SNORE (Sleep Deprivation Among Night Shift Health Staff on Rotation Evaluation) Study Protocol

Background: SNORE (Sleep deprivation among Night shift health staff On Rotation-Evaluation) study is conceptualized to study the effects of sleep deprivation on healthcare professionals working night shifts on rotation. Materials and Methods: A comparative cross-sectional study is devised including health-care profes-sionals working night shifts on rotation at a tertiary level health-care facility, using a semi-structured questionnaire which can test sleep deprivation, cognitive ability, and quality of life. The process is to ap-proach 309 probable study participants based on stratified random sampling, after exclusion of health-care professionals with other factors which may interfere with sleep deprivation testing. Discussion: The study protocol was set in such a way as to randomly include participants from all cadres of healthcare providers as per population proportion. By measuring the effects on cognitive effect and quality of life necessary steps can be taken to provide better quality of life and to decrease cognitive im-pairment, especially among health care professionals working night shifts.

​Evaluating Outcome of Radiofrequency Surgery for Obstructive Sleep Apnea

Background: Pleural effusion is one of the most common signs seen in respiratory pathologies. An attempt to establish commonetiologies underlying pleural effusion helps in effective management of the same.Materials and Methods: After obtaining proper informed consent, patients presenting with pleural effusion underwent clinicalexamination in addition to radiological and biochemical investigations. Where needed, the diagnosis was confirmed usingpleural biopsy and bacteriological analysis.Results: Investigations confirmed tuberculosis in 23 patients, malignancy in seven cases, congestive cardiac failure in fourcases, parapneumonic causes in 12 patients, hypoproteinemia in two patients, and pulmonary thromboembolism in two patients.Conclusion: The present findings show that tuberculosis is the most common cause of pleural effusion in our patients. A morecomprehensive study would help us to further strengthen our findings.

Research on the changes in upper airway shape and respiratory function before and after upper airway treatment of patients with mild and moderate OSAHS by wearing mandibular advancement snore stopping devices / 口腔疾病防治

Objective@#To investigate the changes of the upper airway shape and respiratory function in patients with mild and moderate obstructive sleep apnea-hypopnea syndrome (OSAHS) before and after wearing mandibular advancement snore stopping devices (MASSD), providing a reference and basis for the treatment mechanisms and clinical efficacy of MASSD for patients with mild and moderate OSAHS.@*Methods@#Sixty patients who were diagnosed with mild and moderate OSAHS by polysomnography were selected. Snoring frequency, the apnea hypopnea index and lowest oxygen saturation in 60 patients before and after treatment were compared. The patients’ upper airways were scanned by CBCT before and after wearing MASSD. In Vivo Dental software was used to reconstruct the three-dimensional shape of upper airway. The upper airway sagittal diameter, the coronal diameter, the minimum cross-sectional area and the volume of each segment were measured. The snoring frequency, the apnea hypopnea index and the lowest oxygen saturation were compared before and after treatment.@*Results@#Before wearing MASSD, the snoring frequency, the apnea hypopnea index, and the minimum oxygen saturation of 60 patients were [946 (542,1 010)], (20.61 ± 5.19), and (78 ± 8)%, respectively. After wearing MASSD, the snore frequency [19(11,30)] and the respiratory disorder index (10.86 ± 4.31) decreased significantly and the minimum oxygen saturation increased (92 ± 3)%. Compared with before wearing MASSD, no statistically significance differences were detected (P > 0.05) except for the sagittal diameter and coronal diameter of the surface of the palatum durum. The sagittal diameter and the coronal diameter of each plane of the airway increased, and the minimum cross-sectional area of each section of the airway and the volume of each section of the airway displayed varying degrees of significant increases (P < 0.001) after wearing MASSD. @*Conclusion@#Wearing MASSD can open the airways of patients with mild and moderate OSAHS and increase the airway volume of the upper airway to improve the respiratory function.

Research on the changes in upper airway shape and respiratory function before and after upper airway treatment of patients with mild and moderate OSAHS by wearing mandibular advancement snore stopping devices / 口腔疾病防治

Objective@#To investigate the changes of the upper airway shape and respiratory function in patients with mild and moderate obstructive sleep apnea-hypopnea syndrome (OSAHS) before and after wearing mandibular advancement snore stopping devices (MASSD), providing a reference and basis for the treatment mechanisms and clinical efficacy of MASSD for patients with mild and moderate OSAHS.@*Methods@#Sixty patients who were diagnosed with mild and moderate OSAHS by polysomnography were selected. Snoring frequency, the apnea hypopnea index and lowest oxygen saturation in 60 patients before and after treatment were compared. The patients’ upper airways were scanned by CBCT before and after wearing MASSD. In Vivo Dental software was used to reconstruct the three-dimensional shape of upper airway. The upper airway sagittal diameter, the coronal diameter, the minimum cross-sectional area and the volume of each segment were measured. The snoring frequency, the apnea hypopnea index and the lowest oxygen saturation were compared before and after treatment. @*Results@#Before wearing MASSD, the snoring frequency, the apnea hypopnea index, and the minimum oxygen saturation of 60 patients were [946 (542,1 010)], (20.61 ± 5.19), and (78 ± 8)%, respectively. After wearing MASSD, the snore frequency [19(11,30)] and the respiratory disorder index (10.86 ± 4.31) decreased significantly and the minimum oxygen saturation increased (92 ± 3)%. Compared with before wearing MASSD, no statistically significance differences were detected (P > 0.05) except for the sagittal diameter and coronal diameter of the surface of the palatum durum. The sagittal diameter and the coronal diameter of each plane of the airway increased, and the minimum cross-sectional area of each section of the airway and the volume of each section of the airway displayed varying degrees of significant increases (P < 0.001) after wearing MASSD.@*Conclusion@#Wearing MASSD can open the airways of patients with mild and moderate OSAHS and increase the airway volume of the upper airway to improve the respiratory function.

Correlation between sleepiness and anxiety,depression in patients with OSAHS / 中国基层医药

Objective To investigate the correlation between daytime sleepiness and anxiety,depression in patients with obstructive sleep apnea and hypopnea syndrome(OSAHS).Methods A total of 117 patients with sleep -snoring from September 2015 to September 2017 who admitted to the Department of Respiratory Medicine of Shengjing Hospital Affiliated to China Medical University were collected for general information.ESS,SDS,SAS questionnaire and polysomnography were detected.The differences between simple snoring and OSAHS group were compared,and the correlation between Epworth Sleepiness Scale (ESS),Self-rating Depression Scale (SDS),Self-rating Anxiety Scale(SAS) score was analyzed.Results The scores of ESS,SDS and SAS in the OSAHS group were (16.24 ± 3.82) points,(46.27 ± 9.01) points,(48.21 ± 9.44) points,respectively,which were higher than those in the simple snoring group [(6.0 ± 2.58) points,(35.50 ± 18.40) points,(36.55 ± 17.97) points] (t =-14.425,-2.521,-2.780,all P ＜ 0.05).There was a correlation between SDS or SAS score and ESS score in OSAHS group(r=0.419,0.313,all P ＜0.05).Conclusion The sleepiness and anxiety,depression in OSAHS patients is more severe than simple snoring;ESS score in OSAHS patients can reflect the severity of the disease,the degree of sleepiness in patients with OSAHS is related to depression and anxiety.

Prevalence and influencing factors of obstructive sleep apnoea syndrome among hypertensive patients / 中国综合临床

Objective To explore the prevalence and influencing factors of obstructive sleep apnoea syndrome(OSAS)among hypertensive patients. Methods Two hundred and ninety-eight hypertensive patients who used a portable OSAS monitoring device were selected as our subjects. Of which,197 patients who completed their OSAS monitoring were divided into OSAS group( 165 cases) and non-OSAS group. Stepwise linear regression and Logistic regression analysis were used to analyze the relevant factors correlated to AHI and OSAS with hypertension. Results The average age of the 197 patients(122 were males)were 59. 93 ± 10. 18 years old. The prevalence of OSAS was 83. 8% in hypertension patients. Body mass index( BMI),systolic pressure (SBP),diastolic pressure(DBP),low density lipoprotein cholesterol(LDL-C)and waist circumference in OSAS groups were(26. 37 ± 2. 77)kg/ m2 ,(159. 59 ± 14. 42)mmHg,(98. 71 ± 9. 40)mmHg,(2. 85 ± 0. 82)mmol/L,(90. 56 ± 8. 62)cm,higher than those in non-OSAS group((22. 43 ± 2. 04)kg/ m2 ,(146. 83 ± 4. 60) mmHg,(85. 51 ± 7. 52)mmHg,(2. 22 ± 0. 60)mmol/ l. ,(81. 84 ± 8. 00)cm). There were statistical differences between the two groups(t = - 7. 654,- 4. 945,- 7. 490,- 4. 110 and - 5. 289;P < 0. 001). BMI,SBP and DBP were positively associated with AHI,and they were in depended risk factors of OSAS(OR(95% CI)=2. 554(1. 408 - 4. 632),1. 432(1. 154 - 1. 777),1. 286(1. 058 - 1. 562);P < 0. 05). Conclusion The prevalence of OSAS is high in hypertension patients. Higher BMI,SBP,DBP are associated with OSAS in hypertension pateints.

Incidencia y tratamiento de la roncopatía en el Hospital Universitario General Calixto García Íñiguez, diciembre 2008-2009 / Incidence and treatment of snore disease in the General Calixto García Iñíguez University Hospital, December 2008-2009

Introducción: La roncopatía es un problema de salud actual, frecuente en la población adulta por su incidencia y repercusión negativa sobre la calidad de vida de los pacientes afectados. Objetivos: Conocer la incidencia, los síntomas, los factores predisponentes, las enfermedades asociadas más frecuentes y evaluar los resultados del tratamiento quirúrgico de esta afección en la población sometida a estudio. Métodos: Se realizó un estudio descriptivo prospectivo transversal. Se estudiaron 21 pacientes, 14 (66,6 por ciento) del sexo masculino y 7 (33,4 por ciento) del femenino, atendidos en el servicio de Otorrinolaringología del Hospital Universitario General Calixto García Íñiguez durante el período comprendido de diciembre de 2008 a diciembre de 2009. Resultados. El 33 por ciento de los pacientes presentaron síndrome de apnea del sueño, más trastornos diurnos como hipersomnolencia diurna y cefalea matinal y en algunos casos popliglobulia e hipertensión arterial. Los factores predisponentes más frecuentes fueron la obesidad y la obstrucción orofaríngea. A 19 (90,47 por ciento) de los pacientes con roncopatía se les realizó tratamiento quirúrgico y evolucionaron satisfactoriamente a la semana y al mes de operados. Conclusiones: Los síntomas más frecuentes en los pacientes roncadores fueron la hipersonmolencia diurna, los ahogos nocturnos y la cefalea matinal. Los factores de riesgo más frecuentes fueron la obesidad y la obstrucción orofaríngea

Introduction: The snore disease is a current health problem frequent in adult population due to its incidence and negative repercussion on the quality of life of involved patients. Objectives: To know the incidence, symptoms, predisposing factors, the more frequent associated diseases and also to assess the results of surgical treatment of this affection in the study population. Methods: A cross-sectional and descriptive study was conducted. Twenty one patients were studied, 14 (66,6 percent) of male sex and 7 (33,4 percent) of female sex, seen in the Otorhinolaryngology Service of the "General Calixto GarcÝa I±iguez " University Hospital from December, 2008 to December, 2009. Results: The 33 percent of patients had sleep apneic syndrome plus diurnal disorders like the diurnal hypersomnia and morning headache and in some cases popligulia and arterial high blood pressure. The more frequent risk factors were obesity and oropharyngeal obstruction. A total of 19 patients (90,47 percent) were surgically treated with a satisfactory evolution at one week and at one month after surgery. Conclusions: The more frequent symptoms in snoring patients were the diurnal hypersomnia, nocturnal breathlessness and morning headache. The more frequent risk factors were obesity and oropharyngeal obstruction

Comparativo entre aparelho intraoral e CPAP no tratamento do ronco e apneia do sono: relato de um caso clínico / Comparative study between intra oral appliance and CPAP in snoring and sleep apnea treatment: case report

A síndrome da apneia obstrutiva do sono (SAOS) é um distúrbio respiratório do sono caracterizado por episódios recorrentes de obstrução da via aérea superior durante o sono, pelo colapso da Faringe. O ronco, sonolência excessiva diurna e a presença de pausas respiratórias durante o sono são os sinais e sintomas mais comumente relatados. A classificação da gravidade da SAOS depende do grau de sonolência diurna e do índice de apneia e hipoapneia (IAH). Aparelhos de pressão positiva (CPAP) e aparelhos intraorais (AIO) tem apresentado resultados satisfatórios no controle da SAOS. O Cpap é atualmente o tratamento de escolha para os pacientes com SAOS moderada e grave. Os AIO laboratoriais são os que apresentam os melhores resultados promovendo avanço mandibular afastando os tecidos da garganta, aumentando a tonicidade da musculatura e estabilizando a mandíbula, são indicados para tratamento de ronco primário e apneia leve ou moderada, podendo ser utilizados em pacientes com apneia grave que não se adaptem ao Cpap e não tenham indicação cirúrgica. O caso descrito neste artigo compara a eficácia do AIO com o Cpap em um paciente com SAOS moderada (IAH basal de 20,93), utilizando um avanço mandibular de 07mm. Através de uma polissonografia dividida em duas partes, na primeira metade da noite com o AIO e na segunda com o Cpap, foi possível comparar os resultados dos dois tipos de terapia para SAHOS, obtendo resultados semelhantes nos dois casos, com resolução completa do caso (IAH final < 5) tanto no AIO como no Cpap).

The obstructive sleep apnea syndrome (OSAS) is a sleep breathing disorder characterized by recurrent episodes of upper airway obstruction during sleep, caused for the the pharynx collapse. Snoring, excessive daytime sleepiness and the presence of pauses in breathing during sleep are the signs and symptoms most commonly reported. The severity of OSAS depends on the degree of daytime sleepiness and apnea-hipopneia index (IHA). Positive airway pressure devices (CPAP) and the intra-oral appliance(IOA) has shown satisfactory results controlling OSAS. The CPAP is currently the gold standard for patients with moderate and severe OSAS. The laboratory made IOA are those with the best results, promoting mandibular advancement, improving the collapse of the tissues of the throat, increasing muscle tone and stabilizing the mandible. It are indicated for the treatment of primary snoring and mild or moderate apnea and may be used in patients with severe apnea that are not comppliant with Cpap therapy and have not referred to surgery. The case described in this article compares the effectiveness of IOA and CPAP in a patient with moderate OSA (baseline IHA 20.93), using a mandibular advancement of 07mm. Through a split-night polysomnography where the first half with the AIO and the second with the CPAP, it was possible to compare the results of these two types of therapy for OSAS, obtaining similar results in both cases, with complete resolution of the case ( final IHA <5) in both treatments (IAO X CPAP).

Systematic head and neck physical examination as a predictor of obstructive sleep apnea in class III obese patients

Our aim was to determine if anatomical abnormalities of the upper airway (UA) and facial skeleton of class III severely obese patients are related to the presence and severity of obstructive sleep apnea syndrome (OSAS). Forty-five patients (69 percent females, mean age 46.5 ± 10.8 years) with a body mass index (BMI) over 40 kg/m² underwent UA and facial skeletal examinations as well as polysomnography. Mean BMI was 49 ± 7 kg/m² and mean neck circumference was 43.4 ± 5.1 cm. Polysomnographic findings showed that 22 percent had a normal apnea-hypopnea index (AHI) and 78 percent had an AHI over 5. The presence of OSAS was associated with younger age (P = 0.02), larger neck circumference (P = 0.004), presence of a voluminous lateral wall (P = 0.0002), posteriorized soft palate (P = 0.0053), thick soft palate (P = 0.0014), long uvula (P = 0.04), thick uvula (P = 0.0052), and inferior turbinate hypertrophy (P = 0.04). A larger neck circumference (P = 0.02), presence of a voluminous lateral wall (P = 0.04), posteriorized soft palate (P = 0.03), and thick soft palate (P = 0.04) were all associated with OSAS severity. The prevalence of OSAS in this group was high. A larger neck circumference and soft tissue abnormalities of the UA were markers for both the presence and severity of OSAS. Conversely, no abnormalities in the facial skeleton were associated with OSAS in patients with morbid obesity.

The size of upper airway of the snorer in upright and supine position / 대한치과교정학회지

The purpose of this study was to compare and evaluate the upper airway structure between the snorers and asymptomatic control subjects depending on the positional change. Lateral cephalograms in the upright and supine position were taken in 25 female snorers and 20 female asymptomatic control subjects, The length and the area of the soft palate, tongue and airway were measured and evaluated statistically. The results obtained were as follows : 1. The snorers showed longer and higher tongue, narrower and longer airway, inferiorly positioned hyoid bone, longer and broader soft palate and narrower hypopharynx than the control subjects both in the upright and supine position. In addition, the snorers showed broader tongue area and narrower oropharynx area than the control subjects in supine position. 2. Depending on the positional change from upright to supine position, the controls and the snorers showed decreased airway length and superior positioned the hyoid bone. In addition, the snorers showed decreased tongue length and height, airway length and thickness and oropharynx area, but increased tongue area and soft palate area.