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Anatomy and Pathophysiology of Upper Airway Obstructive Sleep Apnoea: Review of the Current Literature 上呼吸道阻塞性睡眠呼吸暂停的解剖学和病理生理学:文献综述
Q4 Medicine Pub Date : 2021-06-30 DOI: 10.17241/smr.2020.00829
T. S. Nee, Yang Hyung Chae, Lim Sang chul
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引用次数: 4
The Influence of Obesity on the Association of Obstructive Sleep Apnea and Atrial Fibrillation. 肥胖对阻塞性睡眠呼吸暂停与心房颤动关系的影响
Q4 Medicine Pub Date : 2021-06-01 Epub Date: 2021-06-24 DOI: 10.17241/smr.2021.00857
Patrick L Stafford, Evan K Harmon, Paras Patel, McCall Walker, Gen-Min Lin, Seung-Jung Park, Neal A Chatterjee, Nishaki K Mehta, Sula Mazimba, Kenneth Bilchick, Younghoon Kwon

Background and objective: The association between obstructive sleep apnea (OSA) and atrial fibrillation (AF) has been closely studied. However, obesity is a powerful confounder in the causal relationship between OSA and cardiovascular disease. The contribution of obesity in the relationship between OSA and AF remains unclear.

Methods: We recruited 457 consecutive patients equally with and without AF who underwent clinically indicated diagnostic polysomnography at a single academic sleep center. Multivariable logistic regression adjusting for age, sex, hypertension, and heart failure was performed to study the independent association between OSA and AF stratified by obesity.

Results: A total of 457 patients (male: 56.2%, mean age 63.1 ± 13.3 years) was included. OSA prevalence was similar between those with and without AF (52.6% vs. 47.4%, respectively; p = 0.24). In multivariable analysis, no association was found between AF and OSA regardless of obesity status. When severe OSA (vs. non-severe OSA) was modeled as a dependent variable, AF was associated with a higher likelihood of severe OSA in non-obese patients [odds ratio (OR): 2.29, 95% confidence interval (CI): 1.23-4.35, p = 0.01], but not in obese patients (OR: 0.95, 95% CI: 0.48-1.90, p = 0.89).

Conclusion: The association of OSA with AF was present only in the non-obese and was limited to severe OSA patients. In contrast, no association was found in obese patients. The association between OSA and AF is partly dependent on the body habitus.

背景和目的:阻塞性睡眠呼吸暂停(OSA)与心房颤动(AF)之间的关系一直受到密切关注。然而,肥胖是影响 OSA 与心血管疾病之间因果关系的一个重要混淆因素。肥胖在 OSA 和房颤关系中的作用仍不清楚:我们在一家学术性睡眠中心连续招募了 457 名患者,这些患者中既有房颤患者,也没有房颤患者,他们都接受了有临床指征的多导睡眠图诊断。我们对年龄、性别、高血压和心衰进行了多变量逻辑回归调整,以研究肥胖分层后 OSA 与房颤之间的独立关联:共纳入 457 名患者(男性:56.2%,平均年龄(63.1 ± 13.3)岁)。房颤患者和非房颤患者的 OSA 患病率相似(分别为 52.6% 和 47.4%;P = 0.24)。在多变量分析中,无论肥胖状况如何,均未发现房颤与 OSA 之间存在关联。当将严重 OSA(与非严重 OSA 相比)作为因变量建模时,在非肥胖患者中,房颤与较高的严重 OSA 可能性相关[几率比(OR):2.29,95% 置信区间(CI):1.23-4.35,P = 0.01],但在肥胖患者中却不相关(OR:0.95,95% CI:0.48-1.90,P = 0.89):结论:OSA与房颤的关系仅存在于非肥胖人群中,且仅限于严重OSA患者。相反,在肥胖患者中未发现相关性。OSA 与房颤之间的关系部分取决于体型。
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引用次数: 0
The development and psychometric evaluation of the Survey of Obstructive Sleep Apnea Functional Health Literacy. 阻塞性睡眠呼吸暂停功能性健康素养调查的开发和心理测量评估。
Q4 Medicine Pub Date : 2021-06-01 DOI: 10.17241/smr.2021.00885
Rebecca Robbins, Ron D Hays, José Luís Calderón, Azizi Seixas, Valerie Newsome, Alicia Chung, Girardin Jean-Louis

Objective and objective: Obstructive Sleep Apnea (OSA) is a highly prevalent disorder that disparately affects racial/ethnic minorities. OSA functional health literacy can contribute to health disparities. Documenting poor OSA functional health literacy is needed to inform research agendas, policy, and advocacy efforts. The objective of this study is to develop a scale for measuring OSA functional health literacy among diverse audiences and a variety of reading levels and to ascertain its reliability and validity.

Methods: Development of the 18-item Survey of OSA Functional Health Literacy (SOFHL) was guided by literature review and input from experts. A convenience sample of persons enrolled in a clinical trial completed the survey (n=194). The psychometric evaluation was conducted using factor analysis to identify the number of dimensions in the SOFHL and their relationship to other domains that are relevant to OSA functional health literacy.

Results: Internal consistency reliability (alpha) was estimated for the resulting scale and correlations with educational attainment and income completed. All respondents were Black and 29% reported average household income less than $10,000 USD. Confirmatory factor analysis provided support for two dimensions: OSA general knowledge (alpha=0.81) and self-efficacy for OSA self-management (alpha=0.71).

Conclusions: Higher educational attainment and socioeconomic status were associated with better OSA functional health literacy. These results provide preliminary support for the SOFHL, a measure that can be used to assess OSA functional health literacy.

目的和目标:阻塞性睡眠呼吸暂停(OSA)是一种发病率很高的疾病,对少数种族/族裔的影响很大。OSA 功能保健知识会造成健康差异。需要记录 OSA 功能性健康素养差的情况,以便为研究议程、政策和宣传工作提供信息。本研究的目的是开发一个量表,用于测量不同受众和不同阅读水平的 OSA 功能保健素养,并确定其可靠性和有效性:方法:在文献综述和专家意见的指导下,开发了 18 个项目的 OSA 功能保健知识调查表(SOFHL)。对参加临床试验的人员进行了抽样调查(194 人)。心理测量学评估采用因子分析法,以确定SOFHL的维度数量及其与OSA功能性健康素养相关的其他领域的关系:结果:对最终量表的内部一致性可靠性(α)进行了估算,并完成了与教育程度和收入的相关性分析。所有受访者均为黑人,29%的受访者称平均家庭收入低于10,000美元。确认性因子分析为两个维度提供了支持:结论:结论:较高的教育程度和社会经济地位与较好的 OSA 功能保健知识相关。这些结果为 SOFHL 提供了初步支持,SOFHL 可用于评估 OSA 功能性健康素养。
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引用次数: 0
Sleep-Related Eating Disorder and Nocturnal Eating Syndrome 睡眠相关进食障碍和夜间进食综合症
Q4 Medicine Pub Date : 2020-12-31 DOI: 10.17241/smr.2020.00780
Jahyeon Cho, J. Lee, Seung-Chul Hong
Eating and sleeping are vital functions of human life. They reciprocally influence each other in both quality and quantity. Nocturnal eating syndrome (NES) and sleep-related eating disorder (SRED) are two distinct diseases that share symptomatology of an abnormal association between the timing of eating and sleep. NES is represented by purging, a non-controllable manner of eating in the evening before sleep, followed by morning anorexia. SRED is a chronic condition showing eating episodes after sleep onset with partial to complete amnesia. Terminology was used confusedly until the third edition of the International Classification of Sleep Disorders, which defined SRED in the parasomnia section. Unlike NES, SRED usually does not respond to psychotherapy but to medication, most promisingly, to topiramate. Both are related to weight control problems, leading to obesity or excessive preoccupation with weight control issues. Sleep Med Res 2020;11(2):65-69
吃饭和睡觉是人类生命的重要功能。它们在质量和数量上相互影响。夜间进食综合征(NES)和睡眠相关进食障碍(SRED)是两种截然不同的疾病,它们具有进食和睡眠时间异常相关的共同症状。NES表现为排便,这是一种不可控制的进食方式,在晚上睡觉前进食,随后是早晨厌食。SRED是一种慢性疾病,在睡眠开始后出现进食发作,并伴有部分或完全失忆。直到第三版《国际睡眠障碍分类》(International Classification of Sleep Disorders)在睡眠异常(parasomnia)一节中定义了SRED之前,术语的使用一直很混乱。与NES不同的是,SRED通常对心理治疗没有反应,而对药物(最有希望的是托吡酯)有反应。两者都与体重控制问题有关,导致肥胖或过度关注体重控制问题。睡眠医学杂志,2020;11(2):65-69
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引用次数: 2
Restless Genital Syndrome: A Rare Case Series of Four Patients and a Literature Review 不宁生殖器综合征:一个罕见的病例系列的四个病人和文献回顾
Q4 Medicine Pub Date : 2020-12-31 DOI: 10.17241/smr.2020.00787
Hye-Rim Shin, S. Han, K. Jung
Restless genital syndrome (RGS) is a rare disorder with unpleasant sensation in the genital area and unwanted sexual arousal. Only a few cases of RGS have been reported, so we presented four cases of RGS. Four cases were all middle-age female, and was commonly complaint paresthesia on their genital area and unwanted sexual arousal. The typical symptoms of restless legs syndrome (RLS), affecting on their lower extremities were accompanied. RGS is difficult to diagnose because it presents ambiguous sensations that are difficult to describe, along with embarrassment in reporting sexual feelings. Clinicians should be aware of the genital discomfort and sexual arousal that can develop in RLS. Sleep Med Res 2020;11(2):145-148
不安生殖器综合征(RGS)是一种罕见的疾病,生殖器区域有不愉快的感觉和不想要的性唤起。只有少数RGS病例被报道,因此我们介绍了四例RGS病例。四个病例都是中年女性,通常抱怨生殖器区域感觉异常和不想要的性唤起。伴有下肢不宁腿综合征(RLS)的典型症状。RGS很难诊断,因为它表现出难以描述的模糊感觉,以及在报告性感觉时的尴尬。临床医生应该意识到RLS中可能出现的生殖器不适和性唤起。睡眠医学研究2020;11(2):145-148
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引用次数: 1
Effect of National Health Insurance Coverage on Adherence to Positive Airway Pressure Therapy in Obstructive Sleep Apnea Patients 国家健康保险覆盖对阻塞性睡眠呼吸暂停患者坚持气道正压治疗的影响
Q4 Medicine Pub Date : 2020-12-31 DOI: 10.17241/smr.2020.00766
Ji-Hwan Park, Ji-Hun Kang, Myeong-gu Seo, Ha-Nee Kwon, Sung-Dong Kim, Kyu-Sup Cho
Background and ObjectiveaaPositive airway pressure (PAP) is considered a standard treatment for obstructive sleep apnea (OSA). Although PAP is effective in resolving upper airway collapse, a major challenge is maximizing adherence. Polysomnography and PAP have been included in Korean National Health Insurance (NHI) coverage since July 2018. This study was performed to investigate the adherence to PAP therapy according to the device manager after NHI coverage in OSA patients. MethodsaaBetween July 2018 and May 2020, a total of 211 patients were prescribed PAP in a single tertiary hospital, and the PAP devices were managed by two companies. Among them, 187 patients constituted the final study population. Assessment of adherence was performed at 3 and 12 months after initiating PAP therapy. Good adherence was defined as using a PAP device for ≥ 4 hours daily and on ≥ 70% of nights. ResultsaaNinety-three patients used the PAP machine obtained from device manager A and 94 patients used the PAP machine obtained from device manager B. During 90 days, the total good adherence rate was 66.8% (n = 125). The good adherence rate for device manager A was 66.7% (62/93) and that for device manager B was 67.0% (63/94), which was not statistically different (p = 0.959). However, the good adherence rate at 1 year after initiating PAP therapy was 38.7% (36/93) for device manager A and 58.5% (55/94) for device manager B, which was statistically significant (p = 0.007). ConclusionsaaThe good adherence rate was decreased at 1 year after initiating PAP therapy despite NHI coverage. Furthermore, the device manager may play an important role in increasing the adherence rate in patients with OSA. Sleep Med Res 2020;11(2):140-144
背景和目的气道正压通气(PAP)被认为是阻塞性睡眠呼吸暂停(OSA)的标准治疗方法。尽管PAP在解决上呼吸道塌陷方面是有效的,但最大限度地提高依从性是一个主要挑战。自2018年7月起,多导睡眠图和PAP已纳入韩国国家健康保险(NHI)的保险范围。本研究旨在调查OSA患者在NHI覆盖后根据设备管理器对PAP治疗的依从性。方法aa 2018年7月至2020年5月,一家三级医院共为211名患者开具了PAP处方,PAP设备由两家公司管理。其中187名患者构成了最终研究人群。在开始PAP治疗后3个月和12个月进行依从性评估。良好的依从性被定义为每天使用PAP设备≥4小时,夜间≥70%。结果93例患者使用了设备管理者A提供的PAP机,94例患者使用设备管理者B提供的PAP机。在90天内,总的良好依从率为66.8%(n=125)。设备管理者A的良好依从性为66.7%(62/93),设备管理者B为67.0%(63/94),差异无统计学意义(p=0.959)。然而,启动PAP治疗后1年的良好依从率,设备管理器A为38.7%(36/93),设备管理器B为58.5%(55/94),有统计学意义(p=0.007)。此外,设备管理器可能在提高OSA患者的依从性方面发挥重要作用。睡眠医学研究2020;11(2):140-144
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引用次数: 1
Evaluating Diet and Sleep Quality of Shift and Non-Shift Nurses Using Three-Factor Pittsburgh Sleep Quality Index and Healthy Eating Index-2015 用三因素匹兹堡睡眠质量指数和健康饮食指数评估轮班护士和非轮班护士饮食和睡眠质量-2015
Q4 Medicine Pub Date : 2020-12-31 DOI: 10.17241/smr.2020.00682
Gizem Helvacı, N. N. Aslan Çİn, Şahinde Canbulat, H. Yardımcı
Background and ObjectiveaaThe objective of this study was to determine whether there were differences in diet and sleep quality between shift and non-shift nurses. Nurses among healthcare professionals mostly work in shifts. Therefore, they may face many health problems. Changes of their dietary pattern and sleep quality might be among underlying causes for their health risks. MethodsaaThis descriptive and cross-sectional research enrolled 298 nurses working in two hospitals who volunteered to participate in this study. The work schedule of nurses included a non-shift work and a shift-work. Sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI). Data were analyzed using a three-factor PSQI model. ResultsaaBased on the three-factor PSQI model, scores for sleep efficiency, sleep quality, and daily disturbances were significantly (p < 0.05) higher in shift nurses than in non-shift nurses. Among individuals with good sleep quality, the diet quality of shift nurses was worse (p < 0.05) than that of non-shift nurses. Among individuals with poor sleep quality, there was no significant (p > 0.05) difference in total diet quality score according to shift status. ConclusionsaaShift work was significantly associated with poor sleep quality. Among nurses with good sleep quality, the diet quality of shift nurses was worse than that of non-shift nurses. Sleep Med Res 2020;11(2):94-101
背景和目的本研究的目的是确定轮班护士和非轮班护士在饮食和睡眠质量方面是否存在差异。医护人员中的护士大多轮班工作。因此,他们可能面临许多健康问题。他们饮食模式和睡眠质量的变化可能是他们健康风险的根本原因之一。方法aa这项描述性和横断面研究招募了来自两家医院的298名护士,他们自愿参与这项研究。护士的工作安排包括非轮班工作和轮班工作。睡眠质量采用匹兹堡睡眠质量指数(PSQI)进行测量。使用三因素PSQI模型对数据进行分析。结果a基于三因素PSQI模型,轮班护士的睡眠效率、睡眠质量和日常干扰得分显著高于非轮班护士(p<0.05)。在睡眠质量良好的个体中,轮班护士的饮食质量比非轮班护士差(p<0.05)。在睡眠质量较差的个体中,根据轮班状态,饮食质量总分没有显著差异(p>0.05)。结论saaShift工作与睡眠质量差显著相关。在睡眠质量良好的护士中,轮班护士的饮食质量比非轮班护士差。睡眠医学研究2020;11(2):94-101
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引用次数: 2
Determination of Sleep Apnea Severity Using Multi-Layer Perceptron Neural Network 应用多层感知器神经网络测定睡眠呼吸暂停严重程度
Q4 Medicine Pub Date : 2020-12-17 DOI: 10.17241/smr.2020.00689
Z. Kohzadi, R. Safdari, K. Haghighi
Background and ObjectiveaaSleep apnea is a rather common illness, which occurs due to dyspnea during night sleep. The effects of this illness can cause problems in the patient’s life and affect its quality. Therefore, its timely diagnosis, using machine algorithms can be an important step towards preventing and controlling this illness. MethodsaaIn this study is using artificial neural networks, in order to detect the severity of sleep apnea among 200 patients, who visited the Imam Khomeini sleep clinic in Tehran. Then the artificial neural network with the structure (8-10-3-1), Sigmoid transfer function and 120 educational cycles were designed and educated based on 70% of the data at hand. The artificial neural network was designed, using MATLAB2018. ResultsaaUsing the multi-layer perceptron classifier with 10-fold cross validation tests led to 96.5%, 92.4%, 91.5% and 94.5% correctness, respectively for normal, mild, moderate and severe classifications. Enough correctness of the algorithm reduces the patients’ need to take the polysomnography test. ConclusionsaaThe results show that using artificial neural network can be useful in detecting the sleep apnea severity, without using costly tests and limited PSG. Sleep Med Res 2020;11(2):70-76
背景与目的睡眠呼吸暂停是一种比较常见的疾病,它是由于夜间睡眠呼吸困难引起的。这种疾病的影响可能会给患者的生活带来问题,并影响其质量。因此,使用机器算法对其进行及时诊断可以成为预防和控制这种疾病的重要一步。方法在这项研究中,使用人工神经网络来检测200名患者的睡眠呼吸暂停的严重程度,这些患者访问了德黑兰的伊玛目霍梅尼睡眠诊所。然后,基于70%的现有数据,设计并教育了具有结构(8-10-3-1)、Sigmoid传递函数和120个教育周期的人工神经网络。使用MATLAB2018设计了人工神经网络。结果a使用多层感知器分类器进行10次交叉验证测试,对正常、轻度、中度和重度分类的正确率分别为96.5%、92.4%、91.5%和94.5%。算法的足够正确性减少了患者进行多导睡眠图测试的需要。结论saa结果表明,使用人工神经网络可以在不使用昂贵的测试和有限的PSG的情况下检测睡眠呼吸暂停的严重程度。睡眠医学研究2020;11(2):70-76
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引用次数: 1
The Effect of Breathing Cycles Program on Heart Rate and Sleep Parameters in Healthy Young Adults 呼吸循环程序对健康青年心率和睡眠参数的影响
Q4 Medicine Pub Date : 2020-12-17 DOI: 10.17241/smr.2020.00668
Jirawat Wattanapanyawech, Premtip Thaveeratitham
Background and ObjectiveaaIn recent years, sleep problems have been increasing globally, there exists an urgent need to develop a therapeutic program promoting sleep quality. This study investigated the effect of three types of deep breathing cycles programs on heart rate (HR) and sleep parameters in healthy young adults. MethodsaaThirty healthy participants were recruited. HR and sleep parameters were measured via a smartwatch in all participants for two consecutive days. Participants were randomized into the forced deep breathing cycles (FDBC), non-forced deep breathing cycles (N-FDBC) and breathing control (BC) groups, with each participant performing the breathing cycle programs before sleep latency for 30 minutes. ResultsaaN-FDBC showed a significant increase in sleep quality (p < 0.001), time in bed (p < 0.05), and total sleep time (p < 0.001), as well as a significant decrease in sleep latency and %awake during sleep (p < 0.001). During sleep, maximum HR, minimum HR, average awake HR during sleep, average light sleep HR, and average deep sleep HR were significantly lower (p < 0.01). For the FDBC group, significant increases in sleep latency (p < 0.05) and decreases in %awake during sleep (p < 0.05) were observed. HR before sleep was higher (p < 0.01). Average HR while awake during sleep and light sleep stages significantly decreased (p < 0.001). Such changes in all parameters were not observed after the BC group. ConclusionsaaOur study demonstrates that N-FDBC yields clinical benefits by improving sleep quality and HR response during sleep in healthy adults. Sleep Med Res 2020;11(2):108-115
背景与目的近年来,睡眠问题在全球范围内不断增加,迫切需要开发一种提高睡眠质量的治疗方案。本研究探讨了三种类型的深呼吸循环程序对健康年轻人心率(HR)和睡眠参数的影响。方法:招募30名健康受试者。通过智能手表连续两天测量所有参与者的人力资源和睡眠参数。参与者被随机分为强制深呼吸周期(FDBC)、非强制深呼吸周期(N-FDBC)和呼吸控制(BC)组,每个参与者在睡眠潜伏期前进行30分钟的呼吸周期程序。结果saan - fdbc显著提高了睡眠质量(p < 0.001)、卧床时间(p < 0.05)和总睡眠时间(p < 0.001),显著降低了睡眠潜伏期和睡眠清醒率(p < 0.001)。睡眠时最大HR、最小HR、睡眠时平均清醒HR、平均浅睡眠HR、平均深睡眠HR均显著降低(p < 0.01)。FDBC组睡眠潜伏期显著增加(p < 0.05),睡眠清醒率显著降低(p < 0.05)。睡前HR较高(p < 0.01)。睡眠和浅睡眠阶段清醒时的平均HR显著降低(p < 0.001)。在BC组后未观察到所有参数的变化。结论:本研究表明,N-FDBC通过改善健康成人睡眠质量和HR反应而具有临床益处。睡眠医学杂志,2020;11(2):108-115
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引用次数: 1
Drug-Induced Sleep Endoscopy: A Guide for Treatment Selection 药物诱发睡眠内窥镜检查:治疗选择指南
Q4 Medicine Pub Date : 2020-06-30 DOI: 10.17241/smr.2020.00584
Jin Youp Kim, Seung Cheol Han, H. J. Lim, H. J. Kim, Jeong-Whun Kim, C. Rhee
Identifying the sites, severity, and pattern of upper airway obstruction in obstructive sleep apnea is crucial for determining the treatment options, particularly the surgical plan. Although early methods of assessment, such as Muller’s maneuver, computed tomography, and magnetic resonance imaging in awake patients have been utilized to assess obstructive sites, the physiologic and anatomical differences between awake and sleeping patients showed a limited ability of those methods as diagnostic tools. Recently, drug-induced sleep endoscopy (DISE) was introduced as a useful diagnostic and evaluation tool to identify dynamic upper airway collapse during sedation that simulates natural sleep. In this article, we review all aspects of DISE, including the technique, evaluation methods, and clinical application. Sleep Med Res 2020;11(1):1-6
确定阻塞性睡眠呼吸暂停患者上呼吸道阻塞的部位、严重程度和模式对于确定治疗方案,尤其是手术计划至关重要。尽管早期的评估方法,如穆勒手法、计算机断层扫描和清醒患者的磁共振成像,已被用于评估阻塞部位,但清醒和睡眠患者之间的生理和解剖差异表明,这些方法作为诊断工具的能力有限。最近,药物诱导睡眠内窥镜(DISE)被引入作为一种有用的诊断和评估工具,用于识别模拟自然睡眠的镇静过程中的动态上呼吸道塌陷。在这篇文章中,我们回顾了DISE的各个方面,包括技术、评估方法和临床应用。睡眠医学研究2020;11(1):1-6
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引用次数: 1
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Sleep Medicine Research
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