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Prevalence and assessment of sleep-disordered breathing in head and neck cancer patients: a systematic review. 头颈部癌症患者睡眠呼吸障碍的发生率和评估:系统综述。
IF 4.6 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-12-01 Epub Date: 2024-10-10 DOI: 10.1007/s11325-024-03075-4
Guihua Hao, Fen Gu, Min Hu, Wenjing Ding, Wentao Shi, Jingjing Dai, Lili Hou

Study objectives: Sleep-disordered breathing (SDB) is a very common and underdiagnosed condition in head and neck cancers (HNC) patients. If untreated, SDB can lead to negative health consequences. The identification of SDB in HNC patients is crucial to ensure appropriate treatment and to improve outcomes. The purpose of the study was to investigate the incidence of coexisting SDB in HNC patients and to evaluate methods of assessing SDB in the population.

Methods: A systematic search of PubMed, Embase, CINAHL, Cochrane Database, the Web of Science, and Scopus was performed for studies related to SDB in HNC patients. In total, 1713 articles were identified. 19 articles were selected for qualitative synthesis. The studies involved 584 subjects.

Results: The prevalence of SDB ranged from 57 to 90% before cancer treatment and from 12 to 96% after. When using an apnea-hypopnea index (AHI) cut-off ≥ 5/h to diagnosis SDB, the prevalence of SDB was 57-90% before cancer treatment and 12-94% after treatment. Sleep studies using polysomnography are the most commonly used assessment tools, but thresholds for diagnosis have been inconsistent.

Conclusions: There is a high prevalence of SDB in HNC patients. However, the diagnostic and thresholds methods used for detecting SDB vary widely. To determine the accurate prevalence of SDB, prospective, systematic studies of SDB in unselected cohorts of HNC participants are required.

研究目的:睡眠呼吸障碍(SDB)是头颈部癌症(HNC)患者中一种非常常见且诊断不足的疾病。如果不及时治疗,SDB 可能会对健康造成负面影响。识别 HNC 患者的 SDB 对确保适当治疗和改善预后至关重要。本研究旨在调查HNC患者并存SDB的发生率,并评估评估人群中SDB的方法:方法:对PubMed、Embase、CINAHL、Cochrane数据库、Web of Science和Scopus进行了系统检索,寻找与HNC患者SDB相关的研究。共发现 1713 篇文章。筛选出 19 篇文章进行定性综合。这些研究涉及 584 名受试者:结果:在癌症治疗前,SDB 的患病率为 57% 至 90%,而在治疗后,患病率为 12% 至 96%。当使用呼吸暂停-低通气指数(AHI)≥5/h的临界值来诊断SDB时,癌症治疗前SDB的患病率为57%-90%,治疗后为12%-94%。使用多导睡眠图进行的睡眠研究是最常用的评估工具,但诊断阈值并不一致:结论:HNC 患者的 SDB 患病率很高。然而,用于检测 SDB 的诊断方法和阈值却大相径庭。要确定 SDB 的准确患病率,需要对未选择的 HNC 患者队列进行 SDB 的前瞻性、系统性研究。
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引用次数: 0
The effect of supplemental oxygen and continuous positive airway pressure withdrawal on endocan levels. 补充氧气和持续气道正压撤机对内啡肽水平的影响。
IF 2.1 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-12-01 Epub Date: 2024-09-06 DOI: 10.1007/s11325-024-03120-2
Chris D Turnbull, John R Stradling, Nayia Petousi, Philippe Lassalle

Purpose: Endocan is a biomarker of endothelial dysfunction, which is a precursor to cardiovascular disease. Obstructive sleep apnoea (OSA) is associated with elevated endocan levels but the effects of treatment on endocan levels in OSA are not fully established. We aimed to determine whether endocan levels could be detected by immunoassay and to determine the effect of supplemental oxygen during continuous positive airway pressure (CPAP) withdrawal on circulating endocan levels.

Methods: We conducted an exploratory analysis from a randomised controlled crossover study which included participants with OSA. Participants stopped their CPAP therapy and were randomised to receive either supplemental oxygen or sham for 14 nights before crossing over. Supplemental oxygen blocked the rise in blood pressure seen in the sham group. We analysed plasma endocan levels by immunoassay at baseline and after 14 nights of intervention in both groups.

Results: Twenty-five participants were included, with a total of 100 samples. Endocan levels were detectable at all time points in 22 participants (88%), and in 93 (93%) samples. Supplemental oxygen had no effect on endocan levels compared to sham (+ 0.52 ng/ml, 95%CI -0.21 to + 1.25, p = 0.16), and there was no significant difference in endocan levels from baseline to follow-up in either the sham (-0.30 ng/ml, 95%CI -0.89 to + 0.30, p = 0.31) or supplemental oxygen (+ 0.22 ng/ml, 95%CI 0.00 to + 0.44, p = 0.05) arm.

Conclusions: We have shown that endocan levels are detectable before and after CPAP withdrawal. However, we found no effect of supplemental oxygen following CPAP withdrawal on circulating endocan levels.

Trial registration and date: ISRCTN 17,987,510 19/02/2015.

目的:内皮功能障碍是心血管疾病的前兆,而内皮功能障碍是内皮功能障碍的生物标志物。阻塞性睡眠呼吸暂停(OSA)与内皮素水平升高有关,但治疗对 OSA 内皮素水平的影响尚未完全确定。我们的目的是确定是否可以通过免疫测定法检测内皮素水平,并确定在停用持续气道正压(CPAP)期间补充氧气对循环内皮素水平的影响:我们对一项随机对照交叉研究进行了探索性分析,该研究的参与者包括 OSA 患者。参与者停止了 CPAP 治疗,并在交叉研究前的 14 个晚上随机接受补氧或假氧治疗。补氧阻止了假组中出现的血压升高。我们通过免疫测定分析了两组患者在基线和14晚干预后的血浆内皮素水平:结果:共有 25 名参与者参与,共采集了 100 份样本。22 名参与者(88%)和 93 个样本(93%)在所有时间点都能检测到内切酶水平。补充氧气与假吸氧(+ 0.52 纳克/毫升,95%CI -0.21 至 + 1.25,p = 0.16)相比,对内皮生长素水平没有影响,而且假吸氧(-0.30 纳克/毫升,95%CI -0.89 至 + 0.30,p = 0.31)或补充氧气(+ 0.22 纳克/毫升,95%CI 0.00 至 + 0.44,p = 0.05)臂的内皮生长素水平从基线到随访均无显著差异:我们的研究表明,在停用 CPAP 之前和之后都能检测到内切酶水平。结论:我们的研究表明,在停用 CPAP 之前和之后都能检测到内切酶水平,但我们发现停用 CPAP 后补充氧气对循环内切酶水平没有影响。
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引用次数: 0
Therapeutic adherence in patients with Obstructive Sleep Apnea Syndrome: a retrospective cohort study. 阻塞性睡眠呼吸暂停综合征患者坚持治疗的情况:一项回顾性队列研究。
IF 4.6 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-12-01 Epub Date: 2024-08-28 DOI: 10.1007/s11325-024-03097-y
Carmen Samà, Sandro Longu, Giorgio Bergesio, Francesca Samà, Alessia Faioli

Introduction: Obstructive Sleep Apnea Syndrome (OSAS) is a respiratory disorder characterized by repeated episodes of partial or complete airway obstruction. Continuous Positive Airway Pressure therapy (CPAP) is effective in improving sleep quality and daytime sleepiness. The aim of the study was to evaluate therapeutic adherence in a sample of patients with OSAS from the Pneumology ward of the "Cardinal Massaia" Hospital in Asti.

Materials and methods: A sample of 221 patients with OSAS were collected and retrospectively analyzed from January 2019 to December 2021. Ventilation hours during device titration (T1), possible second titration (T2) and one-year control (T3) were considered. The use of the CPAP device equal to or greater than 4 h/night was considered as therapeutic adherence. Age, gender, severity of OSAS, smoking, interface used and Epworth Sleepiness Scale (ESS) score were considered.

Results: The analysis data showed that the percentage of adhesion during T1 was 84%. Only 9% needed T2, with 84% adherence. At T3 the adherence was 86%. Correlation studies showed that only smoking had a positive correlation with adherence, while OSAS severity, gender, ESS score, interface used and age had no statistically significant correlation.

Conclusion: It was important to understand that OSAS is a disease with prolonged treatment, which affects the life of the person and his family. Therefore, the concept of assistance network was born, which sees the healthcare operators, the person and his family as the main actors involved in a care process.

简介阻塞性睡眠呼吸暂停综合征(OSAS)是一种呼吸系统疾病,其特征是反复发作的部分或完全气道阻塞。持续气道正压疗法(CPAP)能有效改善睡眠质量和白天嗜睡。本研究的目的是评估阿斯蒂 "Cardinal Massaia "医院气科病房 OSAS 患者的治疗依从性:收集了221名OSAS患者样本,并对2019年1月至2021年12月期间的情况进行了回顾性分析。考虑了设备滴定(T1)、可能的第二次滴定(T2)和一年控制(T3)期间的通气时间。使用 CPAP 设备的时间等于或大于 4 小时/晚被视为坚持治疗。研究还考虑了年龄、性别、OSAS 严重程度、吸烟、使用的界面和埃普沃思嗜睡量表(ESS)评分:分析数据显示,T1期间的粘附率为84%。只有 9% 的人需要接受 T2 治疗,坚持治疗的比例为 84%。在 T3 阶段,坚持率为 86%。相关性研究显示,只有吸烟与坚持率呈正相关,而 OSAS 严重程度、性别、ESS 评分、使用的界面和年龄在统计学上没有显著相关性:必须认识到,OSAS 是一种需要长期治疗的疾病,会影响患者及其家人的生活。因此,援助网络的概念应运而生,它将医疗机构、患者及其家人视为参与护理过程的主要角色。
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引用次数: 0
Effect of snoring on pregnant women and fetal outcomes: a cross sectional study. 打鼾对孕妇和胎儿的影响:一项横断面研究。
IF 4.6 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-12-01 Epub Date: 2024-08-28 DOI: 10.1007/s11325-024-03098-x
Biying Wang, Jianming Zhao, Lifang Fu, Caiyun Wang, Meixin Nian, Xuefen Cai, Jiefeng Huang

Purpose: Snoring frequently occurs among pregnant women, particularly in the later stages of pregnancy. It often signals obstructive sleep apnea (OSA), which could potentially affect pregnancy outcomes negatively. Hence, our study aimed to investigate how snoring influences the likelihood of pregnancy complications and fetal outcomes in a cohort of expectant mothers.

Methods: We enrolled pregnant women in their second and third trimesters and had them fill out a questionnaire concerning sleep-related symptoms such as snoring, excessive daytime sleepiness, and frequency of nighttime awakenings, along with anthropometric measurements. Subsequently, the participants were divided into snorers and non-snorers, and the occurrence of pregnancy complications and fetal outcomes was monitored.

Results: The study enrolled a total of 212 pregnant women, among whom 35 were identified as snorers and 177 as non-snorers during mid to late pregnancy. This indicated a snoring prevalence of 16.5% in our sample. Significant differences were noted between the two groups regarding the occurrence of oligohydramnios (11.43% vs. 2.82%, p = 0.044) and fetal distress (28.57% vs. 8.47%, p = 0.003). Logistic regression analyses revealed that snoring was independently associated with fetal distress (odds ratio [OR] = 4.99, 95% confidence interval [CI] 1.88-13.23, p = 0.001).

Conclusions: Our findings suggest that habitual snoring was the independent risk factor fetal distress after adjusting for potential confounders, indicating that habitual snoring may have a detrimental effect during mid to late pregnancy.

目的:孕妇经常打鼾,尤其是在妊娠后期。打鼾通常是阻塞性睡眠呼吸暂停(OSA)的信号,有可能对妊娠结局产生负面影响。因此,我们的研究旨在调查打鼾如何影响孕妇妊娠并发症和胎儿预后:我们招募了怀孕第二和第三个月的孕妇,让她们填写一份有关睡眠相关症状的调查问卷,如打鼾、白天过度嗜睡、夜间觉醒频率以及人体测量数据。随后,参与者被分为打鼾者和不打鼾者,并对妊娠并发症的发生率和胎儿结局进行了监测:研究共招募了 212 名孕妇,其中 35 人被确定为鼾症患者,177 人被确定为非鼾症患者。这表明在我们的样本中,打鼾的发生率为 16.5%。两组孕妇在少胎畸形(11.43% 对 2.82%,P = 0.044)和胎儿窘迫(28.57% 对 8.47%,P = 0.003)的发生率上存在显著差异。逻辑回归分析表明,打鼾与胎儿窘迫独立相关(几率比 [OR] = 4.99,95% 置信区间 [CI] 1.88-13.23,P = 0.001):我们的研究结果表明,在对潜在的混杂因素进行调整后,习惯性打鼾是导致胎儿窘迫的独立风险因素,这表明习惯性打鼾可能会对中晚期妊娠产生不利影响。
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引用次数: 0
Effects of different masks on diaphragm motion in OSAS patients undergoing CPAP: results from an ultrasound-based proof of concept study. 不同面罩对使用 CPAP 的 OSAS 患者横膈膜运动的影响:基于超声波的概念验证研究结果。
IF 2.1 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-12-01 Epub Date: 2024-09-09 DOI: 10.1007/s11325-024-03155-5
Sonia Zotti, Simone Scarlata, Anna Annunziata, Lidia Atripaldi, Rosa Cauteruccio, Valentina Di Spirito, Claudio Pedone, Raffaele Antonelli-Incalzi, Giuseppe Fiorentino

Purpose: Obstructive sleep apnea (OSA) is characterized by recurrent upper airway narrowing or collapse during sleep. Continuous positive airway pressure (CPAP) remains the preferred treatment in selected patients and masks' choice plays an important role for subsequent respiratory events' reduction. It is known that oronasal masks are not as effective at opening the upper airway compared to nasal ones. Thus, the objective of this study was to investigate differences in US-assessed diaphragmatic excursion (DE) using oronasal vs. nasal CPAP masks.

Methods: This observational study included 50 OSA patients presenting a moderate to severe apnea-hypopnea index and requiring CPAP treatment. All participants received US evaluations on diaphragm motion during their oronasal and nasal CPAP trial at equal positive end-expiratory pressure level.

Results: The difference of DE switching mask during CPAP was assessed by using the non-parametric Wilcoxon signed-rank test. A statistically significant increase in US- assessed DE was found when shifting from oronasal to nasal mask (p-value < 0.01). Linear regression models revealed that increased neck circumference and more severe AHI were associated with decreased DE when shifting to an oronasal mask.

Conclusion: This study evaluated the acute impact on US-assessed DE after changing CPAP route from oronasal to nasal mask. Our results suggest that the nasal type should be the more suitable option for most patients with OSA, especially those with higher nasal circumference. Diaphragmatic motion throughout US may become a practical tool to help in the choice of the fittest mask in patients undergoing CPAP.

目的:阻塞性睡眠呼吸暂停(OSA)的特点是睡眠时上气道反复狭窄或塌陷。持续气道正压(CPAP)仍是特定患者的首选治疗方法,而面罩的选择对减少后续呼吸事件起着重要作用。众所周知,口鼻面罩在打开上气道方面的效果不如鼻罩。因此,本研究的目的是调查使用口鼻CPAP面罩与鼻腔CPAP面罩时美国评估的横膈膜偏移(DE)的差异:这项观察性研究包括 50 名中度至重度呼吸暂停-低通气指数并需要 CPAP 治疗的 OSA 患者。所有参与者在相同呼气末正压水平下试用口鼻CPAP时都接受了横膈膜运动的US评估:使用非参数 Wilcoxon 符号秩检验评估了 CPAP 期间切换面罩时横膈膜运动的差异。从口鼻面罩转换到鼻面罩时,US 评估的 DE 值有明显增加(p 值 结论:该研究评估了 CPAP 对呼吸机的急性影响:本研究评估了将 CPAP 使用途径从口鼻罩改为鼻罩后对 US 评估的 DE 的急性影响。我们的结果表明,对于大多数 OSA 患者,尤其是鼻围较大的患者来说,鼻罩应该是更合适的选择。在使用 CPAP 的患者中,横膈膜在整个 US 过程中的运动可能会成为帮助他们选择最合适面罩的实用工具。
{"title":"Effects of different masks on diaphragm motion in OSAS patients undergoing CPAP: results from an ultrasound-based proof of concept study.","authors":"Sonia Zotti, Simone Scarlata, Anna Annunziata, Lidia Atripaldi, Rosa Cauteruccio, Valentina Di Spirito, Claudio Pedone, Raffaele Antonelli-Incalzi, Giuseppe Fiorentino","doi":"10.1007/s11325-024-03155-5","DOIUrl":"10.1007/s11325-024-03155-5","url":null,"abstract":"<p><strong>Purpose: </strong>Obstructive sleep apnea (OSA) is characterized by recurrent upper airway narrowing or collapse during sleep. Continuous positive airway pressure (CPAP) remains the preferred treatment in selected patients and masks' choice plays an important role for subsequent respiratory events' reduction. It is known that oronasal masks are not as effective at opening the upper airway compared to nasal ones. Thus, the objective of this study was to investigate differences in US-assessed diaphragmatic excursion (DE) using oronasal vs. nasal CPAP masks.</p><p><strong>Methods: </strong>This observational study included 50 OSA patients presenting a moderate to severe apnea-hypopnea index and requiring CPAP treatment. All participants received US evaluations on diaphragm motion during their oronasal and nasal CPAP trial at equal positive end-expiratory pressure level.</p><p><strong>Results: </strong>The difference of DE switching mask during CPAP was assessed by using the non-parametric Wilcoxon signed-rank test. A statistically significant increase in US- assessed DE was found when shifting from oronasal to nasal mask (p-value < 0.01). Linear regression models revealed that increased neck circumference and more severe AHI were associated with decreased DE when shifting to an oronasal mask.</p><p><strong>Conclusion: </strong>This study evaluated the acute impact on US-assessed DE after changing CPAP route from oronasal to nasal mask. Our results suggest that the nasal type should be the more suitable option for most patients with OSA, especially those with higher nasal circumference. Diaphragmatic motion throughout US may become a practical tool to help in the choice of the fittest mask in patients undergoing CPAP.</p>","PeriodicalId":21862,"journal":{"name":"Sleep and Breathing","volume":" ","pages":"2515-2520"},"PeriodicalIF":2.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Co-morbid Insomnia and Sleep Apnea (COMISA) in a large sample of Iranian: prevalence and associations in a sleep clinic population. 大样本伊朗人共病性失眠和睡眠呼吸暂停(COMISA):睡眠诊所人群的患病率和相关性。
IF 4.6 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-12-01 Epub Date: 2024-08-26 DOI: 10.1007/s11325-024-03102-4
Habibolah Khazaie, Mirza Aghazadeh, Ali Zakiei, Soroush Maazinezhad, Azita Tavallaie, Behrouz Moghbel, Mehrnaz Azarian, Farina Mozafari, Ebrahim Norouzi, Alexander Sweetman, Amir Sharafkhaneh

Background: Sleep apnea (SA) and insomnia (INS) are prevalent sleep disorders among referrals to sleep clinics. People with comorbid insomnia and sleep apnea (COMISA) suffer both disorders simultaneously. The epidemiology of COMISA is not well known in the Middle East including Iran. We hypothesized that COMISA is prevalent in metropolitan sleep clinic cohorts in Iran.

Method: The records of patients aged < 95 years referred to sleep disorders centers in four large metropolitan areas including Kermanshah, Tabriz, Shiraz, and Ahvaz were examined. Polysomnography (PSG) was performed in all these patients in specialized centers and the results were scored by a trained technician and interpreted by a sleep specialist. SA was defined as an Apnea-Hypopnea Index (AHI ≥ 5), INS was defined by psychiatrists according to self-report and clinical interviews, and COMISA was defined if both disorders were present. Participants with neither condition were included in as comparator group. One-way ANOVAs, correlation, and linear/logistic regression analyses were used.

Results: This study included 1807 patients (Mean age 49.3, SE ± 13.7; 38.8% Female). Comparator, INS, SA and COMISA made up 7.2%, 16%, 50.2% and 26.6% of the sample, respectively. Logistic regression analyses showed that male gender, older age, and increasing neck circumference, but not BMI, were associated with COMISA. Epworth Sleepiness Scale scores were lower in INS (5.39 ± 5.78) compared to the other three groups.

Conclusion: COMISA is a prevalent condition in metropolitan sleep centers in Iran among participants referred to sleep centers. The data showed that male gender and age were associated significantly with COMISA.

背景:睡眠呼吸暂停(SA)和失眠(INS)是睡眠诊所转诊患者中普遍存在的睡眠障碍。合并失眠和睡眠呼吸暂停(COMISA)的患者同时患有这两种疾病。包括伊朗在内的中东地区对 COMISA 的流行病学并不十分了解。我们假设,COMISA 在伊朗大都市的睡眠诊所队列中普遍存在:方法:对患者的年龄记录进行分析:本研究包括 1807 名患者(平均年龄 49.3 岁,SE ± 13.7;38.8% 为女性)。对照组、INS、SA 和 COMISA 分别占样本的 7.2%、16%、50.2% 和 26.6%。逻辑回归分析表明,男性性别、年龄和颈围的增加与 COMISA 有关,但与体重指数无关。与其他三组相比,INS 的埃普沃思嗜睡量表得分较低(5.39 ± 5.78):结论:COMISA 是伊朗大都市睡眠中心转诊患者中的一种普遍病症。数据显示,男性性别和年龄与 COMISA 有显著相关性。
{"title":"Co-morbid Insomnia and Sleep Apnea (COMISA) in a large sample of Iranian: prevalence and associations in a sleep clinic population.","authors":"Habibolah Khazaie, Mirza Aghazadeh, Ali Zakiei, Soroush Maazinezhad, Azita Tavallaie, Behrouz Moghbel, Mehrnaz Azarian, Farina Mozafari, Ebrahim Norouzi, Alexander Sweetman, Amir Sharafkhaneh","doi":"10.1007/s11325-024-03102-4","DOIUrl":"10.1007/s11325-024-03102-4","url":null,"abstract":"<p><strong>Background: </strong>Sleep apnea (SA) and insomnia (INS) are prevalent sleep disorders among referrals to sleep clinics. People with comorbid insomnia and sleep apnea (COMISA) suffer both disorders simultaneously. The epidemiology of COMISA is not well known in the Middle East including Iran. We hypothesized that COMISA is prevalent in metropolitan sleep clinic cohorts in Iran.</p><p><strong>Method: </strong>The records of patients aged < 95 years referred to sleep disorders centers in four large metropolitan areas including Kermanshah, Tabriz, Shiraz, and Ahvaz were examined. Polysomnography (PSG) was performed in all these patients in specialized centers and the results were scored by a trained technician and interpreted by a sleep specialist. SA was defined as an Apnea-Hypopnea Index (AHI ≥ 5), INS was defined by psychiatrists according to self-report and clinical interviews, and COMISA was defined if both disorders were present. Participants with neither condition were included in as comparator group. One-way ANOVAs, correlation, and linear/logistic regression analyses were used.</p><p><strong>Results: </strong>This study included 1807 patients (Mean age 49.3, SE ± 13.7; 38.8% Female). Comparator, INS, SA and COMISA made up 7.2%, 16%, 50.2% and 26.6% of the sample, respectively. Logistic regression analyses showed that male gender, older age, and increasing neck circumference, but not BMI, were associated with COMISA. Epworth Sleepiness Scale scores were lower in INS (5.39 ± 5.78) compared to the other three groups.</p><p><strong>Conclusion: </strong>COMISA is a prevalent condition in metropolitan sleep centers in Iran among participants referred to sleep centers. The data showed that male gender and age were associated significantly with COMISA.</p>","PeriodicalId":21862,"journal":{"name":"Sleep and Breathing","volume":" ","pages":"2693-2700"},"PeriodicalIF":4.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142056541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Use of vouchers for CPAP therapy initiation - public and private health care could work together. 使用优惠券启动 CPAP 治疗--公共和私营医疗保健机构可以合作。
IF 4.6 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-12-01 Epub Date: 2024-09-20 DOI: 10.1007/s11325-024-03159-1
Toni Jämsänen, Pirkko Brander, Adel Bachour

Purpose: The increasing incidence of sleep apnea has led to an increased workload for healthcare professionals. Continuous positive airway pressure (CPAP) is the gold standard therapy for obstructive sleep apnea. To reduce the CPAP waiting list in public healthcare, we proposed a CPAP voucher for use in private clinics for CPAP initiation. This study evaluated the success rate of CPAP initiation via this voucher.

Methods: We selected patients from our sleep apnea clinic referred to CPAP initiation aged 18-80 years with no significant physical or psychological comorbidity. Three private clinics (A, B, C) accepted the CPAP voucher.

Results: A total of 1922 patients fulfilled CPAP voucher criteria. Of these, we included 1604 patients (38% women). Mean BMI was 32 kg/m2, mean age was 55 years, and mean apnea-hypopnea index was 34/h. Data were missing for 113 patients at the 1-year follow-up visit. Of the remaining 1491 patients, 1398 continued CPAP therapy beyond 1 year, indicating a CPAP therapy success rate of 94%. There were no significant differences between clinics in the number of patients staying on CPAP at 1 year after initiation.

Conclusion: A CPAP voucher may reduce the CPAP initiation waiting list in public healthcare with a good success rate.

目的:随着睡眠呼吸暂停发病率的增加,医护人员的工作量也随之增加。持续气道正压疗法(CPAP)是治疗阻塞性睡眠呼吸暂停的金标准疗法。为了减少 CPAP 在公共医疗机构的候诊人数,我们建议在私立诊所使用 CPAP 优惠券来启动 CPAP。本研究评估了通过该凭证启动 CPAP 的成功率:方法:我们从睡眠呼吸暂停诊所中挑选了年龄在 18-80 岁之间、无明显生理或心理并发症的患者,让他们开始使用 CPAP。三家私人诊所(A、B、C)接受了 CPAP 凭证:结果:共有 1922 名患者符合 CPAP 凭单标准。其中,我们纳入了 1604 名患者(38% 为女性)。平均体重指数为 32 kg/m2,平均年龄为 55 岁,平均呼吸暂停-低通气指数为 34/h。在 1 年的随访中,有 113 名患者的数据缺失。在剩余的 1491 名患者中,有 1398 人在 1 年后继续接受 CPAP 治疗,表明 CPAP 治疗的成功率为 94%。在开始使用 CPAP 1 年后继续使用 CPAP 的患者人数方面,各诊所之间没有明显差异:心肺复苏术治疗券可以减少公共医疗机构中心肺复苏术候诊人数,且成功率较高。
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引用次数: 0
The influence of sleep education supported and unsupported with social media reminders on the sleep quality in adolescents aged 14-18: a three-center, parallel-arm, randomized controlled study. 有社交媒体提醒支持和无社交媒体提醒支持的睡眠教育对 14-18 岁青少年睡眠质量的影响:三中心平行臂随机对照研究。
IF 2.1 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-12-01 Epub Date: 2024-09-25 DOI: 10.1007/s11325-024-03138-6
Songül Çağlar, Makbule Tokur Kesgin

Purpose: Poor sleep quality is a global health problem for adolescent. The aim of this study was to examine how sleep education, with or without social media reminders, affects sleep quality in adolescents aged 14 to 18.

Methods: The study was a three-center, parallel-arm, randomized controlled study, recruiting participants from September 9, 2019, to January 6, 2020. Adolescents with poor sleep quality and sleepiness, using smartphones apps and internet browser, without chronic diseases, and obesity, and without mental problems were included in the study. Primary outcomes were sleep quality, sleepiness, sleep hygiene, and sleep parameters at week 5 as measured by subjective report scales and actigraphy. Sleep quality was measured by the Pittsburgh Sleep Quality Index (Poor sleep quality = PSQI > 5), sleepiness by the Cleveland Adolescent Sleepiness Questionnaire (CASQ > 16), and sleep hygiene developed by the researchers in the literature of Adolescent Sleep Habits Form.

Results: A total of 55 participants (mean [SD] age, 15.64 [1.22] years) participated. PSQI and CASQ scores of adolescents in sleep education that were not supported by social media reminders decreased compared to the baseline (p = 0.01, p = 0.02). Adolescent PSQI score in sleep education supported by social media reminders decreased from baseline, their sleep hygiene score increased (p = 0.02). There were no significant differences between the groups in terms of sleep parameters (total sleep duration, deep and light sleep levels, nighttime sleeping, and morning wake-up times) (p > 0.05).

Conclusion: This study suggests that sleep education, supported by reminders via social media, can be used to improve the quality of sleep of adolescents.

Trial registration: ClinicalTrials.gov Identifier: NCT05071989.

目的:睡眠质量差是一个全球性的青少年健康问题。本研究旨在探讨睡眠教育(无论有无社交媒体提醒)如何影响14至18岁青少年的睡眠质量:该研究是一项三中心、平行臂、随机对照研究,从 2019 年 9 月 9 日至 2020 年 1 月 6 日招募参与者。研究对象包括睡眠质量差、嗜睡、使用智能手机应用程序和互联网浏览器、无慢性疾病和肥胖、无精神问题的青少年。研究的主要结果是睡眠质量、嗜睡、睡眠卫生以及第5周时的睡眠参数,这些参数通过主观报告量表和动觉计测量。睡眠质量通过匹兹堡睡眠质量指数(睡眠质量差 = PSQI > 5)进行测量,嗜睡通过克利夫兰青少年嗜睡问卷(CASQ > 16)进行测量,睡眠卫生由研究人员在青少年睡眠习惯表文献中制定:共有 55 名参与者(平均 [SD] 年龄,15.64 [1.22] 岁)参加了调查。与基线相比,没有社交媒体提醒支持的青少年在睡眠教育中的 PSQI 和 CASQ 分数有所下降(p = 0.01,p = 0.02)。在社交媒体提醒支持的睡眠教育中,青少年的 PSQI 分数比基线有所下降,但他们的睡眠卫生分数有所上升(p = 0.02)。在睡眠参数(总睡眠时间、深睡眠和浅睡眠水平、夜间睡眠和早晨起床时间)方面,组间无明显差异(P > 0.05):本研究表明,通过社交媒体提醒的睡眠教育可用于改善青少年的睡眠质量:试验注册:ClinicalTrials.gov Identifier:试验注册:ClinicalTrials.gov Identifier:NCT05071989。
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引用次数: 0
Stress is simultaneously related to sleep and temporomandibular disorders. 压力同时与睡眠和颞下颌关节紊乱有关。
IF 4.6 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-12-01 Epub Date: 2024-09-20 DOI: 10.1007/s11325-024-03139-5
Hao Chih Chuang, Yoshihiro Tamura, Haruka Fukuda, Shunya Yamazaki, Kosei Kubota, Koki Takagi, Shotaro Komatsu, Akihiro Matsumura, Shigeyuki Nakaji, Koichi Murashita, Wataru Kobayashi

Purpose: This study aimed to clarify the relationship between the oral environment and psychological factors as predictor variables of sleep quality, in addition to inferring the relevant mechanisms of sleep and temporomandibular disorders (TMDs) by analyzing the relationship between TMDs and stress.

Methods: This cross-sectional study analyzed data from 1,032 participants, comprising 420 men and 612 women, from the 2017 Iwaki Health Promotion Project using multiple regression analysis. The primary endpoints were the scores of each item in the Pittsburgh Sleep Quality Index (PSQI) and its sum. Predictor variables included the number of teeth; TMDs; stress, assessed using the World Health Organization-5 (WHO-5); sleep bruxism; and oral health-related quality of life, assessed using the oral health impact profile-14 (OHIP14). The confounding factors included age, body mass index, and alcohol intake.

Results: Multiple regression analysis revealed that TMDs (β value = 0.293, p = 0.034) and stress (β value = 1.3, p < 0.001) were significantly correlated with the PSQI total score. In addition, TMDs were significantly correlated with stress (β value = 0.076, p = 0.007).

Conclusion: The significant relationship between sleep and TMDs suggests that mental stress contributes to the development sleep disorders and consequently is associated with the development of TMD symptoms.

目的:本研究旨在阐明作为睡眠质量预测变量的口腔环境与心理因素之间的关系,并通过分析颞下颌关节紊乱症(TMD)与压力之间的关系,推断睡眠与颞下颌关节紊乱症(TMD)的相关机制:这项横断面研究采用多元回归分析法分析了2017年磐城健康促进项目的1032名参与者的数据,其中包括420名男性和612名女性。主要终点是匹兹堡睡眠质量指数(PSQI)中每个项目的得分及其总和。预测变量包括牙齿数量、TMDs、使用世界卫生组织-5(WHO-5)评估的压力、睡眠磨牙症以及使用口腔健康影响档案-14(OHIP14)评估的口腔健康相关生活质量。混杂因素包括年龄、体重指数和酒精摄入量:多元回归分析表明,TMDs(β 值 = 0.293,p = 0.034)和压力(β 值 = 1.3,p 结论:睡眠与 TMDs 有显著关系:睡眠与 TMD 之间的重要关系表明,精神压力会导致睡眠障碍,进而与 TMD 症状的发展相关联。
{"title":"Stress is simultaneously related to sleep and temporomandibular disorders.","authors":"Hao Chih Chuang, Yoshihiro Tamura, Haruka Fukuda, Shunya Yamazaki, Kosei Kubota, Koki Takagi, Shotaro Komatsu, Akihiro Matsumura, Shigeyuki Nakaji, Koichi Murashita, Wataru Kobayashi","doi":"10.1007/s11325-024-03139-5","DOIUrl":"10.1007/s11325-024-03139-5","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to clarify the relationship between the oral environment and psychological factors as predictor variables of sleep quality, in addition to inferring the relevant mechanisms of sleep and temporomandibular disorders (TMDs) by analyzing the relationship between TMDs and stress.</p><p><strong>Methods: </strong>This cross-sectional study analyzed data from 1,032 participants, comprising 420 men and 612 women, from the 2017 Iwaki Health Promotion Project using multiple regression analysis. The primary endpoints were the scores of each item in the Pittsburgh Sleep Quality Index (PSQI) and its sum. Predictor variables included the number of teeth; TMDs; stress, assessed using the World Health Organization-5 (WHO-5); sleep bruxism; and oral health-related quality of life, assessed using the oral health impact profile-14 (OHIP14). The confounding factors included age, body mass index, and alcohol intake.</p><p><strong>Results: </strong>Multiple regression analysis revealed that TMDs (β value = 0.293, p = 0.034) and stress (β value = 1.3, p < 0.001) were significantly correlated with the PSQI total score. In addition, TMDs were significantly correlated with stress (β value = 0.076, p = 0.007).</p><p><strong>Conclusion: </strong>The significant relationship between sleep and TMDs suggests that mental stress contributes to the development sleep disorders and consequently is associated with the development of TMD symptoms.</p>","PeriodicalId":21862,"journal":{"name":"Sleep and Breathing","volume":" ","pages":"2741-2749"},"PeriodicalIF":4.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142295949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The knowledge profile, attitudes, and perioperative management of Chinese anesthesiologists towards patients with obstructive sleep apnea: a cross-sectional survey. 中国麻醉医师对阻塞性睡眠呼吸暂停患者的知识概况、态度和围手术期管理:一项横断面调查。
IF 2.1 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-12-01 Epub Date: 2024-08-22 DOI: 10.1007/s11325-024-03119-9
Lingcan Tan, Zhongjing Pan, Qinghan Zeng, Yuanyuan Peng, Fengling Yang, Dan Lu

Backgrounds: Obstructive sleep apnea syndrome (OSA) is increasingly encountered by anesthesiologists in clinical practice. However, research on managing these patients among anesthesiologists in China is scarce. This study aims to investigate the knowledge, attitudes, and perioperative management strategies for OSA patients among Chinese anesthesiologists.

Methods: In this cross-sectional study, anesthesiologists from various hospitals across China were invited to complete a thirty-eight-item online questionnaire survey between October 1 and November 1, 2022. The Obstructive Sleep Apnea Knowledge and Attitude (OSAKA) scale was utilized to measure their knowledge and attitudes.

Results: A total of 470 valid participants were recruited for this research, resulting in a valid response rate of 73.3%. (1) While the majority of participants acknowledged the importance of identifying OSA during perioperative management, only 58.3% felt confident in managing OSA patients; (2) Anesthesiologists with higher professional titles and longer work experience exhibited greater confidence in managing OSA patients; (3) Just under half of the participants were familiar with the STOP-Bang and Berlin questionnaires. Anesthesiologists with over 20 years of work experience were more likely to use the STOP-Bang and Berlin questionnaires compared to those with less than 10 years of work experience (OR = 3.166, P < 0.001); (4) 71.1% of participants expressed approval regarding the preparation of sugammadex for muscle relaxation reversal, while only 32.8% approved the safety of opioid use for postoperative analgesia in OSA patients.

Conclusion: The study displayed that Chinese anesthesiologists have inadequate knowledge and perioperative management of OSA than expected. However, they have positive attitudes towards the assessment and management of OSA. The study highlights the need for high-quality training to identify and manage OSA among Chinese anesthesiologists.

背景:在临床实践中,麻醉医师遇到的阻塞性睡眠呼吸暂停综合征(OSA)患者越来越多。然而,中国麻醉医生对此类患者管理的研究却很少。本研究旨在调查中国麻醉医生对 OSA 患者的认识、态度和围术期管理策略:在这项横断面研究中,我们邀请了来自全国各家医院的麻醉医生在 2022 年 10 月 1 日至 11 月 1 日期间完成了一项包含 38 个项目的在线问卷调查。调查采用阻塞性睡眠呼吸暂停知识和态度量表(OSAKA)来测量他们的知识和态度:本研究共招募了 470 名有效参与者,有效回复率为 73.3%。(1)虽然大多数参与者承认在围手术期管理中识别 OSA 的重要性,但只有 58.3% 的参与者对管理 OSA 患者有信心;(2)职称越高、工作经验越长的麻醉医生对管理 OSA 患者越有信心;(3)只有不到一半的参与者熟悉 STOP-Bang 和柏林问卷。与工作经验少于 10 年的麻醉医生相比,工作经验超过 20 年的麻醉医生更有可能使用 STOP-Bang 和柏林问卷(OR = 3.166,P 结论):该研究表明,中国麻醉医生对 OSA 的认识和围术期管理不足。然而,他们对 OSA 的评估和管理持积极态度。该研究强调了对中国麻醉医师进行识别和管理 OSA 的高质量培训的必要性。
{"title":"The knowledge profile, attitudes, and perioperative management of Chinese anesthesiologists towards patients with obstructive sleep apnea: a cross-sectional survey.","authors":"Lingcan Tan, Zhongjing Pan, Qinghan Zeng, Yuanyuan Peng, Fengling Yang, Dan Lu","doi":"10.1007/s11325-024-03119-9","DOIUrl":"10.1007/s11325-024-03119-9","url":null,"abstract":"<p><strong>Backgrounds: </strong>Obstructive sleep apnea syndrome (OSA) is increasingly encountered by anesthesiologists in clinical practice. However, research on managing these patients among anesthesiologists in China is scarce. This study aims to investigate the knowledge, attitudes, and perioperative management strategies for OSA patients among Chinese anesthesiologists.</p><p><strong>Methods: </strong>In this cross-sectional study, anesthesiologists from various hospitals across China were invited to complete a thirty-eight-item online questionnaire survey between October 1 and November 1, 2022. The Obstructive Sleep Apnea Knowledge and Attitude (OSAKA) scale was utilized to measure their knowledge and attitudes.</p><p><strong>Results: </strong>A total of 470 valid participants were recruited for this research, resulting in a valid response rate of 73.3%. (1) While the majority of participants acknowledged the importance of identifying OSA during perioperative management, only 58.3% felt confident in managing OSA patients; (2) Anesthesiologists with higher professional titles and longer work experience exhibited greater confidence in managing OSA patients; (3) Just under half of the participants were familiar with the STOP-Bang and Berlin questionnaires. Anesthesiologists with over 20 years of work experience were more likely to use the STOP-Bang and Berlin questionnaires compared to those with less than 10 years of work experience (OR = 3.166, P < 0.001); (4) 71.1% of participants expressed approval regarding the preparation of sugammadex for muscle relaxation reversal, while only 32.8% approved the safety of opioid use for postoperative analgesia in OSA patients.</p><p><strong>Conclusion: </strong>The study displayed that Chinese anesthesiologists have inadequate knowledge and perioperative management of OSA than expected. However, they have positive attitudes towards the assessment and management of OSA. The study highlights the need for high-quality training to identify and manage OSA among Chinese anesthesiologists.</p>","PeriodicalId":21862,"journal":{"name":"Sleep and Breathing","volume":" ","pages":"2617-2627"},"PeriodicalIF":2.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142018610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Sleep and Breathing
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