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1.
Acta otorrinolaringol. esp ; 70(6): 364-372, nov.-dic. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-184882

RESUMO

En noviembre 2014 la Sociedad Española de Otorrinolaringología, la Sociedad Española de Sueño y la Sociedad Española de Cirugía Maxilofacial propusieron y avalaron la elaboración de una Guía de Práctica Clínica sobre la exploración física de la vía aérea superior en pacientes con apnea obstructiva del sueño. La Guía ha seguido de forma estricta en toda su elaboración las recomendaciones del manual de elaboración de guías de práctica clínica del Sistema Nacional de Salud 2007 y 2009 y el manual de la Scottish Intercollegiate Guidelines Network (SIGN) 2015. El documento final puede ser altamente útil para los fines que se propuso inicialmente: ser un referente para unificar las regiones que deben ser exploradas en los pacientes con síndrome de apnea-hipoapnea obstructiva del sueño, mediante qué tipo de exploración y cómo gradarla, y expresada para todos los ámbitos asistenciales a los que estos pacientes pueden acudir. Las conclusiones y recomendaciones están basadas en una revisión exhaustiva y actualizada de la bibliografía con alto nivel de evidencia, además de la experiencia y conocimientos demostrados de todos los integrantes del grupo de elaboración. Dicho grupo se constituyó pensando siempre en la transversalidad del proyecto, y, por tanto, han participado especialistas de todos los ámbitos implicados (cirugía maxilofacial, medicina de familia, neumología, neurofisiología clínica, odontología y otorrinolaringología). Con la misma idea se seleccionaron los revisores externos del texto final


In November 2014 the Spanish Society of Otolaryngology, the Spanish Sleep Society and the Spanish Society of Maxillofacial Surgery proposed and endorsed the development of a Clinical Practice Guideline on the physical examination of the upper airway in patients with obstructive sleep apnoea. The Guideline strictly followed the recommendations of the manual for the preparation of clinical practice guidelines of the National Health System 2007 and 2009 and the manual of the Scottish Intercollegiate Guidelines Network (SIGN) 2015. The final document could be highly useful for the purposes that were originally proposed: to act as a reference to unify the regions that should be explored in patients with obstructive sleep apnoea-hypopnoea syndrome, the type of examination and how to grade it, and specific to all the care areas to which these patients have access. The conclusions and recommendations are based on a thorough and up-to-date review of the literature with a high level of evidence, as well as the experience and knowledge demonstrated by all the members of the drafting group. This group was formed bearing in mind at all times the transversality of the project, and, therefore, specialists from all the involved areas participated (maxillofacial surgery, family medicine, pneumology, clinical neurophysiology, odontology and otolaryngology). The external reviewers of the final text were selected along the same lines


Assuntos
Humanos , Síndromes da Apneia do Sono/diagnóstico , Síndromes da Apneia do Sono/terapia , Manuseio das Vias Aéreas/normas , Exame Físico/métodos , Sociedades Médicas/normas , Exame Físico/normas
2.
Zhonghua Er Ke Za Zhi ; 57(10): 792-796, 2019 Oct 02.
Artigo em Chinês | MEDLINE | ID: mdl-31594067

RESUMO

Objective: To study the short-term and long-term efficacy of the non-invasive ventilation treatment in children with spinal muscular atrophy (SMA) and sleep-disordered breathing. Methods: This was a prospective research to study the effect of night-time non-invasive ventilation in children with SMA and moderate to severe sleep-disordered breathing during March 2016 to January 2018, from the Pulmonary Department of Capital Institute of Pediatrics Affiliated Children's Hospital. Patients were divided into the treated group (with night-time non-invasive ventilation) and the control group (without ventilator). Sleep breathing pressure titration was suggested to the patients who were prepared to receive non-invasive ventilation. All cases were followed up for one year. Parameters'changes in polysomnography were assessed (paired t-test) in titration patients. Frequency of respiratory tract infection during the next year in the patients with and without ventilation was collected and compared (Mann-Whitney U-test). Results: Seventeen cases were recruited. The average age was (5.1±2.9) years, 10 cases were boys and 7 cases were girls. In the titration group (8 patients), after non-invasive ventilation, the average apnea hypopnea index was (3.8±2.5) times/h (t=4.086, P=0.005), hypopnea index was (2.4±1.2) times/h (t=2.779, P=0.027), average oxygen saturation during total sleep time was 0.966±0.007 (t=-5.292, P=0.001), and the minimum oxygen saturation was 0.906±0.023 (t=-3.938, P=0.006). All the above parameters were significantly improved after treatment. Than before, which was (16.6±9.7) times/h, (7.2±4.7) times/h, 0.946±0.015, 0.786±0.092 respectively. Ventilator mode for the 9 children with long time non-invasive ventilation at home was Bi-level positive airway pressure S/T. The positive airway pressure was set at 8-14 cmH(2)O (1 cmH(2)O=0.098 kPa) in inspiratory phase and 4-6 cmH(2)O in expiratory phase. In the treated group (9 patients), the average frequency of upper respiratory tract infection was 1.0 (0, 3.0) times/year (Z=-2.245, P=0.023), the lower respiratory tract infection was 0 (0, 0) times/year (Z=-3.189, P=0.001), hospitalization was 0 (0, 0) times/year (Z=-3.420, P<0.01), and admission to intensive care unit was 0 (0, 0) times/year (Z=-3.353, P=0.029). All the above indexes were significantly decreased compared with the control group (8 patients), which was 3.0 (2.3, 7.0) times/year, 2.0 (1.3, 4.5) times/year, 1.0 (1.0, 4.3) times/year, 0.5 (0, 1.0) times/year respectively. Conclusion: Non-invasive ventilation is efficient to SMA children with sleep-disordered breathing, and also can reduce the incidence of respiratory tract infections for children with SMA.


Assuntos
Ventilação não Invasiva/métodos , Síndromes da Apneia do Sono/terapia , Atrofias Musculares Espinais da Infância/terapia , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Ventilação não Invasiva/efeitos adversos , Polissonografia , Estudos Prospectivos , Síndromes da Apneia do Sono/diagnóstico , Atrofias Musculares Espinais da Infância/diagnóstico , Resultado do Tratamento
3.
Praxis (Bern 1994) ; 108(12): 793-798, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31530127

RESUMO

Fatigue - a Common Symptom in General Practice Abstract. When patients suffering from fatigue consult a GP surgery, GPs should understand what patients mean by fatigue, how strongly they are affected in everyday life and how they themselves explain the symptom. In a next step, dangerous diseases such as depression, addiction or sleep apnea syndrome must be excluded. The main somatic and psychiatric causes of fatigue should be explored simultaneously with a more in-depth history. A simple physical exam and a few lab examinations are sufficient to capture the major disorders that present with the isolated symptom of fatigue. For further care, a primary biopsychosocial approach with a viable physician-patient relationship is crucial. Rough conclusions based on laboratory findings should be avoided; comorbidities must be considered.


Assuntos
Fadiga , Medicina Geral , Comorbidade , Depressão/complicações , Depressão/diagnóstico , Medicina de Família e Comunidade , Fadiga/diagnóstico , Fadiga/etiologia , Humanos , Síndromes da Apneia do Sono/complicações , Síndromes da Apneia do Sono/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/complicações , Transtornos Relacionados ao Uso de Substâncias/diagnóstico
4.
Sensors (Basel) ; 19(15)2019 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-31370241

RESUMO

Sleep monitoring in an unattended home setting provides important information complementing and extending the clinical polysomnography findings. The validity of a wearable textile electrocardiography (ECG)-belt has been proven in a clinical setting. For evaluation in a home setting, ECG signals and features were acquired from 12 patients (10 males and 2 females, showing an interquartile range for age of 48-59 years and for body mass indexes (BMIs) of 28.0-35.5) over 28 nights. The signal quality was assessed by artefacts detection, signal-to-noise ratio, and Poincaré plots. To assess the validity, the data were compared to previously reported data from the clinical setting. It was found that the artefact percentage was slightly reduced for the ECG-belt from 9.7% ± 14.7% in the clinical setting, to 7.5% ± 10.8% in the home setting. The signal-to-noise ratio was improved in the home setting and reached similar values to the gel electrodes in the clinical setting. Finally, it was found that for artefact percentages above 3%, Poincaré plots are instrumental to evaluate the origin of artefacts. In conclusion, the application of the ECG-belt in a home setting did not result in a reduction in signal quality compared to the ECG-belt used in the clinical setting, and thus provides new opportunities for patient pre-screening or follow-up.


Assuntos
Eletrocardiografia/métodos , Monitorização Fisiológica , Polissonografia/métodos , Síndromes da Apneia do Sono/diagnóstico , Índice de Massa Corporal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Processamento de Sinais Assistido por Computador , Razão Sinal-Ruído , Sono/fisiologia , Síndromes da Apneia do Sono/fisiopatologia , Têxteis , Dispositivos Eletrônicos Vestíveis
5.
Zhongguo Yi Liao Qi Xie Za Zhi ; 43(4): 243-247, 2019 Jul 30.
Artigo em Chinês | MEDLINE | ID: mdl-31460712

RESUMO

Sleep posture recognition is the core index of diagnosis and treatment of positional sleep apnea syndrome. In order to detect body postures noninvasively, we developed a portable approach for sleep posture recognition using BCG signals with their morphological difference. A type of piezo-electric polymer film sensor was applied to the mattress to acquire BCG, the discrete wavelet transform with cubic B-spline was used to extract characteristic parameters and a naive Bayes learning phase was adapted to predict body postures. Eleven healthy subjects participated in the sleep simulation experiments. The results indicate that the mean error obtained from heart rates was 0.04±1.3 beats/min (±1.96 SD). The final recognition accuracy of four basic sleep postures exceeded 97%, and the average value was 97.9%. This measuring system is comfortable and accurate, which can be streamlined for daily sleep monitoring application.


Assuntos
Leitos , Polissonografia , Postura , Síndromes da Apneia do Sono , Teorema de Bayes , Humanos , Polissonografia/instrumentação , Sono , Síndromes da Apneia do Sono/diagnóstico
8.
Artigo em Inglês | MEDLINE | ID: mdl-31295818

RESUMO

The improvement of sleep quality in patients with cancer has a positive therapeutic effect on them. However, there are no specific treatment guidelines for treating sleep disturbance in cancer patients. We investigated the effect of forest therapy on the quality of sleep in patients with cancer. This study was conducted on nine patients (one male, eight female; mean age, 53.6 ± 5.8 years) with gastrointestinal tract cancer. All patients participated in forest therapy for six days. They underwent polysomnography (PSG) and answered questionnaires on sleep apnea (STOP BANG), subjective sleep quality (Pittsburgh Sleep Quality Index, PSQI), sleepiness (Stanford and Epworth Sleepiness Scales), and anxiety and depression (Hospital Anxiety and Depression Scale) to evaluate the quality of sleep before and after forest therapy. Sleep efficiency from the PSG results was shown to have increased from 79.6 ± 6.8% before forest therapy to 88.8 ± 4.9% after forest therapy (p = 0.027) in those patients, and total sleep time was also increased, from 367.2 ± 33.4 min to 398 ± 33.8 min (p = 0.020). There was no significant difference in the STOP BANG score, PSQI scores, daytime sleepiness based on the results of the Stanford and Epworth Sleepiness Scales, and depression and anxiety scores. Based on the results of this study, we suggest that forest therapy may be helpful in improving sleep quality in patients with gastrointestinal cancers.


Assuntos
Florestas , Neoplasias Gastrointestinais/complicações , Terapia de Relaxamento/métodos , Síndromes da Apneia do Sono/terapia , Transtornos do Sono-Vigília/terapia , Sono/fisiologia , Sonolência , Adulto , Ansiedade/etiologia , Ansiedade/terapia , Depressão/etiologia , Depressão/terapia , Feminino , Neoplasias Gastrointestinais/fisiopatologia , Neoplasias Gastrointestinais/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Polissonografia , Síndromes da Apneia do Sono/diagnóstico , Síndromes da Apneia do Sono/psicologia , Transtornos do Sono-Vigília/diagnóstico , Transtornos do Sono-Vigília/psicologia , Fatores de Tempo , Resultado do Tratamento
9.
Rev Port Cardiol ; 38(6): 451-455, 2019 06.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31320221

RESUMO

INTRODUCTION: Sleep Apnea Syndrome (SAS) is a prevalent respiratory disease with marked expression in the population with cardiovascular disease. The diagnosis is based on polysomnography. In patients with cardiac implantable electronic devices (CIED), the prevalence of SAS may reach 60%. The objective of this study was to evaluate the value of DEC in the SAS screening. METHODS: Prospective study that included patients with CIED with sleep apnea algorithm. The frequency response function was activated and simplified polygraphy was performed. The data of the device were collected on the day of the polygraph. RESULTS: The sample included 29 patients, with a mean age of 76.1 years, 71.4% of the male gender. The prevalence of SAS was 77%. For SAS, the agreement between polysomnography and the Pacemaker was Kappa = 0.54 (p = 0.001), 95% CI (0.28, 0.81) (moderate agreement); for moderate to severe SAS, the agreement was Kappa = 0.73 (p <0.001), 95% CI (0.49, 0.976) (substantial agreement). Severe SAS was obtained: sensitivity 60%, specificity 100%, positive predictive value 100%, negative predictive value 60% and diagnostic accuracy 75%; for moderate to severe SAS: sensitivity of 90%, specificity of 83%, positive predictive values of 90% and negative of 87.5%, with a diagnostic accuracy of 87.5%. CONCLUSION: SAS is highly prevalent in patients with CIED. The values obtained through these devices have a strong positive correlation with the Apnea-Hypopnea Índex, which makes them a good tool for the screening of severe SAS.


Assuntos
Dispositivos de Terapia de Ressincronização Cardíaca/efeitos adversos , Insuficiência Cardíaca/terapia , Polissonografia/métodos , Síndromes da Apneia do Sono/diagnóstico , Idoso , Algoritmos , Feminino , Seguimentos , Humanos , Masculino , Valor Preditivo dos Testes , Estudos Prospectivos , Síndromes da Apneia do Sono/etiologia
10.
J Stroke Cerebrovasc Dis ; 28(9): 2481-2487, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31277996

RESUMO

The Goal: The aim of the study was to investigate whether stroke volume or the presence of ischemic stroke lesion on follow-up computed tomography 1 day after admission had association with sleep apnea among ischemic stroke patients undergoing thrombolysis. MATERIALS AND METHODS: We prospectively recruited 110 consecutive ischemic stroke patients and performed computed tomography on admission and after 24 hours after intravenous thrombolysis. Stroke volume was measured from post-thrombolysis computed tomography scans. Unattended cardiorespiratory polygraphy with a 3-channel device was performed during 48 hours after admission. FINDINGS: Of 110 ischemic stroke patients treated with thrombolysis 65.5% were men. Mean age was 65.8 years and body mass index 27.5 kg/m2. The mean Epworth sleepiness scale score was 4.7. Eight patients (12.7%) with visible acute stroke after thrombolysis and none in the other group had hemorrhage as complication (P ˂ .001). Sleep apnea, determined as a respiratory event index greater than or equal to 5/hour, was diagnosed in 96.4% patients. Respiratory event index greater than 15/h was found in 72.8% of patients. Both mean baseline oxygen desaturation index (23.9 versus 16.5, P = .028) and obstructive apneas/hour (6.2 versus 2.7, P = .007) were higher in visible stroke group. Stroke volume (mean 15.9 mL) correlated with proportion of time spent below saturation less than 90%, P = .025. CONCLUSIONS: Acute ischemic stroke patients treated with thrombolysis with visible stroke were more likely to have nocturnal hypoxemia than patients with not visible strokes. Stroke volume correlated with time spent below saturation of 90%.


Assuntos
Isquemia Encefálica/tratamento farmacológico , Fibrinolíticos/efeitos adversos , Hipóxia/etiologia , Síndromes da Apneia do Sono/etiologia , Acidente Vascular Cerebral/tratamento farmacológico , Terapia Trombolítica/efeitos adversos , Idoso , Idoso de 80 Anos ou mais , Isquemia Encefálica/complicações , Isquemia Encefálica/diagnóstico por imagem , Isquemia Encefálica/fisiopatologia , Feminino , Fibrinolíticos/administração & dosagem , Humanos , Hipóxia/diagnóstico , Hipóxia/fisiopatologia , Infusões Intravenosas , Pulmão/fisiopatologia , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Respiração , Fatores de Risco , Sono , Síndromes da Apneia do Sono/diagnóstico , Síndromes da Apneia do Sono/fisiopatologia , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/diagnóstico por imagem , Acidente Vascular Cerebral/fisiopatologia , Fatores de Tempo , Tomografia Computadorizada por Raios X , Resultado do Tratamento
11.
Acta Otolaryngol ; 139(9): 777-782, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31268404

RESUMO

Aims/objectives: To examine the effects of surgery for unilateral sinonasal lesions on sleep-disordered breathing (SDB). Material and methods: Oxygen desaturation index (3%ODI) as a marker of SDB and bilateral/unilateral nasal resistance were measured before and after surgery for 18 patients with unilateral sinonasal lesions. Various parameters were compared between those who achieved 60% or less decrease of 3%ODI and those who did not. Results: Bilateral nasal resistance as well as that of the surgical side five days after surgery was significantly lower than those of pre-operative value. Preoperative 3%ODI (times/hour) was 10.08 ± 7.32, which significantly decreased to 7.67 ± 5.79 five days after surgery. Even in unilateral patients, sinonasal surgery could reduce the bilateral nasal resistance, resulting in a decrease in 3%ODI. Age was younger and postoperative nasal resistance of the surgical side was significantly lower in the group who achieved 60% or less decrease in 3%ODI than those who did not. Conclusions and significance: SDB is influenced by even unilateral nasal obstruction. Surgery for unilateral lesion can improve the respiration during sleep as well as bilateral nasal resistance. Favorable outcome by surgery could be brought about in younger patients and those for whom sufficient improvement of nasal resistance was expected by surgery.


Assuntos
Obstrução Nasal/cirurgia , Procedimentos Cirúrgicos Nasais/métodos , Recuperação de Função Fisiológica/fisiologia , Síndromes da Apneia do Sono/etiologia , Adulto , Estudos de Coortes , Feminino , Seguimentos , Hospitais Universitários , Humanos , Masculino , Pessoa de Meia-Idade , Obstrução Nasal/complicações , Obstrução Nasal/diagnóstico , Polissonografia/métodos , Estudos Prospectivos , Medição de Risco , Índice de Gravidade de Doença , Síndromes da Apneia do Sono/diagnóstico , Resultado do Tratamento
12.
Rev Chil Pediatr ; 90(3): 309-315, 2019 Jun.
Artigo em Espanhol | MEDLINE | ID: mdl-31344191

RESUMO

INTRODUCTION: The early diagnosis of Sleep Disordered Breathing (SDB) may allow proper intervention. Currently, polygraphy (PG) is a reliable and accessible alternative. OBJECTIVE: To describe and analyze the PG of children > 1 year old with suspicion of SDB. PATIENTS AND METHOD: PG of children > 1 year old and adolescents from Concepcion, Chile, with suspected SDB were included, from December 2011 to Au gust 2017. Demographic, clinical and polygraphic variables were collected. It was used descriptive sta tistics, expressing results in median and range. The association between apnea-hypopnea index (AHI) and oxygen saturation was determined by Spearman's Rho, considering significance of p < 0.05. Re sults: 190 studies were analyzed. Age 7.9 years old (1.0-20.6), 61% males. DIAGNOSIS: neuromuscular disease (NMD) (24.2%), chronic lung damage (21.1%), upper airway obstruction (UAO) (19.5%), neurological damage (11%), Down syndrome (8.9%), upper airway malformations (7.4%), central hypoventilation (3.7%), obesity (2.6%), and others (1.6%). 55.3% were altered PG, with 53.3% of mild Obstructive Sleep Apnea Hypopnea Syndrome (OSAHS), 30.5% moderate, and 16.2% severe. There were no significant differences in AHI between groups of pathologies (p = 0.032), highlighting a higher AHI in obese patients 9 (0.41-51), and those with NMD 23.9 (0.4-36.6). It was found asso ciation between AHI and oxygen saturation parameters: mean saturation (rho = -0.425; p = 0.001), minimum (rho = -0.654; p = 0.001), and oxygen saturation below 90% (rho = 0.323; p = 0.001) in the whole sample. DISCUSSION: There was a high percentage of OSAHS in at-risk pediatric patients, especially in those with NMD and obesity. PG is an accessible and implementable tool in a public hospital, a situation that can potentially be extrapolated to other healthcare centers.


Assuntos
Polissonografia/métodos , Síndromes da Apneia do Sono/diagnóstico , Apneia Obstrutiva do Sono/diagnóstico , Adolescente , Criança , Pré-Escolar , Chile/epidemiologia , Feminino , Humanos , Lactente , Masculino , Doenças Neuromusculares/epidemiologia , Oxigênio/metabolismo , Obesidade Pediátrica/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Síndromes da Apneia do Sono/epidemiologia , Apneia Obstrutiva do Sono/epidemiologia
13.
Comput Methods Programs Biomed ; 176: 93-104, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31200916

RESUMO

BACKGROUND AND OBJECTIVE: Apnea is one of the most common conditions that causes sleep-disorder breathing. With growing number of patients worldwide, more and more patients suffer from complications of apnea. But most of them stay untreated due to the complex and time-consuming polysomnography (PSG) diagnosis method. Effective and precise diagnosis support system using electrocardiograph (ECG) is required. In this paper, we propose an approach using residual network to detect apnea based on RR intervals (intervals between R-peaks of ECG signal). METHODS: In our model, we apply residual network to represent information carried by RR intervals. Moreover, we proposed a novel perspective, called dynamic autoregressive representation, to provide interpretation of representing the RR intervals by convolutional layers. RESULTS: This approach is tested for per-segment apnea detection using publicly available dataset on Physionet. 30 overnight recordings are used for training and 5 for testing. We achieve a good result of 94.4% accuracy, 93.0% sensitivity and 94.9% specificity. This result outperform other prevalent methods based on RR intervals. This model also shows its good adaptivity while using ECG-derived respiration signal (EDR) in experiments. Its extensiveness is evaluated and compared in experiments. The proposed model is also compared with deep neural networks using original ECG signals for apnea detection, and it achieves better result using fewer input samples. CONCLUSIONS: We develop a deep residual network to detect apnea on low-sample-rate RR intervals. The result suggests a possibility of representing RR intervals by neural network. The model showed strong adaptivity when using EDR input.


Assuntos
Eletrocardiografia , Processamento de Sinais Assistido por Computador , Síndromes da Apneia do Sono/diagnóstico , Adulto , Algoritmos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polissonografia , Reprodutibilidade dos Testes , Respiração , Sensibilidade e Especificidade , Máquina de Vetores de Suporte
14.
HNO ; 67(9): 670-678, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31190193

RESUMO

BACKGROUND: Acoustic snoring sound analysis is a noninvasive method for diagnosis of the mechanical mechanisms causing snoring that can be performed during natural sleep. The objective of this work is development and evaluation of classification schemes for snoring sounds that can provide meaningful diagnostic support. MATERIALS AND METHODS: Based on two annotated snoring noise databases with different classifications (s-VOTE with four classes versus ACLTE with five classes), identically structured machine classification systems were trained. The feature extractor openSMILE was used in combination with a linear support vector machine for classification. RESULTS: With an unweighted average recall (UAR) of 55.4% for the s­VOTE model and 49.1% for the ACLTE, the results are at a similar level. In both models, the best differentiation is achieved for epiglottic snoring, while velar and oropharyngeal snoring are more often confused. CONCLUSION: Automated acoustic methods can help diagnose sleep-disordered breathing. A reason for the restricted recognition performance is the limited size of the training datasets.


Assuntos
Aprendizado de Máquina , Síndromes da Apneia do Sono , Ronco , Humanos , Ruído , Síndromes da Apneia do Sono/diagnóstico , Ronco/classificação , Espectrografia do Som
15.
Rom J Ophthalmol ; 63(1): 2-9, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31198891

RESUMO

The purpose of this paper is to review the association between a medical entity called the floppy eyelid syndrome (FES) and a very serious respiratory disease with repercussions on various other body organs and systems: the obstructive sleep apnea syndrome. The epidemiology, pathophysiology, and treatment of these two diseases are intertwined but still not enough recognized. Eye disorders affect a great number of patients in modern societies and the cause of their suffering is often left undiscovered, practitioners preferring a symptomatic treatment. However, the ophthalmologist should be aware of the possibility of a sleep disorder in their patients with certain pathologies, as well as sleep physicians, who should be aware of the possibility of eye problems and refer them for a checkup. Finally, a review of literature is undergone, evaluating the possibility that the treatment of one or the other disease may benefit both.


Assuntos
Doenças Palpebrais/etiologia , Síndromes da Apneia do Sono/complicações , Doenças Palpebrais/diagnóstico , Doenças Palpebrais/epidemiologia , Saúde Global , Humanos , Incidência , Polissonografia , Fatores de Risco , Síndromes da Apneia do Sono/diagnóstico , Síndrome , Lágrimas/metabolismo
16.
Diabetes Res Clin Pract ; 152: 16-22, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31078669

RESUMO

OBJECTIVE: To estimate the prevalence of Obstructive Sleep Apnea (OSA) among patients with type 2 Diabetes Mellitus (T2DM) in Jordan, and to explore the association between sleep apnea and clinical and demographic variables. METHOD: A cross-sectional study was carried out from the 1st of November 2011 to the 1st of February 2012 on 1143 patients with T2DM (aged 30-90 years) at the National Center for Diabetes, Endocrinology, and Genetics (NCDEG). The center is considered to be the only referral center in the country and accordingly, the patients represent the population in different parts of the country. All participants completed the Arabic version of the Berlin Questionnaire and were categorized as either low or high-risk patients for OSA. RESULTS: A total of 1143 patients with T2DM were included in this study. There were 587 (51.4%) males and 556 (48.6%) females. The findings showed that 554 (48.5%) patients were at high risk for OSA and 589 (51.5%) were low risk for OSA. Logistic regression analysis revealed that age, smoking, and neck circumference were significantly correlated with high risk for OSA. The clinical and demographic variables were also collected for analysis. CONCLUSIONS: The study found that high risk for OSA was highly prevalent among Jordanian patients with T2DM and that age, smoking and neck circumference were significantly correlated with OSA. Health care providers should be made aware of the high prevalence of sleep problems affecting patients with diabetes and should consider the appropriate screening and treatment for these patients, therefore improving their quality of life.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Apneia Obstrutiva do Sono/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Diabetes Mellitus Tipo 2/complicações , Feminino , Humanos , Jordânia/epidemiologia , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Prevalência , Qualidade de Vida , Fatores de Risco , Síndromes da Apneia do Sono/complicações , Síndromes da Apneia do Sono/diagnóstico , Síndromes da Apneia do Sono/epidemiologia , Apneia Obstrutiva do Sono/complicações , Apneia Obstrutiva do Sono/diagnóstico , Inquéritos e Questionários
17.
Orv Hetil ; 160(20): 780-783, 2019 May.
Artigo em Húngaro | MEDLINE | ID: mdl-31081357

RESUMO

Introduction: Numerous data suggest that episodes of breathing disorder during sleep are closely related to chronic cardiovascular and mental illnesses. Aim: In this study, we sought to find out how the decrease in oxygen saturation level and its duration during sleep are affected by the degree of depression and its extent. Method: Data of 76 persons were processed in the study. The oxygen saturation measured during sleep was obtained from data from a polysomnographic filter device. Data collection for depression symptoms was done with a validated questionnaire. The decrease of night oxygen saturation on the effect of the disease was illustrated by the odds ratio calculation. Results: The value below 90% of the average oxygen saturation during sleep time will more than double the risk of developing depression. It is also a risk factor for the severity of depression. Examining the duration of sleep time at reduced saturation, it mainly increases the chance of severe depression. Conclusions: Hypoxia during sleep and duration of hypoxic periods are a risk factor for the development of depression with therapeutic and diagnostic consequences. Orv Hetil. 2019; 160(20): 780-783.


Assuntos
Depressão/complicações , Oxigênio/sangue , Síndromes da Apneia do Sono/diagnóstico , Apneia Obstrutiva do Sono/complicações , Sono/fisiologia , Depressão/psicologia , Humanos , Consumo de Oxigênio/fisiologia , Polissonografia/métodos
18.
Sensors (Basel) ; 19(9)2019 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-31072036

RESUMO

There exists a technological momentum towards the development of unobtrusive, simple, and reliable systems for long-term sleep monitoring. An off-the-shelf commercial pressure sensor meeting these requirements is the Emfit QS. First, the potential for sleep apnea screening was investigated by revealing clusters of contaminated and clean segments. A relationship between the irregularity of the data and the sleep apnea severity class was observed, which was valuable for screening (sensitivity 0.72, specificity 0.70), although the linear relation was limited ( R 2 of 0.16). Secondly, the study explored the suitability of this commercial sensor to be merged with gold standard polysomnography data for future sleep monitoring. As polysomnography (PSG) and Emfit signals originate from different types of sensor modalities, they cannot be regarded as strictly coupled. Therefore, an automated synchronization procedure based on artefact patterns was developed. Additionally, the optimal position of the Emfit for capturing respiratory and cardiac information similar to the PSG was identified, resulting in a position as close as possible to the thorax. The proposed approach demonstrated the potential for unobtrusive screening of sleep apnea patients at home. Furthermore, the synchronization framework enabled supervised analysis of the commercial Emfit sensor for future sleep monitoring, which can be extended to other multi-modal systems that record movements during sleep.


Assuntos
Balistocardiografia/instrumentação , Programas de Rastreamento , Monitorização Fisiológica/instrumentação , Síndromes da Apneia do Sono/diagnóstico , Síndromes da Apneia do Sono/fisiopatologia , Sono/fisiologia , Algoritmos , Artefatos , Eletrocardiografia , Feminino , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Polissonografia , Respiração , Processamento de Sinais Assistido por Computador
19.
Sensors (Basel) ; 19(11)2019 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-31141955

RESUMO

Even for 1-lead electrocardiography (ECG), single-use gel conductive electrodes are employed in a clinical setting. However, gel electrodes show limited applicability for long-term monitoring due to skin irritation and detachment. In the present study, we investigated the validity of a textile ECG-belt suitable for long-term measurements in clinical use. In order to assess the signal quality and validity of the ECG-belt during sleep, 242 patients (186 males and 56 females, age 52 (interquartile range 42-60) years, body mass index 29 (interquartile range 26-33) kg·m-2) with suspected sleep apnoea underwent overnight polysomnography including standard 1-lead ECG recording. The single intervals between R-peaks (RR-intervals) were calculated from the ECG-signals. We found a mean difference for average RR-intervals of -2.9 ms, a standard error of estimate of 0.39%, as well as a Pearson r of 0.91. Furthermore, we found that the validity of the ECG-belt decreases when lying on the side, which was potentially due to the fitting of the belt. In conclusion, the validity of RR-interval measurements using the ECG-belt is high and it may be further improved for future applications by optimizing wear fitting.


Assuntos
Eletrocardiografia , Monitorização Fisiológica , Têxteis , Adulto , Artefatos , Eletrodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Postura , Razão Sinal-Ruído , Síndromes da Apneia do Sono/diagnóstico , Análise de Ondaletas
20.
Tuberk Toraks ; 67(1): 47-54, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31130135

RESUMO

Introduction: Sleep deprivation is known to increase the risks for workplace accidents, neuro-behavioural symptoms and reduced quality of life. Shift work leads to sleep related problems, such as sleep deprivation, poor sleep quality and daytime sleepiness. The purpose of our study is to assess snoring prevalence and obstructive sleep apnoea risk among healthcare workers (HCWs) by using the Berlin Questionnaire. Materials and Methods: HCWs employed at different centres that agreed to take part in this study were enrolled. Employing the Berlin Questionnaire, demographic characteristics, smoking histories, comorbidities, on-call shifts, number of on-call shifts and sleep durations of the participants were surveyed. Result: 604 HCWs including specialist, nurse, junior doctor, medical student, clinical academic, health technician and hospital staff were enrolled in this study. In terms of sleep apnoea, 92 (15.1%) participants were identified as high-risk and 512 (84.8%) as low-risk according to the findings of the questionnaire. When the two groups identified as high and low risk for sleep apnoea according to the Berlin Questionnaire were compared, significant differences were found between the two groups in terms of age, sex, height, weight, BMI value and hypertension (p< 0.001 for all variables). Multivariate logistic regression analysis has shown that on-call shifts (OR= 0.199, CI= 0.053-0.747, p= 0.017) are negative associated with sleep apnoea risk. Conclusions: With extended working hours and on-call shifts increasing the risk of sleep disorders among HCWs, surveys designed for screening can be used to identify the prospective cases in this population for further examination.


Assuntos
Pessoal de Saúde/estatística & dados numéricos , Qualidade de Vida , Medição de Risco/métodos , Síndromes da Apneia do Sono/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Peso Corporal , Comorbidade , Estudos Transversais , Feminino , Humanos , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Síndromes da Apneia do Sono/diagnóstico , Inquéritos e Questionários , Turquia/epidemiologia , Adulto Jovem
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