited. Breathing preference (nose or mouth) was assessed at the mean age of 27 months by otorhinolaryngologist. At the mean age of 33 months, an orthodontic examination was performed, including sagittal relationship of second deciduous molars, overjet, overbite, and occurrence of crowding and lateral crossbite. Bite index was obtained to measure maxillary dental arch dimensions (intercanine and intermolar width, arch length). A profile photograph was obtained to measure facial convexity. RESULTS: No significant differences were found between nonsnorers and snorers in any of the studied occlusal characteristics or in measurements of maxillary dental arch dimensions. Snorers were found to have a more convex profile than nonsnorers. Occurrence of mouth breathing was more common among snorers. CONCLUSIONS: Parent-reported snoring (≥3 nights/week) does not seem to be associated with an adverse effect on the early development of deciduous dentition, but snoring children seem to have more convex profile than nonsnorers. Snoring is a mild sign of sleep-disordered breathing, and in the present study its short time lapse may not have had adequate functional impact on occlusion.


Assuntos
Má Oclusão , Síndromes da Apneia do Sono , Ronco , Dente Decíduo , Pré-Escolar , Arco Dental/crescimento & desenvolvimento , Feminino , Humanos , Masculino , Maxila
7.
Eur J Paediatr Dent ; 20(4): 302-305, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31850773

RESUMO

AIM: The aim of this study was to determine the prevalence of OSAS' risk in children of the province of Catanzaro, Italy. MATERIALS AND METHODS: A sample of 2445 scoolchildren aged 6 to 12 years of the province of Catanzaro (Italy) were administered the Pediatric Sleep Questionnaires (PSQs) in its validated Italian version. A total of 1772 questionnaires were collected; however, 130 of them were excluded, and 1642 questionnaires were accepted and scored. RESULTS: According to final scores of questionnaires, 172 children (10.47%) were considered at risk for OSAS. No statistically significant association between sex and risk of OSAS was found (p = 0.189). The risk of OSAS was equally distributed in all ages (p = 0.984). It was found that the most common habits in children with risk of OSAS were: snoring, heavy or noisy breathing, oral breathing, xerostomia, difficulty waking up in the morning, behavioural disturbances during the day and excess weight. CONCLUSION: The study showed a high risk of OSAS, suggesting the importance of first-level screening and the need to pay special attention to the diagnosis of this syndrome.


Assuntos
Apneia Obstrutiva do Sono , Criança , Humanos , Itália , Prevalência , Sono , Ronco , Inquéritos e Questionários
8.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi ; 54(12): 902-906, 2019 Dec 07.
Artigo em Chinês | MEDLINE | ID: mdl-31887815

RESUMO

Objective: To investigate the snoring status and related family factors of children from 3 to 14 years old in Beijing. Methods: From May to July, 2015, data of children from 3 to 14 years old were obtained from a status survey from 7 districts(Xicheng, Chaoyang, Changping, Shunyi, Fangshan, Huairou and Mentougou) in Beijing. A total of 11 420 children from 25 primary and middle schools were randomly selected. Pediatric Sleep Questionnaire (PSQ) and a self-administered questionnaire were carried out for the adopted children. Self-administered questionnaire included the snoring related family factors. Logistic regression was used to estimate the odd ratio(OR) with 95% confidence intervals for variables. Results: A total of 9 198 children meet the inclusion criteria and are analyzed in the study, of whom 901 (9.80%) were found with snoring behavior. The incidence of boys is higher than girls. Obese children take higher risk of snoring. Compared with younger children (≤6 years old), older children (≥12 years old) have a significantly lower risk of snoring (OR=0.464, 95%CI 0.368-0.585). There is no statistical association between full-term infants, infant feeding pattern, parental cigarette smoking and child snoring.The children with family history of snoring have a significantly higher risk of snoring occurrence. The educational background of mother is statistically related to children snoring (OR=1.241, 95%CI 1.058-1.457). Conclusions: The incidence of children snoring in Beijing is 9.80%, male gender, obesity, and young age are all risk factors for children snoring. There is a significantly statistical relationship between snoring and related family factors, such as family snoring history and education experience.


Assuntos
Sono , Ronco , Adolescente , Pequim , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Masculino , Prevalência , Fatores de Risco , Ronco/epidemiologia , Inquéritos e Questionários
9.
Cas Lek Cesk ; 158(5): 170-174, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31703527

RESUMO

In the field of sleep disorders, otorhinolaryngology is mainly concerned with snoring and obstructive sleep apnea (OSA). Prevalence of OSA is suggested between 14-49 % of male and 5-30 % of female population, which makes it most common sleep disorder. The treatment of choice is positive airway pressure (PAP) therapy with excellent success rate of 90 %, however many patients dont tolerate it. Sleep surgery is usually used to get off snoring and for mild cases of OSA. Most of surgical approaches has much lower effectivity than PAP therapy; however, surgery benefit is present constantly, while PAP therapy demands patients cooperation, that is why many patients still prefer sleep surgery.


Assuntos
Otolaringologia , Apneia Obstrutiva do Sono , Feminino , Humanos , Masculino , Cooperação do Paciente , Apneia Obstrutiva do Sono/terapia , Ronco
10.
Med Oral Patol Oral Cir Bucal ; 24(6): e782-e786, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31655840

RESUMO

BACKGROUND: The literature does not report any association between habitual snoring and sleep bruxism, but these situations can be a reason for frequent complaints of individuals, impairing the quality of life. This study was performed to investigate the sleep period and amount of habitual snoring in individuals with sleep bruxism observing expiratory, inspiratory, and mixed snoring. MATERIAL AND METHODS: A total of 90 individuals were screened and divided into the following groups: with sleep bruxism (n=45) and those without sleep bruxism (n=45). Single night sleep polysomnography was performed to diagnose sleep bruxism, quantify habitual snoring and sleep period. The results were tabulated and submitted to a Multivariate analysis of variance (MANOVA) to compare the means of the two independent groups, considering the affected diagnosis of sleep bruxism, snoring (independent variables) and age as covariate. For the post hoc, was used correcting for multiple comparisons (Bonferroni test, P<.05). RESULTS: There was statistically significant difference among the groups ( p=.001) in the sleep period, in that individuals with sleep bruxism slept for a longer duration (with sleep bruxism group: 460 minutes and without sleep bruxism group: 401 minutes). There were no statistically significant differences among the groups for the number of inspiratory, expiratory and mixed snores, but was observed greater amount of snoring in the with sleep bruxism group. CONCLUSIONS: The main finding of this study is that individuals with sleep bruxism slept longer than the control group. It may also be suggested that individuals with sleep bruxism tended to increase the amount of habitual snoring during sleep.


Assuntos
Bruxismo do Sono , Ronco , Humanos , Polissonografia , Qualidade de Vida , Fatores de Tempo
11.
Zhongguo Dang Dai Er Ke Za Zhi ; 21(10): 987-991, 2019 Oct.
Artigo em Chinês | MEDLINE | ID: mdl-31642432

RESUMO

OBJECTIVE: To investigate the prevalence of obesity and sleep disorders and the association between them among children in Lanzhou, China. METHODS: The stratified cluster random sampling method was used to select 3 283 primary school students in four districts of Lanzhou of Gansu province. Physical examination and sleep questionnaire were conducted to screen out the children who met the criteria for sleep disorders or obesity as subjects. Among the 3 283 children, 200 healthy children without sleep disorders or obesity were enrolled as the control group. RESULTS: The prevalence rate of obesity among the 3 283 children was 5.76% (189/3 283). Among these 189 obese children, 80 (42.3%) had sleep disorders. The prevalence rate of sleep disorders was 16.24% (533/3 283), and the prevalence rate of obesity among the children with sleep disorders was 24.6% (131/533). Snoring was the most common sleep disorder in obese children. The prevalence rate of obstructive sleep apnea hypopnea syndrome was 45% (36/80) among obese children with sleep disorders. The obese children had a significantly higher prevalence rate of sleep disorders than the children with normal body weight [42.3% (80/189) vs 20% (40/200), P<0.01]. CONCLUSIONS: There is a close relationship between obesity and sleep disorders in children in Lanzhou, China.


Assuntos
Obesidade , Transtornos do Sono-Vigília , Índice de Massa Corporal , Criança , China , Humanos , Obesidade/complicações , Transtornos do Sono-Vigília/complicações , Ronco
12.
Int J Pediatr Otorhinolaryngol ; 127: 109621, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31521054

RESUMO

OBJECTIVE: This study aimed to identify the heterogeneity of obstructive sleep apnea syndrome clinical presentation in children. PARTICIPANTS: Children who were 3-14 years old and with obstructive sleep apnea syndrome after polysomnography monitoring (apnea and hypopnea index>5 or obstructive apnea index>1) in the sleep center of Beijing Children's Hospital were included. METHODS: A sleep disorder questionnaire including different combinations of symptoms and co-morbidities of obstructive sleep apnea syndrome in children was used. A cluster analysis was used to classify the data. RESULTS: The apnea hypopnea index alone is not adequate to predict clinical phenotypes. Based on symptoms and co-morbidities of obstructive sleep apnea syndrome, three distinct clusters were identified. They were "nocturnal snoring and daytime sleepiness group" (cluster 1), "hyperactivity group" (cluster 2), and "minimally symptomatic group" (cluster 3). A prediction model was built according to eight variables which showed statistical significance by pairwise comparison among clusters. Overall accuracy of the prediction model could reach 86%. Both the sensitivity and specificity of cluster 2 and 3 prediction were around 90%. CONCLUSION: Children with obstructive sleep apnea syndrome have different patterns of clinical presentation and the identification of the different clinical profiles of obstructive sleep apnea syndrome can provide clues for more personalised diagnoses and therapies.


Assuntos
Distúrbios do Sono por Sonolência Excessiva/etiologia , Fenótipo , Apneia Obstrutiva do Sono/complicações , Apneia Obstrutiva do Sono/diagnóstico , Ronco/etiologia , Adolescente , Criança , Pré-Escolar , Comorbidade , Feminino , Humanos , Masculino , Modelos Estatísticos , Polissonografia , Sensibilidade e Especificidade , Índice de Gravidade de Doença , Sonolência , Inquéritos e Questionários , Avaliação de Sintomas
13.
Laryngorhinootologie ; 98(9): 638-650, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31499555

RESUMO

The prevalence of mild obstructive sleep apnea (OSA) in adults is 20 %, of moderate to severe OSA about 6-7 %. The current gold standard for the treatment of moderate to severe OSA is the continuous positive airway pressure (CPAP) therapy. It is the most effective treatment modality, if there is good compliance and therapy adherence. Poor adherence still remains a problem for OSA treatment. In contrast to CPAP therapy, surgical therapy offers 100 % therapy adherence. Various surgical procedures are available for the treatment of primary snoring and mild to moderate OSA.Surgical therapy requires adequate preoperative diagnostics including a good clinical basic ENT examination after detailed sleep medicine anamnesis. Additionally, the drug-induced sleep endoscopy to determine collapse location, collapse pattern and degree of collapse could be performed. According to Sher et al, the surgical success of a therapy in OSA is defined as a reduction of the apnea-hypopnea-index (AHI) by at least half and below a value of 20/h. In contrast, successful CPAP therapy is defined with an AHI below < 5/h but the acceptance, adherence and compliance to CPAP therapy should be always considered too.In severe OSA, surgical approaches should only be performed to optimize ventilation therapy or in cases of intolerance or lack of adherence.


Assuntos
Apneia Obstrutiva do Sono , Sono , Ronco , Pressão Positiva Contínua nas Vias Aéreas , Humanos , Resultado do Tratamento
14.
Artigo em Inglês | MEDLINE | ID: mdl-31500221

RESUMO

We conducted a multicenter survey for oral appliance (OA) therapy to grasp and analyze the current situation of OA therapy, including efficacy, side effects, and follow-up, in Japan. The Japanese cross-sectional multicenter survey (JAMS) for obstructive sleep apnea (OSA) was undertaken by patients in 10 institutions associated with oral appliance therapy during two years, from 2014 to 2015, retrospectively. Age, sex, body mass index (BMI), baseline apnea-hypopnea index (AHI), OA type, adjustment, adverse reactions with OA, and AHI with OA were elicited from the patient clinical record. The number of included OSA patients was 3217. The number of patients with OA therapy was 2947. We evaluated 1600 patients for the OA treatment. The patients treated with OA, both male and female, were most commonly in their 50s. In terms of OSA severity, snoring was 2.3%, mild was 38.5%, moderate was 39.9%, and severe was 19.3%. The use of mono bloc appliance was 91.8%, bi bloc appliance was 7.9%, and tongue-retaining device (TRD) was 0.3%. After OA treatment, AHI decreased from 22.4/h to 9.3/h. The AHI reduction rate with OA was 52.0%. The rate of AHI <5 with OA was 35.6%. Adverse reactions developed in 14.7% of the subjects. OA reassessment was conducted for 54.3%. This study revealed the current situation of efficacy and side effects of OA therapy, and the problem that the reassessment rate of OA was low in Japan.


Assuntos
Aparelhos Ortodônticos Removíveis , Apneia Obstrutiva do Sono/terapia , Ronco/prevenção & controle , Língua/fisiopatologia , Índice de Massa Corporal , Estudos Transversais , Feminino , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Inquéritos e Questionários , Resultado do Tratamento , Adulto Jovem
15.
Artigo em Inglês | MEDLINE | ID: mdl-31480465

RESUMO

Oral appliance (OAm) therapy has demonstrated efficacy in treating obstructive sleep apnea (OSA). The aim of this systematic review was to clarify the efficacy of device designs (Mono-block or Bi-block) in OAm therapy for OSA patients. We performed a meta-analysis using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system. Two studies (Mono-block OAm versus Bi-block OAm) remained eligible after applying the exclusion criteria. When comparing Mono-block OAm and Bi-block OAm, Mono-block OAm significantly reduced the apnea-hypopnea index (2.92; 95% confidence interval (95%CI), 1.26 to 4.58; p = 0.0006), and patient preference for Mono-block OAm was significantly higher (2.06; 95%CI, 1.44 to 2.06; p < 0.0001). Lowest SpO2, arousal index, non-REM stage 3, sleep efficiency, Epworth Sleepiness Scale (ESS), Snoring Scale, and side effects were not significantly different between the two groups (lowest SpO2: -11.18; 95%CI, -26.90 to 4.54; p = 0.16, arousal index: 4.40; 95%CI, -6.00 to 14.80; p = 0.41, non-REM stage 3: -2.00; 95%CI, -6.00 to 14.80; p = 0.41, sleep efficiency: -1.42, 95%CI, -4.71 to 1.86; p = 0.40, ESS: 0.12; 95%CI, -1.55 to 1.79; p = 0.89, Snoring Scale: 0.55; 95%CI, -0.73 to 1.83, p = 0.55, side effects: 1.00, 95%CI, 0.62 to 1.61, p = 1.00). In this systematic review, the use of Mono-block OAm was more effective than Bi-block OAm for OSA patients.


Assuntos
Desenho de Aparelho Ortodôntico , Aparelhos Ortodônticos , Apneia Obstrutiva do Sono/terapia , Ronco/prevenção & controle , Nível de Alerta , Humanos
16.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(8): 917-923, 2019 Aug 10.
Artigo em Chinês | MEDLINE | ID: mdl-31484254

RESUMO

Objective: To describe the characteristics of habitual snoring among adults from 10 regions engaged in the China Kadoorie Biobank (CKB) study. Methods: The baseline survey of CKB was conducted from 2004 to 2008. Data was collected regarding the information on socio- demographic characteristics, lifestyle, sleeping habits, and results from the physical examination of the participants. Logistic regression models were used to compare the regional differences and to estimate the associations of other baseline characteristics on snoring habit. Results: A total of 512 713 participants were included in this study. The overall prevalence of habitual snoring was 21.2%, higher among men, in south regions and urban areas, but no difference observed among people with different socioeconomic status after adjusting for age, regions, BMI, waist circumference or lifestyle factors. Results showed that the prevalence of habitual snoring under the multivariable adjusted model increased among current and ever smokers, also among current and ever alcohol consumers. The risk of habitual snoring was increased by 19% per 1 kg/m(2) and 6% per 1 cm increment in BMI or waist circumference, respectively. Among participants with similar BMI, central obese individuals were more likely to be habitual snorers. For individuals with similar waist circumference, the prevalence of habitual snoring was higher among those with higher BMI. Conclusion: The prevalence of habitual snoring varied across regions. Substantial differences in habitual snoring were also seen among people with different lifestyles and body sizes.


Assuntos
Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Ronco/epidemiologia , Adulto , Fatores Etários , Idoso , Índice de Massa Corporal , China/epidemiologia , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Circunferência da Cintura
17.
Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi ; 33(9): 862-865;869, 2019 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-31446706

RESUMO

Objective:To explore the relationship between smoking and the severity of OSA. Method:There were 719 patients included in the study, who were accompanied by snoring, daytime sleepiness and other symptoms. Laboratory-based polysomnographic variables (including AHI, oxygen desaturation index and microarousal index, etc.), and anthropometric measurements (including weight, neck circumference, waist circumference, hip circumference etc.) were collected for all participants. The severity of OSA was determined by AHI. No OSA was defined as AHI<5, mild OSA as AHI of 5 to 15,moderate OSA as AHI of >15 to 30, and severe OSA as AHI of >30. Smoking severity was determined by the smoking index (SI). Light smoke was defined as SI<200, moderate smoke was as SI 200 to 400, and severe smoke as SI>400. Result:There were 138 cases of non-OSA and 581 cases of OSA. There were 381 non-smokers, 279 smokers and 59 quit smokers. The smoking rate of OSA group was significantly higher than that of non-OSA group (41.5% vs. 27.5%,P<0.01). After excluding 59 quit smokers, the remaining 660 subjects were divided into four groups according to the severity of smoking, then each group was further divided into four groups according to OSA severity. Unadjusted analysis showed that OSA severity positively correlated with smoking severity (r=0.203,P<0.01). The positive correlation remained significant after further adjustment for age, BMI and waist-hip ratio. In addition, logistic regression analysis showed that compared to non-smokers, the odd ratios for OSA in moderate smokers were 1.72 (95%CI 1.08-2.75) and in severe smokers were 2.68 (95%CI 1.61-4.46), after adjustment for age, BMI and waist-hip ratio. Conclusion:The severity of smoking significantly correlated with the severity of OSA. There was increased risk of OSA in patients with severe smoke. The correlation was independent of some confounders such as age and obesity.


Assuntos
Apneia Obstrutiva do Sono/diagnóstico , Fumar/efeitos adversos , Humanos , Polissonografia , Índice de Gravidade de Doença , Ronco
18.
Rev Assoc Med Bras (1992) ; 65(7): 995-1000, 2019 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-31389512

RESUMO

OBJECTIVES: Assess the performance of the Stop-Bang questionnaire in Brazilian patients for the screening of OSA. METHODS: A cross-sectional study with historical and consecutive analysis of all patients who underwent polysomnography tests in the Sleeping Sector of the Ear, Nose, and Throat, and Cardiopulmonary (LabSono) Departments of the Gaffrée and Guinle University Hospital (HUGG), from 10/17/2011 to 04/16/2015. The variables relating to the SB questionnaire were collected by direct research from the medical records of patients. RESULTS: In a series of 83 patients, we found that our sample were similar to other studies conducted in specialized centers of Sleep Medicine, and the population presented characteristics similar to those found by studies in Latin America. Men and women only behaved similarly in relation to the presence of Observed Apnea and body mass index, with a predominance of women who had systemic hypertension over men. In our study, the discriminatory value of 4 or more positive answers to the questionnaire had the best performance in identifying patients with an hourly Apnea-Hypopnea Index greater than 15/h, with a sensitivity of 72.97% (55.9% - 86.2%) and specificity of 67.39% (52.0% - 80.5%). CONCLUSIONS: The Stop-Bang questionnaire proved to be, in our sample, a good screening instrument for diagnosing OSA Syndrome.


Assuntos
Apneia Obstrutiva do Sono/diagnóstico , Inquéritos e Questionários/normas , Adulto , Idoso , Brasil , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polissonografia/métodos , Valores de Referência , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Índice de Gravidade de Doença , Distribuição por Sexo , Apneia Obstrutiva do Sono/fisiopatologia , Ronco/diagnóstico , Adulto Jovem
19.
Adv Exp Med Biol ; 1222: 37-42, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31372855

RESUMO

Obstructive sleep apnea (OSA) is a common breathing disorder affecting millions of people worldwide. The disorder is connected with serious consequences including hypertension, myocardial infarction, arrhythmias, coronary disease, cardiac insufficiency, stroke, transient ischemic attack, and cognitive decline. Epidemiological data assessing the prevalence of OSA in different countries vary in methodology, size, and characteristics of population chosen and thus are hardly comparable. There are very few reports on the prevalence of OSA and on the diagnostic accuracy of sleep questionnaires available in Poland. In this report we present the analysis of the prevalence of, and risk factors for OSA in the Polish adult population consisting of 613 community-based subjects (227 men and 386 women). The study was based on the STOP-BANG questionnaire, a validated Screening Tool for OSA in primary care. It is a part of Polish subset of the Prospective Urban Rural Epidemiology (PURE) study, an ongoing population cohort study of individuals from urban and rural communities from 21 countries. We took into account age, gender, body mass index (BMI), and antihypertensive treatment. The findings are that over one half of the Polish population investigated had a moderate to high risk of OSA (66.5% of men and 60.1% of women). After the adjustments for age, gender, and BMI we noticed a dose-response relationship between arterial blood pressure behavior and OSA. The association was significant among women, but not men. Based on previous studies we can assume that one half of this high risk group would be further diagnosed for OSA. This study, the first large scale screening for OSA in Poland, shows a substantial, much higher than previously appreciated, prevalence of risk for OSA in the population at large.


Assuntos
Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Hipertensão/epidemiologia , População Rural/estatística & dados numéricos , Apneia Obstrutiva do Sono/epidemiologia , Ronco/etiologia , População Urbana/estatística & dados numéricos , Adulto , Estudos de Coortes , Feminino , Humanos , Masculino , Polônia/epidemiologia , Polissonografia , Prevalência , Estudos Prospectivos , Apneia Obstrutiva do Sono/etnologia , Ronco/epidemiologia , Inquéritos e Questionários
20.
J Craniofac Surg ; 30(5): e454-e460, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31299813

RESUMO

BACKGROUND: Velopharyngeal insufficiency is a feared complication of adenoidectomies in patients with palatal abnormalities. Thus, the benefits of adenoidectomy in this population are less understood. The techniques of partial adenoidectomy aim to preserve velopharyngeal closure while sufficiently debulking the nasal airway to ameliorate obstruction and snoring. METHODOLOGY: Systematic review of online databases using a combination of search terms including "cleft palate," "submucosal cleft palate," "short palate," "adenoidectomy," "partial adenoidectomy," "subtotal adenoidectomy," and "powered adenoidectomy." Two independent reviewers assessed the eligibility of each study based on predefined inclusion criteria. RESULTS: From 323 studies identified, 8 were included. All were retrospective case series, except 1 prospective study. Study period ranged from 1.1 to 14 years (median 7.5 years). There were 172 patients with a cleft palate (n = 80), submucous cleft palate (n = 67) or another defined palatal abnormality [short soft palate (n = 14), bifid uvula (n = 4), questionable palatal mobility (n = 4) or incomplete CP (n = 3)] identified. Mean age was 5.5 years and just over half were male (58%). Nearly all patients showed improvement in nasal airway obstruction and snoring. The pooled risk for velopharyngeal insufficiency across all studies was 2 out of 122, which approximates to 1.6% of patients. There were very few complications. CONCLUSION: This is the first systematic review of partial adenoidectomy in patients with palatal abnormalities. Sub-total adenoidectomy in patients with submucosal cleft palate or repaired cleft palate appears to be a safe and efficacious procedure. There is; however, a need for prospective data collection using a standardized technique in large patient series required to properly assess outcomes.


Assuntos
Adenoidectomia , Fissura Palatina/cirurgia , Adenoidectomia/métodos , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Obstrução Nasal/cirurgia , Nasofaringe , Palato Mole , Estudos Prospectivos , Ronco , Insuficiência Velofaríngea/cirurgia
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