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1.
Medicina (Kaunas) ; 59(1)2023 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-36676751

RESUMO

Objectives: The transphenoidal bi-nostril endoscopic resection of pituitary adenomas is regarded as a minimally invasive treatment nowadays. However, sino-nasal outcome and health-related quality of life (HRQoL) might still be impaired after the adenomectomy, depending on patients' prior medical history and health status. A systematic postoperative comparison is required to assess differences in perceived sino-nasal outcome and HRQoL. Methods: In this single-center observational study, we collected data from 81 patients, operated between August 2016 and August 2021, at a 3-6-month follow-up after adenomectomy. We employed the sino-nasal outcome test for neurosurgery (SNOT-NC) and the HRQoL inventory Short Form (SF)-36 to compare sino-nasal and HRQoL outcome in patients with or without allergies, previous nose surgeries, presence of pain, snoring, sleep apnea, usage of continuous positive airway pressure (cpap), and nose drop usage. Results: At the 3-6-month follow-up, patients with previous nasal surgery showed overall reduced subjective sino-nasal health, increased nasal and ear/head discomfort, increased visual impairment, and decreased psychological HRQoL (all p ≤ 0.026) after pituitary adenomectomy. Patients with pain before surgery showed a trend-level aggravated physical HRQoL (p = 0.084). Conclusion: Our data show that patients with previous nasal surgery have an increased risk of an aggravated sino-nasal and HRQoL outcome after pituitary adenomectomy. These patients should be thoroughly informed about potential consequences to induce realistic patient expectations. Moreover, the study shows that patients with moderately severe allergies, snoring, and sleep apnea (± cpap) usually do not have to expect a worsened sino-nasal health and HRQoL outcome.


Assuntos
Hipersensibilidade , Neoplasias Hipofisárias , Síndromes da Apneia do Sono , Humanos , Qualidade de Vida , Ronco , Resultado do Tratamento , Neoplasias Hipofisárias/cirurgia , Dor
2.
Respirology ; 28(2): 110-119, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36617387

RESUMO

Primary snoring impacts a significant portion of the adult population and has the potential to significantly impair quality of life. The purpose of these guidelines is to provide evidence-based recommendations to assist Australasian practitioners in the management of adult patients who present with primary snoring without significant obstructive sleep apnoea. The Timetable, Methodology and Standards by which this Position Statement has been established is outlined in the Appendix S1. The main recommendations are: Weight loss, and reduced alcohol consumption should be recommended, where appropriate If clinical judgement dictates, benzodiazepine and opioid reduction or avoidance may be advised Positional therapy should be considered in supine dominant snorers In dentate patients, Mandibular advancement devices (MAD) should be recommended as a first line treatment following assessment by both an appropriate Dentist and Sleep physician Continuous positive airway pressure (CPAP) devices may be recommended in patients with primary snoring in those already committed to their use or willing to try Surgical treatment of primary snoring by an appropriately credentialled surgeon may be advised and includes nasal (adjunctive), palatal and other interventions This position statement has been designed based on the best available current evidence and our combined expert clinical experience to facilitate the management of patients who present with primary snoring. It provides clinicians with a series of both non-surgical and surgical options with the aim of achieving optimal symptom control and patient outcomes. This is the first such set of recommendations to be established within Australasia and has also been reviewed and endorsed by the Australasian Sleep Association.


Assuntos
Avanço Mandibular , Ronco , Adulto , Humanos , Ronco/etiologia , Ronco/terapia , Consenso , Qualidade de Vida , Avanço Mandibular/métodos , Sono
3.
JAMA ; 329(2): 169-170, 2023 01 10.
Artigo em Inglês | MEDLINE | ID: mdl-36625823

RESUMO

A 50-year-old patient with epilepsy, hypertension, loud snoring, recent 50-lb weight gain, and abrupt awakenings with a feeling of breathlessness but no headaches or excessive daytime sleepiness presented with concerns. What would you do next?


Assuntos
Técnicas de Diagnóstico do Sistema Respiratório , Monitorização Ambulatorial , Apneia Obstrutiva do Sono , Humanos , Sono , Síndromes da Apneia do Sono/diagnóstico , Apneia Obstrutiva do Sono/diagnóstico , Ronco/etiologia
4.
Sleep Med ; 101: 414-420, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36516525

RESUMO

BACKGROUND: Snoring may play an important role in a variety of diseases, especially metabolic diseases. However, there are no reports on the relationship between snoring and the risk of metabolic-associated fatty liver disease (MAFLD). This study aimed to investigate the association between snoring and MAFLD. METHODS: A cross-sectional analysis was performed based on the National Health and Nutrition Examination Survey (NHANES) 2017-2018. Self-reported snoring frequency was grouped into four categories (never, rarely, occasionally, and frequently). MAFLD was diagnosed based on the evidence of hepatic steatosis and any of the following three conditions: overweight/obesity, diabetes mellitus or metabolic dysfunction. Logistic regression with sampling weights was used to examine the association between snoring and MAFLD. RESULTS: A total of 5016 patients were included, and 50.14% of individuals had MAFLD. Compared with nonsnorers, those who snored frequently were associated with increased odds for MAFLD (odds ratio (OR): 1.376, 95% confidence interval (CI): 1.122-1.688, p trend <0.001). The subgroup analyses suggested that no significant interactions were found between snoring and other potential effect modifiers, including age, sex, body mass index (BMI), smoking status, chronic obstructive pulmonary disease (COPD) and hypertension. CONCLUSION: Snoring was independently and positively associated with a higher prevalence of MAFLD, suggesting that attention to snoring may contribute to the early detection of MAFLD.


Assuntos
Hepatopatia Gordurosa não Alcoólica , Ronco , Humanos , Estudos Transversais , Autorrelato , Inquéritos Nutricionais , Ronco/complicações , Ronco/epidemiologia , Hepatopatia Gordurosa não Alcoólica/complicações , Hepatopatia Gordurosa não Alcoólica/epidemiologia
5.
Sleep Med ; 101: 468-477, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36521367

RESUMO

STUDY OBJECTIVES: Obstructive sleep disordered breathing (SDB), has adverse neurocognitive and behavioral sequelae in children, despite conventional measures of sleep disruption being unaffected. There is growing evidence that sleep spindles may serve as a more sensitive marker of sleep quality. We investigated the relationship between sleep spindles and sleep fragmentation and neurocognition across the spectrum of SDB severity in children. METHODS: Children 3-12 years old referred for clinical assessment of SDB and age matched control children from the community were recruited and underwent polysomnography. Sleep spindles were identified manually during N2 and N3 sleep. Spindle activity was characterised as spindle number, density (number of spindles/h) and intensity (spindle density x average spindle duration). Children completed a battery of tests assessing global intellectual ability, language, attention, visuospatial ability, sensorimotor skills, adaptive behaviors and skills and problem behaviors and emotional difficulties. RESULTS: Children were grouped into control, Primary Snoring, Mild OSA and Moderate/severe OSA, N = 10/group. All measures of spindle activity were lower in the SDB groups compared to the Control children and this reached statistical significance for Mild OSA (p < 0.05 for all). Higher spindle indices were associated with better performance on executive function and visual ability assessments but poorer performance on auditory attention and communication skills. Higher spindle indices were associated with better behavior. CONCLUSION: The reduced spindle activity observed in the children with SDB, particularly Mild OSA, indicates that sleep micro-architecture is disrupted and that this disruption may underpin the negative effects of SDB on attention, learning and memory.


Assuntos
Síndromes da Apneia do Sono , Apneia Obstrutiva do Sono , Criança , Humanos , Pré-Escolar , Sono , Polissonografia , Ronco
6.
J Hypertens ; 41(1): 63-73, 2023 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-36129105

RESUMO

OBJECTIVE: The purpose of research is to investigate the associations of sleep factors separately and jointly with risk of hypertension. METHODS: The National Health and Nutrition Examination Surveys (NHANES) is a nationally representative survey. Participants aged over 20 years with complete and credible data from the NHANES 2015-2016 and 2017-2018 waves were included. Hypertension was assessed based on self-report medical diagnoses, or antihypertensive medication use, or systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg. Sleep information (sleep duration, trouble sleeping, daytime sleepiness, self-reported snoring and sleep-related breathing issue) was obtained from household interview. RESULTS: Of 7426 participants, the mean (standard deviation) age was 48.0 (17.3) years, 3845 (51.8%) were females. The prevalence of hypertension was 32.8%, and lower in those with 7-9 h sleep, no trouble sleeping, no excessive daytime sleepiness, no snoring or sleep apnea symptoms, decreased as the quantity of healthy sleep factors increased. The self-reported short sleep (odds ratio [OR]: 1.25, 95% confidence interval [CI]: 1.02-1.54, P  = 0.032), trouble sleeping (OR: 1.53, 95% CI: 1.20 to 1.95, P  = 0.001), excessive daytime sleepiness (OR: 1.17, 95% CI: 1.01-1.35, P  = 0.041) and sleep apnea symptoms (OR: 1.33, 95% CI: 1.10-1.61, P  = 0.004) were associated with 25%, 53%, 17% and 33% increased risk of hypertension, respectively. Participants with a poor sleep pattern was associated with higher hypertension risk (OR: 2.47, 95% CI: 1.90-3.22, P  < 0.001). CONCLUSION: Sleep behaviors were cross-sectionally associated with a considerably higher hypertension risk.


Assuntos
Distúrbios do Sono por Sonolência Excessiva , Hipertensão , Síndromes da Apneia do Sono , Transtornos do Sono-Vigília , Adulto , Feminino , Estados Unidos/epidemiologia , Humanos , Pessoa de Meia-Idade , Masculino , Inquéritos Nutricionais , Fatores de Risco , Hipertensão/diagnóstico , Ronco/complicações , Ronco/epidemiologia , Sono , Distúrbios do Sono por Sonolência Excessiva/complicações , Distúrbios do Sono por Sonolência Excessiva/diagnóstico , Síndromes da Apneia do Sono/complicações , Síndromes da Apneia do Sono/epidemiologia , Transtornos do Sono-Vigília/complicações , Transtornos do Sono-Vigília/epidemiologia , Inquéritos e Questionários
7.
Rev. Odontol. Araçatuba (Impr.) ; 43(3): 61-67, set.-dez. 2022. tab
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1381326

RESUMO

Atualmente, o tratamento do ronco primário e da Síndrome da Apnéia/Hipopnéia Obstrutiva do Sono (SAHOS)1 através de aparelhos intra-orais (AIO) tem recebido a atenção dos pesquisadores pela comprovada eficácia destes dispositivos. Os aparelhos mais indicados são os reposicionadores de mandíbula que promovem um avanço mandibular, afastando os tecidos da orofaringe superior, o que evita a obstrução parcial ou total da área. Sua indicação é para casos de ronco primário e apnéias leves e moderadas2, no entanto é necessário que os candidatos apresentem número de dentes suficientes com saúde periodontal para a ancoragem do aparelho. Por ser uma doença de consequências sistêmicas graves, o tratamento da SAHOS é em sua essência de responsabilidade do médico especialista na área, porém o cirurgião dentista deve ter conhecimento para diagnosticar e tratar, quando o AIO for a opção terapêutica. A interpretação da polissonografia, exame que diagnostica e conduz para a escolha correta do tratamento, e dos dados cefalométricos são os principais quesitos ao Cirurgião Dentista que se propõe a tratar portadores da SAHOS. Nesse trabalho foi elaborado um questionário e aplicado aos cirurgiões dentistas de três diferentes cidades do Estado de São Paulo para que fosse possível avaliar o conhecimento desses profissionais a respeito do diagnóstico e tratamento da SAHOS. 70 Cirurgiões Dentistas foram entrevistados e os resultados mostraram que 70% destes têm interesse em trabalhar com os AIOs. Esse grupo se relacionou estatisticamente significante com aqueles que afirmaram já terem sido alguma vez questionado por algum paciente a respeito desse tratamento. Quanto à criação de uma especialidade para essa área, os profissionais da área de prótese e implante se mostraram mais interessados. E, do número total de entrevistados, apenas 25% já tiveram contato com esse tipo de aparelho, mas não conhece o protocolo de atendimento para o tratamento desses pacientes(AU)


Currently, the treatment of primary snoring and Obstructive Sleep Apnea/Hypopnea Syndrome (OSAHS)1 through intraoral appliances (OA) has received the attention of researchers due to the proven effectiveness of these devices. The most suitable devices are jaw repositioning devices that promote mandibular advancement, moving the tissues away from the upper oropharynx, which prevents partial or total obstruction of the area. Its indication is for cases of primary snoring and mild to moderate apnea2, however it is necessary that candidates have a sufficient number of teeth with periodontal health to anchor the appliance. As it is a disease with serious systemic consequences, the treatment of OSAHS is, in essence, the responsibility of the specialist in the area, but the dental surgeon must have the knowledge to diagnose and treat, when OA is the therapeutic option. The interpretation of polysomnography, na exam that diagnoses and leads to the correct choice of treatment, and cephalometric data are the main requirements for the Dental Surgeon who proposes to treat patients with OSAHS. In this work, a questionnaire was developed and applied to dentalsurgeons from three different cities in the State of São Paulo so that it was possible to assess the knowledge of these professionals regarding the diagnosis and treatment of OSAHS. 70 Dental Surgeons were interviewed and the results showed that 70% of them are interested in working with AIOs. This group had a statistically significant relationshipwith those who stated that they had already been asked by a patient about this treatment. Regarding the creation of a specialty for this area, professional in the area of ??prosthesis and implant were more interested. And, of the total number of respondents, only 25% have already had contact with this type of device, but do not know the care protocol for the treatment of these patients(AU)


Assuntos
Apneia Obstrutiva do Sono , Apneia Obstrutiva do Sono/terapia , Apneia Obstrutiva do Sono/diagnóstico por imagem , Modelos Dentários , Ronco , Polissonografia , Avanço Mandibular , Odontólogos
8.
Sensors (Basel) ; 22(23)2022 Nov 29.
Artigo em Inglês | MEDLINE | ID: mdl-36501996

RESUMO

Sleep accounts for one-third of an individual's life and is a measure of health. Both sleep time and quality are essential, and a person requires sound sleep to stay healthy. Generally, sleep patterns are influenced by genetic factors and differ among people. Therefore, analyzing whether individual sleep patterns guarantee sufficient sleep is necessary. Here, we aimed to acquire information regarding the sleep status of individuals in an unconstrained and unconscious state to consequently classify the sleep state. Accordingly, we collected data associated with the sleep status of individuals, such as frequency of tosses and turns, snoring, and body temperature, as well as environmental data, such as room temperature, humidity, illuminance, carbon dioxide concentration, and ambient noise. The sleep state was classified into two stages: nonrapid eye movement and rapid eye movement sleep, rather than the general four stages. Furthermore, to verify the validity of the sleep state classifications, we compared them with heart rate.


Assuntos
Fases do Sono , Ronco , Humanos , Fases do Sono/fisiologia , Sono REM/fisiologia , Sono , Inconsciência
9.
Artigo em Inglês | MEDLINE | ID: mdl-36554323

RESUMO

Hypoglossal nerve stimulation (HGNS) is a therapeutic option for patients with obstructive sleep apnea (OSA) and intolerance of positive airway pressure (PAP) therapy. Most reported data are based on multicentre pivotal trials with selected baseline core clinical features. Our aim was to investigate polysomnography (PSG)-based outcomes of HGNS-therapy in a patient cohort with higher average AHI and BMI than previously reported. Data of 29 consecutive patients (nine female; mean age: 55.52 ± 8.6 years, mean BMI 30.13 ± 3.93 kg/m2) were retrospectively evaluated. Numerical values of PSG- based metrics were compared before and after intervention using Wilcoxon's rank-sum test. AHI (38.57/h ± 12.71, 24.43/h ± 13.3, p < 0.001), hypopnea index (24.05/h ± 9.4, 15.27/h ± 8.23, p < 0.001), apnea index (14.5/h ± 12.05, 9.17/h ± 10.86, p < 0.01), snoring index (262.68/h ± 170.35, 143.48/h ± 162.79, p < 0.001), cortical arousal index (20.8/h ± 10.34 vs. 14.9/h ± 8.36, p < 0.01) and cumulative duration of apnea and hypopnea during sleep (79.79 min ± 40.32 vs. 48.62 min ± 30.56, p < 0.001) were significantly lower after HGNS. HGNS provides an effective therapy option for selected patients not tolerating PAP-therapy with higher average AHI and BMI than usually reported. HGNS-therapy appears to suppress central nervous system arousal circuits while not eliciting peripheral autonomous sympathetic activation. Such metrics as the snoring index and the cumulative duration of respiratory events during sleep may be considered in future HGNS studies.


Assuntos
Terapia por Estimulação Elétrica , Apneia Obstrutiva do Sono , Humanos , Feminino , Pessoa de Meia-Idade , Nervo Hipoglosso/fisiologia , Ronco , Estudos Retrospectivos , Apneia Obstrutiva do Sono/terapia
10.
Artigo em Chinês | MEDLINE | ID: mdl-36543398

RESUMO

Objective:To investigate the effect of orofacial myofunctional therapy on the clinical efficacy of upper airway surgery for adults with severe obstructive sleep apnea(OSA). Methods:A total of 48 patients with OSA who underwent upper airway surgery in the Shenzhen Second People's Hospital from June 2020 to September 2021 were included in this study. These patients were randomly divided into the combination group(21 cases) and the surgery group(27 cases). The effective rate, AHI, minimum blood oxygen saturation, snoring events and Epworth sleepiness scale scores at 6 months after operation were compared and analyzed between the two groups. Results:The proportions of AHI, LSaO2, snoring events, and total snoring time in the combined group at 6 months after operation were(14.77±9.15) times/h, (81.19±6.52)%, (172.43±73.67) times, and(13.16±6.02)%. The proportion of AHI, LSaO2, snoring events, and total snoring time in surgical group at 6 months after operation was(23.87±10.6) times/h, (80.78±4.88)%, (235.81±83.23) times, (17.58±5.94)%. Compared with preoperative 6 months after operation, the proportion of AHI, snoring events, and total snoring time was significantly decreased, and LSaO2was significantly increased, and the differences were statistically significant(P<0.05). The time of snoring and the proportion of snoring to time were significantly improved compared with those in the simple operation group, and the differences were statistically significant(P<0.05). Conclusion:This study verified that orofacial myofunctional therapy can improve the clinical efficacy after upper airway surgery for adults with severe obstructive sleep apnea.


Assuntos
Apneia Obstrutiva do Sono , Ronco , Humanos , Adulto , Ronco/cirurgia , Apneia Obstrutiva do Sono/terapia , Terapia Miofuncional , Polissonografia , Nariz
11.
Laryngorhinootologie ; 101(12): 997-1011, 2022 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-36513091

RESUMO

Sleep-related breathing disorders can be divided into obstructive and central sleep apnea, and hypoventilation syndromes. The diagnosis is made according to an algorithm in which clinical symptoms and a polygraphy or polysomnography usually point the way. After initial diagnosis of the most common obstructive sleep apnea, conservative therapies such as positive airway pressure therapy (PAP therapy), positional therapy, and/or mandibular advancement splint are used in many cases, supplemented by treatment of risk factors. If PAP therapy is not possible, more detailed diagnosis of airway obstruction, often with sleep videoendoscopy, is required. In general, "muscle-sparing" surgical techniques such as tonsillectomy with uvulapalatopharyngoplasty (TE-UPPP) should be considered whenever possible. This is especially important in the surgical treatment of snoring. More surgical therapy alternatives are for example barbed wire pharyngoplasty, tongue pacemaker and bimaxillary advancement. Optimal therapy alternatives should be evaluated in a sleep medicine center.


Assuntos
Apneia Obstrutiva do Sono , Tonsilectomia , Humanos , Polissonografia , Apneia Obstrutiva do Sono/diagnóstico , Apneia Obstrutiva do Sono/cirurgia , Ronco/cirurgia , Sono
12.
Clinics (Sao Paulo) ; 77: 100131, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36334493

RESUMO

PURPOSE: To determine the clinical and anatomical characteristics associated with obstructive sleep apnea severity in children with adenotonsillar hypertrophy. METHODS: The authors conducted a cross-sectional multidisciplinary survey and selected 58 Brazilian children (4‒9 years old) with adenotonsillar hypertrophy, parental complaints of snoring, mouth-breathing, and witnessed apnea episodes. The authors excluded children with known genetic, craniofacial, neurological, or psychiatric conditions. Children with a parafunctional habit or early dental loss and those receiving orthodontic treatment were not selected. All children underwent polysomnography, and three were excluded because they showed an apnea-hypopnea index lower than one or minimal oxygen saturation higher than 92%. The sample consisted of 55 children classified into mild (33 children) and moderate/severe (22 children) obstructive sleep apnea groups. Detailed clinical and anatomical evaluations were performed, and anthropometric, otorhinolaryngological, and orthodontic variables were analyzed. Sleep disorder symptoms were assessed using the Sleep Disturbance Scale for Children questionnaire. All children also underwent teleradiography exams and Rickett's and Jarabak's cephalometric analyses. RESULTS: The mild and moderate/severe obstructive sleep apnea groups showed no significant differences in clinical criteria. Facial depth angle, based on Ricketts cephalometric analysis, was significantly different between the groups (p = 0.010), but this measurement by itself does not express the child's growth pattern, as it is established by the arithmetic mean of the differences between the obtained angles and the normal values of five cephalometric measurements. CONCLUSIONS: The clinical criteria and craniofacial characteristics evaluated did not influence the disease severity.


Assuntos
Apneia Obstrutiva do Sono , Humanos , Pré-Escolar , Criança , Estudos Transversais , Apneia Obstrutiva do Sono/diagnóstico , Ronco , Polissonografia , Hipertrofia
13.
Sci Rep ; 12(1): 18317, 2022 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-36316431

RESUMO

Researchers have identified an association between lifestyle factors and colorectal cancer (CRC) risk. This study examined the relationship between sleep patterns and CRC events. 392,252 individuals were sampled from the UK Biobank. Chronotype, sleep duration, insomnia, snoring, and excessive daytime sleepiness were combined to measure a healthy sleep score. A number of healthy sleep factors were defined, along with factors for healthy lifestyle scores. Using Cox proportional hazards regression, computed hazard ratios (HRs) were used to examine the associations between sleep patterns, healthy lifestyles, and the incidence of CRC. Healthy sleep scores were inversely associated with CRC events. The HRs for CRC were 0.90 (95% CI, 0.88-0.92) and 0.95 (95% CI, 0.92-0.98) for a 1-point healthy sleep score increase among males and females. When analyzing sleep components, sleeping 7-8 h/day, no frequent insomnia, no snoring, and no frequent daytime sleepiness were independently associated with a 9%, 14%, 8%, and 14% lower risk of CRC, respectively, whilst healthy lifestyle scores were inversely associated with CRC incidence across all models. Sleep pattern and lifestyle are significantly correlated with CRC risk. The healthier the subject's lifestyle and sleep pattern, the lower their CRC risk.


Assuntos
Neoplasias Colorretais , Distúrbios do Sono por Sonolência Excessiva , Distúrbios do Início e da Manutenção do Sono , Masculino , Feminino , Humanos , Distúrbios do Início e da Manutenção do Sono/complicações , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Incidência , Sono , Estilo de Vida Saudável , Ronco/epidemiologia , Neoplasias Colorretais/epidemiologia , Fatores de Risco
14.
BMJ Open ; 12(11): e063676, 2022 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-36319053

RESUMO

OBJECTIVES: Given the role of intraocular pressure in glaucoma, the patient's sleeping pattern might contribute to the development and progression of glaucoma. We performed a study to understand the association between sleep behaviours and glaucoma. DESIGN: Our study was a prospective cohort study. SETTING: This was a prospective cohort study in the UK Biobank. Self-reported data on five sleep behaviours were collected using a questionnaire at baseline. We identified four sleep patterns based on a cluster analysis of the sleep behaviours. PARTICIPANTS: In the UK Biobank, 409 053 participants were recruited between 2006 and 2010 and followed for a diagnosis of glaucoma. We identified glaucoma as any hospital admission with a diagnosis of glaucoma, based on UK Biobank inpatient hospital data. Individuals who withdrew from the UK Biobank, or were diagnosed with glaucoma before recruitment, or had self-reported surgery or laser treatment for glaucoma, or had no information on sleep behaviors were excluded. PRIMARY AND SECONDARY OUTCOME MEASURES: We estimated hazard ratios (HRs) with 95% confidence intervals (CI) using Cox proportional hazards models to estimate the associations of different sleep behaviors, as well as identified sleep patterns, with the risk of glaucoma, adjusting for multiple confounders. RESULTS: Compared with individuals who had a healthy sleep pattern, an excess risk of any glaucoma was observed among individuals with snoring and daytime sleepiness (HR 1.11, 95% CI 1.03 to 1.19) or insomnia and short/long sleep duration (HR 1.13, 95% CI 1.06 to 1.20), but not late chronotype sleep pattern (HR 0.98, 95% CI 0.93 to 1.03). CONCLUSION: Snoring, daytime sleepiness, insomnia, and short/long duration, individually or jointly, were all associated with the risk of glaucoma. These findings underscore the need for sleep intervention for individuals at high risk of glaucoma as well as potential ophthalmologic screening among individuals with chronic sleep problems for glaucoma prevention.


Assuntos
Distúrbios do Sono por Sonolência Excessiva , Glaucoma , Distúrbios do Início e da Manutenção do Sono , Transtornos do Sono-Vigília , Humanos , Ronco , Estudos Prospectivos , Bancos de Espécimes Biológicos , Sono , Reino Unido
15.
Sci Rep ; 12(1): 20582, 2022 Nov 29.
Artigo em Inglês | MEDLINE | ID: mdl-36447027

RESUMO

This study aimed to investigate the proportion of young OSA adults with sleep-related complaints in a sleep center, affiliated with a tertiary medical center for over a decade. This study presents a chronicle change in the numbers of young adults receiving polysomnography (PSG) and young patients with OSA from 2000 to 2017. We further analyzed 371 young patients with OSA among 2378 patients receiving PSG in our sleep center from 2016 to 2017 to capture their characteristics. Young adults constituted a substantial and relatively steady portion of examinees of PSG (25.1% ± 2.8%) and confirmed OSA cases (19.8 ± 2.4%) even though the total numbers increased with the years. Young adults with OSA tend to be sleepier, have a greater body mass index, and have a higher percentage of cigarette smoking and alcohol consumption. They also complained more about snoring and daytime sleepiness. They had a higher apnea-hypopnea index on average and experienced more hypoxemia during their sleep, both in terms of duration and the extent of desaturation. Even though the prevalence of comorbidities increased with age, hypertension in young male adults carried higher risks for OSA. Young adults with OSA have constituted a relatively constant portion of all confirmed OSA cases across time. The young adults with OSA were heavier, more symptomatic, and with more severe severity.Clinical trial: The Institutional Review Board of Taipei Veterans General Hospital approved the study (VGHIRB No. 2018-10-002CC). The study is registered with ClinicalTrials.gov, number NCT03885440.


Assuntos
Apneia Obstrutiva do Sono , Adulto Jovem , Humanos , Masculino , Apneia Obstrutiva do Sono/epidemiologia , Sono , Polissonografia , Ronco/epidemiologia , Hospitais Gerais
16.
J Am Anim Hosp Assoc ; 58(6): 283-287, 2022 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-36315861

RESUMO

A 2 yr old castrated male shih tzu was presented for assessment of worsening chronic snoring since first detected at 3 mo of age. An upper respiratory endoscopic examination and a computed tomographic scan showed a well-circumscribed, fluid-filled nasopharyngeal mass located in the median plane on the nasal side of the soft palate. This lesion was removed using a ventral approach to the nasopharynx by blunt-sharp dissection from the submucosal tissues of the soft palate. Histopathology revealed a cystic lesion lined by a single layer of a pseudostratified columnar ciliated epithelium, characteristic of a pharyngeal cyst. Follow-up 5 mo after surgery revealed complete resolution of the clinical signs with no evidence of local recurrence. Pharyngeal cysts are developmental abnormalities of the branchial apparatus. Most derive from the second branchial arch and cause cysts, sinuses, and fistulae to develop in the neck region. In our case, the lesion was located in the nasopharynx, leading to snoring and exercise intolerance. This condition should be included in the differential diagnosis of suspected nasopharyngeal obstruction.


Assuntos
Branquioma , Doenças do Cão , Masculino , Cães , Animais , Branquioma/diagnóstico , Branquioma/patologia , Branquioma/veterinária , Região Branquial/patologia , Ronco/veterinária , Doenças do Cão/diagnóstico por imagem , Doenças do Cão/cirurgia , Nasofaringe/cirurgia , Nasofaringe/patologia
17.
Ann Med ; 54(1): 2828-2840, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36259469

RESUMO

BACKGROUND: Obstructive sleep apnoea (OSA) is the most common sleep-related breathing disorder, yet it remains undiagnosed in a large proportion of adults. OBJECTIVE: This study aims to investigate the status of patient delay and provider delay in OSA patients and examine related factors affecting patient delay in OSA individuals in China. METHODS: A cross-sectional design was conducted on a sample of 309 OSA patients (aged from 18 to 76, median age of 47 years, 84.8% male) in Northeast China. Participants were required to complete the sociodemographic questionnaire, the symptom characteristics questionnaire, the help-seeking attitude scale (HSAS), the social support rating scale and the chronic disease self-efficacy scales (CDSES) to test the hypothesis. Binary logistic regression analysis was conducted to explore factors that account for the patient delay. RESULTS: The median patient delay among OAS patients in this study was 22 months, the median provider delay was one month, and the median total delay was 26 months. As shown by multivariate analysis results, patients who have snored for over 6 years (OR = 3.377, 95%CI: 1.175-9.702) were more likely to experience prolonged patient delays. Per capita monthly family income above 3000 RMB (OR = 0.172, 95%CI: 0.052-0.571), taking up residence in cities or towns (OR = 0.484, 95%CI: 0.248-0.946), higher self-recognition of the disease (OR = 0.793, 95%CI: 0.647-0.972), higher objective support (OR = 0.825, 95%CI: 0.739-0.921) and stronger self-efficacy (OR = 0.674, 95%CI: 0.525-0.867) were significantly associated with shorter patient delays. CONCLUSION: Patient delay is common in Chinese OSA patients. The upstream factors affecting the patient delay in individuals with OSA include income, place of residence, and objective support; midstream factors include self-recognition of the disease and self-efficacy; downstream factors include years of snoring.KEY MESSAGESDespite being a high-prevalence disease, many obstructive sleep apnoea (OSA) patients are not clearly diagnosed and treated.The factors affecting the delay in seeking medical treatment in individuals with OSA included income, place of residence, objective support, self-recognition of the disease, self-efficacy and years of snoring.Investigations into OSA patients' care-seeking behaviours can better reflect the secondary prevention of OSA, and it is crucial to pay attention to the delayed phase of patients.


Assuntos
Apneia Obstrutiva do Sono , Ronco , Adulto , Humanos , Masculino , Pessoa de Meia-Idade , Feminino , Estudos Transversais , Apneia Obstrutiva do Sono/diagnóstico , Apneia Obstrutiva do Sono/epidemiologia , Prevalência , Inquéritos e Questionários
18.
Sleep Med ; 100: 472-478, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36252416

RESUMO

STUDY OBJECTIVES: Children with late-onset (2-5 years) or persistent (3 months-5 years) sleep-related breathing disorder (SRBD) have an increased risk of behavior problems compared to children with no or early-onset SRBD. We sought to determine whether a combination of urine metabolites and sleep questionnaires could identify children at risk for SRBD-associated behavior problems. METHODS: Urine and data were analyzed from the Edmonton site of the CHILD birth cohort study. We measured urine metabolites (random, mid-stream) at age three-years among a sub-cohort of participants (n = 165). Random Forest with a Boruta wrapper was used to identify important metabolites (creatinine-corrected, z-scores) for late/persistent SRBD versus no/early SRBD (reference). An algorithm was subsequently generated to predict late/persistent SRBD in children with a history of snoring using a metabolite composite score (z-scores < or ≥ 0) plus the SDBeasy score defined as [age (yrs.) of most recent positive SRBD]2 - [age (yrs.) first reported ever snoring]2. RESULTS: Of the 165 children with SRBD data, 40 participants had late/persistent SRBD. Seven urinary metabolites in addition to the SDBeasy score were confirmed as important for late/persistent SRBD (AUC = 0.87). Among children with an ever-snoring history and a metabolite composite score ≥0, those with SDBeasy score ≥3 were over 13-fold more likely to have late/persistent SRBD (OR 13.7; 95%CI: 3.0, 62.1; p = 0.001). This algorithm has a Sensitivity of 69.6%, Specificity of 85.7% and a positive likelihood ratio (+LR) of 4.9. CONCLUSIONS: We developed a predictive algorithm using a combination of questionnaires and urine metabolites at age three-years to identify children with late/persistent SRBD by five-years of age.


Assuntos
Transtornos Respiratórios , Síndromes da Apneia do Sono , Transtornos do Sono-Vigília , Pré-Escolar , Humanos , Algoritmos , Estudos de Coortes , Sono , Síndromes da Apneia do Sono/diagnóstico , Síndromes da Apneia do Sono/complicações , Transtornos do Sono-Vigília/complicações , Ronco/complicações , Inquéritos e Questionários
19.
Sleep Med Rev ; 65: 101674, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36209649

RESUMO

While emerging literature has shown that sleep-disordered breathing (SDB) in pregnancy occurs in up to ∼30% of women by the third trimester, it is less clear if SDB persists after delivery. In this scoping review, our main objectives were to summarize the evidence on SDB with respect to 1) its persistence from pregnancy to after delivery and 2) its prevalence after delivery. Searches in Medline (PubMed), Web of Science, and Scopus until February 2022 were performed. Of the 1591 studies initially identified, 13 studies met the eligibility criteria. Nine were longitudinal studies from pregnancy to postpartum and four were cross-sectional studies of postpartum only. Our review demonstrated that over half (53-65%) of women had persistent SDB after delivery, but that the overall severity of SDB improved. The prevalence of snoring was reduced by two-fold (62% vs 29%) from pregnancy to after delivery. In addition, the overall prevalence of SDB using objective sleep studies was ∼24% (range 13-83%) after delivery. Changes in body weight from pregnancy to postpartum did not reliably predict persistent SDB across studies, but increased postpartum weight was associated with a greater risk of having persistent SDB after delivery.


Assuntos
Síndromes da Apneia do Sono , Estudos Transversais , Feminino , Humanos , Gravidez , Prevalência , Fatores de Risco , Síndromes da Apneia do Sono/complicações , Síndromes da Apneia do Sono/epidemiologia , Ronco/complicações
20.
Artigo em Chinês | MEDLINE | ID: mdl-36217654

RESUMO

Objective:This study aimed to investigate the long-term clinical efficacy and safety of inferior turbinate submucosal plasma ablation combined with or without tonsillar and adenoid surgery in children with allergic rhinitis(AR) combined with obstructive sleep apnea syndrome(OSAS) who were ineffective after conservative systemic treatment. Methods:A total of 43 children with AR complicated with OSAS who met the inclusion criteria among 68 children hospitalized from January 2019 to February 2022 were retrospectively analyzed. The data were collected, including the clinical characteristics, surgical methods perioperative management and prevention and treatment of complications. Moreover, one year follow-up was performed to compare the VAS scores of children before and after surgery, and to evaluate their mid-term and long-term outcomes. Results:The average operation time was 36 minutes, meanwhile, the intraoperative blood was limited. The symptoms of nasal congestion, runny nose, sleep snoring, and mouth breathing were significantly improved after operation, and the results were satisfactory after one-year follow-up without complications such as bleeding, hematoma, intraoperative adhesion, and nasal dryness. Conclusion:Submucosal plasma ablation of inferior turbinate with or without tonsillectomy adenoidectomy in children with AR can effectively improve the clinical symptoms of AR combined with OSAS children who are ineffective after conservative treatment. It can improve the symptoms of sleep-disordered breathing such as sleep snoring and mouth breathing, with good mid-and long-term curative effects and fewer complications, which is an effective and safe treatment for children with AR combined with OSAS.


Assuntos
Rinite Alérgica , Apneia Obstrutiva do Sono , Tonsilectomia , Adenoidectomia/efeitos adversos , Criança , Humanos , Respiração Bucal/complicações , Respiração Bucal/cirurgia , Estudos Retrospectivos , Rinite Alérgica/complicações , Rinite Alérgica/cirurgia , Apneia Obstrutiva do Sono/diagnóstico , Ronco/complicações , Tonsilectomia/efeitos adversos , Conchas Nasais/cirurgia
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