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Otterstedt, Boel, e Gabriella Ryd. "Sova med fiender -En litteraturstudie om obstruktivt sömnapné syndrom". Thesis, Malmö högskola, Fakulteten för hälsa och samhälle (HS), 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-24459.
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Senare års forskning visar på att obstruktivt sömnapnésyndrom, OSAS, är en både underdiagnostiserad och underbehandlad sjukdom. Detta beror delvis på att många personer med OSAS är omedvetna om sitt tillstånd. Sjukdomen innebär återkommande totala andningsuppehåll under sömn och en hypoxi som leder till en rad olika komplikationer, däribland hjärtkärlsjukdomar. Syftet med denna studie var att utreda vad som påverkar OSAS och vilken roll sjuksköterskan kan spela i vården av dessa patienter. Metoden som användes var en litteraturundersökning. Resultatet baseras på tio vetenskapliga artiklar som erhölls genom databaserna PUBMED samt SAMSÖK. Teman som utkristalliserades var sömnposition, kroppsvikt och tandstatus. Trots att behandlingen av OSAS till stor del bygger på medicinska åtgärder visar resultaten i denna litteraturundersökning att sjuksköterskor har en viktig funktion i både upptäckten av nya fall samt i behandlingen. Omvårdnadsåtgärder såsom information om förändrad sömnposition och viktnedgång har visat sig ha signifikant betydelse för obstruktiv andning.Medical research in recent years has shown that Obstructive Sleep Apnea Syndrome, OSAS, is an affliction for which both diagnosis and treatment are often inadequate. In part, this is due to the fact that many people suffering from OSAS are not aware of the problem. The disease causes recurrent complete stops of breathing during sleep and hypoxia that may bring about various complications, for instance cardiovascular disorders. The purpose of this study, carried out as a literature survey, was to determine what factors affect OSAS and what role the nurse may play in the care of patients suffering from this disease. The survey of the literature by means of the data bases PUBMED and SAMSÖK yielded ten scientific articles showing that although various medical measures constitute the treatment of choice of OSAS the nurse plays an important role in the treatment and the diagnosis of new cases. Preventive care measures such as information about appropriate sleeping positions and reduction of weight have proven to be of significant value in the treatment of OSAS.
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Rivera, Claudia, e Eveli Wallin. "Livskvalité hos patienter med obtruktivt sömnapnésyndrom med CPAP-behandling". Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-311783.
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Bakgrund: Obstruktivt sömnapnésyndrom (OSAS) är en vanlig sömnrelaterad andningsstörning som innebär att patienten får apnéer (totalt andningsflödesstopp) och/eller hypoapnéer (delvis andningsflödesstopp) under nattsömnen. Dessa leder till störd nattsömn, vilket leder till kroppslig påverkan. OSAS ger både fysisk och psykisk påverkan, vilket i sin tur resulterar i att många patienter upplever sämre livskvalité. En av de vanligaste behandlingarna för OSAS är CPAP (Continuous Positive Airway Pressure) som med hjälp av övertrycksandning hjälper till att hålla de övre luftvägarna öppna under sömn. Syfte: Syftet med litteraturöversikten var att undersöka hur patienters livskvalité påverkas av behandling med CPAP samt om det finns vetenskapligt bevisade omvårdnadsåtgärder som underlättar för patienter att uppnå god livskvalité vid CPAP-behandling. Metod: En systematisk litteraturöversikt baserad på 10 kvantitativa originalartiklar. Resultat: Majoriteten av de genomgångna studierna visade att användning av CPAP minskar psykiska och fysiska symptom och därmed förbättrar patienternas livskvalité. Genom att följa upp patienter i sjukvården, erbjuda dem utbildningar samt gruppdiskussioner främjar man deras hälsa och höjer livskvalitén. Studierna visade också att grunden för en god omvårdnad är att sjuksköterskan har evidensbaserade kunskaper för att kunna planera och genomföra omvårdnadsåtgärder samt följa upp hur CPAP-behandlingen påverkar patienternas livskvalité. Slutsats: Användningen av CPAP förbättrar OSAS-patienternas livskvalité, bland annat genom att minska symptom. Det är av stor vikt att sjuksköterskan har tillräckliga kunskaper för att kunna undervisa samt informera patienten om sin sjukdom och behandling. Detta hjälper patienter till en bättre egenvård, vilket har en stor betydelse för livskvalitet.
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Di, Maria Julie. "Prise en charge des troubles respiratoire du sommeil chez les patients lésés médullaires ˸ optimisation du diagnostic à la prise en charge". Electronic Thesis or Diss., université Paris-Saclay, 2024. http://www.theses.fr/2024UPASW012.
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Les lésions de la moelle épinière sont responsables de tableaux cliniques très variables en fonction du niveau anatomique et de la sévérité de la lésion. Parmi les conséquences de la lésion médullaire, les troubles du sommeil occupent une place importante, au premier rang desquels les troubles respiratoires qui sont 3 à 4 fois plus prévalent qu'en population générale et de nature variée (apnées obstructives et/ou centrale, hypoventilation alvéolaire).En dépit de leur excès de prévalence, les mécanismes physiopathologiques des troubles respiratoires du sommeil associés à la lésion médullaire ne sont pas parfaitement élucidés. De plus, en raison des multiples comorbidités souvent associées à la lésion médullaire, les problématiques liées au sommeil sont fréquemment reléguées au second plan et sous diagnostiquées. L'objectif de cette thèse est d'enrichir les connaissances relatives à la prise en charge spécifique des troubles respiratoires du sommeil chez les patients lésés médullaires, depuis la physiopathologie jusqu'aux modalités de traitement en passant par les stratégies de dépistages et les conséquences spécifiques.Au cours de cette thèse nous avons abordé la physiopathologie des troubles respiratoire nocturne des patients lésés médullaires et notamment le rôle des mouvements de fluides nocturnes au décubitus. Nos résultats soulignent l'importance du phénotypage et la nécessité de stratégies de dépistage adaptées des troubles respiratoires. Les conséquences spécifiques notamment vésico-sphinctérienne et cardiovasculaires ont également été abordée. Enfin, les bénéfices et limites des traitements conventionnels ont été étudiés notamment les déterminants spécifiques de l'observance au traitementSpinal cord injuries (SCI) lead to variable clinical presentations depending on the level and severity of the lesion. Sleep disorders are a frequent complication of SCI: sleep disordered breathing (SDB) is 3-4 times more frequent than in the general population and includes obstructive and/or central apneas and alveolar hypoventilation.Despite its increased prevalence, the pathophysiological mechanisms underpinning SDB associated with SCI are poorly understood. Furthermore, the presence of other complications linked to SCI means that sleep disorders are often under investigated. The objective of this thesis is to improve knowledge both of the pathophysiology and management of SDB, focussing on screening, treatment modalities and consequences.We look at the pathophysiology of SDB in SCI patients and notably the role of rostral fluid shift when lying down. Our results underline the importance of accurate phenotyping and adapted SDB screening strategies in this population. We also examine specific consequences such as bladder and bowel function and cardiovascular morbidity. Finally, the benefits and limits of conventional treatments are explored, focussing on the factors associated with treatment to continual positive airway pressure (CPAP) and non-invasive ventilation (NIV)
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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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Revol, Bruno. "Pharmacoépidémiologie des apnées du sommeil Impact of concomitant medications on obstructive sleep apnoea Drugs and obstructive sleep apnoeas Diagnosis and management of central sleep apnea syndrome Baclofen and sleep apnoea syndrome: analysis of VigiBase® the WHO pharmacovigilance database Gabapentinoids and sleep apnea syndrome: a safety signal from the WHO pharmacovigilance database Valproic acid and sleep apnea: a disproportionality signal from the WHO pharmacovigilance database Ticagrelor and Central Sleep Apnea What is the best treatment strategy for obstructive sleep apnoea-related hypertension? Who may benefit from diuretics in OSA? A propensity score-matched observational study". Thesis, Université Grenoble Alpes, 2020. http://www.theses.fr/2020GRALV026.
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Avant leur mise sur le marché, l'évaluation clinique des médicaments repose sur des essais contrôlés randomisés. Bien qu'ils représentent la méthode de référence, leurs résultats sont nécessairement limités aux patients inclus dans ces essais. De plus, ils sont d’abord conçus pour mesurer l'efficacité des traitements, avant d’évaluer leurs effets indésirables. Concernant le syndrome d'apnées du sommeil (SAS), alors que de nombreux essais médicamenteux ont été menés, la plupart des résultats sont de faible niveau de preuve, voire contradictoires. Outre la durée et les effectifs limités de ces essais, une explication est que le SAS est une pathologie hétérogène en termes de symptômes et de physiopathologie, incluant divers "phénotypes" de patients. Des données de vie réelle sont donc nécessaires pour définir quels médicaments pourraient améliorer le SAS ou les comorbidités associées et quels patients pourraient en bénéficier. Au contraire, les cliniciens doivent être avertis que certains médicaments peuvent induire ou aggraver le SAS.La pharmacoépidémiologie fait désormais partie de toute enquête de pharmacovigilance, car elle permet une approche à la fois descriptive et comparative des notifications spontanées. Des associations entre l'exposition à un ou plusieurs médicaments et l'apparition d'effets indésirables peuvent ainsi être recherchées. Comme pour toutes les études observationnelles, la principale difficulté consiste à contrôler les facteurs de confusion. L'un des modèles couramment utilisés est l'analyse cas/non-cas, qui étudie la disproportionnalité entre le nombre d’effets indésirables rapportés avec le médicament d’intérêt, par rapport aux effets notifiés pour les autres médicaments. Nous avons ainsi montré des associations significatives entre l'utilisation de baclofène, des gabapentinoïdes ou de l'acide valproïque et la survenue de SAS dans la base de pharmacovigilance de l'OMS, suggérant le rôle du système GABAergique dans la pathogenèse des apnées centrales d’origine médicamenteuse. Un signal de disproportionnalité a également été observé pour le ticagrélor, reposant sur un mécanisme d'action différent.Les analyses pharmacoépidémiologiques permettent également d'étudier le bénéfice des médicaments en vie réelle. Le score de propension est utilisé pour minimiser les biais de sélection et recréer des conditions de comparabilité proches de celles des essais randomisés. À l'aide de ces méthodes statistiques, nous avons évalué l'intérêt potentiel de cibler le système rénine-angiotensine pour la prise en charge de l'hypertension artérielle chez les patients atteints d’apnées obstructives, en particulier avec l’utilisation des sartans. Chez ces mêmes patients apnéiques et hypertendus, nos travaux suggèrent que les diurétiques pourraient diminuer la sévérité des apnées, notamment en cas de surpoids ou d’obésité modérée. Des études prospectives sont désormais nécessaires afin de confirmer ces résultats, car les données de vie réelle ne peuvent se substituer aux essais cliniques contrôlésThe clinical evaluation of drugs before approval is based on randomized controlled trials. Although they are considered as the gold standard for testing drugs, their results are necessarily limited to patients included in the trials. Moreover, almost all clinical trials are primarily designed to assess the efficacy of a treatment, so safety is only a secondary concern. Regarding sleep apnea syndrome (SAS), while many drug trials have been conducted, most of the results are weak or even contradictory. In addition to limited trial duration and population size, one explanation is that the sleep apnea population is highly heterogeneous with respect to symptoms and physiological traits linked to disease pathogenesis, giving various patient “phenotypes”. Real-life data are therefore needed to define which drugs could improve SAS or associated comorbidities and who might benefit from them. On the contrary, clinicians need to be aware that some drugs may induce or worsen sleep apnea.Pharmacoepidemiology is now part of any pharmacovigilance survey, as it provides both descriptive and comparative approaches of spontaneous reports. Associations between the exposure to one or more drugs and the occurrence of adverse effects can thus be sought. As for all observational studies, the major difficulty is to control for confounding factors. One of the study designs commonly used, is the case/non-case analysis, which investigates disproportionality between the numbers of adverse drug reactions reported with the drug of interest compared to the number reported with all other drugs. In this way, we showed significant associations between the use of baclofen, gabapentinoids or valproic acid and the reporting of SAS in the WHO drug adverse event database, suggesting a role of the GABAergic system in the pathogenesis of drug-induced central sleep apnea. A disproportionality signal was also found for ticagrelor, based on a different mechanism of action.Pharmacoepidemiological analyses also make it possible to study the benefit of drugs in real-life. Propensity scores are used to minimize selection bias, leading to a comparability between the exposure groups close to that observed in randomized trials. Using these statistical methods, we have investigated the potential value of targeting the renin-angiotensin system for the management of hypertension in obstructive sleep apnea (OSA) patients, especially the use of sartans. For hypertensive apneic patients, our work suggests that diuretics could decrease the severity of OSA, particularly in the overweight or moderately obese. Prospective studies are now needed to confirm these findings, because real-life data cannot be a substitute for controlled clinical trials
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Riedel, Frank. "Prävalenz schlafbezogener Atmungsstörungen bei Herzschrittmacherpatienten". Doctoral thesis, Humboldt-Universität zu Berlin, Medizinische Fakultät - Universitätsklinikum Charité, 1998. http://dx.doi.org/10.18452/14398.
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Ziel der Untersuchung war die Ermittlung der Prävalenz schlafbezogener Atmungsstörungen (SBAS) in einer Gruppe von Herzschrittmacherpatienten. Durch Gegenüberstellung mit der in der Literatur angegebenen Prävalenz SBAS in vergleichbaren Patientengruppen ohne Herzschrittmacher sollte eine Aussage über einen möglichen Zusammenhang zwischen SBAS und schrittmacherbedürftigen Herzrhythmusstörungen getroffen werden. Dieser Zusammenhang könnte indirekt über die bekannte Koinzidenz zwischen SBAS und arterieller Hypertonie bzw. KHK bestehen. Es wurden 192 Patienten (100 Männer, 92 Frauen) der Rhythmussprechstunde des Universitätsklinikums Charité in Berlin mit einem Durchschnittsalter von 62,2 +/- 12,2 Jahren ambulant für eine Nacht untersucht. Zum Einsatz kam das tragbare Schlafapnoe-Monitoring-Gerät MESAM IV. Schlafbezogene Atmungsstörungen lagen dann vor, wenn der respiratorische Gesamtindex (RDI = respiratory disturbance index) als Summe der Apnoen und Hypopnoen pro Stunde Schlaf größer oder gleich 10 war. Anhand des RDI erfolgte eine Einteilung der Patienten in Diagnosegruppen: Gruppe A (RDI < 5, kein Vorliegen SBAS), Gruppe B (RDI >= 5 und < 10, Grenzbefund) und Gruppe C (RDI >= 10, Vorliegen SBAS). Ergebnisse (Gesamtkollektiv / Männer / Frauen): Gruppe A: 100 / 44 / 56 Patienten (52,1 / 44,0 / 60,9 %) Gruppe B: 30 / 16 / 14 Patienten (15,6 / 16,0 / 15,2 %) Gruppe C: 62 / 40 / 22 Patienten (32,3 / 40,0 / 23,9 %). Signifikant häufiger wurden SBAS (Gruppe C) bei Männern als bei Frauen nachgewiesen. Ebenso liegen das Durchschnittsalter (Gruppe A: 58,5 +/- 14,5 Jahre, Gruppe C 67,3 +/- 6,8 Jahre) sowie der durchschnittliche Body-Mass-Index (Gruppe A: 24,8 +/- 3,4 kg/m2, Gruppe C 27,1 +/- 3,3 kg/m2) bei Patienten mit SBAS signifikant höher als bei Patienten ohne SBAS. Patienten mit unterschiedlichen, der Schrittmacherimplantation zugrundeliegenden, Herzerkrankungen (z. B. Sick-Sinus-Syndrom, AV-Block, Bradyarrhythmia absoluta) wiesen keine signifikanten Differenzen in der Häufigkeit SBAS auf. Gleichermaßen konnte das Vorliegen zusätzlicher kardiovaskulärer Erkrankungen und Risikofaktoren (z. B. KHK, arterielle Hypertonie, Rauchen) nicht als Einflußfaktor für das gehäufte Auftreten SBAS nachgewiesen werden. Angaben zur Prävalenz SBAS in der Literatur schwanken für die entsprechende Altersgruppe von Patienten ohne Herzschrittmacher zwischen 24 % und 73 %. Die für die Herzschrittmacherpatienten ermittelte Prävalenz der SBAS mit 32,3 % liegt innerhalb dieser großen Spannbreite. Die Untersuchungsergebnisse ergaben daher keinen Zusammenhang zwischen SBAS und schrittmacherbedürftigen Herzrhythmusstörungen. Auch konnte kein Unterschied im Auftreten SBAS in Abhängigkeit von der Art der Herzrhythmusstörung nachgewiesen werden. Weiterführende Untersuchungen (z. B. in Form einer Fall-Kontroll-Studie) erscheinen notwendig.The study was aimed to determine prevalence of sleep-related respiratory disturbances (SRRD) in a group of pacemaker patients. It was investigated if SRRD are more prevalent in pacemaker patients compared to corresponding patients without pacemaker. This question was raised in background of the wellknown coincidence of SRRD and arterial hypertension respectively coronary heart disease. References about the prevalence of SRRD in corresponding elderly people served as standard of comparison. 192 hospital outpatients (100 men and 92 women) from rhythmological ambulance of university hospital "Charité" in Berlin were randomly selected and examined for one night by means of MESAM IV device, a Non-laboratory-monitoring-system". The mean age of these patients was 62,2 +/- 12,2 years. A respiratory disturbance index (RDI; the sum of apneas and hypopneas per hour of sleep) equal or greater than 10 was laid down for the existence of SRRD. The RDI built the basis for dividing the patients into three groups: Group A (RDI < 5, no SRRD), Group B (RDI >= 5 and < 10, borderline SRRD) an Group C (RDI >= 10, SRRD). Results (all patients / men / women): Group A: 100 / 44 / 56 patients (52,1 / 44,0 / 60,9 %) Group B: 30 / 16 / 14 patients (15,6 / 16,0 / 15,2 %) Group C: 62 / 40 / 22 patients (32,3 / 40,0 / 23,9 %). Significant differences occured in the frequency of SRRD (Group C) between men and women. Apart from that the mean age (Group A: 58,5 +/- 14,5 years, Group C: 67,3 +/- 6,8 years) as well as the Body-Mass-Index (Group A: 24,8 +/- 3,4 kg/m2, Group C: 27,1 +/. 3,3 kg/m2) were significantly higher in patients with SRRD than in patients without SRRD. No significant differences in the frequency of SRRD could be demonstrated in dependence on underlying rhythm disturbances (e. g. Sick-Sinus-Syndrom, atrioventricular block, Bradyarrhythmia absoluta). In the same manner no evidences regarding significant influences of additionally existing cardiovascular diseases or risk factors (e. g. coronary heart disease, arterial hypertension, smoking) on the appearance of SRRD were shown. References about the prevalence of SRRD in corresponding elderly people without pacemaker vary from 24 % to 73 %. The prevalence of SRRD in pacemaker patients (32,3 %) fits right in the frame of this great variety. A more frequent appearance of SRRD in patients with pacemaker than in patients without could not be proved. Equally, the underlying rhythm disturbance has apparently no correlation to SRRD. Extended studies are necessary.
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Lam, Chung-mei Jamie, e 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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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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Lam, Yau-min, e 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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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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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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Chittenden, Thomas William. "Chronic Hypoxia and Cardiovascular Dysfunction in Sleep Apnea Syndrome". Diss., Virginia Tech, 2002. http://hdl.handle.net/10919/28718.
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The purpose of the current study was to test the hypothesis that chronic hypoxia associated with sleep-disordered breathing relates to abnormal Nitric Oxide (NO) production and vascular endothelial growth factor (VEGF) expression patterns that contribute to aberrancy of specific determinates of cardiovascular and cardiopulmonary function before, during, and after graded exercise. These patterns may further reflect pathologic alteration of signaling within the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt-1) transduction network. To this end, 7 medically diagnosed OSA patients (3 male, 4 female), mean age 48 years and 7 apparently healthy control subjects (3 male, 4 female), mean age 42 years, underwent baseline venous blood draws and maximal bicycle ergometry. Mononuclear cells isolated from peripheral blood were utilized as reporter cells for measurement of VEGF, Akt-1, hypoxia inducible factor-1 alpha (HIF-1 alpha), and vascular endothelial growth factor receptor-2 (VEGFR2) gene expression by redundant oligonucleotide DNA microarray and real-time PCR technologies. Circulating angiogenic progenitor cells expressing VEGFR2 were profiled by flow cytometry. Plasma and serum concentrations of VEGF, nitrates/nitrites, catecholamines, and dopamine were measured by enzyme-linked immunosorbent assay (ELISA) and high performance liquid chromatography (HPLC). Arterial blood pressure, cardiac output, oxygen consumption and total peripheral resistance were determined at Baseline, 100W, and peak ergometric stress by standard techniques. There were no apparent differences (p < .05) observed in biochemical markers relating to vascular function and adaptation including, serum nitrates/nitrites, norepinephrine, dopamine, and plasma VEGF. No differences were found relative to cardiac output, stroke volume, cardiopulmonary or myocardial oxygen consumption, expired ventilation, heart rate, arteriovenous oxygen difference, total peripheral resistance, and mean arterial pressure. Due to methodological issues related to the redundant oligonucleotide DNA microarray and real-time PCR gene expression analyses, results of these experiments were uninterpretable. Thus, the research hypothesis was rejected. Conversely, significant (p < .05) differences were observed in waist: hip ratios, recovery: peak systolic blood pressure ratio at 1 minute post-exercise and %VEGFR2 expression. OSA was associated with elevations in both waist: hip ratios and recovery: peak systolic blood pressure ratio at 1 minute post-exercise as well as significant depression of %VEGFR2 profiles. Moreover, significant negative correlations were found regarding waist: hip ratios and %VEGFR2 expression (r = -.69;p =.005) and recovery: peak systolic blood pressure ratio at 1 minute post-exercise and %VEGFR2 expression (r = -.65;p =.01). These findings did not provide evidence that NO-dependent vasoactive mechanisms are suppressed nor did they support the supposition that angiogenic mechanisms are pathologically activated in sleep-disordered breathing.Ph. D.
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Cloonan, Yona Keich. "Sleep outcomes in children with craniofacial microsomia /". Thesis, Connect to this title online; UW restricted, 2007. http://hdl.handle.net/1773/10877.
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Riha, Renata Ludmilla. "Genetics of the sleep apnoea/hypopnoea syndrome". Thesis, University of Edinburgh, 2004. http://hdl.handle.net/1842/25122.
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This thesis examined possible candidate genes that might contribute towards the development of OSAHS. The genes of interest included tumour necrosis factor –alpha (potential associations with ageing, hypercytokinaemia in OSAHS, obesity and sleepiness). Apolioprotein E (associations with the development of cerebrovascular disease), the serotonin receptor 2A (modulation of upper airway muscle tone and response to selective serotonin re-uptake inhibitors), beta-2 adrenoreceptor (growth, fat metabolism and blood pressure) and the growth hormone receptor (influence on postnatal bone growth and height including the craniofacial complex). 557 consecutive subjects with a diagnosis of OSAHS were approached at the Scottish Sleep Centre. 104 subjects (all Caucasian) were recruited together with 107 of their siblings as well as an additional 17 unrelated subjects without OSAHS and underwent overnight polysomnography and cephalometry. Blood was taken for DNA analysis. Subjects were classified as having definite OSAHS (n=110), indeterminate status (n=34) or not having OSAHS (n=83) based on their apnoea/hypopnoea frequency and sleepiness as measured by the Epworth Sleepiness Score. DNA was extracted using standard techniques and polymorphisms in the candidate genes were examined using allelic discrimination testing with TaqMan™. The Apolipoprotein E4 polymorphisms were determined using polymerase chain reaction, restriction fragment length polymorphism. DNA from192 random, healthy UK blood donors (assumed not to have OSAHS) was used as an additional control. Differences between subjects with and without OSAHS were as expected: there were over twice as many men in the OSAHS group compared to the non-OSAHS group (p<0.0001) and systolic blood pressure was significantly higher (p = 0.002) in the OSAHS group. Furthermore, the OSAHS group were more obese (p<0.0001) and had a greater neck circumference (p<0.0001) than the non-OSAHS group. Cephalometry revealed that both male and female apnoeics had significantly lower-set hyoid bones than non-apnoeic snorers (p = 0.01 and p = 0.038 respectively). In male subjects with OSAHS, a smaller mandible and lower-set hyoid were the most important characteristics distinguishing siblings with from sibs without OSAHS, independently of age and BMI. However, age, sex, BMI and edentulism were found to influence craniofacial parameters in both groups. For the genetic analyses, the Apo E e4 allele (examined in 73 subjects) was not associated significantly with a diagnosis of OSAHS. In addition, the TNF-a – 308 A allele showed significant association with the OSAHS phenotype when comparing siblings discordant for carriage of this allele. The increased prevalence of some of the minor polymorphisms in the study population with OSAHS suggested there may be abnormalities in metabolism and the regulation of growth, which may directly contribute to its aetiology. These preliminary findings would require exploration in other populations, but are compatible with OSAHS being a polygenic disorder. This thesis highlights that there is much to be done in our search for relevant genetic factors that will lead to a greater understanding of this complex, chronic and very common disease.
15
Wichmann, Mark William. "A device for the treatment of adult Sleep Apnea Syndrome". Thesis, Virginia Tech, 1988. http://hdl.handle.net/10919/45960.
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An electronically-controlled positive-displacement bellows-type air pump has been developed in the Bio-medical Engineering Laboratory for the treatment of adult Sleep Apnea Syndrome (SAS). An electronically-controlled positive-displacement pump has been employed in order to eliminate the pressure regulator and accompanying noise of present therapeutic devices. The positive-displacement pump is found to quietly and effectively provide the required airway pressures for the treatment of adult Sleep Apnea Syndrome. New developments in the reduction of the size and noise levels of current therapeutic devices, however, preclude mass production of the bellows-type pump because of its size disadvantage. The custom nasal mask and exhalation valve, control system, pressure-monitoring alarm system, and the controlled humidifier of the positive-displacement pump should be incorporated within the present fanâ type Nasal Continuous Positive Airway Pressure (NCPAP) system to provide quieter, more comfortable, and safer NCPAP therapy. Before the design and development of the positive displacement NCPAP pump is detailed in this thesis, however, the problem of adult Sleep Apnea Syndrome is introduced, available therapies are investigated, and the current NCPAP therapy system is examined.
Master of Science
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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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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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Groenewald, Liechka. "The prevalence of sleep apnea in patients with Cushing's syndrome". Diss., University of Pretoria, 2020. http://hdl.handle.net/2263/77081.
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Patients with Cushing’s syndrome often complain about sleep disruption and excessive day time sleepiness, which could contribute to worsening quality of life and metabolic comorbidities (obesity, hypertension, diabetes mellitus, dyslipidaemia) associated with hypercortisolism. Sleep disorders have been shown to increase the risk of developing cardiovascular disease and that the risk of cardiovascular disease in patients with hypercortisolism may be worsened by impaired sleep. Cushing’s syndrome patients may also be at increased risk for obstructive sleep apnea due to their obesity.Dissertation (MSc)--University of Pretoria, 2020.
Physiology
MSc
Restricted
20
Santos, Telma Cristiana Resse Nunes dos. "Erectile disfunction in obstrutive sleep apnea syndrome - prevalence and determinants". Master's thesis, Faculdade de Medicina da Universidade do Porto, 2010. http://hdl.handle.net/10216/61110.
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Santos, Telma Cristiana Resse Nunes dos. "Erectile disfunction in obstrutive sleep apnea syndrome - prevalence and determinants". Dissertação, Faculdade de Medicina da Universidade do Porto, 2010. http://hdl.handle.net/10216/61110.
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Devita, Maria. "Neuropsychology of sleep and breathing: the effects of obstructive sleep apnea syndrome on cognition". Doctoral thesis, Università degli studi di Bergamo, 2018. http://hdl.handle.net/10446/102657.
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Obstructive Sleep Apnea Syndrome (OSAS) is a common sleep disorder that has drawn the attention of neuropsychologists because of its possible deleterious effects on cognition. Several are the causes of the impairments this syndrome can produce, like fragmentation of sleep, intermittent nocturnal hypoxia and daytime sleepiness. Apolipoprotein E4 (APOE4) may also play a role in OSAS and it has been suggested as a trigger of cognitive impairment and of dementia-like patterns.
This dissertation begins with a critical review of the literature, with the aim to provide the current overview of the main controversies about OSAS and its effects on brain and cognition. Three experimental studies aiming to shed light on the nature of the relationship between OSAS and cognition are then proposed. The first two studies focus on the effects of OSAS on information processing speed. Innovative measures have been proposed to clarify whether different components of information processing speed are impaired in OSAS (Study 1), and to evaluate the efficacy over time of the continuous positive airway pressure treatment (Study 2). Finally, Study 3 aims to evaluate the effects of APOE4 on psychometric performance, and to investigate at which sleep stage its presence could be a predictor of cognitive impairments in OSAS patients. Results show that OSAS is associated with impairment of the motor component of information processing speed, which can however be properly recovered after treatment. Furthermore, a retention memory deficit is reported in OSAS patients carrying APOE4, and NREM sleep fragmentation has been found to be directly involved in this impairment. This dissertation supports the hypothesis of a cognitive frailty associated with OSAS, however discouraging its irreversibility, and argues that APOE4 can be considered a risk factor for the memory loss observed in this syndrome.
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Breslin, Jennifer H. "Sleep Disturbance, Cognition, and Behavior in Down Syndrome". Diss., The University of Arizona, 2011. http://hdl.handle.net/10150/201494.
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Children and adolescents with Down Syndrome (DS) have a high incidence of sleep problems, including Obstructive Sleep Apnea Syndrome (OSAS). They are also likely to have deficits in neuropsychological tasks tapping prefrontal function and hippocampal function. There has recent revival of literature suggesting an active role for sleep in memory consolidation and problem-solving in both children and adults. Furthermore, given the cognitive and behavioral sequellae of OSAS in typically developing children it is logical to test if the hypoxemia and increased sleep fragmentation, the two major pathophysiological mechanisms of OSAS, seen in children with DS and OSAS may exacerbate learning or behavior disorders.Forty children with DS aged 7-18 were administered the Arizona Cognitive Test Battery (ACTB) for DS (Edgin et al., 2010), and in-home ambulatory polysomnography. Their parents were asked to complete several questionnaires assessing their child's sleep and behavior. Seventy-seven percent (n = 40) of our sample met criteria for pediatric sleep apnea (AHI>1.5), and the mean apnea hypoppnea index (AHI) was 8.4 events per hour. Our sample had a mean arousal index of 10.3, a respiratory arousal index of 3.2, and a SaO2 nadir of 86.9%. Over 70% of our sample had a SaO2 nadir below 90%. We examined the relationship between OSAS severity and cognitive and behavioral outcomes. We found that children with DS with a lower apnea hypopnea index (AHI) attained a greater number of stages on the CANTAB PAL task compared to chronologically age-matched children with higher AHI, and the variance in performance was partially explained by sleep fragmentation (i.e., the arousal index) and experimenter-rated "attention" but not hypoxemia. In addition, we also found that the low apnea group showed a trend toward outperforming the high apnea group on the KBIT-II Verbal IQ scale and DAS-2 Pattern Construction subtest.These findings have important clinical implications. First, these results suggest that early screening for OSAS in DS is important, as OSAS severity seems to explain some of the variance in cognitive functioning. Second, these findings suggest that an early intervention for OSAS might be warranted.
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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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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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Donoghue, Simon. "The cardiovascular consequences of obstructive sleep apnoea hypopnoea syndrome". Thesis, University of Liverpool, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.269700.
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Cheng, Hai-kiu Kelvin. "Evaluation on the quality of life for patients with obstructive sleep apnea using the continuous positive airway pressure device treatment". Click to view the E-thesis via HKUTO, 2008. http://sunzi.lib.hku.hk/hkuto/record/B4072041X.
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Sam, Kim. "Short term effects of an oral appliance in the treatment of mild to moderate Obstructive Sleep Apnea in Chinese subjects". Hong Kong : University of Hong Kong, 1999. http://sunzi.lib.hku.hk/hkuto/record.jsp?B21879278.
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Moss, James. "Physiological effects of treatments in obstructive sleep apnoea syndrome". Thesis, Sheffield Hallam University, 2013. http://shura.shu.ac.uk/20763/.
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The original research in this thesis aimed to investigate physiological effects of different treatment approaches in obstructive sleep apnoea syndrome (OSAS). OSAS is a prevalent public health concern independently associated with increased cardiovascular risk. Specifically, study 1 examined the feasibility of conducting a pragmatic lifestyle intervention in patients reporting compliance with continuous positive airway pressure (CPAP) and collected provisional data about its efficacy, and study 2 investigated the physiological effects of low compliance to CPAP therapy in a four-arm observational study. The intervention in study 1 involved supervised exercise, dietary advice and behaviour change counselling. Primary outcome measures were recruitment, retention and compliance data and secondary outcome measures assessed anthropometrics, cardiovascular risk, quality of life and exercise capacity. Study 2 investigated macro-and microvascular function, anthropometrics, quality of life, cardiovascular risk and exercise capacity. The novel findings of this research were: 1) the lifestyle intervention was feasible to deliver; 2) the intervention improved key health outcomes such as exercise capacity (A +16%) and serum C-reactive protein (A -57%), which were maintained after 3 months of independence (A +22% and -57%, respectively); 3) self-reported CPAP compliance is an unreliable indicator of actual compliance; 4) it is difficult to recruit low-compliance patients onto research trials, and recruiting newly diagnosed patients is also difficult without interrupting the patient pathway; 5) vascular function seems impaired in low-compliance patients versus high-compliance patients, although further work is needed to confirm this. These findings contribute to the growing evidence base for the role of lifestyle intervention in OSAS, and provide provisional data on the effects of low compliance to CPAP therapy on vascular endothelial function. In summary, future research investigating pragmatic lifestyle interventions in OSAS and the physiological effects of low-compliance to CPAP is certainly warranted.
31
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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Mok, Yuk-wan Wendy. "A validation of the Calgary Sleep Apnea quality of life index (Chinese version) and an evaluation of treatment effectiveness and patient perference by physiological and neurobehavioural outcome measures in Chinese sleep apnea patients /". Hong Kong : University of Hong Kong, 2002. http://sunzi.lib.hku.hk/hkuto/record.jsp?B2520564x.
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Ahrens, Anika. "A randomized clinical trial of the treatment of obstructive sleep apnoea using oral appliances". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B47849599.
Texto completo da fonteResumo:
Obstructive sleep apnoea (OSA) is the most common sleep-related breathing disorder and is associated with a range of adverse physical, social and psychological outcomes that affect quality of life (QoL). Two systematic reviews of the literature (part of this thesis work) found there is conflicting evidence of how different mandibular advancement device (MAD) designs features may affect clinical and subjective OSA outcomes in certain patients. Therefore, a randomized cross-over trial was conducted. Firstly, the correlation between clinical OSA indicators and QOL was explored among patients referred for OSA treatment using MADs. In addition, associations of OSA risk factors, dental status and demographic variables with clinical OSA indicators and QoL indices were determined. Secondly, the efficacy of two different MADs in the treatment of adult OSA patients was assessed and compared. Thirdly, the efficacy of the two MADs in the treatment of adult OSA patients from the subjective perspective of their bed partners was determined.
A consecutive sample of 45 adult OSA patients referred from Queen Mary Hospital Sleep Centre to the Prince Philip Dental Hospital for oral appliance therapy was recruited and treated with a monobloc MAD and a twinblock MADs for a period of 3 months per MAD (cross-over randomised trial). Changes in clinical OSA outcomes were assessed by polysomnography (PSG) and changes in subjective outcomes by the disease-specific Sleep Apnoea Quality of Life Index (SAQLI) questionnaire, the Functional Outcome of Sleep Questionnaire (FOSQ) and Epworth Sleepiness Scale (ESS). Patient compliance, side-effects and MAD preference, as well as MAD treatment impact on the patients’ bed partner was also assessed.
At baseline, some clinical OSA indicators, subjective QoL and certain OSA risk factors were significantly correlated (p<0.05). There were significant variations in clinical OSA indicators and subjective QoL indices with respect to certain risk factors (p<0.05), demographic variables (p<0.05) and dental status (p<0.01).
There was a significant difference in favour of the monobloc MAD in terms of improving the apnoea-hypopnoea index (AHI) (p<0.05) and oxygen desaturation index (ODI) (p<0.01). Significantly more patients achieved clinical treatment success with the monobloc compared to the twinblock (p<0.05). Both MADs were efficacious in improving patients’ SAQLI score (p<0.01), FOSQ score (p<0.01) and ESS score (p<0.01). Significantly more patients achieved QoL treatment success with the monobloc (p<0.05) compared to the twinblock. More patients were ‘very satisfied’ with the monobloc treatment (p<0.05) and 63% preferred it to the twinblock.
No significant difference was found between patients’ and bed partners perceptions of symptom improvement post treatment, however, the monobloc resulted in a significant reduction in bed partners’ daytime sleepiness (p<0.01) and allowed significantly more co-sleeping at night (p<0.05).
This study concluded that the monobloc is superior in improving subjective QoL and clinical OSA indicators. The monobloc was the preferred MAD and patients were more satisfied with it; bed partners rated this MAD as superior in improving their own daytime sleepiness and co-sleeping.published_or_final_version
Dentistry
Doctoral
Doctor of Philosophy
34
Lai, Yuen-kwan Agnes, e 賴婉君. "Continuous positive airway pressure education on adherence in adults with obstructive sleep apnoea". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/198849.
Texto completo da fonteResumo:
Poor adherence to continuous positive airway pressure (CPAP) treatment in patients with obstructive sleep apnoea (OSA) limits its therapeutic effectiveness and has a major impact on clinical outcomes. Effective education programme is important to enhance CPAP use. However, existing education programmes are either manpower or resource demanding and may not be feasible in clinical practice. Moreover, the Self-Efficacy Measure for Sleep Apnoea (SEMSA) has been widely adopted for assessing adherence-related cognitions on CPAP therapy in OSA patients, but it was not available for Chinese.
The aims of this thesis are: (i) to perform linguistic and psychometric evaluation of a Chinese version of SEMSA (SEMSA-C); (ii) to examine the efficacy of brief motivational enhancement education programme in addition to standard care versus standard care only on improving adherence to CPAP treatment in patients with OSA.
The SEMSA-C was obtained after the standard forward-backward translation process. A randomised controlled trial was then conducted on newly diagnosed OSA patients. Patients in the control group received standard care (SC) comprising advice on the importance of CPAP therapy and its care while those in the intervention group received SC plus motivational enhancement education programme (ME). ME focused to enhance subjects’ knowledge, motivation and self-efficacy to use CPAP, comprising one 45-minute session on the day after CPAP titration and one 10-minute telephone follow-up shortly after commencing CPAP treatment. Epworth Sleepiness Scale (ESS), SEMSA-C, and quality of life were assessed. CPAP usage data were downloaded at the completion of this 3-month study. The primary outcome was the CPAP adherence. Furthermore, 21 patients were randomly sampled at baseline and completed the SEMSA-C at one week.
100 patients (Men : Women, 84 : 16) with OSA indicated for CPAP treatment were recruited, with an average age of 52±10 years, and apnoea hypopnoea index (AHI) of 36.2±22 events/hour. Factor analysis of SEMSA-C identified three factors: risk perception, outcome expectancies and treatment self-efficacy. Their corresponding internal consistency was high with Cronbach’s alpha >0.88, which were larger than all correlations between subscales (Range: 0.14 to 0.58). The correlations between items and their hypothesized subscale (Range: 0.58 to 0.85) were generally higher than the correlations between items and their competing subscales (Range: -0.10 to 0.58). One-week test-retest intra-class correlation ranged from 0.70 to 0.82. CPAP adherence was associated with outcome expectancies and treatment self-efficacy at 3-month assessment. Furthermore, SEMSA-C demonstrated an improvement in self-efficacy (standardised response mean = 0.33, p = .044) but no significant changes were observed in the other two factors, after CPAP use.
The 100 patients were followed for 3 months. The interventional effects maintained during the 3-month study period. There were a better CPAP use [higher daily CPAP usage of 2 hours/day (Cohen d = 1.33, p < .001), four-fold the number of subjects using CPAP for ≥ 70% of days with ≥ 4 hours per day (p < 0.001)], and greater improvements in ESS by 2.2 (p = 0.001) and treatment self-efficacy by 0.2 (p = 0.012) in the intervention group, relative to the control group.
The traditional Chinese SEMSA-C possesses satisfactory psychometric properties. It is a reliable and responsive instrument to measure perceived risks, outcome expectancies and treatment self-efficacy in Chinese patients with OSA. Moreover, the newly developed brief motivational enhancement education programme in addition to standard care is effective in improving adherence to CPAP treatment, treatment self-efficacy and daytime sleepiness.published_or_final_version
Nursing Studies
Doctoral
Doctor of Nursing
35
Al-Abri, Mohammed A. "Studies in blood pressure and obstructive sleep apnoea/hypopnoea syndrome". Thesis, University of Edinburgh, 2007. http://hdl.handle.net/1842/24009.
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This thesis aims to explore baroreflex sensitivity (BRS) in a randomised controlled trial. The hypothesis is that BRS is impaired in sleep apnoea patients, which might be reversed with one month of CPAP therapy. The study was designed to test for BRS in newly diagnosed OSAHS patients and perform a single blinded placebo controlled crossover trial of the effect of CPAP. Twenty-nine patients were recruited with Epworth Sleepiness Scale (ESS) of more than 10 and apnoea/hypopnoea index (AHI) was more than 15. Ten healthy control subjects were also studied. The study has shown weak difference between controls and OSAHS patients in the sequential analysis measure of BRS (P=0.05) but there was no difference with other BRS variables (P>0.05). However, the study did not show any significant difference between CPAP and placebo in terms of an effect on any measure of BRS not of 24-hour blood pressure. Even a priori sub group analyses of desaturating and compliant patients (4% Desaturating Index > 10 & CPAP use > 3.9 hour/night) showed no effect of CPAP (P>0.05). Patients did improve symptomatically with CPAP (P=0.02).The main criticisms of this study are the lack of reproducibility of the BRS measuring technique. Furthermore, relatively small sample size, may perhaps, had a negative impact on the results. The new methods were investigated further by another study, looking into the reproducibility of eth technique and the principles of BRS measurement, either the sequence as well as the spectral analysis of heart rate and systolic blood pressure. This study has revealed that spontaneous methods of BRS particularly the spectral domains are quite variables over time and thus difficult to reproduce. The third study was to assess endothelial function, as part of the process of understanding the pathogenesis of development hypertension and cardiovascular diseases in OSAHS patients and the contribution of hypoxemia in these disorders. The 24 blood pressure monitoring analysis revealed that hypoxemia is a putative predictor for hypertension.
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Kingshott, Ruth N. "Factors affecting daytime function in the sleep apnoea/hypopnoea syndrome". Thesis, University of Edinburgh, 1998. http://hdl.handle.net/1842/28365.
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This thesis examines the relationships between a wide range of nocturnal sleep and breathing variables and daytime function. Additionally this thesis examines the use of subjective and objective measures of daytime sleepiness, to determine which tests provide the most useful information for SAHS patients. A pilot study found that neither the 103 patients' nor their partners' Epworth rating of sleepiness were strong predictors of SAHS severity. In 150 patients with a wide range of SAHS severity, relationships between nocturnal events and daytime function were examined using newer definitions of arousal and measures of sleep continuity. A broad battery of daytime tests were used including the Maintenance of Wakefulness Test (MWT) and the Short Form (SF)-36. Unlike previous studies, all correlations were controlled for age and awake oxygen saturation, known to influence the variables measured. The current study also examined these correlations in an unselected patient sample with a range of disease severity. The study showed a lack of strong relationships between conventional nocturnal sleep and breathing variables and daytime function. Few baseline variables significantly predicted CPAP use. Daytime function measures were compared within the 150 patients. The Multiple Sleep Latency Test (MSLT) and the MWT displayed a weak, discordant relationship. Measures of cognitive function, psychological well-being and subjective sleepiness better related to the MWT than MSLT, suggesting that the MWT may be a more useful tool in assessing functional impairment in sleep apnoea. The studies presented in this thesis demonstrate a lack of identified factors affecting daytime function in a group of unselected SAHS patients. This may be due to inter-individual patient variability. Also, more sophisticated nocturnal SAHS measures should be examined, as should more 'real-life' daytime assessments, such as ambulatory EEG recorded during a patient's normal daily routine.
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Ghiassi, Ramesh. "The development of pictorial tools for obstructive sleep apnoea syndrome". Thesis, Imperial College London, 2014. http://hdl.handle.net/10044/1/24435.
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Introduction: Obstructive sleep apnoea syndrome (OSAS) is common but remains underdiagnosed and is linked with several disease states and increased risk of mortality. The key symptom, excessive daytime sleepiness, is commonly measured with the Epworth Sleepiness Scale which is not always easily completed by patients. The aim of this thesis is to develop pictorial material for assessing sleepiness and risk of OSAS. Methods: Health literacy was measured in a sample sleep population and the Epworth Sleepiness Scale was investigated for ease of use. Images were developed to translate the Epworth into pictures and the response to pictures of 'driving while sleepy' was investigated in detail. A new tool, the pictorial Sleepiness and Sleep Apnoea Scale, was devised by adding four sleepiness images from the pictorial Epworth to four new images representing 'risk of OSAS'. Evaluations were made in two populations of the tool's potential in predicting those at risk of OSAS. Results: Poor or impaired health literacy was found in 16% of patients attending the sleep clinic. Evaluation of the Epworth Sleepiness Scale found that a third of new patients made quantifiable errors. A preference for the pictorial Epworth Sleepiness Scale was reported by 55% of users and a kappa statistic indicated good agreement between the pictorial and traditional Epworth Sleepiness Scale. Drivers were more inclined to record feeling sleepy if the image in Q8 depicted the sleepy person in the car as a passenger. In a sleep clinic population the pictorial Sleepiness and Sleep Apnoea Scale was slightly better at predicting disease than the Epworth. In a cardiac rehabilitation clinic use of the witnessed apnoea image from the pictorial Sleepiness and Sleep Apnoea Scale, along with the Epworth Sleepiness Scale, helped to identify symptoms suggestive of sleep apnoea in a third of those screened. When investigated with a sleep study, the prevalence of sleep-disordered breathing in this patient group was 14.8%. Conclusion: Pictorial tools for patients with potential obstructive sleep apnoea syndrome have clinical value and can help bridge the gap between poor or impaired health literacy and the material we use to assess sleepiness and likelihood of obstructive sleep apnoea syndrome.
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Mathur, Rajat. "Family studies in patients with the sleep apnoea/hypopnoea syndrome". Thesis, University of Edinburgh, 1995. http://hdl.handle.net/1842/19996.
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The predisposing factors leading to the development of sleep apnoea/hypopnoea syndrome (SAHS) in many cases are unclear. Snoring, a prerequisite for SAHS, runs in families. There have been reports of familial SAHS in several families but this may have resulted from an association with obesity. I have therefore investigated whether SAHS is familial. In a pilot study breathing and oxygen desaturation data during sleep in 40 first degree relatives of 20 non obese SAHS patients has been compared with that in retrospective controls. Ten out of 40 relatives had >15 apnoeas+hypopnoeas/hr of sleep and 8 had >5 4% desaturations/hr. These frequencies of irregular breathing (p<0.005) and desaturation (p<0.0001) are significantly higher than in the British population. A case control study has therefore been performed examining sleep symptoms, sleep studies, upper airway calibre by acoustic reflectance and facial structure by cephalometry in first degree relatives of non obese (BMI<30 kg/m2) patients with SAHS and matched controls drawn from a general practitioner's register. In a pilot study to determine whether there might be any association between SAHS and Sudden Infant Death Syndrome, it was found that 8 unexpected sudden infant deaths were reported in 28 SAHS families compared to none in 35 control families (p<0.01). This preliminary observation requires independent verification. Thus SAHS is familial and this family tendency is associated with anatomical changes which predispose to upper airway narrowing.
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Faccenda, Jacqueline Frances. "Systemic blood pressure in the obstructive sleep apnoea/hypopnoea syndrome". Thesis, University of Edinburgh, 2002. http://hdl.handle.net/1842/23341.
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The purpose of this thesis was to demonstrate in a randomised controlled trial whether BP was higher in untreated OSAHS. The study was crossover in design with the patients acting as their own controls, so increasing the power of the study. Sixty-eight patients were studied with at least two major symptoms of OSAHS, and a mean AHI of 15 events/hour slept and a mean age of 49 years (27-77). Diastolic Blood Pressure (DBP) was reduced by CPAP in patients with OSAHS. These data were analysed on an intention to treat basis, including all 68 patients including poorly compliant patients. This showed a 1.5 mmHg drop in DBP (p = 0.043) with CPAP. In an a priori compliant subset (CPAP use 3.5 hours/night) DBP remained significantly lower by a magnitude of 1.9 mmHg (p = 0.042). In the other a priori subset of severely hypoxaemic patients (4% desaturation index 20/hour) there were also falls in Systolic BP (4.0 mmHg, p = 0.011), DBP (5.0 mmHg, p = 0.001) and mean arterial pressure (3.4 mmHg, P=0.023). Although all the reductions in pressures were small, data from population studies suggest such reductions may be associated with significant health benefits. In addition the effects may have been underestimated as the equipment used to measure BP may cause an arousal from sleep there by artificially elevating the night-time BP recorded. The baroreceptor function was not different between the two treatments. The urinary microalbumin was abnormal in 35% of the patient group, the reasons for this needs further investigation. The benefits found in quality of life confirmed previous studies although this is the first randomised controlled trial to show benefits in the Functional Outcomes of Sleep Questionnaire. The lack of improvement in the neuropsychological testing may reflect the tests used. The CPAP compliance on this study was less than ideal, but similar to those in other prospective studies.
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Stepnowsky, Carl Joseph. "Determinants of adherence with nasal cpap therapy /". Diss., Connect to a 24 p. preview or request complete full text in PDF format. Access restricted to UC campuses, 2000. http://wwwlib.umi.com/cr/ucsd/fullcit?p9970685.
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BURATTI, LAURA. "The role of obstructive sleep apnea syndrome in the pathogenesis and evolution of dementia". Doctoral thesis, Università Politecnica delle Marche, 2017. http://hdl.handle.net/11566/245258.
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Premessa e scopo. Il sonno è coinvolto nel mantenimento dell’ integrità anatomica e funzioni cerebrale attraverso meccanismi diversi, tra cui la promozione della plasticità sinaptica, il consolidamento della memoria e l'attività scavenger. Studi epidemiologici suggeriscono che la sindrome delle apnee ostruttive del sonno (OSAS) può aumentare il rischio di deterioramento cognitivo. Una conoscenza più approfondita del legame fisiopatologico tra OSAS e demenza e la dimostrazione che l’OSAS è in grado di influenzare direttamente lo sviluppo di alterazioni cognitive, potrebbe portare ad un miglioramento delle strategie di prevenzione e trattamento. L'obiettivo principale di questo studio è stato quello di valutare la correlazione tra deficit cognitivo e la presenza / gravità dell’OSAS, così come la possibile influenza di fattori vascolari. Soggetti e metodi. Sono stati arruolati 41 soggetti senza demenza affetti da OSAS, diagnosticata con una polisonnografia. Al basale, tutti i soggetti sono stati sottoposti ad uno screening vascolare completo e standardizzato, incluso uno studio della reattività cerebrovascolare mediante il calcolo dell’indice di apnea volontaria (BHI) sulla base della valutazione con Doppler transcranico. E’ stata inoltre eseguita una valutazione neuropsicologica per studiare i principali domini cognitivi. Come controlli, sono sati arruolati e sottoposti allo stesso protocollo di valutazione vascolare e cognitiva soggetti con caratteristiche anagrafiche simili, non affetti da OSAS. Tutti i pazienti con OSAS sono stati sottoposti al miglior protocollo di trattamento in base alle raccomandazioni delle linee guida internazionali e rivalutati dopo 6 mesi. In questo momento, ogni paziente ha ripetuto gli esami polisomnografici, neuropsicologici e ultrasonografici. Risultati. Al basale, le prestazioni cognitive erano più basse nei pazienti rispetto ai controlli nei seguenti compiti: Stroop test T1 e T2 e E1 ed E2 (p = 0,001), test delle parole di Rey per l’apprendimento verbale a breve termine / lungo termine (p = 0,0001 e 0,001, rispettivamente) e test di fluenza semantica e fonetica (p = 0,001). Considerando la reattività cerebrovascolare, una differenza significativa tra pazienti e controlli era presente per il BHI medio (p <0.05). Alla valutazione a 6 mesi, sulla base dei risultati del confronto tra le due valutazioni polisonnografiche, 21 pazienti presentavano un miglioramento della gravità dell’OSAS (gruppo 1) e 20 erano rimasti stabili (gruppo 2). Nel gruppo 1 è stato trovato un miglioramento significativo nel BHI sinistro (p = 0.001) e medio (p = 0.001) e nel test delle parole di Rey per l’apprendimento verbale a breve termine (p = 0.02) e a lungo termine (p = 0,001). Nessun cambiamento nella reattività cerebrovascolare e nel profilo cognitivo è stato rilevato nei pazienti del gruppo. Conclusioni. Il dato più significativo di questo studio riguarda la dimostrazione di una significativa associazione tra OSAS e riduzione dell’efficienza in alcuni compiti cognitivi in pazienti senza una storia di demenza. Il legame tra la riduzione delle prestazioni cognitive e le alterazioni emodinamiche cerebrali suggerisce un possibile ruolo patogenetico di una condizione circolatoria sfavorevole nel sostenere la disfunzione cerebrale nell’OSAS. La possibilità di migliorare le alterazioni vascolari e cognitive con trattamenti specifici merita una attenta considerazione per una strategia terapeutica completa e tempestiva nei pazienti con OSAS al fine di ridurre il rischio di sviluppo di un deterioramento cognitivo.ABSTRACT Background. Sleep is involved in maintaining cerebral anatomic integrity and functions through different mechanisms including promotion of synaptic plasticity, memory consolidation and scavenger activity. Epidemiological studies suggest that obstructive sleep apnea syndrome (OSAS) may increase the risk of cognitive impairment. A deeper knowledge of the pathophysiological link between OSAS and dementia and the demonstration that OSAS may directly influence the development of cognitive alterations, would improve prevention and treatment strategies. The main aim of this study was to evaluate the correlation between cognitive impairment and presence/severity of OSAS, as well as the possible influence of vascular factors. Subjects and methods. Forty-one non demented subjects with OSAS, diagnosed with an all-night polysomnography were enrolled. At baseline, all subjects underwent a complete and standardized vascular screening including a study of cerebrovascular reactivity by means of the breath-holding index (BHI) calculation based on transcranial Doppler evaluation. A neuropsychological evaluation to study main cognitive domains was also performed. As controls, an age- and sex-matched group of subjects without OSAS were enrolled and submitted to the same protocol of vascular and cognitive assessment. All OSAS patients were submitted to the best treatment protocol according with International specific guidelines and re-evaluated after 6 months. At this time, each patient repeated polisomnographic, neuropsychologic and transcranial Doppler assessment. Results. At baseline, the cognitive performances were lower in patients with respect to controls in the following tasks: Stroop Test T1 and T2 and E1 and E2 (p=0.001), Rey auditory verbal learning test (AVLT) short-term/long-term (p=0.0001 and 0.001, respectively) and semantic and phonetic fluency test (p=0.001). Considering cerebrovascular reactivity, a significant difference between patients and controls was present in mean BHI (p<0.05). At the 6-month evaluation, based on the results of the comparison between the polisomnographic evaluations, 21 patients had an improvement of OSAS severity (group 1) and 20 remained stable (group 2). In group 1 patients, a significant improvement was found in left and mean BHI (p=0.001) and in short-term (p=0.02) and long-term Rey AVLT (p=0.001) No change in cerebrovascular reactivity and cognitive profile was detected in group 2 patients. Conclusions. The main finding of the present study was the demonstration of a significant association between OSAS and reduced efficiency in some cognitive tasks in patients without a history of dementia. The link between reduced cognitive performances and alteration in cerebral hemodynamics suggests a possible pathogenic role of unfavorable circulatory changes in sustaining the cerebral dysfunction in OSAS. The possibility to improve vascular and cognitive alterations with specific treatments deserves full consideration for a comprehensive and timely therapeutic strategy in OSAS patients in order to reduce the risk of cognitive impairment.
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Wåhlin, Larsson Britta. "Skeletal muscle in Restless legs syndrome (RLS) and Obstructive sleep apnoea syndrome (OSAS)". Doctoral thesis, Örebro universitet, Hälsoakademin, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-6245.
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Restless legs syndrome (RLS) and Obstructive sleep apnoea syndrome (OSAS) are two sleep disorders that affect daily life with symptoms such as sleepiness and fatigue. It was therefore hypothesised that the skeletal muscle could be affected as symptoms from skeletal muscle are common. The overall aim of the thesis was to investigate aerobic capacity and structure of skeletal muscle in patients with OSAS and RLS and an age matched control group to provide information regarding the underlying mechanisms. The specific aims were to investigate muscle fibre composition, capillary network, capillary proliferation and sings of local inflammation in musculus tibialis anterior of RLS and OSAS.OSAS and RLS patients had a significantly lower predicted VO2 max expressed in ml/min/kg compared with the control group and in the OSAS group apnoes-hyponea index (AHI) was inversely correlated to maximal oxygen uptake Fibre type composition and muscle fibre cross sectional area in the tibialis anterior muscle was equal in all groups with a predominant proportion of slow type I fibres and a smaller fibre area in slow type I fibres compared to fast type II fibres. The distribution of fast fibres (I/IIA, IIA) did not differ except for the group IIX and IIA/IIX where OSAS and RLS had a significantly higher percentage. OSAS patients had a significantly higher number of capillaries per fibre (CAF) for slow type I fibres and CAF per fibre area (CAFA) for fast type II fibres. CFPE- index (capillary to fibre perimeter exchange) and LC/PF-index (length of capillary/perimeter of fibre) were higher in both patient groups. Vascular endothelial growth factor (VEGF) and proliferating endothelial cells were analysed by double-immunofluorescence staining and were presented to a greater extent in the patient groups compared with the healthy controls. Based on normal amounts of T-cells and macrophages in the histological picture it was also demonstrated that local inflammation was not present in the tibialis anterior muscle of RLS and OSAS whish was also supported by the absence of expression of major histocompatibility complex class I molecules (MHC class I) on the surface of the tibialis anterior muscle fibres.In conclusion, the low predicted VO2 max together with higher percentage of type IIX and IIA/IIX muscle fibres indicates a low central capacity in the patient groups. The increased capillary network and the absence of inflammation indicate the occurrence of local hypoxia in tibialis anterior muscle in patients OSAS and RLS.
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Wåhlin, Larsson Britta. "Skeletal muscle in Restless legs syndrome (RLS) and Obstructive sleep apnoea syndrome (OSAS) /". Örebro : Örebro University, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-6245.
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Campisi, Raffaele. "Insuline resistance and insuline sensibility in patients with obstructive sleep apnea". Doctoral thesis, Università di Catania, 2014. http://hdl.handle.net/10761/1596.
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Obstructive sleep apnea (OSA), also referred to as obstructive sleep apnea-hypopnea (OSAH), is a sleep disorder that involves cessation or significant decrease in airflow in the presence of breathing effort. It is the most common type of sleep disordered breathing (SDB) and is characterized by recurrent episodes of upper airway collapse during sleep. These episodes are associated with recurrent oxyhemoglobin desaturations and arousals from sleep. Despite being a common disease, OSAS is underrecognized by most primary care physicians; an estimated 80% of Americans with OSAS are not diagnosed. Apnea may occur hundreds of times nightly, 1-2 times per minute, in patients with severe OSA, and it is often accompanied by wide swings in heart rate, a precipitous decrease in oxygen saturation, and brief electroencephalographic (EEG) arousals concomitant with loud breathing sounds as a bolus of air is exhaled when the airway reopens. The cardinal symptoms of sleep apnea include the "3 S s": S noring, S leepiness, and S ignificant-other report of sleep apnea episodes.
Recent studies suggest that OSA increases the risk of developing insulin resistance and type 2 diabetes. The aim of the present study was to assess whether obstructive sleep apnea is a risk factor for insulin resistance, using surrogate estimates of insulin-mediated glucose uptake. We studied a population of 174 (122 males) subjects evaluated in our Sleep Lab for the suspect of OSA. All subjects underwent a standard nocturnal polysomnography (Compumedics S-Series). The HOMA index, an index of insulin resistance and the QUICKI index, an index of insulin sensitivity, were calculated from the values of fasting glucose and insulin obtained in the morning. The percentage of patients with iper-trigliceridemia was significantly higher in patients with OSAS than in controls (P <00.5) . Insulin resistance (HOMA > 2.4) was higher in OSAS patients than in controls (P < 00.5), as well as BMI values were higher in patients with OSAS than in controls (P < 00.5) .
The results showed that the risk factors for insulin resistance (HOMA > 2:45 ) were predominantly the BMI (OR 2.4, 95 % CI 1.3-4.6 , P <0.001) , OSA (OR 4.0, 95 % CI 1.6 -9.7 , P <0.001) and hypertension (OR 2.3 , 95% CI 1.2-4.3 , P<0.001). Revealed no correlation with sex , age, hypercholesterolemia and ipertrigligeridemia .
We did a multiple regression in which the OSAS (OR 2.7, 95 % CI 1.2-3.70 , P <0.05) and BMI (OR 2.3, 95% CI 0.29-2.70 , P <0.05), but not hypertension (OR 1.8, 95% CI 0.8-6.0, P <0.8) were independent risk factors for insulin resistance. From the correlation between insulin levels and OSAS we got a positive relationship between insulin and AHI (r = 0:32, P <0.001) and insulin levels and BMI (r = 0:43, P <0.001).
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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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Ng, Kwok-keung Daniel. "Sleep related breathing disorders in children /". View the Table of Contents & Abstract, 2006. http://sunzi.lib.hku.hk/hkuto/record/B36223724.
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Ng, Kwok-keung Daniel, e 吳國強. "Sleep related breathing disorders in children". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2006. http://hub.hku.hk/bib/B45007688.
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Igelström, Helena. "Physical Activity and Eating Behaviour Changes in Patients with Obstructive Sleep Apnea Syndrome". Doctoral thesis, Uppsala universitet, Sjukgymnastik, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-197595.
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This thesis aimed at developing and evaluating a tailored behavioural sleep medicine intervention for enhanced physical activity and healthy eating in patients with obstructive sleep apnea syndrome (OSAS) and overweight. Participants with moderate or severe OSAS (apnea-hypopnea index ≥15) and obesity (Studies I-II) or overweight (Studies III-IV), treated with continuous positive airway pressure (CPAP) (Studies I-II) or admitted to CPAP treatment (Studies III-IV), were recruited from the sleep clinic at Uppsala University Hospital, Sweden. Semi-structured individual interviews were analysed using qualitative content analysis (Study I). Data on moderate-to-vigorous physical activity (MVPA) and sedentary time were collected with three measurement methods and analysed regarding the level of measurement agreement (Study II). Potential disease-related and psychological correlates for the amount of MVPA, daily steps and sedentary time were explored using multiple linear regression (Study III). Physical activity and eating behaviour changes were examined after a six month behaviour change trial (Study IV). A tailored behavioural sleep medicine intervention targeting physical activity and healthy eating in combination with first- time CPAP treatment was compared with CPAP treatment and advice on the association between weight and OSAS. According to participants’ conceptions, a strong incentive is needed for a change in physical activity and bodily symptoms, external circumstances and thoughts and feelings influence physical activity engagement (Study I). Compared with accelerometry, the participants overestimated the level of MVPA and underestimated sedentary time when using self-reports (Study II). The participants spent 11 hours 45 minutes (71.6% of waking hours) while sedentary. Fear of movement contributed to the variation in steps and sedentary time. Body mass index was positively correlated to MVPA (Study III). The experimental group increased intake of fruit and fish and reduced more weight and waist circumference compared with controls. There were no changes in physical activity (Study IV). The novel tailored behavioural sleep medicine intervention combined with first-time CPAP facilitated eating behaviour change, with subsequent effects on anthropometrics, but it had no effects on physical activity and sedentary time. Fear of movement may be a salient determinant of sedentary time, which has to be further explored in this population. The results confirm sedentary being a construct necessary to separate from the lower end of a physical activity continuum and highlight the need of developing interventions targeting sedentary behaviours specifically.
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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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Cheung, Yuk-mei Agnes. "Validation of a questionnaire instrument for prediction of obstructive sleep apnea syndrome in Hong Kong Chinese children". Click to view the E-thesis via HKUTO, 2004. http://sunzi.lib.hku.hk/hkuto/record/B31971635.
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