Dissertations / Theses on the topic 'Sleep apnea, obstructive'
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Lam, Chung-mei Jamie, and 林頌眉. "Obstructive sleep apnea and cardiometabolic complications." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2009. http://hub.hku.hk/bib/B43085854.
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Mariscal, Norma Linda, and Norma Linda Mariscal. "Management of Postoperative Obstructive Sleep Apnea." Diss., The University of Arizona, 2017. http://hdl.handle.net/10150/624558.
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Background: Obstructive sleep apnea (OSA) is a sleep disorder characterized by episodes of cessation of breathing (apnea) during sleep. Unfortunately, a significant number of surgical patients are unaware they are afflicted with this disorder increasing the risks of postoperative complications. The lingering effect of general anesthesia causes an increase in frequency of airway collapse, leading to longer periods of apnea. This increasingly common sleep disorder is concerning for many anesthesia providers.
Purpose: The purpose of this study was to evaluate the anesthesia provider's knowledge and postoperative management of patients with suspected or diagnosed OSA.
Setting: The study setting was a local urban hospital Mountain Vista Medical Center (MVMC) in Gilbert, AZ. The study included (N=7) participants, who were predominantly male (85%) and a majority of the participants were Master’s prepared (85%) anesthesia providers.
Method: An online survey was disseminated to participants via email. The survey included questions regarding the anesthesia provider's knowledge and postoperative practice habits of patients with suspected or diagnosed OSA at MVMC.
Results: The response rate was (24%). All the respondents acknowledged that OSA was a risk factor for postoperative complications. Over half of the respondents (85%) reported encountering postoperative complications such as desaturation and apnea in their patients with OSA. The main complication that was encountered was postoperative apnea (50%), followed by decreased in saturations (33.33%), and one respondent (16.67%) encountered re-intubation during the postoperative period. However, the most important finding of the study is that over half of the providers did not routinely include continued positive airway pressure (CPAP)/noninvasive positive pressure ventilation (NIPPV) in their postoperative management of patients with suspected or known OSA due to the time needed to initiate the therapy.
Conclusion: The study illustrates that a majority of anesthesia providers at MVMC agreed OSA is a significant risk factor for postoperative complications, but time constraints limited the implementation of noninvasive ventilation (NIV) therapies. Recommended strategies would be to establish a task force to examine this barrier to therapy and develop plans to address it.
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Lam, Chung-mei Jamie. "Obstructive sleep apnea and cardiometabolic complications." Click to view the E-thesis via HKUTO, 2009. http://sunzi.lib.hku.hk/hkuto/record/B43085854.
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Wimms, Alison Jane. "Gender Differences in Obstructive Sleep Apnea." Thesis, The University of Sydney, 2019. https://hdl.handle.net/2123/21632.
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The overall aim of this thesis was to understand gender differences in obstructive sleep apnea (OSA) and use this information to develop a tailored therapy for female patients. Specific aims were to determine whether gender differences commonly reported in the literature are present in mild OSA and upper airway resistance syndrome (UARS) patient groups, and whether symptoms could be linked to respiratory parameters in these groups. The final aim was to develop, test and validate a new AutoSet treatment for female OSA patients. CHAPTER 1 of this thesis provides a detailed review of gender differences in the prevalence, symptoms, clinical experience, and health outcomes of OSA and UARS patients, with a focus on the implications of different scoring rules. CHAPTER 2 reviews of quality of life questionnaires from 259 untreated patients with mild OSA. Females reported statistically significantly higher levels of sleepiness, fatigue, insomnia, and anxiety/depression compared to males. CHAPTER 3 of this thesis reviews polygraphy data from patients with mild OSA. Male patients were found to have significantly more breathing disturbances than females, however many of these difference disappeared when updated scoring criteria were used. Some weak correlations were found between respiratory parameters and symptoms; however, no clear conclusions could be drawn. CHAPTER 4 outlines the development of a new AutoSet device designed for female- specific breathing patterns. The remaining chapters (CHAPTER 5, and CHAPTER 6) of this thesis describe the testing and validation activities undertaken on the AutoSet F, including a clinical trial to test efficacy; a bench test to compare performance against other commercially available devices; a controlled product launch to validate the features of the algorithm; and finally a clinical trial which demonstrated improvements in sleep efficacy and quality of life over a three-month usage period. In summary, this thesis has shown that at the mild end of the OSA spectrum females are more symptomatic than males, even though respiratory differences in the genders are less pronounced than those described in moderate-to-severe patients. An AutoSet designed specifically for female OSA patients was successful in demonstrating efficacy and clinical effectiveness.
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Ulander, Martin. "Psychometric aspects of obstructive sleep apnea syndrome." Doctoral thesis, Linköpings universitet, Avdelningen för neurovetenskap, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-97475.
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Introduction: Obstructive sleep apnea (OSA) is a common chronic disorder consisting of episodes with impaired breathing due to obstruction of the upper airways. Treatment with Continuous Positive Airway Pressure (CPAP) is a potentially effective treatment, but adherence is low. Several potential factors affecting adherence, e.g., subjective sleepiness and personality, are only quantifiable through questionnaires. Better knowledge about psychometric properties of such questionnaires might improve future research on CPAP adherence and thus lead to better treatment options. Aim: Study I: To describe the devlopment and initial testing of the Side Effects of CPAP treatment Inventory (SECI) questionnaire. Study II: To describe the prevalence of Type D personality in OSAS patients with CPAP treatment longer than 6 months and the association with self-reported side effects and adherence. Study III: To study whether any of the items in the Epworth Sleepiness Scale (ESS) exhibit differential item functioning and, if so, to which degree. Study IV: To examine the evolution of CPAP side effects over time; and prospectively assess correlations between early CPAP side effects and treatment adherence. Patients and Methods: In study I, SECI items were based on a literature review, an expert panel and interviews with patients. It was then mailed to 329 CPAP-treated OSAS patients. Based on this, a principal component analysis was performed, and SECI results were compared between adherent and non-adherent patients. In study II, the population consisted of 247 OSAS patients with ongoing CPAP treatment. The DS14 was used to assess the prevalence of type D personality, and SECI and adherence data from medical records were used to correlate Type D personality to side effects and adherence. In study III, the population consisted of pooled data from 1,167 subjects who had completed the ESS in five other studies. Ordinal regression and Rasch analysis were used to assess the existence of differential item functioning for age and gender. The cutoff for age was 65 years in the Rasch analysis. In study IV, SECI was sent to 186 subjects with newly diagnosed OSAS three times during the first year on CPAP. SECI results were followed over time within subjects, and were correlated to treatment dropout during the first year and machine usage time after 6 months. Results: SECI provides a valid and reliable instrument to measure side effects, and non-adherent patients have higher scores (i.e., were more bothered by side effects) than adherent patients (study I). Type D personality was prevalent in approximately 30 % of CPAP treated OSAS patients, and was associated to poorer objective and subjective adherence as well as more side effects (study II). Differential item functioning was present in items 3, 4 and 8 for age in both DIF analyses, and to gender in item 8 the Rasch analysis (study III). Dry mouth and increased number of awakenings were consistently associated to poorer adherence in CPAP treated patients. Side effects both emerged and resolved over time (study IV). Conclusions: Differences in previous research regarding side effects and CPAP adherence might be explained by differences in how side effects and adherence are defined. While some side effects are related to adherence, others are not. Side effects are furthermore not stable over time, and might be related to personality. ESS scores are also related to CPAP adherence according to previous research, but might be affected by other factors than sleepiness, such as age and possibly gender.
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Lee, Kevin Chien-Hsun. "Dentofacial morphology in children with obstructive sleep apnea." Thesis, University of British Columbia, 2015. http://hdl.handle.net/2429/54507.
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Objectives: Altered dentofacial morphology has been suggested as an etiology for childhood OSA. Nevertheless, existing reports on the dentofacial characteristics of children with OSA vary significantly and are limited by the infrequent use of polysomnography (PSG) for diagnosis. Therefore, the objective of this study is to establish the prevalence of dentofacial morphology in children with OSA diagnosed using PSG.
Methods: The sample comprised 64 children between the ages of 4-16 who were referred to BC Children’s Hospital for PSG. Diagnosis of OSA was provided by an overnight, in-laboratory PSG. Malocclusion was assessed clinically by one orthodontist (K.L.), blinded to PSG results.
Results: Children with previous orthodontic treatment were excluded and children with craniofacial syndromes were analyzed separately. The 17 patients with craniofacial syndromes presented a significantly different dentofacial features and higher prevalence of OSA when compared to the non-syndromic children. The remaining 39 patients were divided into an OSA group (AHI ≥ 2; n=17) and a non-OSA group (AHI < 2; n=22). There were no statistically significant differences in frequency of any dentofacial features between the two groups, although the OSA group had a lower prevalence of convex profile, Class II molar relationship, and overjet (OJ) ≥ 5mm.
Subjects in the OSA group were further divided into a lower AHI (AHI between 2-5; n=9) group and a higher AHI group (AHI ≥ 5; n=8). There was no statistically significant difference in frequency of any dentofacial features between the three groups. Nevertheless, subjects in the higher AHI group had a lower prevalence of convex profile and poster crossbite, with less crowding and smaller OJ on average.
Conclusions: In this patient population of 39 children between the ages of 4-16 who were referred to BCCH for an overnight sleep study, no statistically significant differences in dentofacial morphology and occlusal characteristics were found between children diagnosed with and without OSA. It is likely that children with OSA have a highly variable presentation of anatomical features, and future studies with a larger sample size and a true control group is needed to establish the dentofacial morphology of this population.Dentistry, Faculty of
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Kalra, Maninder. "Genetic Susceptibility to Obstructive Sleep Apnea in Children." University of Cincinnati / OhioLINK, 2008. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1226552538.
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Aihara, Kensaku. "Local and systemic inflammation in obstructive sleep apnea." Kyoto University, 2013. http://hdl.handle.net/2433/170073.
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Gagnon, Victoria Lee. "Obstructive sleep apnea syndrome and associated health risks /." Abstract Full Text (HTML) Full Text (PDF), 2008. http://eprints.ccsu.edu/archive/00000538/02/1986FT.htm.
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Thesis (M.S.) -- Central Connecticut State University, 2008.Thesis advisor: Ruth Rollin. "... in partial fulfillment of the requirements for the degree of Master of Science in Biology." Includes bibliographical references (leaves 39-41). Also available via the World Wide Web.
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Huhtakangas, J. (Jaana). "Evolution of obstructive sleep apnea after ischemic stroke." Doctoral thesis, Oulun yliopisto, 2019. http://urn.fi/urn:isbn:9789526224343.
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Abstract In Finland, the costs of stroke are approximately 1.1 billion euros annually due to long disability and hospitalization episodes. Sleep apnea is a risk factor for stroke. The prevalence of sleep apnea among stroke patients is unknown because sleep recording is not usually performed on stroke patients. There are no previous studies investigating the association of thrombolysis on the prognosis of sleep apnea. The relation between sleep apnea and cardiovascular events is still unclear. In this prospective, observational study, I recruited voluntary, consecutive ischemic stroke patients over the age of 18 years who were or were not eligible for thrombolysis treatment. The investigators did not affect the treatment and patients were not randomized to thrombolysis. The final analysis included 204 patients; of these, 110 underwent thrombolysis therapy and 94 were treated without thrombolysis. Cardiorespiratory polygraphy was carried out with a portable three-channel device (ApneaLinkPlus™, Resmed, Sydney, Australia) at the ward within 48 hours after the onset of stroke symptoms. The cardiorespiratory polygraphy was repeated at home after a six-month follow-up. Both automatic scoring and manual scoring pointed out excellent agreement in arterial oxyhemoglobin decrease of > 4% (ODI4), lowest arterial oxyhemoglobin saturation (SaO2) or percentage of time spent below 90 percent saturation. The automated scoring underestimated the severity of sleep apnea, recognized poorly the type of event, and missed 18.6% of sleep apnea diagnoses. The total prevalence of sleep apnea in this study was 91.2% on admission to hospital. The stroke patients treated with thrombolysis had more, and more severe sleep apnea in the first sleep recording compared to those without thrombolysis therapy. After follow-up, the prevalence of sleep apnea still remained high, and sleep apnea was aggravated in two thirds of the stroke patients. The study patients without thrombolysis treatment had six-fold higher risk for incident sleep apnea after the follow-up. The stroke patients with thrombolysis therapy and visible stroke on CT had more nocturnal hypoxemia and higher obstructive apnea index than the patients without stroke lesion on follow-up CT 24 hours after thrombolysis treatment. The larger the ischemic stroke volume, the greater the time spent with saturation below 90%Tiivistelmä Aivoinfarkti on yleinen ja kansanterveydellisesti sekä taloudellisesti merkittävä sairaus, jonka aiheuttamat kustannukset Suomessa ovat noin 1.1 miljardia euroa pitkistä työkyvyttömyys- ja sairaalajaksoista johtuen. Uniapnea on aivoinfarktille altistava tekijä. Uniapnean esiintyvyys suomalaisilla aivoinfarktipotilailla ei ole arvioitavissa, koska aivoinfarktin sairastaneille ei yleensä tehdä unirekisteröintiä. Kannettavat yöpolygrafialaitteet saattaisivat olla vaihtoehto aivoinfarktipotilaiden uniapnean diagnosoinnille. Tutkittua tietoa liuotushoidon yhteydestä uniapnean ennusteeseen ei ole. Uniapnean sekä sydän- ja verisuonitapahtumien syy-yhteys on edelleen epäselvä. Rekrytoin prospektiiviseen tutkimukseeni vapaaehtoisia, peräkkäisiä yli 18-vuotiaita iskeemiseen aivoinfarktiin sairastuneita liuotushoidettuja ja liuotushoitoon soveltumattomia potilaita. Tutkimuksen lopullinen potilasmäärä oli 204, joista 110 sai liuotushoidon ja 94 hoidettiin ilman liuotusta. Kaikille potilaille tehtiin yöpolygrafia kannettavalla, kolmikanavaisella yöpolygrafialaitteella (Apnealink Plus, Resmed, Sydney, Australia) osastolla 48 tunnin kuluessa sairastumisesta. Yöpolygrafia toistettiin potilaan kotona kuuden kuukauden kuluttua. Sekä automaattitulos että manuaalisesti arvioitu unirekisteröintitulos olivat erittäin yhteneväisiä, kun arvion kohteena olivat happikyllästeisyyden neljän prosenttiyksikön suuruiset pudotukset tuntia kohti, matalin veren happikyllästeisyys tai alle 90 % happikyllästeisyyden osuus yöstä. Automaattianalyysi aliarvioi uniapnean vaikeuden, havaitsi huonosti hengityskatkosten tyypin eikä löytänyt 18,6 prosenttia uniapneadiagnooseista. Uniapnean esiintyvyys koko aineistossa oli sairaalaan tullessa 91,2 %. Liuotushoidetuilla potilailla todettiin ensimmäisessä rekisteröinnissä enemmän uniapneaa ja se oli vaikeampaa kuin ei-liuotushoidetuilla. Seurannassa uniapnean määrä pysyi edelleen korkeana ja uniapnea vaikeutui kahdella potilaalla kolmesta. Liuotushoitoon soveltumattomilla aivoinfarktipotilailla todettiin liuotushoidon saaneisiin verrattuna kuusinkertainen riski sairastua uniapneaan puolen vuoden aikana. Liuotushoidetuilla aivoinfarktipotilailla, joilla oli infarktimuutos kuvantamistutkimuksessa, oli yöllistä valtimoveren happikyllästeisyyden huononemista ja ylähengitysteiden ahtautumisesta johtuvia hengityskatkoksia enemmän kuin niillä potilailla, joilla ei todettu iskeemisiä muutoksia aivokuvantamisessa 24 tuntia liuotushoidon jälkeen. Mitä suurempi aivoinfarktin tilavuus, sitä suuremman osuuden yöstä veren happikyllästeisyys oli alle 90 %
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Appelberg, Jonas. "Ventilation and Lung Volume During Sleep and in Obstructive Sleep Apnea." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2003. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-3363.
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Wong, Keith K. H. "Measuring sleep and neurobiological functional parameters in patients with obstructive sleep apnea." Connect to full text, 2007. http://hdl.handle.net/2123/2245.
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Thesis (Ph. D.)--University of Sydney, 2008.Title from title screen (viewed Mar. 12, 2008). Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy to the Discipline of Medicine, Faculty of Medicine. Degree awarded 2008; thesis submitted 2007. Includes bibliography. Also issued in print.
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Wong, Keith Keat Huat. "Measuring sleep and neurobiological functional parameters in patients with obstructive sleep apnea." University of Sydney, 2008. http://hdl.handle.net/2123/2245.
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Doctor of Philosophy (Medicine)Sleepiness is an important source of morbidity in the community, with potentially catastrophic consequences of occupational or driving injuries or accidents. Although many measures of sleepiness exist, there is no gold standard. The electroencephalograph (EEG) has been studied as an indicator of sleep pressure in the waking organism, or sleep depth. A mathematical model has been developed, relating the observed EEG to interactions between groups of neurons in the cortex and thalamus (Robinson, Rennie, Rowe, O'Connor, & Gordon, 2005; Robinson, Rennie, & Wright, 1997). These interactions are thought to be important in the transition from wake to sleep. Sleepiness is common in obstructive sleep apnea (OSA). The measurement of sleepiness would have great utility in quantifying the disease burden, measuring treatment response, or determining fitness for work or driving. This study will evaluate parameters derived from the EEG mathematical model as a measure of sleepiness. It is divided into the following four parts: 1. Subjects with likely OSA based on symptoms and demographics from an international database were compared with matched non-OSA controls. The OSA group showed deficits in executive function and abnormalities on evoked response potential testing. 2. Outcomes from a cross-sectional study in a sleep-clinic OSA population were aggregated by factor analysis into a five summary variables relevant to sleepiness: subjective sleepiness, mood & anxiety, memory & learning, driving, and executive functioning. 3. EEG mathematical model parameters from wake EEG recordings were related to the five summary outcomes. Executive function correlated with a parameter Z, representing the negative feedback loop between the thalamic reticular nucleus and the thalamocortical relay nuclei. 4. EEG model parameters during first NREM sleep cycle of 8 subjects with regular sleep architecture were studied. Net cortical excitation (parameter X) is predicted to increase across the cycle, while there was, as predicted, a greater inhibitory effect of the thalamic reticular nucleus upon thalamocortical relay cells (parameter Z). In this preliminary assessment, EEG model parameters reflecting thalamocortical interactions are sensitive to prefrontal lobe tasks such as executive function, which are known to be vulnerable to sleep loss and sleepiness, and these parameters also show variation with increasing sleep depth.
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Wong, Keith Keat Huat. "Measuring sleep and neurobiological functional parameters in patients with obstructive sleep apnea." Thesis, The University of Sydney, 2007. http://hdl.handle.net/2123/2245.
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Sleepiness is an important source of morbidity in the community, with potentially catastrophic consequences of occupational or driving injuries or accidents. Although many measures of sleepiness exist, there is no gold standard. The electroencephalograph (EEG) has been studied as an indicator of sleep pressure in the waking organism, or sleep depth. A mathematical model has been developed, relating the observed EEG to interactions between groups of neurons in the cortex and thalamus (Robinson, Rennie, Rowe, O'Connor, & Gordon, 2005; Robinson, Rennie, & Wright, 1997). These interactions are thought to be important in the transition from wake to sleep. Sleepiness is common in obstructive sleep apnea (OSA). The measurement of sleepiness would have great utility in quantifying the disease burden, measuring treatment response, or determining fitness for work or driving. This study will evaluate parameters derived from the EEG mathematical model as a measure of sleepiness. It is divided into the following four parts: 1. Subjects with likely OSA based on symptoms and demographics from an international database were compared with matched non-OSA controls. The OSA group showed deficits in executive function and abnormalities on evoked response potential testing. 2. Outcomes from a cross-sectional study in a sleep-clinic OSA population were aggregated by factor analysis into a five summary variables relevant to sleepiness: subjective sleepiness, mood & anxiety, memory & learning, driving, and executive functioning. 3. EEG mathematical model parameters from wake EEG recordings were related to the five summary outcomes. Executive function correlated with a parameter Z, representing the negative feedback loop between the thalamic reticular nucleus and the thalamocortical relay nuclei. 4. EEG model parameters during first NREM sleep cycle of 8 subjects with regular sleep architecture were studied. Net cortical excitation (parameter X) is predicted to increase across the cycle, while there was, as predicted, a greater inhibitory effect of the thalamic reticular nucleus upon thalamocortical relay cells (parameter Z). In this preliminary assessment, EEG model parameters reflecting thalamocortical interactions are sensitive to prefrontal lobe tasks such as executive function, which are known to be vulnerable to sleep loss and sleepiness, and these parameters also show variation with increasing sleep depth.
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Haddad, Diane. "Oxidative stress and endothelial dysfunction in obstructive sleep apnea." Connect to resource, 2010. http://hdl.handle.net/1811/45466.
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Brooks, Dina. "The effects of obstructive sleep apnea on blood pressure." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1996. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/NQ27881.pdf.
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Iliescu, Eduard Andrei. "Prevalence of proteinuria in the obstructive sleep apnea syndrome." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape4/PQDD_0018/MQ54460.pdf.
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Champagne, Katéri A. "The association of obstructive sleep apnea and gestational hypertension /." Thesis, McGill University, 2006. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=99328.
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Rationale. Hypertension occurs in 10% of pregnancies. Snoring is a marker for sleep apnea, and is a newly identified risk factor for gestational hypertension. Moreover, sleep apnea is an independent risk factor for hypertension in the non-pregnant population. I hypothesized that sleep apnea was associated with gestational hypertension.Hypothesis. The prevalence of sleep apnea is higher among pregnant women with hypertensive pregnancies than among those without hypertension during pregnancy.
Design. Case-control study of 17 pregnant women with gestational hypertension and 33 pregnant women without hypertension, with matching by gestational age. Sleep apnea was ascertained by polysomnography.
Results. The crude odds ratio for the presence of obstructive sleep apnea, given the presence of gestational hypertension, was 5.6. The odds ratio was 7.5 (95% CI 3.5-16), based on a logistic regression model with adjustment for maternal age, gestational age, nulliparity, first pregnancy, and body mass index.
Conclusion. Gestational hypertension was strongly associated with the presence of obstructive sleep apnea.
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Hlaing, EiEi. "Neuropsychological Sequelae of Obstructive Sleep Apnea in Later Adulthood." OpenSIUC, 2015. https://opensiuc.lib.siu.edu/dissertations/1043.
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The present study examined the neuropsychological relevance of poor sleep in a sample of community dwelling healthy older adults and a clinical sample of patients with untreated obstructive sleep apnea (OSA) between 40 and 90 years of age. The cognitive performance of 67 patients with obstructive sleep apnea (OSA) was compared to those of 46 controls screened for OSA using a portable device called ApneaLinkTM. The current study identified common neuropsychological variables associated with poor sleep quality in general (i.e., as a result of daytime sleepiness) and neuropsychological variables unique to only OSA patients (i.e., manifesting oxygen desaturation at night in addition to daytime sleepiness). Results indicated executive functions were related to hypoxemia and sustained attention was related to sleep fragmentation in the current study. A medical sequelae model and a neuropsychological sequelae model were tested. The neuropsychological sequelae model predicted whether one was a control or an OSA patient 70% accurately based on the predictors (scores on Wisconsin Card Sorting Test perseverance error, vigilance task, WAIS III forward digit span, WAIS III Block Design, phonemic and semantic fluency, and WAIS III backward digit span). The medical sequelae model predicted OSA status 89% accurately based on the predictors (BMI, depression, subjective sleep quality, age, hypertension, diabetes, total mood disturbance, gender, and general health). The current study provides further justification for OSA screening in the general population during middle age and late adulthood especially in those most at risk (i.e., overweight, male, hypertensive, and poor subjective sleep quality).
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Kidwai, Asif. "Technology Acceptance and Compliance in Obstructive Sleep Apnea Patients." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5209.
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The focus of this study is the problem of declining trend in obstructive sleep apnea (OSA) patient compliance. Studies reported improved compliance in patients with chronic diseases due to technology-based interventions. However, researchers have not investigated the advantages of technology to improve the compliance of OSA patients in detail. The specific problem was the lack of engagement between patients and healthcare managers, resulting in low compliance within OSA patients. The purpose of this qualitative study was to evaluate how technology-based interventions can improve OSA patient engagement with the healthcare managers resulting in improved compliance with treatment procedures. In this study, the technology acceptance model was used as the instrument in evaluating the information collected through interviews with 20 healthcare managers about their attitudes toward usage, perceived usefulness, and perceived ease of use. The transcribed interviews were open-coded using the RQDA library in R Studio. In general, results from this study indicated that the healthcare managers showed a positive attitude towards the use of technology for patient engagement and expressed that the technology is useful for patient engagement and is easier to use. However, they identified technology-related and patient-related challenges in implementing technology for patient engagement. Further, the respondents identified process-related and patient-related opportunities in using technology for patient engagement. Results from this study have practice and policy implications by enabling healthcare managers to devise better compliance plans for OSA patient management. The findings could have a social benefit by helping healthcare managers to implement technology-based interventions to better achieve a higher compliance resulting in better patient health at lower costs.
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Matsumoto, Takeshi. "Microalbuminuria in Patients with Obstructive Sleep Apnea-Chronic Obstructive Pulmonary Disease Overlap Syndrome." Kyoto University, 2018. http://hdl.handle.net/2433/232105.
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Craig, Sonya Elizabeth. "Cardiovascular consequences of obstructive sleep apnoea in minimally symptomatic patients." Thesis, University of Cambridge, 2015. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.708448.
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Tsai, Willis Harvey. "A decision rule for diagnostic testing in obstructive sleep apnea." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape8/PQDD_0021/MQ48052.pdf.
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Hagander, Louise. "Quantitative sensory testing, obstructive sleep apnea and peripheral nervous lesions /." Stockholm, 2006. http://diss.kib.ki.se/2006/91-7140-780-4/.
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Tessema, Tizita Gedeon. "Detecting Obstructive Sleep Apnea in an Adult Primary Care Population." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6867.
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Obstructive sleep apnea (OSA) is a sleep-related disorder that pauses or decreases air flow during sleep as a result of an obstructed upper airway. About 25 million people in the United States are affected by OSA. OSA has low identification and referral rates, especially in primary care facilities as indicated by the lack of patients' sleep histories. Screening tools such as questionnaires ensure an effective detection of OSA. The practice-focused question examined whether implementing the Epworth sleepiness scale (ESS) in an outpatient primary care setting would increase the number of referrals of high-risk patients. The purpose of the project was to improve the referral rates of high-risk patients for OSA evaluation through ESS in a primary care clinic. The plan-do-study-act model was used to guide and evaluate the intervention and analysis of outcomes to determine the success and failure rates of the intervention in relation to the project goal. The data were collected from an outpatient primary care clinic. Measures of central tendency were used to summarize the data, and a 2-proportion z test was employed to analyze the efficiency of the education procedure. The findings showed that the implementation of the ESS increased the number of referrals for high-risk patients (z = 4.140, p = 0.000), indicating that the ESS is an effective tool in facilitating the management of OSA. The findings of this project could be used to increase awareness of the positive benefits of the ESS, which can encourage the implementation of the tool in other clinical facilities and further education about the ESS. The project might contribute to positive social change and nursing practice through the increase of referrals for OSA, which improves the quality of life of patients.
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D'ROZARIO, Angela Louise. "Electroencephalogram (EEG) biomarkers of neurobehavioural dysfunction in obstructive sleep apnea." Thesis, The University of Sydney, 2014. http://hdl.handle.net/2123/9886.
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Obstructive sleep apnea (OSA) affects an estimated 2-4% of middle–aged adults yet we are still exploring how best to delineate the neurophysiological deficits that accompany this disorder. Untreated OSA leads to an increased risk of motor vehicle accidents. Traditional polysomnographic (PSG) metrics do not consistently correlate with daytime functioning. There is a clinical need for simple biomarkers to identify individuals susceptible to OSA-related cognitive deficits. There is a close relationship between EEG-based changes in brain activity and daytime function in healthy sleepers. No studies have explored quantitative EEG (qEEG) biomarkers during baseline sleep and resting wakefulness (baseline) as correlates of waking neurobehavioural performance during extended wakefulness in OSA. The aims of the thesis were 1) to identify qEEG biomarkers of neurobehavioural dysfunction and sleepiness in OSA and controls during 40-hours (h) of extended wakefulness, and 2) to develop and validate automated EEG artefact processing methods for subsequent qEEG analysis of waking and sleep EEG. EEG biomarkers were derived using conventional power spectral analysis and a novel qEEG analysis technique, detrended fluctuation analysis (DFA). This study showed that wake qEEG markers significantly correlated with impaired performance and increased sleepiness across 40-h of extended wakefulness in both groups. Baseline waking measures of the DFA scaling exponent, but not power spectra, were associated with impaired simulated driving after 24-h awake in OSA. Furthermore, OSA patients with greater EEG slowing during REM sleep showed a marked decline in performance after 24-h awake. These key findings highlight the potential utility of qEEG analysis to yield simple biomarkers of neurobehavioural impairment and sleepiness. Automated EEG artefact processing methods for resting awake and PSG recordings were developed and validated against a reference-standard of manual artefact recognition as part of this study. These proven artefact processing methods will be pivotal for exploring qEEG biomarkers in future studies.
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Cayanan, Elizabeth Anne. "Obstructive Sleep Apnea and Behavioural Obesity Management in Adult Patients." Thesis, The University of Sydney, 2015. http://hdl.handle.net/2123/14765.
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The association between obstructive sleep apnea (OSA) and obesity is well established and their frequent coexistence induces cardio-metabolic impairment. While mechanical therapies such as continuous positive airway pressure (CPAP) offer symptomatic alleviation, they fail to cure OSA in the absence of treatment use. Potential disease resolution depends on obesity reduction however there is a paucity of data regarding intensive weight loss regimes such as a very low energy diet (VLED) and dietary strategies for long-term weight loss maintenance in patients suffering OSA. This thesis entails a lifestyle modification program tailored to patients with OSA to promote behavioural change. An open label cohort study tested this program in 24 patients using mechanical treatment (CPAP or mandibular advancement splint) and in 18 patients not prescribed mechanical treatment. All patients initiated a 2 month VLED and significantly reduced anthropometry and maintained this by 12 month follow up. Healthy cardio-metabolic function was sustained and use of antihypertensive medication was reduced. This model of weight loss was feasible, tolerable and efficacious in a clinical setting. Weight loss maintenance was simultaneously tested in a randomised controlled trial. Stratified patients were allocated to the Australian Guide to Healthy Eating diet (n= 20) or an iso-caloric low glycemic index high protein diet (n= 22) following successful completion of the VLED. Both diets maintained significant obesity reduction and healthy cardio-metabolic function for 10 months. Sympathetic activity measured by the urinary catecholamines epinephrine and norepinephrine and heart rate variability were assessed had no association with weight loss and cannot predict treatment responders. This research provides novel insight into weight loss treatment strategies for patients with OSA in a clinical setting and furthers our understanding of effective obesity management in this vulnerable population.
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Rowsell, Luke Joshua. "The Effect of Acute Oral Morphine on Obstructive Sleep Apnea." Thesis, The University of Sydney, 2016. http://hdl.handle.net/2123/16441.
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This thesis aims to evaluate the effect of 40mg oral slow release morphine on obstructive sleep apnea (OSA) and awake ventilatory chemoreflexes in 60 OSA men in a randomised, double-blind placebo controlled crossover study. The study attempts to phenotype and genotype the potentially large variability of OSA response to a common dose of morphine using cutting edge techniques. We found that morphine caused mild respiratory depression but did not affect the percent of TST spent below 90% oxygen saturation (T90), nor apnea-hypopnea index (AHI). However, large inter-individual variability was observed. Morphine tended to improve T90 in A/G vs A/A OPRM1 genotype subjects. 2. Morphine reduced slow wave sleep and rapid eye movement (REM) sleep overall, however did not attenuate REM sleep in subjects with (CT + TT) vs CC HTR3B genotype. Total sleep time (TST) increased following morphine in C/C vs (C/T + T/T) ABCB1 genotype subjects only. 3. CO2 ventilatory recruitment threshold (VRT) was increased and hypercapnic/hypoxic ventilatory response (HCVR/HVR) was depressed overall. HCVR depression following morphine was greater in A/G vs A/A OPRM1 subjects, and C/C vs (C/T + T/T) ABCB1 subjects. 4. A mechanism by which morphine may improve OSA in some OSA patients through reducing chemosensitivity and widening CO2 reserve was proposed. 5. Negative linear relationships were found in severe OSA patients between baseline VRT and morphine effect on AHI, oxygen desaturation index, arousal index and T90. 6. Subjects with extreme improvement in T90 following morphine were older, had higher VRT and were often A/G OPRM1 genotype compared to those with greatest deterioration. In conclusion, 40mg morphine on average only caused mild respiratory depression but with a large variability in men with OSA. The large inter-individual variability may be partly explained by baseline awake chemoreflexes. Certain genotypes associated with differential morphine effect on OSA were identified.
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Patel, Mayur Mahendra. "A comparison of the edentulous and dentate prosthodontic patient for the occurrence of obstructive sleep apnea." Morgantown, W. Va. : [West Virginia University Libraries], 2004. https://etd.wvu.edu/etd/controller.jsp?moduleName=documentdata&jsp%5FetdId=3321.
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Thesis (M.S.)--West Virginia University, 2004.Title from document title page. Document formatted into pages; contains vii, 47 p. : ill. (some col.). Vita. Includes abstract. Includes bibliographical references (p. 30-31).
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Shepherd, Kelly. "Gastro-oesophageal reflux in obstructive sleep apnoea : prevalence and mechanisms." University of Western Australia. School of Anatomy and Human Biology, 2009. http://theses.library.uwa.edu.au/adt-WU2009.0085.
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Background. Obstructive Sleep Apnoea (OSA) is associated with an increase in nocturnal gastro-oesophageal reflux (nocturnalGOR) events and symptoms, however the mechanism for this remains undefined. Treatment of OSA with continuous positive airway pressure (CPAP) has been shown to reduce nocturnalGOR in individuals with OSA however the reasons for this reduction are not clear. The combination of OSA and nocturnalGOR could be particularly problematic for individuals who have had a lung transplant in whom Bronchiolitis Obliterans Syndrome (BOS) limits survival. It is thought that GOR plays a role in the development of BOS in these individuals. Methods and Results. Five interrelated studies were undertaken. The first two studies sought to determine and compare the prevalence and risk factors of nocturnalGOR in OSA patients with the general population. To do this, a GOR questionnaire was completed by 2,042 members of the general community as part of the Busselton Health Survey and by 1,116 patients with polysomnography-diagnosed OSA. Risk of OSA in the general population was determined using a standardised sleep questionnaire. 137 of the OSA patients completed the questionnaire before and after treatment with CPAP. The prevalence of nocturnalGOR symptoms reported more than once a week (frequent symptoms) was greater in OSA patients (10.1%) than the general population (5.8%) (p<0.001), in individuals from the general population at high (11.2%) than low risk of OSA (4.5%) (p<0.001) and in patients with severe (14.7%) than mild OSA (5.2%) (p<0.001). Treatment of OSA with CPAP decreased the prevalence of frequent nocturnalGOR from 9.0% to 3.8% (p=0.04). In the general population, high risk of OSA was independently associated with a 2.4-fold increased risk of frequent ABSTRACT vi nocturnalGOR symptoms than low risk. In the OSA group, disease severity was independently associated with nocturnalGOR symptoms, with an adjusted odds ratio of 1.7 for frequent nocturnalGOR symptoms.
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Karci, Ersin. "Detection Of Post Apnea Sounds And Apnea Periods From Sleep Sounds." Master's thesis, METU, 2011. http://etd.lib.metu.edu.tr/upload/12612964/index.pdf.
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Obstructive Sleep Apnea Syndrome (OSAS) is defined as a sleep related breathing disorder that causes the body to stop breathing for about 10 seconds and mostly ends with a loud sound due to the opening of the airway. OSAS is traditionally diagnosed using polysomnography, which requires a whole night stay at the sleep laboratory of a hospital, with multiple electrodes attached to the patient's body. Snoring is a symptom which may indicate presence of OSAS
thus investigation of snoring sounds, which can be recorded in the patient'
s own sleeping environment, has become popular in recent years to diagnose OSAS. In this study, we aim to develop a new method to detect post-apnea snoring episodes with the goal of diagnosing apnea or creating a new criteria similar to apnea / hypopnea index. In this method, first segmentation is done to eliminate the silence parts and only deal with active. Then these episodes are represented by distinctive features
some of these features are available in literature but some of them are novel. Finally, these episodes are classified using supervised and unsupervised methods. We are especially interested in detecting post apnea episodes, hence the apnea periods. False alarm rates are reduced by adding additional constraints into the detection algorithm. These methods are applied to snoring sound signals of OSAS patients, recorded in Gulhane Military Medical Academy, to verify the success of our algorithms.
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Lee, Ee Lin. "The correspondence between home and laboratory sleep measures in children with obstructive sleep apnea /." Title page and abstract only, 1998. http://web4.library.adelaide.edu.au/theses/09SB/09sbl447.pdf.
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Crisalli, Joseph A. M. D. "Baroreflex Sensitivity after Adenotonsillectomy in Children with Obstructive Sleep Apnea during Wakefulness and Sleep." University of Cincinnati / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1384334068.
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Ankrah, Naa Kwaduah. "The Improvement in Obstructive Sleep Apnea and Sleep Duration and its Association with Changes Macronutrient Intake in Adults." University of Akron / OhioLINK, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=akron1279563986.
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Lam, Yau-min, and 林宥冕. "Obstructive sleep apnea in children with Down syndrome: a systematic review." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B48423786.
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While obstructive sleep apnea among children with Down syndrome is very common, the pre-existing risk factors and its impact to neurodevelopment are not well known. The aims and objectives of this systematic review are to determine the prevalence of OSA among DS children and to identify the associated risk factors. 6 articles that met the inclusion criteria were retrieved after using PubMed and Google Scholar in literature searching. The prevalence of OSA has great variation among different countries but are relatively high, ranging from 57% to 79%. OSA was significant associated with obesity, age and tonsil size. It is also known to associate with behavioral problem in DS children and delay their neurodevelopment. Therefore, early treatment followed by appropriate modification in lifestyle and diet is crucial in managing OSA.published_or_final_version
Public Health
Master
Master of Public Health
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Cronly, Jo. "Development of a Simplified Pediatric Obstructive Sleep Apnea (OSA) Screening Tool." VCU Scholars Compass, 2014. http://scholarscompass.vcu.edu/etd/3337.
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Background: Obstructive sleep apnea has become recognized as one of the most common, under-diagnosed chronic diseases. Recently studies have shown increased numbers among the pediatric and adolescent population. OSA in children is associated with behavioral problems, poor school achievements, and in severe cases, pulmonary hypertension. OSA is often the Achilles heel of pediatric sedation and analgesic programs; during sedation, children with OSA have an increased vulnerability of their airway undergoing pharyngeal collapse and of having upper airway obstruction. Consequently, pediatric dentists who practice sedation dentistry should exercise extra precautions when treating patients with risk of sleep apnea. Currently there is no screening tool used in pediatric dentistry for diagnosing OSA during the pre-operative appointment or consultation for patients undergoing minimal and moderate oral conscious sedation. The purpose of this study was to develop and test a concise and easy-to-use questionnaire as a screening tool to aid in the diagnosis of OSA in pediatric patients. Materials and Methods: A retrospective chart review of 180 patients under the age of 18, who completed a polysomnogram at the VCU Center for Sleep Medicine between February 2011 and February 2013. A validated adult questionnaire, STOPBANG, was modified using more typical pediatric risk factors for OSA: presence of snoring (S), tonsillar hypertrophy (T1), tiredness; pESS>10 (T2), observed obstruction (O), neuroPsych-behavioral symptoms such as ADHD or daytime irritability (P), BMI percentile for age (B), age at diagnostic screening (A), presence of neuromuscular disorder (N), and presence of genetic/congenital disorder (G). A positive scoring from these variables was measured against the standard OSA measure, Apnea-Hypopnea Index. A multiple logistic regression analysis tested for relationships. Results: There was a statistically significant relationship P= .0007 for the S(T1)OPBANG scale, with a minimum of 4 variables needed to have a sensitivity of 57% and a specificity of 78%. There was also a statistically significant relationship P= .0040 for the S(T2)OPBANG, the cutoff>5 yielding sensitivity=36%, and specificity=90%. Only obstruction, BMI, and age showed a strong significant relationship to OSA. The presence of an obstruction was positively related to apnea (P = 0.0010). Most of the other components had an odds-ratio larger than one (indicating a nominally positive relationship). Conclusions: While both STOPBANG screening tools showed a statistically significant relationship, only obstruction, BMI, and age showed a predictive relationship to OSA. Consequently, consideration of other risk factors may be beneficial for future studies.
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Nisar, Shiraz A., Raghunandan Muppidi, Sumit Duggal, Adrian V. Hernández, Vidyasagar Kalahasti, Wael Jaber, and Omar A. Minai. "Impaired Functional Capacity Predicts Mortality in Patients with Obstructive Sleep Apnea." The American Thoracic Society, 2014. http://hdl.handle.net/10757/337271.
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oam1998@outlook.comBackground: Obstructive sleep apnea (OSA) is associated with increased mortality, for which impaired functional capacity (IFC) has been established as a surrogate. We sought to assess whether IFC is associated with increased mortality in patients with OSA and whether IFC is predictive of increased mortality after accounting for coronary artery disease. Methods: Patients with OSA who underwent both polysomnography testing and exercise stress echocardiogram were selected. Records were reviewed retrospectively for demographics, comorbidities, stress echocardiographic parameters, and polysomnography data. Univariable and multivariable logistic regression analysis was used to evaluate the association between IFC and overall mortality. We then evaluated the variables associated with IFC in the overall population and in the subgroup with normal Duke treadmill score (DTS). Results: In our cohort, 404 (26%) patients had IFC. The best predictors of IFC were female sex, history of smoking, ejection fraction less than 55, increased body mass index, presence of comorbidities, abnormal exercise echocardiogram, abnormal heart rate recovery, and abnormal DTS. Compared with those without IFC, patients with IFC were 5.1 times more likely to die (odds ratio [OR], 5.1; 95% confidence interval [CI], 2.5–10.5; P , 0.0001) by univariate analysis and 2.7 times more likely to die (OR, 2.7; 95% CI, 1.2–6.1; P = 0.02) by multivariate analysis, when accounting for heart rate recovery, DTS, and sleep apnea severity. Among those without coronary artery disease, patients with IFC were at significantly increased risk of mortality (OR, 4.3; 95% CI, 1.35–13.79; P = 0.0088) compared with those with preserved functional capacity. Conclusions: In our OSA population, IFC was a strong predictor of increased mortality. Among those with normal DTS, IFC identified a cohort at increased risk of mortality.
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Fridel, Keith. "Adherence and Effectiveness of Positional Therapy for Obstructive Sleep Apnea Syndrome." Diss., The University of Arizona, 2011. http://hdl.handle.net/10150/203486.
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The purpose of this investigation was to explore how adherence to a positional therapy intervention affected therapeutic outcome in participants with positional-related obstructive sleep apnea syndrome. Eighteen adult participants identified as having positional-related obstructive sleep apnea by an initial overnight polysomnography study were recruited. Participants were instructed to use a “tennis ball technique” positional device for three weeks at home and record their sleep habits and adherence before a final post-treatment polysomnography evaluation. A repeated measures MANOVA found significant effects of treatment between pre- and post-test on the objective polysomnography variables of Total Recording Time [F(1,17) = 5.21, p<.05, η²=.24], Total Sleep Time [F(1,17) = 8.59, p<.01, η²=.34], Sleep Efficiency [F(1,17) = 5.42, p<.05, η²=.24], Total REM sleep time [F(1,17) = 9.91, p<.01, η²=.37], and the Apnea- Hypopnea Index [F(1,17) = 14.28, p<.001, η²=.46]. Sleep onset latency was not statistically significant. There were significant effects of treatment on the subjective measures of the Functional Outcome of Sleep Quality [F(1,17) = 8.92, p<.01, η²=.35], Pittsburgh Sleep Quality Index [F(1,17) = 11.2, p<.01, η²=..39], Epworth Sleepiness Scale [F(1,17) = 6.69, p<.05, η²=.28], and the Brief Symptom Inventory [F(1,17) = 5.14, p<.05, η²=.23]. No significant interaction effects were found between treatment and adherence when participants were grouped post-hoc into an adherent or non-adherent categories based on their self-reported daily log data. In summary, the results of this study indicated that the positional device was efficacious for significantly improving both objective polysomnography variables and subjective variables of sleep. The results also indicated even partially adherent participants reported significant improvements in nighttime sleep quality and quality of life after the three week treatment period. Mixed Linear Modeling demonstrated that significant improvements in sleep quality, time to sleep onset, and total sleep time were not seen until the last weeks of treatment. This study found very acceptable adherence rates with this positional device design; all participants were able to utilize the therapeutic device on at least a portion of every night during the three-week intervention.
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Vranish, Jennifer R. "Obstructive Sleep Apnea: Daytime Assessment And Treatment Of A Nighttime Disorder." Diss., The University of Arizona, 2015. http://hdl.handle.net/10150/566239.
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Obstructive sleep apnea (OSA) is a disease characterized by nighttime airflow limitation, hypoxemia, arousal from sleep, and elevated sympathetic activity and blood pressure. With time, this nighttime dysfunction gives rise to daytime hypertension and a heightened risk for cardiovascular disease. Current treatment options for OSA are not always effective for all patients and the gold-standard intervention, continuous positive airway pressure, has discouraging compliance rates. The work set forth in this dissertation has as its focus a novel intervention for sleep apnea known as inspiratory muscle training (IMT). IMT improves respiratory function and cardiovascular health but has not been implemented previously as a treatment for OSA. As such, Study 1 implements IMT in individuals with mild and moderate OSA, with the objective of assessing the effects of training on the cardio- respiratory parameters of this disease. We randomly assigned 24 individuals with mild- moderate OSA into one of two groups: training vs. placebo, to assess the effects of 6 weeks of training on overnight polysomnography, subjective sleep quality, blood pressure, circulating inflammatory T cells, and plasma catecholamine content. Our results show IMT- related improvements in sleep quality, reduction in the number of arousals from sleep and in periodic limb movements following 6 weeks of training. Most important, IMT was associated with a significant reduction in systolic (~12 mmHg) and diastolic (~5 mmHg) blood pressure, relative to sleep apneics who undertook 6 weeks of placebo training. Additionally, individuals in the training group exhibited ~30% lower levels of sympathetic activity, as measured by plasma catecholamines, relative to placebo trained peers. The mechanism(s) that underlie the IMT-related reductions in blood pressure and sympathetic activity remain to be determined. However, in an effort to determine the precise respiratory stimulus that contributes to the results obtained in Study 1, we subsequently assessed the specific respiratory components of IMT to determine which component (large intrathoracic pressures and/or large lung volumes) likely contributes to the reduction in blood pressure in Study 1. The results of this study conducted in normotensive adults show that respiratory training that entails either large negative or positive intrathoracic pressures reduces systolic and diastolic blood pressure in healthy young adults. Importantly, neither the generation of large lung volumes alone nor performance of daily paced breathing is sufficient to lower blood pressure. Study 3 is a methodologic study that has as its focus upper airway electromyography (EMG) and the utility of assessing EMG activity across a range of conditions and breathing tasks in wakefulness. Because OSA traditionally has been viewed as the result of neuromuscular dysfunction of the upper airway that occurs during sleep, the aim of this work was to develop a "fingerprint" of healthy electromyographic activities during the day in healthy adults across a range of breathing tasks, body positions, and from two different muscle compartments of the upper airway. The findings from this study demonstrate regional differences in muscle activity that vary as a function of body position and task. These data from healthy subjects provide the basis of comparison for subsequent studies in individuals with obstructive sleep apnea.
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Zellmer, Mark R. "Clinical Recognition of Obstructive Sleep Apnea in a Population-Based Sample." ScholarWorks, 2010. https://scholarworks.waldenu.edu/dissertations/837.
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Obstructive sleep apnea (OSA), a disorder in which the airway intermittently collapses and obstructs during sleep, is associated with increased cardiovascular and cerebrovascular morbidity and mortality, increased risk of motor vehicle accidents, metabolic syndrome, hypertension, and depression. Treatment of OSA attenuates or reverses many of these associated risks. However, most cases of OSA are unrecognized and untreated. The two most recent studies using 1990s data found that only 6.5 - 15.4% of OSA cases, depending on severity, are clinically recognized in mixed gender populations. Based on a conceptual framework of improved physician awareness of OSA, and reduced diagnostic access bias with the increased availability of sleep laboratory services, increased OSA recognition since the 1990s was predicted. Study participants with clinically recognized OSA were identified using the resources of the Rochester Epidemiology Project, while the Berlin Questionnaire OSA high risk classification was used as a surrogate for prevalent OSA in this population. Analysis in a mixed gender population determined that OSA clinical recognition among those with prevalent OSA was 22.7 % (95% CI 19.6 - 25.8%) for mild or greater OSA severity leaving more than 75% of prevalent OSA clinically unrecognized and untreated in this population. Obesity and male gender were associated with increased likelihood of clinical recognition in bivariate and multivariate analyses, though even among obese men only 36.5% of OSA was clinically recognized. In order to support positive social change and address these inequities of OSA clinical recognition, strategies that enhance OSA recognition overall, and more specifically target recognition of OSA among women and the nonobese, should be developed and implemented. Further research regarding such strategies should consider whether they reduce OSA associated morbidity and mortality.
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Xu, Chun Wootton David Macmullen. "Computational mechanics models for studying the pathogenesis of obstructive sleep apnea (OSA) /." Philadelphia, Pa. : Drexel University, 2006. http://dspace.library.drexel.edu/handle/1860/746.
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Dingwall, Kylie. "Effects of medication on the sleep architecture of patients with obstructive sleep apnea syndrome (OSAS) /." [St. Lucia, Qld.], 2004. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe19264.pdf.
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Noguchi, Tetsuo. "Heat shock protein 72 level decreases during sleep in patients with obstructive sleep apnea syndrome." Kyoto University, 1997. http://hdl.handle.net/2433/202175.
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Nahapetian, Ryan, Graciela E. Silva, Kimberly D. Vana, Sairam Parthasarathy, and Stuart F. Quan. "Weighted STOP-Bang and screening for sleep-disordered breathing." SPRINGER, 2015. http://hdl.handle.net/10150/623579.
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STOP-Bang is a tool for predicting the likelihood for sleep-disordered breathing (SDB). In the conventional score, all variables are dichotomous. Our aim was to identify whether modifying the STOP-Bang scoring tool by weighting the variables could improve test characteristics.
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Tung, Patricia, Yamini S. Levitzky, Rui Wang, Jia Weng, Stuart F. Quan, Daniel J. Gottlieb, Michael Rueschman, et al. "Obstructive and Central Sleep Apnea and the Risk of Incident Atrial Fibrillation in a Community Cohort of Men and Women." WILEY, 2017. http://hdl.handle.net/10150/625524.
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Background-Previous studies have documented a high prevalence of atrial fibrillation (AF) in individuals with obstructive sleep apnea (OSA). Central sleep apnea (CSA) has been associated with AF in patients with heart failure. However, data from prospective cohorts are sparse and few studies have distinguished the associations of obstructive sleep apnea from CSA with AF in population studies. Methods and Results-We assessed the association of obstructive sleep apnea and CSA with incident AF among 2912 individuals without a history of AF in the SHHS (Sleep Heart Health Study), a prospective, community-based study of existing ("parent") cohort studies designed to evaluate the cardiovascular consequences of sleep disordered breathing. Incident AF was documented by 12-lead ECG or assessed by the parent cohort. obstructive sleep apnea was defined by the obstructive apnea-hypopnea index (OAHI). CSA was defined by a central apnea index >= 5 or the presence of Cheyne Stokes Respiration. Logistic regression was used to assess the association between sleep disordered breathing and incident AF. Over a mean of 5.3 years of follow-up, 338 cases of incident AF were observed. CSA was a predictor of incident AF in all adjusted models and was associated with 2-to 3-fold increased odds of developing AF (central apnea index >= 5 odds ratio [OR], 3.00, 1.40-6.44; Cheyne-Stokes respiration OR, 1.83, 0.95-3.54; CSA or Cheyne-Stokes respiration OR, 2.00, 1.16-3.44). In contrast, OAHI was not associated with incident AF (OAHI per 5 unit increase OR, 0.97, 0.91-1.03; OAHI 5 to <15 OR, 0.84, 0.59-1.17; OAHI 15 to <30 OR, 0.93, 0.60-1.45; OAHI >= 30 OR, 0.76, 0.42-1.36). Conclusions-In a prospective, community-based cohort, CSA was associated with incident AF, even after adjustment for cardiovascular risk factors.
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JOFFE, David. "OBSTRUCTIVE SLEEP APNOEA: THE GENESIS OF DAYTIME SOMNOLENCE AND COGNITIVE IMPAIRMENT - AROUSALS, HYPOXIA AND CIRCADIAN RHYTHM." Thesis, The University of Sydney, 1997. http://hdl.handle.net/2123/382.
Full textAbstract:
Obstructive Sleep Apnoea (OSA) is a disease characterised by repetitive upper airway obstructions which are manifest by desaturation and arousal from sleep. It has been known for many years that this interruption to the normal architecture of sleep may present to the clinician as excessive daytime somnolence often with a complaint of difficulties with concentration and short term memory. Previous work had demonstrated a relationship between variables of cognitive dysfunction in patients with obstructive sleep apnoea, however, little was known about which components of the syndrome contributed to this outcome and whether specific clinical thresholds of sleep disordered breathing could be defined for the development of cognitive dysfunction. In the context of this body of work cognitive dysfunction is defined as: a level of cognitive performance below normal derived values for a given cognitive test, when the subjects performance is controlled for age, sex and level of education.
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JOFFE, David. "OBSTRUCTIVE SLEEP APNOEA: THE GENESIS OF DAYTIME SOMNOLENCE AND COGNITIVE IMPAIRMENT - AROUSALS, HYPOXIA AND CIRCADIAN RHYTHM." University of Sydney, Respiratory Medicine, Royal North Shore Hospital, 1997. http://hdl.handle.net/2123/382.
Full textAbstract:
Obstructive Sleep Apnoea (OSA) is a disease characterised by repetitive upper airway obstructions which are manifest by desaturation and arousal from sleep. It has been known for many years that this interruption to the normal architecture of sleep may present to the clinician as excessive daytime somnolence often with a complaint of difficulties with concentration and short term memory. Previous work had demonstrated a relationship between variables of cognitive dysfunction in patients with obstructive sleep apnoea, however, little was known about which components of the syndrome contributed to this outcome and whether specific clinical thresholds of sleep disordered breathing could be defined for the development of cognitive dysfunction. In the context of this body of work cognitive dysfunction is defined as: a level of cognitive performance below normal derived values for a given cognitive test, when the subjects performance is controlled for age, sex and level of education.
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Mehta, Atul S. "Treatment of snoring and obstructive sleep apnoea using a mandibular advancement splint." Master's thesis, Faculty of Dentistry, 1998. http://hdl.handle.net/2123/4904.
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This work was digitised and made available on open access by the University of Sydney, Faculty of Dentistry and Sydney eScholarship . It may only be used for the purposes of research and study. Where possible, the Faculty will try to notify the author of this work. If you have any inquiries or issues regarding this work being made available please contact the Sydney eScholarship Repository Coordinator - ses@library.usyd.edu.au
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Santos, Bárbara Vicente dos. "Aging and Obstructive Sleep Apnea." Master's thesis, 2019. http://hdl.handle.net/10316/88199.
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Dissertação de Mestrado em Biotecnologia Farmacêutica apresentada à Faculdade de FarmáciaA Síndrome Apneia Obstrutiva do Sono (SAOS) é reconhecida como uma das mais comunsperturbações do sono. Esta doença é caracterizada por episódios regulares de obstrução, parcialou completa, das vias aéreas superiores durante o sono. Estima-se que 80 a 90 % dos casos deSAOS não estejam diagnosticados, fundamentalmente devido ao diagnóstico tardio e baixoconhecimento da doença. A SAOS não tratada está associada a uma maior predisposição a váriosproblemas de saúde, bem como a uma maior mortalidade. Além disso, vários estudos demonstramuma associação entre a SAOS e comprometimento cognitivo e demência, que são frequentementeassociados ao envelhecimento. Neste caso, estas alterações são observadas em doentes comSAOS em idades precoces. Evidências sugerem que a SAOS pode promover/agravar oenvelhecimento através da indução de mecanismos celulares e moleculares associados a este.Neste contexto, os objetivos principais deste trabalho são:1) investigar se os doentes com SAOS apresentam alterações celulares e/ou molecularesperiféricas associadas ao envelhecimento; 2) avaliar se o tratamento da SAOS atenua essasalterações; 3) sensibilizar a população para os fatores de risco, consequências e falta dediagnóstico da SAOS.Uma coorte de 6 doentes Portugueses do sexo masculino [idade: 53 ± 4 anos; IMC: 32,1 ± 2,5]com diagnóstico de SAOS severa [60.9±12 apneias/hipopneia por hora – AHI] foramacompanhados desde o momento do diagnóstico com polissonografia – PSG (t0), após 4 meses(t4M) e 2 anos (t24M) de tratamento com o tratamento de referência – CPAP. Em cada fase doestudo (t0, t4M and t24M) foram realizadas colheitas de sangue aos doentes e controlos e isoladascélulas mononucleares do sangue periférico (PBMCs). Foram avaliadas características doenvelhecimento celular e molecular, nomeadamente a instabilidade genómica, a perda daproteostase e o encurtamento dos telómeros. Todos os resultados foram comparados comcontrolos de idades correspondentes [idade: 47 ± 7 anos: IMC: 25,6 ± 0,5; AHI: 4,7 ± 0,8] e comcontrolos jovens [idade: 24 ± 2 anos; IMC: 23,5 ± 2,8].Os resultados demonstram que em doentes com SAOS se verificam alterações ao nível dahomeostasia proteica, instabilidade genómica e encurtamento dos telómeros. O tratamento decurta duração não parecem ser suficientes para reverter as consequências da SAOS, enquantoque o tratamento a longo-termo com CPAP pode parcialmente restabelecer algumas dasalterações.Em suma, este trabalho sugere que a SAOS promove/agrava o envelhecimento e as doençasassociadas a este. Mais estudos são necessários que permitam descobrir novos biomarcadoresque permitam o diagnóstico precoce da SAOS, estratificação dos doentes e a monitorização daresposta ao tratamento. Por fim, o diagnóstico e tratamento numa fase precoce da SAOS podemconstituir uma nova estratégia para atenuar o envelhecimento.
Obstructive Sleep Apnea (OSA) has been recognized as one of the most common sleep disorders.OSA is characterized by regular episodes of complete or partial obstruction of the upper airwaysduring sleep. Nevertheless, it is estimated that 80 to 90 % of the OSA cases are undiagnosedmainly due to late diagnosis and lack of disease awareness. Untreated, OSA has been associatedwith an increased predisposition to several health problems and increased mortality. Moreover,there is sizable evidence showing the association of OSA with mild cognitive impairment anddementia, which are commonly associated with aging, but this alteration appear at younger agesin OSA patients. There are evidences that OSA might promote/aggravate aging by inducingcellular and molecular aging mechanisms. In this context, the main objectives of present work are:1) to investigate whether OSA patients show peripheral aging-related cellular and molecularimpairments; 2) to assess if OSA treatment can ameliorate such alterations; 3) to raise awarenessof the population to alert the risk factors, consequences and lack of diagnosis of OSA.A cohort of 6 Portuguese male patients [age: 53 ± 4 years; BMI: 32.1 ± 2.5] diagnosed with severeOSA [60.9 ± 12 apneas/hypopneas per hour - AHI] was followed from the moment of diagnosiswith polysomnography - PSG (t0), up to 4 months (t4M) and 2 years (t24M) of treatment withstandard treatment - CPAP. In each phase (t0, t4M and t24M), blood was collected from patients andcontrols subjects and peripheral blood mononuclear cells were isolated. Hallmarks of cellular andmolecular aging were evaluated, namely, genomic instability, loss of proteostasis and telomereshortening. All results were compared to age-matched controls [age: 47±7 years; BMI: 25.6 ± 0.5;AHI: 4.7 ± 0.8] and with younger controls [age: 24 ± 2 years; BMI: 23.5 ± 2.8].The results showed that OSA patients induce impairments in protein homeostasis, nucleargenomic instability and telomere shortening. Short-term treatment does not seem enough torecover from OSA consequences while long-term CPAP treatment might partially re-stablishsome alterations.Overall, this work suggests that OSA promotes/aggravates aging and aging-related diseases.Further investigations are needed to find new biomarkers allowing for OSA early diagnosis, patientstratification and treatment response monitoring. In the end, OSA early diagnosis and treatmentmay constitute a new strategy to delay ageing.
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Chen, Tai-Quan, and 陳泰全. "Effects of sleep posture on obstructive sleep apnea." Thesis, 2018. http://ndltd.ncl.edu.tw/handle/n3v72c.
Full textAbstract:
碩士國立中興大學
生命科學院碩士在職專班
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OBJECTIVE: To investigate the relationship between respiratory problem and sleeping posture in patients with obstructive sleep apnea syndrome. METHODS: In this study, we used retrospectively review data way to analyze. The database is from a sleep medicine center in Central District of Taiwan from January 2016 to June 2016. These databases came from multiple sleep physiological examinations, and we received 708 items. Based on the standard, the study group was divided into two parts, one is (Supine - AHI / Lateral AHI ≥ 2) that is positional patient (PP) group and the other (Supine - AHI / Lateral AHI ＜ 2) is non-positional patient (NPP). The groups were compared for age, body mass index (BMI), neck circumference (NC), total sleep time (TST), apnea hypopnea index (AHI),lowest oxygen saturation (LSaO2), Epworth Sleepiness Scale and other parameters. Each parameter in the group will be analyzed . Results:The results of this study show that AHI clusters’ parameters such as BMI, TST, Lowest oxygen saturation (LSaO2), and Epworth Sleepiness Scale have significant statistical differences (P＜ 0.05). In addition, some cases can use the change of sleep posture to improve the occurrence of sleep apnea. The NPP group and the PP group have significant statistical differences in BMI, neck circumference (NC), total sleep time (TST), apnea hypopnea index (AHI), lowest oxygen saturation (LSaO2), and Epworth Sleepiness Scale. Conclusion:The results show that in some cases of sleep apnea, there is a correlation between clinical sleep posture and the number of sleep apneas, and the change in sleep posture can effectively improve the occurrence of sleep apnea.