ABSTRACT
Objectives@#The aim of this study was to evaluate dizziness in patients with sleep disorders, objectively identify vestibular function through the vestibulo-ocular reflex (VOR) using the video Head Impulse Test (vHIT), and evaluate the association between these findings. @*Methods@#Among the patients who visited the sleep clinic from June to October 2021, 69 who underwent both polysomnography (PSG) and vHIT were included. Participants completed questionnaires including the Dizziness Handicap Inventory (DHI), Beck Anxiety Inventory, Korean-Beck Depression Inventory-II, Epworth Sleepiness Scale, Insomnia Severity Index (ISI), and Pittsburgh Sleep Quality Index (PSQI). The subjects were classified into four groups: insomnia (n=4), rapid eye movement sleep behavior disorder (RBD) (n=13), obstructive sleep apnea syndrome (OSAS) (n=34), and RBD and OSAS (n=18). Moderate to severe OSAS (n=49) was compared with no OSAS and mild OSAS (n=20). @*Results@#In comparison of the four groups according to sleep disorders, the OSAS patients showed the highest DHI scores and the lowest VOR gain, but statistical significance was not found. Although all VOR gains were within the normal range, the VOR gain of the left posterior semicircular canal was significantly lower in the moderate to severe OSA group than in the no OSA and mild OSA groups (1.02±0.18 vs. 0.94±0.10, p=0.019). DHI total scores showed no correlation with VOR gain but showed a positive correlation with ISI (r=0.422, p=0.001) and PSQI (r=0.287, p=0.022). Among PSG parameters, lowest oxygen saturation (SaO2) and percentage of time with SaO2 less than 90% were correlated with the emotional score of DHI (r=-0.245, p=0.043 and r=0.311, p=0.010, respectively). @*Conclusions@#Although our study could not objectively confirm vestibular dysfunction in patients with sleep disorders, we found that subjective sleep complaints were associated with dizziness and hypoxic conditions during sleep were associated with emotional aspects of dizziness. This suggests that the treatment of concomitant sleep disorders may improve dizziness.
ABSTRACT
Background@#and Purpose Obesity is known of one of the risk factors for obstructive sleep apnea (OSA). Although body mass index (BMI) can be an indicator for obesity, it does not represent the actual body composition of fat or muscle. We hypothesized that bioelectrical impedance analysis (BIA) can help analyze the fat and muscle distributions in males and females with OSA. @*Methods@#This study screened subjects who visited the Department of Neurology, Samsung Medical Center, Seoul, Korea due to sleep disturbances with symptoms suggestive of OSA from December 2017 to December 2019. All subjects underwent overnight type I polysomnography (PSG) and BIA. @*Results@#PSG and BIA were completed in 2,064 OSA patients who had an apnea-hypopnea index (AHI) of ≥5/hour (77.1% males and 22.9% females). The females had remarkably higher fat indicators and lower muscle indicators. The AHI was significant correlated with all BIA parameters in all OSA patients: body fat mass (ρ=0.286, p<0.001), percentage body fat (ρ= 0.130, p<0.001), visceral fat area (VFA) (ρ=0.257, p<0.001), muscle mass (ρ=0.275, p<0.001), and skeletal muscle mass (SMM) (ρ=0.270, p<0.001). The correlations in males were similar to those in all patients, where those in females were not. In females with OSA, all of the BIA fat indicators were correlated with AHI, whereas the muscle indicators were not. Adjusting age and BMI when analyzing the SMM/VFA ratio showed a strong correlation in males with OSA (p= 0.015) but not in females with OSA (p=0.354). @*Conclusions@#This study has revealed that the body composition of fat and muscle has different patterns in OSA patients. The SMM/VFA as measured using BIA is the factor most significantly associated with AHI in males but not in females after adjusting for age and BMI.
ABSTRACT
Background@#and Purpose Obesity is known of one of the risk factors for obstructive sleep apnea (OSA). Although body mass index (BMI) can be an indicator for obesity, it does not represent the actual body composition of fat or muscle. We hypothesized that bioelectrical impedance analysis (BIA) can help analyze the fat and muscle distributions in males and females with OSA. @*Methods@#This study screened subjects who visited the Department of Neurology, Samsung Medical Center, Seoul, Korea due to sleep disturbances with symptoms suggestive of OSA from December 2017 to December 2019. All subjects underwent overnight type I polysomnography (PSG) and BIA. @*Results@#PSG and BIA were completed in 2,064 OSA patients who had an apnea-hypopnea index (AHI) of ≥5/hour (77.1% males and 22.9% females). The females had remarkably higher fat indicators and lower muscle indicators. The AHI was significant correlated with all BIA parameters in all OSA patients: body fat mass (ρ=0.286, p<0.001), percentage body fat (ρ= 0.130, p<0.001), visceral fat area (VFA) (ρ=0.257, p<0.001), muscle mass (ρ=0.275, p<0.001), and skeletal muscle mass (SMM) (ρ=0.270, p<0.001). The correlations in males were similar to those in all patients, where those in females were not. In females with OSA, all of the BIA fat indicators were correlated with AHI, whereas the muscle indicators were not. Adjusting age and BMI when analyzing the SMM/VFA ratio showed a strong correlation in males with OSA (p= 0.015) but not in females with OSA (p=0.354). @*Conclusions@#This study has revealed that the body composition of fat and muscle has different patterns in OSA patients. The SMM/VFA as measured using BIA is the factor most significantly associated with AHI in males but not in females after adjusting for age and BMI.
ABSTRACT
Objectives@#To investigate the prevalence of nocturia in young patients with obstructive sleep apnea syndrome (OSAS) and to find out the risk factors of nocturia in the patients. @*Methods@#We enrolled 415 untreated male OSAS patients (apnea-hypopnea index, AHI ≥5/h on polysomnography) who were under 50 years old (mean age 37.5±8.0 years). Participants completed Korean version of Beck depression inventory II (K-BDI-II), Pittsburgh sleep quality index-Korean (PSQI-K), insomnia severity index (ISI), and Epworth sleepiness scale (ESS). Participants were classified into nocturia and non-nocturia group according to the following question “Do you find yourself waking up to urinate more than twice each night?” All information was compared between two groups. @*Results@#22.7% (94/415) of patients reported to have nocturia. Patients with nocturia had higher score of K-BDI-II, PSQI-K, ISI, and ESS although their age and the proportion of consumption of alcohol or caffeine and metabolic diseases were not different from patients without nocturia. AHI was not significantly higher in nocturia group (38.0±29.2/h) than non-nocturia group (32.8±25.7/h, p=0.118), however, parameters indicating sleep quality were worse in nocturia group, i.e. lesser non-rapid eye movement sleep stage 3 (N3) sleep % and higher arousal index, total apnea index, and 90% oxygen desaturation index (ODI). 90% ODI and N3 sleep % were revealed to be independent factors associated with nocturia. @*Conclusions@#Considerable numbers of male OSAS patients who are under 50 years suffer from nocturia and they have worse sleep quality compared to non-nocturia patients. Higher oxygen desaturation and lesser N3 sleep % are highly predictive factors for nocturia rather than AHI in these patients.
ABSTRACT
Neurocysticercosis (NCC) is the most common central nervous system parasite infection, frequently produces seizure, headache, or hydrocephalus as clinical manifestations. Cerebral vasculitis is an infrequent complication of the clinical phenotype of NCC. Moreover, NCC involving basal cerebral arteries, including distal internal carotid artery or middle cerebral artery, has rarely been reported. Therefore, we present a case of NCC with moyamoya-like basal cerebral arterial steno-occlusive disease with an emphasis on the differential diagnosis.