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Journal articles on the topic 'Sleep apnoea'

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Published: 4 June 2021

Last updated: 20 February 2023

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1

Guilleminault, C., C. Crowe, MA Quera-Salva, L. Miles, and M. Partinen. "Periodic leg movement, sleep fragmentation and central sleep apnoea in two cases: reduction with Clonazepam." European Respiratory Journal 1, no. 8 (August 1, 1988): 762–65. http://dx.doi.org/10.1183/09031936.93.01080762.

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Two subjects presented with periodic leg movement (PLM) syndrome during sleep that was characterized by marked sleep fragmentation and repetitive short central apnoeas. Treatment of PLM using Clonazepam, a benzodiazepine with hypnotic properties, markedly reduced the sleep fragmentation due to PLM and, despite its depressant properties on the central nervous system, controlled the repetitive central apnoeas. These two observations, although rare, give insight into the role of non-ventilatory variables in the development of sleep apnoea. Significant sleep fragmentation should be considered when assessing factors leading to respiratory instability during sleep and/or the pathophysiology of sleep apnoea syndromes.

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2

Andreas, S., B. von Breska, K. Magnusson, and H. Kreuzer. "Validation of automated sleep stage and apnoea analysis in suspected obstructive sleep apnoea." European Respiratory Journal 6, no. 1 (January 1, 1993): 48–52. http://dx.doi.org/10.1183/09031936.93.06010048.

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Full-night polysomnography is necessary for the diagnosis of obstructive sleep apnoea (OSA). However, analysis of the sleep stages and apnoeas is time-consuming. Computer systems for automated analysis have, thus, been developed to alleviate this task. We investigated 27 consecutive patients referred to our sleep laboratory with suspected OSA. The analysis of sleep stages and apnoeas was performed by visual scoring, according to Rechtschaffen and Kales, and by commercially available automated analysis device. The mean difference between visual scoring and automated analysis was -1, 111, -140, -3, 1 and 27 min, for sleep stages awake, I, II, III, IV and rapid eye movement (REM) respectively. For the apnoea index, the automated analysis rated a lower figure (mean difference 7.h-1, 95% confidence interval 2-12.h-1). The diagnosis of OSA was performed with a sensitivity of 85% and a specificity of 93% by automated analysis. Comparison of two independent handscores showed good agreement, with a mean difference of 6, 4, 3, -7, 1 and -1 min, for sleep stages awake, I, II, III, IV and REM, respectively. In conclusion, the automated analysis underestimates stage I sleep and the apnoea index. Visual scoring is advisable for control of the results. Automated analysis should only be used by those who are able to perform a visual analysis.

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3

Pokorski, M., and U. Jernajczyk. "Nocturnal Oxygen Enrichment in Sleep Apnoea." Journal of International Medical Research 28, no. 1 (February 2000): 1–8. http://dx.doi.org/10.1177/147323000002800101.

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We hypothesized that a modest oxygen enrichment, rather than 100% oxygen supplementation as used in previous trials, could result in improvement in ventilatory and cardiac symptoms, in patients with obstructive sleep apnoea (OSA), without jeopardizing the chemostimulant ventilatory drive. This hypothesis was tested in five male patients with OSA in a single-blinded trial consisting of one night spent sleeping in control room air (control night), followed by one night spent sleeping while exposed to air with a 9% enriched oxygen content (oxygen-enriched night). Oxygen enrichment resulted in a significant shift in the oxygen saturation profile towards values of ≥ 95% and to decrease desaturation dips throughout the night. The apnoea index decreased from the control night to the oxygen-enriched night from 52.7 ± 10.4 to 38.9 ± 9.3; the decrease being greatest for the longest apnoeas (≥ 30 s). Additionally, the cardiovascular status improved. No signs of depressed chemostimulant drive in the oxygen-enriched night were detected. We conclude that nocturnal oxygen enrichment merits consideration for therapeutic trial in the prevention of long apnoeic and desaturation episodes.

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4

Jun, Jonathan C., Swati Chopra, and Alan R. Schwartz. "Sleep apnoea." European Respiratory Review 25, no. 139 (February 29, 2016): 12–18. http://dx.doi.org/10.1183/16000617.0077-2015.

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Sleep apnoea is a disorder characterised by repetitive pauses in breathing during sleep caused by airway occlusion (obstructive sleep apnoea) or altered control of breathing (central sleep apnoea). In this Clinical Year in Review, we summarise high-impact research from the past year pertaining to management, diagnosis and cardio-metabolic consequences of sleep apnoea.

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5

de Chazal, Philip, Conor Heneghan, and Walter T. McNicholas. "Multimodal detection of sleep apnoea using electrocardiogram and oximetry signals." Philosophical Transactions of the Royal Society A: Mathematical, Physical and Engineering Sciences 367, no. 1887 (October 30, 2008): 369–89. http://dx.doi.org/10.1098/rsta.2008.0156.

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A method for the detection of sleep apnoea, suitable for use in the home environment, is presented. The method automatically analyses night-time electrocardiogram (ECG) and oximetry recordings and identifies periods of normal and sleep-disordered breathing (SDB). The SDB is classified into one of six classes: obstructive, mixed and central apnoeas, and obstructive, mixed and central hypopnoeas. It also provides an estimated apnoea, hypopnoea and apnoea–hypopnoea index. The basis of the method is a pattern recognition system that identifies episodes of apnoea by analysing the heart variability, an ECG-derived respiration signal and blood oximetry values. The method has been tested on 183 subjects with a range of apnoea severities who have undergone a full overnight polysomnogram study. The results show that the method separates control subjects from subjects with clinically significant sleep apnoea with a specificity of 83 per cent and sensitivity of 95 per cent. These results demonstrate that home-based screening for sleep apnoea is a viable alternative to hospital-based tests with the added benefit of low cost and minimal waiting times.

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6

Hanning, C. D. "Sleep apnoea." Anaesthesia 44, no. 9 (September 1989): 786. http://dx.doi.org/10.1111/j.1365-2044.1989.tb09279.x.

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7

Robinson, Tracey D., and Iven H. Young. "Sleep apnoea." Medicine 32, no. 1 (January 2004): 91–95. http://dx.doi.org/10.1383/medc.32.1.91.28473.

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8

Wright, John, Trevor A. Sheldon, and Ian Watt. "Sleep apnoea." Lancet 354, no. 9178 (August 1999): 600. http://dx.doi.org/10.1016/s0140-6736(05)77956-3.

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9

Primhak, R. "SLEEP APNOEA." Archives of Disease in Childhood - Education and Practice 90, no. 4 (December 1, 2005): ep87-ep91. http://dx.doi.org/10.1136/adc.2005.072975.

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10

Prowse, K., and M. B. Allen. "Sleep apnoea." British Journal of Diseases of the Chest 82 (January 1988): 329–40. http://dx.doi.org/10.1016/0007-0971(88)90085-x.

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11

Raut, Aishwarya Deepak, and Bharati Dixit. "Sleep Apnoea Disorder." European Journal of Engineering Research and Science 5, no. 3 (March 20, 2020): 339–42. http://dx.doi.org/10.24018/ejers.2020.5.3.1822.

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This article provides research on sleep apnoea. Sleep apnoea is a capable for suspending breath or frequently pausing in period of deep sleep. This symptoms may leads to an unappropriate death that makes it a critical sleeping disorder. Periods of apnoea generally lasts for five seconds or hardly a minute which affects the sleeping pattern due to breathing. This probably happens five times of an hour or even more. Obstructive sleep apnoea (OSA),central sleep apnoea (CSA) and mixed/complex sleep apnoea(MSA) are common three types of apnoea, where mixed/complex sleep apnoea is combination of other two apnoea. Airway obstruction is caused in OSA, while in CSA airway is not blocked, but the brain dosn’t sends proper signals to the muscles that cause instability of the respiratory center. The study includes the sleep disorders, types, cause, signs and symptoms and methods of Sleep Apnoea. Considering the study; it is very much required to detection of sleep apnoea using noninvasive techniques. Machine learning algorithms based detection of sleep apnoea is a feasible solution which provides more than 90% accuracy. The study surveys the similar techniques based on machine learning.

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12

Raut, Aishwarya Deepak, and Bharati Dixit. "Sleep Apnoea Disorder." European Journal of Engineering and Technology Research 5, no. 3 (March 20, 2020): 339–42. http://dx.doi.org/10.24018/ejeng.2020.5.3.1822.

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This article provides research on sleep apnoea. Sleep apnoea is a capable for suspending breath or frequently pausing in period of deep sleep. This symptoms may leads to an unappropriate death that makes it a critical sleeping disorder. Periods of apnoea generally lasts for five seconds or hardly a minute which affects the sleeping pattern due to breathing. This probably happens five times of an hour or even more. Obstructive sleep apnoea (OSA),central sleep apnoea (CSA) and mixed/complex sleep apnoea(MSA) are common three types of apnoea, where mixed/complex sleep apnoea is combination of other two apnoea. Airway obstruction is caused in OSA, while in CSA airway is not blocked, but the brain dosn’t sends proper signals to the muscles that cause instability of the respiratory center. The study includes the sleep disorders, types, cause, signs and symptoms and methods of Sleep Apnoea. Considering the study; it is very much required to detection of sleep apnoea using noninvasive techniques. Machine learning algorithms based detection of sleep apnoea is a feasible solution which provides more than 90% accuracy. The study surveys the similar techniques based on machine learning.

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13

Schwartz, Katherine, Alejandra C. Lastra, and Antoaneta J. Balabanov. "Obstructive and central sleep apnoea in a patient with medically intractable epilepsy." BMJ Case Reports 15, no. 9 (September 2022): e245564. http://dx.doi.org/10.1136/bcr-2021-245564.

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A woman in her 30s with medically intractable epilepsy and Lennox-Gastaut Syndrome on multiple antiseizure medications and with a deep brain stimulator presented to the epilepsy monitoring unit with increased seizure frequency. She was noted to have periods of apparent apnoea time linked to bursts of epileptiform activity on continuous video EEG monitoring. Once the clinical seizures were controlled, she was discharged to the sleep laboratory. She was noted to have obstructive and central sleep apnoea, which improved with the use of positive airway pressure. Central sleep apnoeas were time linked to electrographic seizures. Ictal central apnoea can easily be overlooked and is likely more common than currently recognised in patients with epilepsy. Ictal central apnoea may be a biomarker for sudden unexpected death in epilepsy.

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14

Cibella, F., O. Marrone, S. Sanci, V. Bellia, and G. Bonsignore. "Expiratory timing in obstructive sleep apnoeas." European Respiratory Journal 3, no. 3 (March 1, 1990): 293–98. http://dx.doi.org/10.1183/09031936.93.03030293.

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Diaphragmatic electromyogram was recorded during NREM sleep in 4 patients affected by obstructive sleep apnoea (OSA) syndrome in order to evaluate the behaviour of expiratory time (TE) in the course of the obstructive apnoea-ventilation cycle. The two components of TE, i.e. time of post-inspiratory inspiratory activity (TPIIA) and time of expiratory phase 2 (TE2) were separately analysed. TPIIA showed a short duration, with only minor variations, within the apnoea, while its duration was more variable and longer in the interapnoeic periods: the longest TPIIA values were associated with the highest inspiratory volumes in the same breaths. This behaviour seemed regulated according to the need of a more or less effective expiratory flow braking, probably as a result of pulmonary stretch receptors discharge. Conversely TE2 showed a continuous gradual modulation, progressively increasing in the pre-apnoeic period, decreasing during the apnoea and increasing in the post-apnoeic period: these TE2 variations seemed related to oscillations in chemical drive. These data show that TE in the obstructive apnoea-ventilation cycle results from a different modulation in its two components and suggest that both mechanical and chemical influences play a role in its overall duration.

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15

Hoffstein, V., and S. Mateika. "Differences in abdominal and neck circumferences in patients with and without obstructive sleep apnoea." European Respiratory Journal 5, no. 4 (April 1, 1992): 377–81. http://dx.doi.org/10.1183/09031936.93.05040377.

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We have recently shown that patients with sleep apnoea have thicker necks than non-apnoeic snoring controls. However, it was not clear whether this difference simply reflects the fact that apnoeic patients are more obese than the non-apnoeic ones, or whether it represents a preferential distribution of fat over the neck region compared to the abnormal region. We therefore measured the neck and abdominal circumferences in a large group of 670 patients suspected of having sleep apnoea, all of whom had full nocturnal polysomnography, including measurement of snoring. We divided these patients into apnoeic and non-apnoeic groups based on the apnoea/hypopnoea index (AHI) of 10. Apnoeic patients had significantly higher body mass index (BMI), neck, and abdominal circumferences than non-apnoeic controls. We then matched apnoeic and non-apnoeic patients exactly, one-for-one for BMI and age; this procedure left us with 156 patients in each group. Abdominal circumferences were similar, but the neck circumference was significantly higher in apnoeic patients (41.2 +/- 3.5 cm vs 39.1 +/- 3.7 cm, p less than 0.0001). Multiple stepwise linear regression analysis revealed that neck circumference and BMI correlated significantly with apnoea (multiple R2 = 0.27, p less than 0.001) and snoring (multiple R2 = 0.19, p less than 0.001). We conclude that obese patients with sleep apnoea have fatter necks than equally obese non-apnoeic snorers, and that the neck circumference could be a significant determinant of apnoea and snoring.

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16

Polo, O., L. Brissaud, B. Sales, A. Besset, and M. Billiard. "The validity of the static charge sensitive bed in detecting obstructive sleep apnoeas." European Respiratory Journal 1, no. 4 (April 1, 1988): 330–36. http://dx.doi.org/10.1183/09031936.93.01040330.

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The demand for polysomnographic recordings associated with respiratory control exceeds the capacity of the few existing sleep disorder centres and therefore a simple and inexpensive method is needed for screening and diagnosing sleep-related breathing disorders. The static charge sensitive bed (SCSB) permits long-term recordings of body movements, respiratory movements and the ballistocardiogram (BCG) without electrodes or cables being attached to the subject. The aim of the present study was to test the validity of this particular method in detecting obstructive sleep apnoeas without airflow measurements. Simultaneous SCSB and spirometer recordings were compared in fourteen sleep apnoea patients and six controls. The mean sensitivity of the SCSB method to detect the obstructive apnoeas was 0.92-0.98. The specificity to detect 2 min apnoea epochs was 0.61-0.68 in the apnoea group, while in the control group it was 0.99-1.00. According to this study, the SCSB detects the obstructive events without always distinguishing between severe periodic hypopnoeas and obstructive apnoeas. The sensitivity of the SCSB makes it valuable for screening subjects suspected of having obstructive sleep apnoeas. Further studies will concentrate on a more detailed analysis of the various respiratory, BCG and body movement patterns, which may lead to additional information on the severity of the upper airway obstruction.

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17

Molnár, Viktória, András Molnár, Zoltán Lakner, László Kunos, Emese Angyal, Fruzsina Németh, and László Tamás. "Az obstruktív alvási apnoe főbb jellemzőinek vizsgálata." Orvosi Hetilap 163, no. 15 (April 10, 2022): 586–92. http://dx.doi.org/10.1556/650.2022.32428.

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Összefoglaló. Bevezetés és célkitűzés: Az obstruktív alvási apnoe az intermittáló hypoxia által cardiovascularis, cerebrovascularis és metabolikus betegségek kialakulását okozhatja. Kutatásunkban célunk volt a betegség főbb jellemzőinek vizsgálata, az obstruktív alvási apnoe és a kontrollcsoport általános, antropometriai, laboratóriumi paramétereinek összehasonlító elemzése által. Anyag és módszer: A prospektív vizsgálatba 100 beteget (74 férfi, 26 nő, átlagéletkor ± SD, 42,15 ± 12,7 év) vontunk be, akiket az elvégzett poliszomnográfia eredménye alapján kontroll- (36 fő) és obstruktív alvási apnoe (64 fő) csoportra osztottunk. A betegeknél részletes anamnézisfelvételt, antropometriai méréseket, laborvizsgálatot és alváskérdőív-kitöltést végeztünk. Eredmények: Az obstruktív alvási apnoe csoportban szignifikánsan nagyobb nyak- (p = 0,015), csípő- és haskörfogat (p<0,000), továbbá BMI-érték (p<0,000) volt megfigyelhető. A férfiak szignifikánsan nagyobb számban voltak képviselve az obstruktív alvási apnoe csoportban (p<0,000). Míg az antropometriai paraméterek közül a kontrollcsoportban a nyakkörfogat különbözött szignifikánsan a nemek között (p<0,000), addig az obstruktív alvási apnoe csoportban a nyak- (p = 0,001) mellett a haskörfogat (p = 0,028) esetében volt megfigyelhető szignifikáns különbség. A társbetegségek jelenléte a kontroll- és az obstruktív alvási apnoe csoportban a hypertonia esetében 21%-nak és 64%-nak, a gastrooesophagealis refluxbetegség 5,42%-nak és 4,71%-nak, a szív-ér rendszeri betegség 2,7%-nak és 1%-nak, míg a 2-es típusú diabetes mellitus 0%-nak és 6,4%-nak adódott. A BMI az obstruktív alvási apnoe és a kontrollcsoportban egyaránt szignifikáns pozitív korrelációt mutatott a nyak-, a has- és a csípőkörfogattal, továbbá a kontrollcsoportban szignifikáns negatív korrelációt találtunk a HDL-koleszterin értéke és a BMI, valamint a nyak- és haskörfogat között. Következtetés: Az elhízás mint az obstruktív alvási apnoe legfőbb rizikófaktora és az obstruktív alvási apnoéban jellemző intermittáló hypoxia hozzájárulnak a komorbid állapotok nagyobb arányban történő megjelenéséhez, melyek mihamarabbi diagnosztikája és kezelésük megkezdése kiemelkedő fontosságú a betegek életminőségére gyakorolt hatásuk miatt. Orv Hetil. 2022; 163(15): 586–592. Summary. Introduction and objective: Obstructive sleep apnoea results in metabolic and cardiovascular disorders due to intermittent hypoxia. The main aim of the present study was to analyze the most important features of obstructive sleep apnoea, using anthropometric measurements and blood tests. Material and method: In this prospective investigation, 100 patients (74 male and 26 female patients, mean age ± SD years, 42.15 ± 12.7) were enrolled. These patients were divided into control (n = 36) and obstructive sleep apnoea (n = 64) groups regarding the results of polysomnography. The examination of the patients consisted of detailed anamnestic data, anthropometric measurements, laboratory test and the use of apnoea questionnaires. Results: In the obstructive sleep apnoea group, significantly higher neck (p<0.015), hip and abdomen circumferences and BMI values (p<0.000) were observed. Significantly higher ratio of male patients in the case of obstructive sleep apnoea was detected (p<0.000). In the control group, only the neck circumferences differed significantly between the two genders (p<0.000), but in the obstructive sleep apnoea group the neck (p = 0.001) and abdominal circumferences (p = 0.028) have also differed. Hypertension (64% and 21%) and type 2 diabetes mellitus (6.4% and 0%) were more frequent in the obstructive sleep apnoea group, while cardiovascular disorders (1% and 2.7 %) and gastroesophageal reflux disease (4.71% and 5.42%) in the control group. BMI values were significantly positively correlated with the neck, abdominal and hip circumferences, both in the control and obstructive sleep apnoea groups. Moreover, in the control group, a significant negative correlation between HDL-cholesterol and BMI, neck and abdominal circumferences was observed. Conclusion: Obesity, as one of the most important risk factors for obstructive sleep apnoea and the intermittent hypoxia contribute to the development of comorbidities. The diagnosis and therapy of the comorbidities is of great importance due to their effects on the patients’ quality of life. Orv Hetil. 2022; 163(15): 586–592.

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18

Krieger, J., L. Laks, I. Wilcox, R. R. Grunstein, L. J. V. Costas, J. G. McDougall, and C. E. Sullivan. "Atrial Natriuretic Peptide Release during Sleep in Patients with Obstructive Sleep Apnoea before and during Treatment with Nasal Continuous Positive Airway Pressure." Clinical Science 77, no. 4 (October 1, 1989): 407–11. http://dx.doi.org/10.1042/cs0770407.

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1. Plasma levels of atrial natriuretic peptide (ANP) were measured in seven patients with obstructive sleep apnoea (OSA) while they were awake, during repetitive apnoea and during treatment with nasal continuous positive airway pressure (CPAP). 2. ANP levels in both pulmonary artery and peripheral venous samples were elevated during apnoeic sleep and reduced when apnoea was prevented by nasal CPAP. Mean values of pulmonary artery ANP were 116.3 ± 17.9 pg/ml during apnoea and 64.8 ± 15.2 pg/ml (P < 0.05) on nasal CPAP. 3. It is concluded that there is increased ANP release during sleep in patients with OSA and that CPAP treatment normalizes ANP secretion. These findings may explain previously identified urinary abnormalities in OSA.

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19

Rodriguez-Villegas, Esther, Gwangwei Chen, Jeremy Radcliffe, and John Duncan. "A pilot study of a wearable apnoea detection device." BMJ Open 4, no. 10 (October 2014): e005299. http://dx.doi.org/10.1136/bmjopen-2014-005299.

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RationaleCurrent techniques for monitoring patients for apnoea suffer from significant limitations. These include insufficient availability to meet diagnostic needs, cost, accuracy of results in the presence of artefacts and difficulty of use in unsupervised conditions.ObjectivesWe created and clinically tested a novel miniature medical device that targets overcoming these limitations.MethodsWe studied 20 healthy control participants and 10 patients who had been referred for sleep apnoea diagnosis. The performances of the new system and also of the Food and Drug Administration (FDA) approved SOMNO clinical system, conventionally used for sleep apnoea diagnosis were evaluated under the same conditions. Both systems were tested during a normal night of sleep in controls and patients. Their performances were quantified in terms of detection of apnoea and hypopnoea in individual 10 s epochs, which were compared with scoring of signals by a blinded clinician.Main resultsFor spontaneous apnoeas during natural sleep and considering the clinician scorer as the gold standard, the new wearable apnoea detection device had 88.6% sensitivity and 99.6% specificity. In comparison the SOMNO system had 14.3% sensitivity and 99.3% specificity. The novel device had been specifically designed to detect apnoea, but if apnoea and hypopnoea during sleep were both considered in the assessment, the sensitivity and specificity were 77.1% and 99.7%, respectively, versus 54% and 98.5%, respectively, for the SOMNO.ConclusionsThe performance of the novel device compares very well to the scoring by an experienced clinician even in the presence of breathing artefacts, in this small pilot study. This can potentially make it a real solution for apnoea home monitoring.

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20

Sil, A., and G. Barr. "Assessment of predictive ability of Epworth scoring in screening of patients with sleep apnoea." Journal of Laryngology & Otology 126, no. 4 (December 13, 2011): 372–79. http://dx.doi.org/10.1017/s0022215111003082.

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AbstractMethod:Numerous studies have considered the benefits, and the disadvantages, of the Epworth Sleepiness Scale. Following an extensive literature review, we found that the evidence was inconclusive as regards the diagnostic efficacy of Epworth scoring for obstructive sleep apnoea syndrome. We undertook a retrospective study of 343 patients who underwent a sleep assessment over a 10-year period at the Monklands Hospital.Analysis and results:A total of 238 patients did not have sleep apnoea whereas 105 patients did. The mean Epworth score in patients with obstructive sleep apnoea syndrome was 10.94 (95 per cent confidence interval 9.46–11.42), and in the non-apnoeic group it was 7.73 (95 per cent confidence interval 7.04–8.41). Logistic regression and receiver operating characteristic curves were used to assess the predictive ability of Epworth scoring. The scores only explained 7–10 per cent of the variation in the probability of occurrence of obstructive sleep apnoea syndrome. The odds ratio for Epworth scoring was 1.118, and only 69 per cent of cases were correctly classified by the Scale.Conclusions:The literature review suggested that the Epworth Sleepiness Scale is associated with a low effect size and/or low predictive value when correlated or regressed on the Apnoea–Hypopnoea Index or Respiratory Disturbance Index, thus limiting its value as a screening test. Our study concluded that the Epworth Scale is only marginally useful in predicting the occurrence of obstructive sleep apnoea syndrome. We believe that every patient with a direct or witnessed history of sleep apnoea with obstructive symptoms have some form of sleep assessment.

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21

Goh, Joel CI, Joyce Tang, Jie Xin Cao, and Ying Hao. "Apnoeic and Hypopnoeic Load in Obstructive Sleep Apnoea: Correlation with Epworth Sleepiness Scale." Annals of the Academy of Medicine, Singapore 47, no. 6 (June 15, 2018): 216–22. http://dx.doi.org/10.47102/annals-acadmedsg.v47n6p216.

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Introduction: Patients with obstructive sleep apnoea (OSA) often present with excessive daytime sleepiness (EDS) as measured by the Epworth Sleepiness Scale (ESS). However, the relationship between EDS and OSA severity as measured by the apnoea-hypopnoea index (AHI) remains inconsistent. We hypothesise that this may be due to the usage and equal weightage of apnoea and hypopnoea events used in determining AHI and that apnoea and hypopnoea load as measured by their total durations may be a better metric to use. We sought to investigate if apnoea or hypopnoea load can display better correlation with ESS. Materials and Methods: Retrospective analysis of 821 patients with AHI ≥5, who underwent in-laboratory polysomnogram for suspected OSA from January 2015 - December 2015, was performed. Objective factors on polysomnogram were correlated with ESS. Results: ESS was correlated with age (r = -0.148, P <0.001), number of apnoeas (r = 0.096, P = 0.006), apnoea load (r = 0.102, P = 0.003), apnoea index (r = 0.075, P = 0.032), number of desaturations (r = 0.081, P = 0.020), minimum SpO2 (r = -0.071, P = 0.041), time SpO2 <85% (r = 0.075, P = 0.031) and REM sleep duration (r = 0.099, P = 0.004). Linear regression analysis found age (P <0.001), apnoea load (P = 0.005), REM (P = 0.021) and stage 1 sleep duration (P = 0.042) as independent factors correlated to ESS. The apnoea load calculated using duration in apnoea correlate with ESS in patients with severe OSA by AHI criteria compared to the mild category. Conclusion: AHI does not correlate with ESS. Younger age, longer apnoea, stage 1 and REM sleep were independently related to higher ESS though the correlations were weak. Apnoea load should be taken into account when determining OSA severity. Key words: Apnoea duration, Epworth sleepiness scale

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22

Timkova, Vladimira, Iveta Nagyova, Sijmen A. Reijneveld, Ruzena Tkacova, Roy E. Stewart, Jitse P. van Dijk, and Ute Bültmann. "Suicidal ideation in patients with obstructive sleep apnoea and its relationship with disease severity, sleep-related problems and social support." Journal of Health Psychology 25, no. 10-11 (March 1, 2018): 1450–61. http://dx.doi.org/10.1177/1359105318758859.

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We aimed to assess the prevalence of suicidal ideation and to examine the relationships between obstructive sleep apnoea severity, sleep-related problems, social support and suicidal ideation in obstructive sleep apnoea patients. We included 149 patients (68% male; mean age, 48.99 ± 9.57 years) with diagnosed obstructive sleep apnoea (Apnoea–Hypopnoea Index ⩾5) based on full-night polysomnography. The prevalence of suicidal ideation among obstructive sleep apnoea patients was 20.1 per cent. Structural equation modelling showed that suicidal ideation in obstructive sleep apnoea was strongly related to poor sleep quality and high fatigue levels. No relationship between social support and suicidal ideation in obstructive sleep apnoea patients was found.

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Anne, Pratibha, Rupa Koothirezhi, Ugorji Okorie, Minh Tam Ho, Brittany Monceaux, Cesar Liendo, Sheila Asghar, and Oleg Chernyshev. "833 Evolution of sleep disordered breathing types in heart failure." Sleep 44, Supplement_2 (May 1, 2021): A324—A325. http://dx.doi.org/10.1093/sleep/zsab072.830.

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Abstract Introduction Central sleep apnea is commonly seen in patients with heart failure. Here we present a case demonstrating shifting of predominant apneic events from central to obstructive type after placement of left ventricular assist device (LVAD) in end stage heart failure patient. Report of case(s) Case Presentation: 66 year-old African American male has past medical history of chronic congestive heart failure diabetes, hypertension, paroxysmal atrial fibrillation, anemia, hypothyroidism, chronic kidney disease and sleep apnea. Prior to his LVAD placement, his left ventricular ejection fraction (EF) was <10%. Patient was diagnosed with central sleep apnea with AHI of 58 (with 92% of apneic events being central events), oxygen nadir of 74%. Subsequently, patient had LVAD placed for symptomatic heart failure and repeat polysomnogram repeated at six month demonstrated an improved AHI of 45.8 with predominantly obstructive and mixed apneic events, with only 12.5% being central events. Conclusion This case report highlights not only the improvement of the sleep apnea in CHF treated with LVAD but also shows the shift of apneic events from predominantly central to obstructive type post LVAD. Support (if any) 1. Henein MY, Westaby S, Poole-Wilson PA, Cowie MR, Simonds AK. Resolution of central sleep apnoea following implantation of a left ventricular assist device. Int J Cardiol. 2010 Feb 4;138(3):317–9. PMID: 18752859. 2. Köhnlein T, Welte T, Tan LB, Elliott MW. Central sleep apnoea syndrome in patients with chronic heart disease: a critical review of the current literature. Thorax. 2002 Jun;57(6):547–54. PMID: 12037232 3. Monda C, Scala O, Paolillo S, Savarese G, Cecere M, D’Amore C, Parente A, Musella F, Mosca S, Filardi PP. Apnee notturne e scompenso cardiaco: fisiopatologia, diagnosi e terapia [Sleep apnea and heart failure: pathophysiology, diagnosis and therapy]. G Ital Cardiol (Rome). 2010 Nov;11(11):815–22. Italian. PMID: 21348318.

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Anand, Neesha, Roberta M. Leu, Dawn Simon, and Ajay S. Kasi. "Recurrent apnoea and respiratory failure in an infant: congenital central hypoventilation syndrome with a novel PHOX2B gene variant." BMJ Case Reports 14, no. 3 (March 2021): e239633. http://dx.doi.org/10.1136/bcr-2020-239633.

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A 20-day-old term infant presented with recurrent apnoea, lethargy and respiratory failure. Examination revealed episodes of apnoea and desaturation to 85% without any signs of respiratory distress requiring initiation of non-invasive positive pressure ventilation (NPPV). Capillary blood gas was indicative of respiratory acidosis and serum bicarbonate was elevated at 35 mmol/L. Chest radiograph, echocardiogram and evaluations for infectious aetiologies resulted normal. Due to inability to wean off NPPV with ensuing apnoea and desaturation, polysomnogram was performed and showed central and obstructive sleep apnoea, hypoxaemia and hypoventilation. Central apnoeas and hypoventilation were worse in non-rapid eye movement sleep. Paired-like homeobox 2B genetic studies showed a novel non-polyalanine repeat mutation (c.429+1G>A) establishing the diagnosis of congenital central hypoventilation syndrome (CCHS). Our case highlights the utility of polysomnography in the evaluation of term infants with apnoea. Although rare, clinicians should consider a diagnosis of CCHS in the evaluation of infants with apnoea and hypoventilation.

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Sun, Huibo, Yanhua Zhang, Jing Wang, and Jie Kong. "Correlation of serum meteorin-like concentration with the presence and severity of obstructive sleep apnoea syndrome." Annals of Clinical Biochemistry: International Journal of Laboratory Medicine 56, no. 5 (June 8, 2019): 593–97. http://dx.doi.org/10.1177/0004563219854115.

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Objective Inflammatory processes that occur in subjects with obstructive sleep apnoea syndrome may contribute to progressive atherosclerosis and increased cardiovascular and cerebrovascular morbidity. Meteorin-like protein, which is also known as subfatin, is transcribed similarly to meteorin protein. Meteorin-like alleviates skeletal muscle inflammation. We aimed to investigate the serum meteorin-like status of obstructive sleep apnoea syndrome subjects and determine the potential link between serum meteorin-like concentration with the presence and severity of obstructive sleep apnoea syndrome. Methods The obstructive sleep apnoea syndrome group was composed of 207 obstructive sleep apnoea syndrome subjects diagnosed via polysomnography. A total of 106 healthy volunteers without clinical symptoms of obstructive sleep apnoea syndrome were recruited as the control group. Blood samples were obtained from all subjects to evaluate the serum meteorin-like concentrations via enzyme-linked immunosorbent assay method. Results Decreased serum meteorin-like concentration was found in obstructive sleep apnoea syndrome subjects compared with the controls. Serum meteorin-like concentration was associated with a reduced OR for having obstructive sleep apnoea syndrome (OR 0.97, 95% CI 0.961 to 0.98; P < 0.001). Severe obstructive sleep apnoea syndrome subjects showed significantly lower meteorin-like concentration compared with mild and moderate cases. Moderate subjects exhibited decreased serum meteorin-like concentration compared with mild cases. Pearson correlation analysis revealed that serum meteorin-like concentration was negatively correlated with obstructive sleep apnoea syndrome severity. Serum meteorin-like concentration negatively correlated with body mass index, low-density lipoprotein cholesterol, apnoea–hypopnea index, number of arousals, hypopnoea and apnoea in subjects with obstructive sleep apnoea syndrome. Conclusion Serum meteorin-like concentration is inversely correlated with the presence and severity of obstructive sleep apnoea syndrome.

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Pepperell, J. C. T., R. J. O. Davies, and J. R. Stradling. "Sleep studies for sleep apnoea." Physiological Measurement 23, no. 2 (March 21, 2002): R39—R74. http://dx.doi.org/10.1088/0967-3334/23/2/201.

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Lee, W. C., D. W. Skinner, and A. J. N. Prichard. "Complications of palatoplasty for snoring or sleep apnoea." Journal of Laryngology & Otology 111, no. 12 (December 1997): 1151–54. http://dx.doi.org/10.1017/s002221510013957x.

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AbstractA questionnaire was sent to consultant Otolaryngologists (483) throughout the UK to identify any mortality associated with uvulopalatoplasty and other forms of palatoplasties for snoring and/or obstructive sleep apnoea. The response rate was 76.8 per cent (371). Six intra- and post-operative deaths were reported and four were known to have obstructive sleep apnoea. Life-threatening morbidity occurred in at least seven patients (three known apnoeic), two required immediate tracheostomy and two were managed in the intensive care unit. This suggests that the apnoeic patients undergoing palatoplasties experienced significant mortality and morbidity. Pre-operative sleep study should be performed in all snoring patients to identify the apnoeic subgroup. Continuous positive airway pressure, management of excessive obesity, elective tracheostomy and other strategies should be first considered before palatoplasties in these patients.

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Baumert, Mathias, Yvonne Pamula, James Martin, Declan Kennedy, Anand Ganesan, Muammar Kabir, Mark Kohler, and Sarah A. Immanuel. "The effect of adenotonsillectomy for childhood sleep apnoea on cardiorespiratory control." ERJ Open Research 2, no. 2 (April 2016): 00003–2016. http://dx.doi.org/10.1183/23120541.00003-2016.

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The efficacy of adenotonsillectomy for relieving obstructive sleep apnoea symptoms in children has been firmly established, but its precise effects on cardiorespiratory control are poorly understood.In 375 children enrolled in the Childhood Adenotonsillectomy Trial, randomised to undergo either adenotonsillectomy (n=194) or a strategy of watching waiting (n=181), respiratory rate, respiratory sinus arrhythmia and heart rate were analysed during quiet, non-apnoeic and non-hypopnoeic breathing throughout sleep at baseline and at 7 months using overnight polysomnography.Children who underwent early adenotonsillectomy demonstrated an increase in respiratory rate post-surgery while the watchful waiting group showed no change. Heart rate and respiratory sinus arrhythmia were comparable between both arms. On assessing cardiorespiratory variables with regard to normalisation of clinical polysomnography findings during follow-up, heart rate was reduced in children who had resolution of obstructive sleep apnoea syndrome, while no differences in their respiratory rate or respiratory sinus arrhythmia were observed.Adenotonsillectomy for obstructive sleep apnoea increases baseline respiratory rate during sleep. Normalisation of apnoea–hypopnoea index, spontaneously orviasurgery, lowers heart rate. Considering the small average effect size, the clinical significance is uncertain.

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29

Casey, Deborah. "Obstructive sleep Apnoea." Nursing Standard 4, no. 52 (September 19, 1990): 25–27. http://dx.doi.org/10.7748/ns.4.52.25.s41.

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Gallacher, Rose. "Obstructive sleep apnoea." Nursing Standard 22, no. 29 (March 26, 2008): 47. http://dx.doi.org/10.7748/ns.22.29.47.s39.

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31

Marshall, Tom. "Obstructive sleep apnoea." British Journal of General Practice 66, no. 645 (March 31, 2016): 178.3–179. http://dx.doi.org/10.3399/bjgp16x684493.

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32

Hanning, C. D. "Adult sleep apnoea." Current Anaesthesia & Critical Care 13, no. 1 (February 2002): 23–29. http://dx.doi.org/10.1054/cacc.2002.0378.

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TIERNEY, N. M., B. J. POLLARD, and B. R. H. DORAN. "Obstructive sleep apnoea." Anaesthesia 44, no. 3 (March 1989): 235–37. http://dx.doi.org/10.1111/j.1365-2044.1989.tb11232.x.

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34

McNamara, S. G., R. R. Grunstein, and C. E. Sullivan. "Obstructive sleep apnoea." Thorax 48, no. 7 (July 1, 1993): 754–64. http://dx.doi.org/10.1136/thx.48.7.754.

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HANNING, C. D. "OBSTRUCTIVE SLEEP APNOEA." British Journal of Anaesthesia 63, no. 4 (October 1989): 477–88. http://dx.doi.org/10.1093/bja/63.4.477.

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36

Stradling, John. "Obstructive sleep apnoea." BMJ 335, no. 7615 (August 16, 2007): 313–14. http://dx.doi.org/10.1136/bmj.39289.484144.be.

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37

How, CH, PP Hsu, and KL Tan. "Recognising sleep apnoea." Singapore Medical Journal 56, no. 03 (March 2015): 129–32. http://dx.doi.org/10.11622/smedj.2015039.

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38

Shneerson, J., I. Smith, A. I. Pack, T. Young, J. R. Stradling, R. J. O. Davies, G. J. Gibson, et al. "Obstructive sleep apnoea." BMJ 315, no. 7104 (August 9, 1997): 367. http://dx.doi.org/10.1136/bmj.315.7104.367.

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39

Wright, J., and T. Sheldon. "Obstructive sleep apnoea." BMJ 315, no. 7107 (August 30, 1997): 551. http://dx.doi.org/10.1136/bmj.315.7107.551b.

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40

Johal, Ama. "Obstructive sleep apnoea." Dental Nursing 2, no. 3 (April 2006): 118–20. http://dx.doi.org/10.12968/denn.2006.2.3.29813.

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West, Sophie D., and Chris Turnbull. "Obstructive sleep apnoea." Eye 32, no. 5 (February 2, 2018): 889–903. http://dx.doi.org/10.1038/s41433-017-0006-y.

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Riha, RL. "Just sleep apnoea?" Breathe 7, no. 3 (March 1, 2011): 277–82. http://dx.doi.org/10.1183/20734735.021710.

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Hardinge, Maxine. "Obstructive sleep apnoea." Medicine 36, no. 5 (May 2008): 237–41. http://dx.doi.org/10.1016/j.mpmed.2008.02.010.

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Manuel, Ari, and Maxine Hardinge. "Obstructive sleep apnoea." Medicine 40, no. 6 (June 2012): 287–92. http://dx.doi.org/10.1016/j.mpmed.2012.03.004.

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Manuel, Ari, and Maxine Hardinge. "Obstructive sleep apnoea." Medicine 44, no. 6 (June 2016): 336–41. http://dx.doi.org/10.1016/j.mpmed.2016.03.007.

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Turnbull, Chris, Irfan Zaki, and Maxine Hardinge. "Obstructive sleep apnoea." Medicine 48, no. 6 (June 2020): 404–11. http://dx.doi.org/10.1016/j.mpmed.2020.03.008.

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Malhotra, Atul, and David P. White. "Obstructive sleep apnoea." Lancet 360, no. 9328 (July 2002): 237–45. http://dx.doi.org/10.1016/s0140-6736(02)09464-3.

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Stone, Julian P. "Obstructive sleep apnoea." Lancet 360, no. 9350 (December 2002): 2078–79. http://dx.doi.org/10.1016/s0140-6736(02)11964-7.

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Gillerot, Gaëlle, and Michel Jadoul. "Obstructive sleep apnoea." Lancet 360, no. 9350 (December 2002): 2079. http://dx.doi.org/10.1016/s0140-6736(02)11965-9.

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O'Toole, Laurence, and Vicki A. Quincey. "Obstructive sleep apnoea." Lancet 360, no. 9350 (December 2002): 2079. http://dx.doi.org/10.1016/s0140-6736(02)11966-0.

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