ABSTRACT
ABSTRACT BACKGROUND: The cardiopulmonary function of patients with obstructive sleep apnea (OSA) is significantly lower than that of patients with simple snoring and is significantly related to the severity of OSA. Currently, only a few studies have been conducted on cardiopulmonary exercise testing in overweight patients with OSA. OBJECTIVE: To analyze the correlation between cardiopulmonary exercise test (CPET) indices and the condition of overweight patients with OSA. DESIGN AND SETTING: Retrospective study in Guangdong Provincial Hospital of Chinese Medicine. METHODS: This study included 73 hospitalized overweight patients. The patients were divided into no, mild, moderate, and severe OSA groups. Differences in the CPET indices among the four groups were compared. The correlation between the CPET indices and conditions was analyzed. RESULTS: No, mild, moderate, and severe OSA groups had 18 men and 5 women, 11 men and 3 women, 12 men and 2 women, and 21 men and 1 woman, respectively (P > 0.05). No significant difference was observed in resting pulmonary function among the four groups (P > 0.05). In the CPET, the anaerobic threshold, maximum oxygen uptake, and oxygen pulse were significantly lower in the severe OSA group than those in the normal OSA group (P < 0.05). Moreover, CPET indices negatively correlated with the apnea-hypopnea index. CONCLUSION: Changes in CPET indices occurred earlier than changes in resting pulmonary function in patients with OSA. CPET might be a potential method for evaluating the severity of OSA combined with overweight status.
ABSTRACT
ABSTRACT BACKGROUND: Neck circumference (NC) is a useful anthropometric measure for predicting obstructive sleep apnea (OSA). Ethnicity and sex also influence obesity phenotypes. NC cut-offs for defining OSA have not been established for the Latin American population. OBJECTIVES: To evaluate NC, waist circumference (WC), and body mass index (BMI) as predictors of OSA in the Colombian population and to determine optimal cut-off points. DESIGN AND SETTING: Diagnostic tests were conducted at the Javeriana University, Bogota. METHODS: Adults from three cities in Colombia were included. NC, WC, and BMI were measured, and a polysomnogram provided the reference standard. The discrimination capacity and best cut-off points for diagnosing OSA were calculated. RESULTS: 964 patients were included (57.7% men; median age, 58 years) and 43.4% had OSA. The discrimination capacity of NC was similar for men and women (area under curve, AUC 0.63 versus 0.66, P = 0.39) but better for women under 60 years old (AUC 0.69 versus 0.57, P < 0.05). WC had better discrimination capacity for women (AUC 0.69 versus 0.57, P < 0.001). There were no significant differences in BMI. Optimal NC cut-off points were 36.5 cm for women (sensitivity [S]: 71.7%, specificity [E]: 55.3%) and 41 cm for men (S: 56%, E: 62%); and for WC, 97 cm for women (S: 65%, E: 69%) and 99 cm for men (S: 53%, E: 58%). CONCLUSIONS: NC and WC have moderate discrimination capacities for diagnosing OSA. The cut-off values suggest differences between Latin- and North American as well as Asian populations.
ABSTRACT
SUMMARY OBJECTIVE: Obstructive sleep apnea syndrome is associated with many chronic diseases. METHODS: Obesity and thyroid function tests were evaluated retrospectively and cross-sectionally for 782 obstructive sleep apnea syndrome patients. RESULTS: The mean patient age was 49.3±11.5 years, and the majority were obese (67.9%) or overweight (26.6%). The mean age of the patients in Group 2 (moderate/severe obstructive sleep apnea syndrome) was higher than that of Group 1 (simple snoring/mild obstructive sleep apnea syndrome). The rate of severe obstructive sleep apnea syndrome among obese patients (35.2%) was significantly higher than that of normal-weight (11.6%) and overweight (18.3%) patients (p=0.001). The oxygen desaturation index/apnea-hypopnea index and levels of leukocytes and C-reactive protein were significantly higher, while mean/minimum saturation values and hemoglobin, hematocrit, and free triiodothyronine levels were significantly lower among obese patients compared with overweight and normal-weight patients (p=0.001). Leukocytes, C-reactive protein, and apnea-hypopnea index/oxygen desaturation index values were higher, and mean/minimum saturation values were lower in Group 2 than in Group 1. CONCLUSION: There were relationships between obstructive sleep apnea syndrome severity and body mass index. Obesity could be a critical predisposing factor for sleep disturbances. The prevention and control of obesity is important while being treated for obstructive sleep apnea syndrome.
ABSTRACT
Introducción: la apnea obstructiva del sueño (AOS) conlleva un alto riesgo cardiovascular, metabólico y neurológico. Los dispositivos de presión positiva continua (CPAP) o dispositivos de avance mandibular (DAM) pueden ferulizar la vía aérea superior (VAS) y mejorar la obstrucción; sin embargo, la adherencia es muy baja. Se ha demostrado que los procedimientos quirúrgicos de la VAS pueden llevar a una reducción significativa en la frecuencia de apneas e hipopneas. El objetivo del estudio fue describir las características clínicas y demográficas y los cambios en la somnolencia diurna excesiva, en el índice de apnea e hipopnea (IAH) y en la saturación de oxígeno (SpO2 ) de los pacientes con AOS manejados quirúrgicamente en el Servicio de Otorrinolaringología entre los años 2016 a 2020. Materiales y métodos: Se realizó un estudio observacional descriptivo tipo serie de casos. Resultados: se incluyeron nueve pacientes que cumplían los criterios de inclusión, el 77,8 % presentaban sobrepeso u obesidad. Se disminuyó la puntuación de la Epworth Sleepiness Scale (ESS) en el 100 % de los pacientes pre y posquirúrgicos. Adicionalmente, la polisomnografía (PSG) pre y posoperatoria mostró un aumento en la eficiencia de sueño con la mejoría de parámetros de oxigenación. Se encontró una disminución en el IAH en el 88,8 % de los pacientes. Conclusión: los hallazgos en este estudio sugieren que la cirugía de VAS es segura para realizar en pacientes con AOS. No todos los pacientes son candidatos a manejo quirúrgico y es importante una selección adecuada para disminuir las complicaciones.
Introduction: Obstructive sleep apnea (OSA) is a pathology that leads to a high risk of developing cardiovascular, metabolic, and neurological diseases. Positive airway pressure (CPAP) or mandibular advancement devices (MAD) can open superior airway (SAW) improve the obstruction, however, adherence is too low. It has already been shown that surgical SAW procedures, compared with medical management, can lead to a significant reduction in the frequency of apneas and hypopneas. The aim of this study was to describe the clinical and demographic characteristics, changes in excessive daytime sleepiness using Epworth Sleepiness Scale (ESS), apnea-hipopnea index (AHI) and SpO2 in patients with OSA managed surgically. Methods: A descriptive observational case series type study was carried out. Results: Nine patients were included, 77.8% were overweight or obese. A decrease in the ESS was found in 100% of the patients when pre- and post-operative scores were compared. Additionally, pre and postoperative polysomnography (PSG) showed an increase in sleep efficiency with improvement in oxygenation parameters such as mean saturation and minimum saturation. Regarding respiratory events, we found a decrease in AHI in 88.8% of patients. Conclusion: The findings in this study suggest that SAW surgery is safe to perform in patients with OSA. However, it is necessary to keep in mind that not all patients are candidates for surgical management and that adequate patient selection is important to reduce procedural complications.
Subject(s)
Humans , Male , Female , Polysomnography , Sleep Apnea, Obstructive , Sleep , General SurgeryABSTRACT
SUMMARY OBJECTIVE: It is known that obstructive sleep apnea syndrome affects many systems due to hypoxemia and hypercarbia. We aimed to demonstrate with the utilization of well-standardized questionnaire tools and electrophysiological tests that cognitive impairment, depression, autonomic dysfunction, and metabolic syndrome may occur in association with obstructive sleep apnea syndrome. METHODS: The electrophysiological examination protocol of autonomic nervous system functions was performed with sympathetic skin response and R-R Interval. Patients were administered Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, Montreal Cognitive Assessment, and Hamilton Depression Rating Scale by physicians in face-to-face interviews. RESULTS: This study included 148 participants, consisting of 73 patients and 75 controls. There was a statistically significant difference between the patient group and control group with regard to sympathetic skin response, R-R Interval, post-hyperventilation R-R Interval, and R-R Interval variation (p<0.001). A statistically significant difference was observed between the patient group and control group in terms of median Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, and Montreal Cognitive Assessment scores. It was observed that the control group achieved significantly better scores than the patient group in delayed recall (p<0.001) and language (p<0.05) categories. CONCLUSION: Obstructive sleep apnea syndrome patients should be screened for diseases, especially in the cardiovascular system, that cause serious morbidity and impair functionality such as dementia and depression. We believe that many comorbid diseases encountered in obstructive sleep apnea syndrome patients can be prevented with early diagnosis and continuous positive airway pressure treatment.
ABSTRACT
Objective:To compare the changes of morphology of pharynx in patients with obstructive sleep apnea hypopnea syndrome （OSAHS） and healthy individuals during oral or nasal breathing, and explore the relevant influencing factors. Methods:Twenty-nine adult patients with OSAHS and 20 non-snoring controls underwent MRI to obtain upper airway structural measurements while the subjects were awake and during mouth breathing with a nasal clip.The following were analyzed. ①The changes of upper airway structure of oral and nasal respiration in non-snoring control/OSAHS patients were observed; ②The differences and influencing factors of upper airway structure changes between OSAHS patients and controls were compared during breathing. Results:The control group consisted of 15 males and 5 females, with an apnea-hypopnea index （AHI）<5 events/h, while the OSAHS group comprised 26 males and 3 females with an AHI of 40.4±23.1 events/h and the mean lowest arterial oxygen saturation （LSaO2） was 79.5% ±10.0%. In the both groups, the vertical distance between the mandible and the posterior pharyngeal wall decreased （P<0.05）; The long axis of tongue body decreased （P<0.05）, and the contact area between tongue and palate decreased. There was no significant change in the total volume of the retropalatine（RP） and retroglossal（RG） airway in the control group （P>0.05）. However, the minimum cross-sectional area and volume of the RP airway in OSAHS decreased （P<0.001）. The lateral diameters of uvula plane in OSAHS decreased during mouth breathing, which was contrary to the trend in the control group （P=0.017）. The AHI of patients was positively correlated with the reduction of the volume of the RP airway during oral breathing （P=0.001）; The reduction of the distance between the mandible and the posterior pharyngeal wall was positively correlated with the length of the airway （P<0.001）. Conclusion:Mouth breathing leads to the shortening of the long axis of the tongue, the reduction of the contact area between the soft palate and the tongue, vertical distance between the mandible and the posterior pharyngeal wall, and the cross-sectional area of the epiglottis plane. These changes vary between OSAHS patients and controls. During mouth breathing, the diameters, areas and volumes of the RP area decreased, and were more significant in severe cases.
Subject(s)
Male , Adult , Female , Humans , Mouth Breathing , Sleep Apnea, Obstructive/surgery , Pharynx/surgery , Palate, Soft , Uvula/surgery , SyndromeABSTRACT
ABSTRACT Objective: The Mallampati classification system has been used to predict obstructive sleep apnea (OSA). Upper airway soft tissue structures are prone to fat deposition, and the tongue is the largest of these structures. Given that a higher Mallampati score is associated with a crowded oropharynx, we hypothesized that the Mallampati score is associated with tongue volume and an imbalance between tongue and mandible volumes. Methods: Adult males underwent clinical evaluation, polysomnography, and upper airway CT scans. Tongue and mandible volumes were calculated and compared by Mallampati class. Results: Eighty patients were included (mean age, 46.8 years). On average, the study participants were overweight (BMI, 29.3 ± 4.0 kg/m2) and had moderate OSA (an apnea-hypopnea index of 26.2 ± 26.7 events/h). Mallampati class IV patients were older than Mallampati class II patients (53 ± 9 years vs. 40 ± 12 years; p < 0.01), had a larger neck circumference (43 ± 3 cm vs. 40 ± 3 cm; p < 0.05), had more severe OSA (51 ± 27 events/h vs. 24 ± 23 events/h; p < 0.01), and had a larger tongue volume (152 ± 19 cm3 vs. 135 ± 18 cm3; p < 0.01). Mallampati class IV patients also had a larger tongue volume than did Mallampati class III patients (152 ± 19 cm3 vs. 135 ± 13 cm3; p < 0.05), as well as having a higher tongue to mandible volume ratio (2.5 ± 0.5 cm3 vs. 2.1 ± 0.4 cm3; p < 0.05). The Mallampati score was associated with the apnea-hypopnea index (r = 0.431, p < 0.001), BMI (r = 0.405, p < 0.001), neck and waist circumference (r = 0.393, p < 0.001), tongue volume (r = 0.283, p < 0.001), and tongue/mandible volume (r = 0.280, p = 0.012). Conclusions: The Mallampati score appears to be influenced by obesity, tongue enlargement, and upper airway crowding.
RESUMO Objetivo: A classificação de Mallampati tem sido usada para prever a apneia obstrutiva do sono (AOS). As estruturas de tecidos moles das vias aéreas superiores são propensas a deposição de gordura, sendo a língua a maior dessas estruturas. Como existe uma relação entre um grau mais elevado na classificação de Mallampati e maior obstrução da orofaringe, aventamos a hipótese de que a classificação de Mallampati está relacionada com o volume da língua e com um desequilíbrio entre o volume da língua e o da mandíbula. Métodos: Homens adultos foram submetidos a avaliação clínica, polissonografia e TC das vias aéreas superiores. O volume da língua e o volume da mandíbula foram calculados e comparados conforme a classificação de Mallampati. Resultados: Foram incluídos 80 pacientes (média de idade: 46,8 anos). Em média, os participantes do estudo apresentavam sobrepeso (IMC = 29,3 ± 4,0 kg/m2) e AOS moderada (índice de apneias e hipopneias = 26,2 ± 26,7 eventos/h). Os pacientes da classe IV de Mallampati eram mais velhos que os da classe II (53 ± 9 anos vs. 40 ± 12 anos; p < 0,01) e apresentavam maior circunferência do pescoço (43 ± 3 cm vs. 40 ± 3 cm; p < 0,05), AOS mais grave (51 ± 27 eventos/h vs. 24 ± 23 eventos/h; p < 0,01) e maior volume da língua (152 ± 19 cm3 vs. 135 ± 18 cm3; p < 0,01). Os pacientes da classe IV de Mallampati também apresentavam maior volume da língua que os da classe III (152 ± 19 cm3 vs. 135 ± 13 cm3; p < 0,05), bem como maior relação entre o volume da língua e o da mandíbula (2,5 ± 0,5 cm3 vs. 2,1 ± 0,4 cm3; p < 0,05). A classificação de Mallampati apresentou relação com o índice de apneias e hipopneias (r = 0,431, p < 0,001), o IMC (r = 0,405, p < 0,001), a circunferência do pescoço e da cintura (r = 0,393, p < 0,001), o volume da língua (r = 0,283, p < 0,001) e o volume da língua/volume da mandíbula (r = 0,280, p = 0,012). Conclusões: A classificação de Mallampati aparentemente é influenciada pela obesidade, aumento da língua e maior obstrução das vias aéreas superiores.
ABSTRACT
ABSTRACT Objective: To compare patients with chronic hypersensitivity pneumonitis (cHP) and controls with normal spirometry in terms of their sleep characteristics, as well as to establish the prevalence of obstructive sleep apnea (OSA) and nocturnal hypoxemia. Secondary objectives were to identify factors associated with OSA and nocturnal hypoxemia; to correlate nocturnal hypoxemia with the apnea-hypopnea index (AHI) and lung function, as well as with resting SpO2, awake SpO2, and SpO2 during exercise; and to evaluate the discriminatory power of sleep questionnaires to predict OSA. Methods: A total of 40 patients with cHP (cases) were matched for sex, age, and BMI with 80 controls, the ratio of controls to cases therefore being = 2:1. The STOP-Bang questionnaire, the Epworth Sleepiness Scale (ESS), the Pittsburgh Sleep Quality Index, the Berlin questionnaire and the Neck circumference, obesity, Snoring, Age, and Sex (NoSAS) score were applied to all cases, and both groups underwent full-night polysomnography. Results: The patients with cHP had longer sleep latency, lower sleep efficiency, a lower AHI, a lower respiratory disturbance index, fewer central apneas, fewer mixed apneas, and fewer hypopneas than did the controls. The patients with cHP had significantly lower nocturnal SpO2 values, the percentage of total sleep time spent below an SpO2 of 90% being higher than in controls (median = 4.2; IQR, 0.4-32.1 vs. median = 1.0; IQR, 0.1-5.8; p = 0.01). There were no significant differences between cases with and without OSA regarding the STOP-Bang questionnaire, NoSAS, and ESS scores. Conclusions: The prevalence of OSA in cHP patients (cases) was high, although not higher than that in controls with normal spirometry. In addition, cases had more hypoxemia during sleep than did controls. Our results suggest that sleep questionnaires do not have sufficient discriminatory power to identify OSA in cHP patients.
RESUMO Objetivo: Comparar pacientes com pneumonite de hipersensibilidade crônica (PHc) e controles com espirometria normal quanto às características do sono, bem como estabelecer a prevalência de apneia obstrutiva do sono (AOS) e hipoxemia noturna. Os objetivos secundários foram identificar fatores associados à AOS e hipoxemia noturna; correlacionar a hipoxemia noturna com o índice de apneias e hipopneias (IAH), função pulmonar, SpO2 em repouso, SpO2 em vigília e SpO2 durante o exercício; e avaliar o poder discriminatório de questionários do sono para predizer AOS. Métodos: Um total de 40 pacientes com PHc (casos) foram emparelhados por sexo, idade e IMC com 80 controles (2:1). O questionário STOP-Bang, a Escala de Sonolência de Epworth (ESE), o Índice de Qualidade do Sono de Pittsburgh, o questionário de Berlim e o escore Neck circumference, obesity, Snoring, Age, and Sex (NoSAS, circunferência do pescoço, obesidade, ronco, idade e sexo) foram aplicados a todos os casos, e ambos os grupos foram submetidos a polissonografia de noite inteira. Resultados: Os pacientes com PHc apresentaram maior latência do sono, menor eficiência do sono, menor IAH, menor índice de distúrbio respiratório, menos apneias centrais, menos apneias mistas e menos hipopneias do que os controles. Os pacientes com PHc apresentaram SpO2 noturna significativamente menor; a porcentagem do tempo total de sono com SpO2 < 90% foi maior que nos controles (mediana = 4,2; IIQ: 0,4-32,1 vs. mediana = 1,0; IIQ: 0,1-5,8; p = 0,01). Não houve diferenças significativas entre os casos com e sem AOS quanto à pontuação no questionário STOP-Bang, no NoSAS e na ESE. Conclusões: A prevalência de AOS em pacientes com PHc (casos) foi alta, embora não tenha sido maior que a observada em controles com espirometria normal. Além disso, os casos apresentaram mais hipoxemia durante o sono do que os controles. Nossos resultados sugerem que os questionários do sono não têm poder discriminatório suficiente para identificar AOS em pacientes com PHc.
ABSTRACT
A apneia obstrutiva do sono (AOS) pediátrica é um distúrbio respiratório, caracterizado por episódios recorrentes de obstrução das vias aéreas superiores. Muitas pesquisas evidenciam déficits relacionados aos distúrbios do sono, como dificuldade em atenção, memória, habilidades visuomotoras e funções executivas. A patogênese das comorbidades associadas à AOS está ligada à hipoxemia e às fragmentações no sono. A AOS infantil afeta negativamente resultados de testes neuropsicológicos, que incluem habilidades de linguagem expressiva e receptiva. A principal conduta terapêutica citada na literatura é cirúrgica, porém existem outras alternativas. A polissonografia (PSG) é o exame padrão para diagnóstico, e define a gravidade da doença, além de registrar outros parâmetros fisiológicos relacionados à arquitetura do sono. Por meio desse exame, foram selecionadas crianças com AOS para realizar um teste neuropsicológico e associar os resultados de ambos. A presente dissertação apresentará dois estudos, um de revisão de literatura e um estudo observacional transversal. OBJETIVOS: o objetivo do primeiro estudo é realizar uma revisão da literatura sobre a presença de déficits neuropsicológicos em crianças com apneia do sono; e o objetivo do segundo estudo é pesquisar crianças do ensino fundamental, diagnosticadas com AOS, por meio da associação dos seus resultados de um teste neuropsicológico, com seus respectivos dados polissonográficos. MÉTODOS: para o primeiro estudo foi realizada uma revisão integrativa da literatura, buscando publicações dos últimos dez anos que descreveram aspectos neuropsicológicos de crianças, de 6 a 12 anos, com AOS. Para o segundo estudo, observacional analítico transversal, a amostra incluiu 17 crianças, faixa etária entre 6 e 12 anos, com diagnóstico de AOS e sem comorbidades associadas, tais como síndromes genéticas e alterações craniofaciais. O diagnóstico de AOS foi feito com PSG, realizada em laboratório de sono. Nessa instituição, foram selecionados os laudos e contactadas as famílias para aplicação do teste NEUPSILIN-Inf, em um único encontro. Em seguida, realizou-se análise estatística descritiva, por meio do teste Mann-Whitney associando as variáveis explicativas (tarefas neuropsicológicas) e os desfechos (dados da PSG). RESULTADOS: os resultados são apresentados por meio da produção de dois artigos científicos. O Estudo 1, que é apresentado pelo artigo de revisão de literatura, consistiu em 21 artigos, selecionados entre 219 artigos encontrados em bases de dados. Foram incluídos ensaios clínicos randomizados, revisões da literatura, estudos transversais e de coorte. Dificuldade em atenção, memória e habilidades visuomotoras, verbais e funções executivas foram alterações neuropsicológicas, associadas a distúrbios do sono, destacadas nas pesquisas selecionadas. O segundo estudo incluiu avaliação neuropsicológica de crianças na faixa etária citada, associação entre os resultados do teste e dados polissonográficos. Valores significativos entre o índice de dessaturação inadequado e déficits de linguagem oral e escrita foram encontrados, evidenciando que prejuízos na qualidade de sono podem afetar negativamente habilidades neuropsicológicas. CONCLUSÃO: a AOS pode causar déficits neuropsicológicos relacionados à atenção, à memória declarativa, às funções executivas e às habilidades de linguagem. Na análise estatística foram encontrados valores significativos entre o índice de dessaturação inadequado e déficits de linguagem oral e escrita. Tais quadros podem ser amenizados com tratamento adequado, porém a relação entre dados diagnósticos e prognósticos carece de mais evidências. É de suma importância a abordagem preventiva e interdisciplinar de crianças com queixas respiratórias de sono para definir melhor intervenção, otimizar desempenho escolar e qualidade de vida das crianças com esse diagnóstico.
To elaborate a bibliographical review on neuropsychological deficits in children with sleep apnea. METHODS: An integrative review on theoretical literature was used to achieve the purpose, analyzing, thereby, specific literature from the last ten years describing neuropsychological aspects of children with sleep apnea. Database consulted were: "Portal Regional da Biblioteca Virtual de Saúde", "PubMed", "Portal CAPES", "PEDro" and "OTseeker". RESULTS: The sample has 21 selected articles, selected from a population of 219 articles found on the databases. Randomized clinical trials, bibliographical reviews, cross- sectional and cohort studies were included. Both Redundant publications or articles that did not specify for age or focused on comorbidities were not considered. Most of the surveys evidenced the existence of neuropsychological changes related to sleep disturbance, which could cause difficulties at paying attention. Memorization and visual motor, speech and executive functions were compromised. Pathogenesis of comorbidities related to obstructive sleep apnea are caused by hypoxemia and sleep interruptions. Surgery is the main medical intervention mentioned in the literature, since there was no other research so far exploring other possibilities to solve these neuropsychological deficits. CONCLUSION: Articles indicate that sleep apnea can cause neuropsychological deficits on attention, memory, and executive functions. In addition, these articles suggests that this situation could be softened with proper treatment, although prognosis and diagnosis data need further evidence.
Subject(s)
Humans , Male , Female , Child , Sleep Apnea, Obstructive , Diagnosis , Speech, Language and Hearing Sciences , NeuropsychologyABSTRACT
Introducción: la apnea obstructiva del sueño (AOS) es una enfermedad de etiología multifactorial. Existen diversos factores que condicionan la baja adherencia al manejo con sistemas de presión positiva desde problemas con el equipo hasta condiciones inherentes al paciente. El objetivo de este estudio es describir la frecuencia de los factores de mala adherencia reportados en la literatura en pacientes manejados entre 2015-2020. Metodos: estudio observacional, descriptivo, tipo serie de casos. Se realizó la revisión de historia clínica y diligenciamiento de una encuesta. Se caracterizaron y describieron las variables clínicas, físicas y relacionadas con el dispositivo. Resultados: se analizaron 26 pacientes, 76,9 % de sexo masculino y 23.1% de sexo femenino (23,1 %). La edad promedio de los pacientes era de 51,2 ± 13,2 anÞos. El índice de masa corporal (IMC) promedio fue de 27,8, de los cuales solo siete pacientes tenían un índice normal (<25; 26.9%). 10 pacientes al momento de la primera consulta no tenían somnolencia diurna (38,5 %). El índice de apnea-hipopnea (IAH) fue en promedio de 37,4/hora ± 17,5. Seis pacientes con presión de tratamiento menor o igual a 8 cmH2O (30 %) y 14 pacientes con presiones superiores (70 %). El promedio de IAH residual fue de 8,3 eventos/hora ± 10,1. Conclusiones: la frecuencia de factores relacionados con baja adherencia al tratamiento sugiere la necesidad de una valoración psicosocial exhaustiva del paciente, una historia clínica detallada y un examen físico completo con el fin de identificar limitantes para la adherencia al manejo y proporcionar estrategias terapéuticas.
Introduction: Obstructive sleep apnea (OSA) is a complex condition with multiple causative factors contributing to poor adherence to positive pressure systems since problems with device and conditions inherent to the patient. This study aims to describe the frequency of such factors reported in the literature for patients treated between 2015-2020. Methods: Observational, descriptive, case series study. The medical history was reviewed, and a survey was completed. Clinical, physical, and device-related variables were characterized and described. Results: 26 patients were analyzed in this study, 76.9% were male and 23.1% female. The average age of the patients was 51.2 ± 13.2 years. The body mass index (BMI) was 27.8, of which only 7 patients had a normal index (<25; 26.9%). 10 patients at the time of the first consultation do not have daytime sleepiness (38.5%). The apnea hypopnea index (AHI) was on average 37.4/hour ± 17.5. 6 patients with treatment pressure less than or equal to 8 cmH2O (30%) and 14 patients with pressure greater (70%). The residual AHI was on average 8.3 events/hour ± 10.1. Conclusions: The fre-quency of factors associated with poor treatment adherence underscores the need for comprehensive psychosocial assessments, detailed clinical histories, and tho-rough physical assessment to identify barriers to adherence and develop effective therapeutic strategies.
Subject(s)
Humans , Male , Female , ColombiaABSTRACT
Abstract Objective We evaluated the association between the triglyceride-glucose (TG) index, a marker of insulin resistance, and obstructive sleep apnoea (OSA) severity in patients without diabetes mellitus, obesity, and metabolic syndrome. Methods This retrospective cohort study included 1,527 patients. We used univariate and multivariate analyses to identify the independent predictors associated with OSA. Results Most patients were males (81.5%) with a mean age of 43.9 ± 11.1 (15-90) years. Based on the apnoea-hypopnea index (AHI), 353 (23.1%) patients were included in the control group, whereas 32.4%, 23.5%, and 21% had mild, moderate, and severe OSA, respectively. The TG index values demonstrated significant associations with OSA patients compared with the control group (p = 0.001). In addition, the mean values of the oxygen desaturation index (ODI), AHI, minimum oxygen saturation, and total sleep time percentage with saturation below 90% demonstrated statistically significant differences among the TG index groups (p: 0.001; p:0.001; p:0.001; p:0.003). The optimal TG index cutoff value to predict OSA was 8.615 (AUC = 0.638, 95% CI = 0.606-0.671, p = 0.001). In multivariate logistic regression analysis, after adjusting for age, sex, and body mass index, the TG index was independently associated with OSA patients. Conclusion The TG index is independently associated with increased risk for OSA. This indicates that this index, a marker for disease severity, can be used to identify severe OSA patients on waiting lists for PSG.
Resumo Objetivo Avaliamos a associação entre o índice triglicerídeos-glicose (TG), um marcador de resistência à insulina, e a gravidade da apneia obstrutiva do sono (AOS) em pacientes sem diabetes mellitus, obesidade e síndrome metabólica. Métodos Este estudo de coorte retrospectivo incluiu 1.527 pacientes. Utilizamos análises univariadas e multivariadas para identificar os preditores independentes associados à AOS. Resultados A maioria dos pacientes era do sexo masculino (81,5%) com idade média de 43,9 ± 11,1 anos (15-90). Com base no índice apneia-hipopneia (IAH), 353 (23,1%) pacientes foram incluídos no grupo de controle, enquanto 32,4%, 23,5% e 21% tinham AOS leve, moderada e grave, respectivamente. Os valores do índice TG demonstraram associações significativas com pacientes com AOS em comparação com o grupo de controle (p = 0,001). Além disso, os valores médios do índice de dessaturação de oxigênio (IDO), IAH, saturação mínima de oxigênio e porcentagem de tempo total de sono com saturação abaixo de 90% demonstraram diferenças estatisticamente significativas entre os grupos de índice TG (p = 0,001; p = 0,001; p = 0,001; p = 0,003). O valor de corte ideal do índice TG para prever a AOS foi de 8,615 (AUC=0,638, IC de 95% = 0,606-0,671, p = 0,001). Na análise de regressão logística multivariada, após o ajuste para idade, sexo e índice de massa corporal, o índice TG foi independentemente associado a pacientes com AOS. Conclusão O índice TG está independentemente associado a um maior risco de AOS. Isso indica que este índice, um marcador de gravidade da doença, pode ser usado para identificar pacientes com AOS grave em listas de espera para polissonografia.
ABSTRACT
ABSTRACT Objective: Obstructive sleep apnea (OSA) is a highly prevalent chronic disease, associated with morbidity and mortality. Although effective treatment for OSA is commercially available, their provision is not guaranteed by lines of care throughout Brazil, making legal action necessary. This study aimed at presenting data related to the volume of legal proceedings regarding the access to diagnosis and treatment of OSA in Brazil. Methods: This was a descriptive study of national scope, evaluating the period between January of 2016 and December of 2020. The number of lawsuits was analyzed according to the object of the demand (diagnosis or treatment). Projections of total expenses were carried out according to the number of lawsuits. Results: We identified 1,462 legal proceedings (17.6% and 82.4% related to diagnosis and treatment, respectively). The projection of expenditure for OSA diagnosis in the public and private spheres were R$575,227 and R$188,002, respectively. The projection of expenditure for OSA treatment in the public and private spheres were R$2,656,696 and R$253,050, respectively. There was a reduction in the number of lawsuits between 2017 and 2019. Conclusions: Legal action as a strategy for accessing diagnostic and therapeutic resources related to OSA is a recurrent practice, resulting in inefficiency and inequity. The reduction in the number of lawsuits between 2017 and 2019 might be explained by the expansion of local health care policies or by barriers in the journey of patients with OSA, such as difficulties in being referred to specialized health care and low availability of diagnostic resources.
RESUMO Objetivo: A apneia obstrutiva do sono (AOS) é uma doença crônica altamente prevalente, associada a morbidade e mortalidade. Embora tratamentos efetivos para a AOS estejam disponíveis comercialmente, seu fornecimento não é garantido pelos fluxos de atendimento em todo o Brasil, tornando necessária a judicialização. Este estudo teve como objetivo apresentar dados referentes ao volume de processos judiciais relacionados ao acesso ao diagnóstico e tratamento da AOS no Brasil. Métodos: Estudo descritivo de abrangência nacional, avaliando o período entre janeiro de 2016 e dezembro de 2020. O número de demandas judiciais foi analisado de acordo com o objeto da demanda (diagnóstico ou tratamento). As projeções das despesas totais foram realizadas de acordo com o número de demandas judiciais. Resultados: Foram identificados 1.462 processos judiciais (17,6% e 82,4% referentes a diagnóstico e tratamento, respectivamente). A projeção dos gastos com o diagnóstico da AOS nas esferas pública e privada foi de R$ 575.227 e R$ 188.002, respectivamente. A projeção dos gastos com o tratamento da AOS nas esferas pública e privada foi de R$ 2.656.696 e R$ 253.050, respectivamente. Houve redução do número de demandas judiciais entre 2017 e 2019. Conclusões: A judicialização como estratégia de acesso a recursos diagnósticos e terapêuticos relacionados à AOS é uma prática recorrente, resultando em ineficiência e iniquidade. A redução do número de demandas judiciais entre 2017 e 2019 pode ser explicada pela expansão das políticas locais de saúde ou por barreiras na jornada dos pacientes com AOS, como dificuldades de encaminhamento para atendimento especializado e a baixa disponibilidade de recursos diagnósticos.
ABSTRACT
Resumo Fundamento A hipertensão arterial sistêmica (HAS) é uma doença multifatorial, altamente prevalente e associada a riscos à saúde. Objetivo O objetivo deste estudo foi investigar a associação entre HAS e marcadores laboratoriais, antropométricos, de variabilidade da frequência cardíaca (VFC) e de apneia obstrutiva do sono e, em segundo plano, analisar a sensibilidade e especificidade das variáveis que são fatores independentes na associação. Métodos Estudo transversal com 95 pacientes obesos atendidos em um ambulatório de referência em obesidade em Salvador, BA, Brasil. Os dados da HAS foram obtidos dos prontuários eletrônicos. A amostra foi estratificada em Grupo Normotenso (GN) e Grupo Hipertenso (GH), sendo medidos marcadores laboratoriais, composição corporal, polissonografia e VFC para avaliar a associação da HAS com as variáveis preditoras. Para as análises, adotou-se p<0,05. Resultados A média da idade do GN foi de 36,3 ± 10,1 e GH 40,4 ± 10,6 anos, 73,7% eram mulheres no GN e 57,9% no GH; 82,4% no GH apresentavam resistência à insulina. No modelo de regressão logística multivariado com ajustes para idade, sexo, altura e saturação de oxi-hemoglobina, a HAS foi inversamente associada à glicose plasmática em jejum mg/dL (odds ratio [OR] = 0,96; intervalo de confiança de 95% [IC] = 0,92-0,99) e área de gordura visceral (AGV) cm2 (OR = 0,98; IC 95% = 0,97-0,99). A área sob a curva AGV foi de 0,728; IC 95% (0,620-0,836) e glicemia de jejum 0,693; IC 95% (0,582-0,804). Conclusão Menores concentrações de AGV e glicemia de jejum foram inversamente associadas à HAS. Além disso, tanto a glicemia de jejum quanto o AGV mostraram alta sensibilidade para triagem de HAS.
Abstract Background Systemic arterial hypertension (SAH) is a multifactorial disease, highly prevalent and associated with health risks. Objective The purpose of this study was to investigate the association between SAH and laboratory, anthropometric, heart rate variability (HRV), and obstructive sleep apnea markers and, secondarily, to analyze the sensitivity and specificity of the variables that are independent factors in the association. Methods Cross-sectional study with 95 obese patients treated at an obesity referral clinic in Salvador, BA, Brazil. SAH data were obtained from electronic medical records. The sample was stratified in the Normotensive Group (NG) and the Hypertensive Group (HG), and laboratory markers, body composition, polysomnography, and HRV were measured to evaluate the association of SAH with the predictor variables. For the analysis, p<0.05 was adopted. Results The average age of the NG was 36.3 ± 10.1 and HG 40.4 ± 10.6 years; 73.7% were women in the NG and 57.9% in HG; 82.4% in HG had insulin resistance. In the multivarious logistics regression model with adjustments in age, sex, height, and oxyhemoglobin saturation, SAH was inversely associated with fasting plasma glucose mg/dL (odds ratio [OR] = 0.96; 95% confidence interval [CI] = 0.92-0.99) and visceral fat area (VFA) cm2(OR = 0.98; 95% CI = 0.97-0.99). The area under the VFA curve was 0.728; CI 95% (0.620-0.836); fasting plasma glucose 0.693;CI 95% (0.582-0.804). Conclusions Lower VFA and fasting plasma glucose concentrations were inversely associated with SAH. In addition, fasting plasma glucose and VFA showed a high sensitivity for SAH screening.
ABSTRACT
Obstructive sleep apnea hypopnea syndrome (OSAHS) is a sleep breathing disorder caused by obstruction of the upper airway during sleep from various causes. At present, the diagnosis and treatment of OSAHS are insufficient. OSAHS causes cognitive decline due to excessive oxidative stress and inflammatory response caused by sleep breathing disorder, and its alteration of the brain gray matter area may be related to cognitive dysfunction. This review investigates the correlation between cognitive dysfunction and brain gray matter areas changes in OSAHS, and elucidates the underlying mechanisms, which provide a theoretical basis for early clinical diagnosis and treatment.
ABSTRACT
Objective:To construct a prediction model for difficult tracheal intubation in the patients with obstructive sleep apnea-hypopnea syndrome (OSAHS).Methods:A total of 324 patients with OSAHS undergoing surgery with general anesthesia, admitted to our hospital from June 2019 to June 2021, were included in model group, and 175 patients with OSAHS undergoing surgery with general anesthesia, admitted from July 2021 to July 2022, were selected and served as validation group. The patients in model group were divided into occurrence group and non-occurrence group according to whether difficult tracheal intubation occurred. Logistic regression was used to construct the prediction model, and R4.2.1 software was used to draw the risk nomogram and calibration curve. The predictive accuracy of the model was evaluated by the area under the receiver operating characteristic curve.Results:Body mass index (BMI), sagittal minimum cross-sectional area, horizontal minimum cross-sectional area and mandibular distance were risk factors for difficult tracheal intubation in OSAHS patients ( P<0.05). A prediction model was developed using the above factors: Logit P=33.726+ 1.411×BMI score-0.014×sagittal airway minimum cross-sectional area-0.013×airway horizontal minimum cross-sectional area-0.312× mandibular distance. The area under the receiver operating characteristic curve was 0.846, Youden index 0.585, sensitivity 0.831, specificity 0.755, and the accuracy 0.889 (Hosmer-Lemeshow test χ2=9.24, P=0.322) in model group. The area under the external validation curve was 0.802, Youden index 0.545, sensitivity 0.636, specificity 0.908, and the accuracy 0.893 (Hosmer-Lemeshow test χ2=10.24, P=0.287) in validation group. Conclusions:The prediction model based on BMI, sagittal minimum cross-sectional area of airway, horizontal minimum cross-sectional area of airway and mandibular distance has a high value in predicting the risk of difficult tracheal intubation in patients with OSAHS.
ABSTRACT
Objective:To analyze the effects of chronic obstructive pulmonary disease (COPD) combined with obstructive sleep apnea hypopnea syndrome (OSAHS) on hypercapnia and its related factors.Methods:In this cross-sectional study, patients with stable COPD were continuously recruited from July 2016 to December 2018 in the Respiratory Department of Peking University Third Hospital. General clinical data of patients were collected, and lung function test, arterial blood gas analysis and portable sleep monitoring were also conducted. Patients with COPD complicated with apnea hypopnea index (AHI)≥10 times/h and apnea events being mainly blockage-type events, accompanied by snoring, sleep apnea, daytime sleepiness and other symptoms were defined as overlapping group, patients with COPD complicated with AHI<10 times/h were defined as simple COPD group. Correlation analysis and logistic regression model were used to explore the determinants of daytime hypercapnia in patients with COPD.Results:Compared with simple COPD group, the median arterial partial pressure of carbon dioxide (PaCO 2) was significantly higher in the overlapping group (42.00 vs 38.95 mmHg (1 mmHg=0.133 kPa), P<0.001), and the rate of daytime hypercapnia was significantly higher (23.3% vs 3.3%, P=0.002). PaCO 2 was correlated with forced vital capacity (FVC), percent predicted forced expiratory volume in one second (FEV 1%pred), the ratio of residual volume (RV) to total lung capacity (TLC), AHI, nocturnal average transcutaneous oxygen saturation (SpO 2), nocturnal minimum SpO 2 and the total sleep time spent with SpO 2≤90% (T90) (all P<0.05). In logistic regression analysis, after adjusting for age, sex, and body mass index (BMI), only severe OSAHS, GOLD Ⅲ-Ⅳ grade (FEV 1%pred<50%), and T90>1% were independent risk factors for hypercapnia. Conclusions:OSAHS can increase the risk of hypercapnia in patients with COPD. AHI, lung function injury and T90 are closely related to hypercapnia.
ABSTRACT
Objective:To investigate the correlations between serum E selectin, intercellular adhesion molecule 1 (ICAM-1), vascular cell adhesion molecule 1 (VCAM-1) and left ventricular geometry and function in patients with obstructive sleep apnea syndrome (OSAS) combined with prehypertension (pre-HT).Methods:A total of 462 patients with pre-HT and OSAS diagnosed by polysomnography (PSG) in the sleep monitoring unit of the Department of Respiratory and Critical Care Medicine at the First Hospital of Shanxi Medical University from July 2019 to July 2022 were restrospectively analysed, and 52 patients with pure pre-HT (pre-HT group) and 73 patients with pure OSAS (OSAS group) in the same period were selected as the control group. OSAS and pre-HT patients were divided into four groups according to left ventricular geometry: normal geometry (NG) group, concentric remodeling (CR) group, eccentric hypertrophy (EH) group and concentric hypertrophy (CH) group. The general clinical data, PSG parameters, blood biochemical parameters and left ventricular structure and function parameters were compared among the six groups. Pearson correlation and multivariate Logistic regression were used to analyze the correlation between E-selection, ICAM-1, VCAM-1, general clinical data, PSG parameters, blood biochemical parameters with left ventricular geometry and function.Results:①Serum E selectin, ICAM-1, and VCAM-1 concentrations increased sequentially from the NG, CR, and EH to CH groups, with the most significant increase in CH group (all P<0.05). In addition, there were statistically significant differences in age, body mass index (BMI), OSAS severity, neck circumference, waist circumference, systolic blood pressure (SBP), diastolic blood pressure (DBP), Glu, lowest oxygen saturation (Lowest-SaO 2), mean oxygen saturation (Mean-SaO 2), percentage of time with oxygen saturation below 90% of total sleep time (T90), left ventricular end-diastolic diameter (LVEDd), interventricular septal thickness (IVST), left ventricular posterior wall thickness (LVPWT), left ventricular mass index (LVMI), relative ventricular wall thickness (RWT), left ventricular ejection fraction (LVEF), peak mitral early diastolic flow velocity/peak mitral late diastolic flow velocity (E/A), E wave deceleration time (DT), A wave duration (AD), and isovolumic relaxation time (IVRT), and overall long-axis longitudinal strain (GLS) and so on(all P<0.05). ②Pearson correlation analysis showed that E selectin was negatively correlated with LVEF, E/A, e′, E/e′, IVRT, and GLS ( r=-0.236, -0.131, -0.224, -0.215, -0.285, -0.336; all P<0.05). ICAM-1 was negatively correlated with LVEF, E, E/A, e′, IVRT, and GLS( r=-0.130, -0.129, -0.104, -0.351, -0.252, -0.259; all P<0.05). VCAM-1 was negatively correlated with E, e′, and IVRT ( r=-0.132, -0.312, -0.387; all P<0.001). ③Multifactorial logistic regression analysis showed that E selectin and VCAM-1 were independently correlated with EH (β=1.139, OR=3.124, P=0.030; β=1.288, OR=3.626, P<0.001) and with CH (β=1.178, OR=3.248, P=0.013; β=1.108, OR=3.028, P<0.001). Conclusions:E selection and VCAM-1 were independently correlated with hypertrophic left ventricular geometry, suggesting that E selectin and VCAM-1 may be involved in the process of abnormal left ventricular structure and function in patients with OSAS combined with pre-HT.
ABSTRACT
Objective:To investigate the correlation between exhaled nitric oxide and obstructive sleep apnea-hypopnea syndrome (OSAHS).Methods:Eighty patients with OSAHS (OSAHS group) who received treatment in Pingxiang People's Hospital from September 2019 to September 2021 were included in this study. An additional 60 patients with snoring (snoring group) who concurrently received treatment in the same hospital were included in the control group. The value of exhaled nitric oxide was measured using an exhaled nitric oxide detector. The relationship between exhaled nitric oxide and apnea-hypopnea index, and the lowest oxygen saturation level during sleep (LSaO 2) was analyzed using Pearson correlation analysis. The optimal cut-off value of exhaled nitric oxide for predicting OSAHS was analyzed using the receiver operating characteristic curve. Results:Exhaled nitric oxide and apnea-hypopnea index in the OSAHS group were (18.61 ± 6.23) μg/L and (44.50 ± 16.15) times/hour, respectively, which were significantly greater than (11.17 ± 4.31) μg/L and (2.91 ± 0.79) times/hour in the snoring group ( t = 7.94, 14.08, both P < 0.05). LSaO 2 in the OSAHS group was significantly lower than that in the snoring group [(66.53 ± 10.17)% vs. (92.15 ± 1.62)%, t = -13.61, P < 0.05]. Correlation analysis showed that exhaled nitric oxide levels in patients with OSAHS were positively correlated with apnea-hyponea index ( r = 0.56, P = 0.001), and negatively correlated with the lowest oxygen saturation level ( r = -0.54, P = 0.002). The receiver operating characteristic curve analysis revealed that when the optimal cut-off value of exhaled nitric oxide was 11.5 μg/L, the area under the curve was 0.846, with sensitivity of 91.3%, and specificity of 63.3%. Conclusion:Patients with OSAHS have airway inflammatory reactions. The level of nitric oxide in exhaled air is positively correlated with the severity of OSAHS, which has a certain clinical value.
ABSTRACT
Objective To investigate the value of triglyceride-glucose index (TyG), TyG combined with body mass index (BMI), and TyG combined with waist circumference (WC) in predicting nonalcoholic fatty liver disease (NAFLD) in patients with obstructive sleep apnea (OSA). Methods A retrospective analysis was performed for 190 patients who underwent sleep respiratory monitoring and were diagnosed with OSA in The Second Affiliated Hospital of Kunming Medical University from January 2020 to December 2021, and according to the results of ultrasonography, they were divided into OSA+NAFLD group with 107 patients and control group with 83 patients. The t -test or the Mann Whitney U test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups. The binary logistic regression analysis was used to explore the influencing factors for the development of NAFLD in patients with OSA. The receiver operating characteristic (ROC) curve was plotted for TyG, TyG combined with BMI, and TyG combined with WC in predicting NAFLD in the patients with OSA, and the area under the ROC curve (AUC) was calculated. The Z test was used for comparison of AUC. Results Compared with the control group, the OSA+NAFLD group had significantly higher BMI, neck circumference, WC, apnea-hypopnea index, oxygen desaturation index, alanine aminotransferase, gamma-glutamyltransferase, triglyceride, fasting plasma glucose, and TyG and significantly lower age, average SpO 2 , LSaO 2 , and high-density lipoprotein cholesterol (all P < 0.05). The binary logistic regression analysis showed that TyG (odds ratio [ OR ]=1.961, 95% confidence interval [ CI ]: 1.03-3.73, P =0.04), BMI ( OR =1.203, 95% CI : 1.03-1.41, P =0.020), and WC ( OR =1.074, 95% CI : 1.01-1.14, P =0.026) were independent risk factors for NAFLD in patients with OSA. TyG, TyG combined with BMI, and TyG combined with WC had an AUC of 0.696 (95% CI : 0.625-0.760), 0.787 (95% CI : 0.722-0.843), and 0.803 (95% CI : 0.739-0.857), respectively, in predicting NAFLD in OSA patients, with an optimal cut-off value of 8.72, 0.36, and 0.60, respectively. TyG combined with BMI had a significantly higher value than TyG in predicting NAFLD in OSA patients ( Z =2.542, P =0.011), and TyG combined with WC also had a significantly higher predictive value than TyG ( Z =2.976, P =0.002 9). Conclusion TyG, TyG combined with BMI, and TyG combined with WC have a good value in predicting NAFLD in OSA patients, among which TyG combined with WC has the best predictive value and is thus expected to become a predictor for the risk of NAFLD in OSA patients.
ABSTRACT
La terapia miofuncional orofacial (TMO) ha tenido un creciente desarrollo durante la última década, presentándose como una opción terapéutica en pacientes con AOS. Sin embargo, la evidencia es limitada y en Chile no hay mucho conocimiento al respecto. Se desarrolló una revisión sistemática en PubMed, MEDLINE, Embase, Web of Science, Lilacs y Scielo, que incluyó estudios primarios publicados en los últimos 10 años en idioma inglés, español o portugués y que utilizaran la TMO en pacientes adultos con AOS. Se excluyeron estudios que combinaran otras estrategias, con alteraciones miofuncionales secundarias a patologías concomitantes y con otro tipo de trastorno del sueño. La revisión consideró 9 artículos en su análisis; los resultados mostraron beneficios significativos a favor de la TMO en relación a disminución del índice de apnea-hipopnea, mejor calidad del sueño, nivel de somnolencia de Epworth, menor intensidad y frecuencia de los ronquidos, menor circunferencia del cuello, entre otros. Se concluye que la TMO genera beneficios en los pacientes con AOS, siendo una opción no invasiva y accesible.
Orofacial myofunctional therapy (OMT) has had a growing development during the last decade, presenting itself as a therapeutic option in patients with OSA. However, the evidence is limited and in Chile there is not much knowledge about it. A systematic review was developed in PubMed, MEDLINE, Embase, Web of Science, Lilacs and Scielo, which included primary studies published in the last 10 years in English, Spanish or Portuguese that used OMT in adult patients with OSA. Studies that combined other strategies, with myofunctional alterations secondary to concomitant pathologies and with another type of sleep disorder were excluded. The review considered 9 articles in its analysis; The results showed significant benefits in favor of OMT in relation to a decrease in the apnea-hypopnea index, better sleep quality, Epworth sleepiness level, less intensity and frequency of snoring, less neck circumference, among others. It is concluded that OMT generates benefits in patients with OSA, being a non-invasive and accessible option.