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1.
Rev. Odontol. Araçatuba (Online) ; 43(2): 55-60, maio-ago. 2022. ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1362040

ABSTRACT

As multifatoriedades do aumento da SHAOS têm diversas causas, desdês de obesidades até sedendarismo de grande proporção. No entanto a ciência tem feito grandes esforços para isso se altere. Mesmo assim muito tem que se pesquisar para um tratamento efetivo que seja capaz de ajudar o paciente a ter um sono reparador e uma qualidade de vida mais satisfatória. A sofisticação dos CPAP, melhores alternativas para o tratamento se sofisticaram de tal em volume, barulho e tamanho que estão aumentanto em muito sua utilização. Os mini-cpaps são uma prova disso. No entanto ainda nos confrontamos com a baixa adesão do tratamento frente ao desconforto causado. Ao aparelhos intra-orais são uma alternativa viáveis para os casos de IAH (índice de apneia e hipopneia) leve, moderada e ronco primário. Importante frisar que sem um exame de polissografia e teleradiografias laterais o Cirurgião Dentista não pode fazer nada(AU)


The multifactorial causes of the increase in SHAOS have several causes, from obesity to a large sedentary lifestyle. However science has made great efforts to change this. Even so, much remains to be researched for an effective treatment that is capable of helping the patient to have a restful sleep and a more satisfactory quality of life. The sophistication of CPAP, the best alternatives for treatment, has become so sophisticated in volume, noise and size that its use is greatly increasing. The mini-cpaps are proof of that. However, we are still faced with the low adherence to the treatment due to the discomfort caused. Intraoral appliances are a viable alternative for cases of mild, moderate AHI (apnea and hypopnea index) and primary snoring. It is important to emphasize that without a polysomnography exam and lateral teleradiographies, the Dental Surgeon cannot do anything(AU)


Subject(s)
Sleep Apnea, Obstructive , Continuous Positive Airway Pressure , Sleep Apnea, Obstructive/diagnosis , Sleep Apnea, Obstructive/therapy
2.
Rev. APS ; 25(Supl 1): 135-146, 2022-05-06.
Article in Portuguese | LILACS | ID: biblio-1370872

ABSTRACT

Introdução: a síndrome da apneia-hipopneia obstrutiva do sono (SAHOS) é o distúrbio respiratório do sono mais comum, associado a condições facilmente identificáveis, como a hipertensão arterial sistêmica. Objetivo: determinar prevalência de rastreamento positivo para SAHOS e identificar fatores associados em hipertensos em serviço de Atenção Primária à Saúde (APS). Métodos: estudo transversal com 326 hipertensos adscritos a uma unidade de APS. Foram obtidas variáveis antropométricas, clínicas e sociodemográficas e utilizados os questionários Short Assessment of Health Literacy for Portuguese-Speaking Adults, para identificar o letramento em saúde; a Morisky Medication Adherence Scale, para a adesão medicamentosa e o Snoring, Tiredness, Observed Apnea, High Blood Pressure, Bodymass index, Age, Neck Circumference, and Gender -STOP-Bang, para rastreamentoda SAHOS. Resultados: o sexo feminino foi majoritário (66,3%). A média temporal de tratamento para hipertensão arterial sistêmica alcançou 12,51 ± 9,83 anos. Constatou-se prevalência de 86,5% de rastreio positivo para SAHOS e o sexo masculino e a obesidade como fatores associados a essa condição (p<0,01). Conclusão: o rastreamento sistemático da SAHOS na APS deve ser incorporado à prática dos profissionais de saúde, assim como é feito para outras doenças crônicas não transmissíveis 1.


Introduction: Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) is the most common sleep breathing disorder, associated with easily identifiable conditions such as systemic arterial hypertension. Objective: To determine the prevalence of positive screening for Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) and to identify associated factors in the hypertensive population in the Primary Health Care (PHC) service. Method: This was a cross-sectional study with 326 hypertensive individuals assigned to a PHC unit in a medium-sized city in the state of Minas Gerais. Anthropometric, clinical, and sociodemographic variables were obtained. The Short Assessment of Health Literacy for Portuguese-Speaking Adults questionnaire was used to identify literacy in health; the Morisky Medication Adherence Scale was used for medication adherence; and the Snoring, Tiredness, Observed Apnea, High Blood Pressure, Body Mass Index, Age, Neck Circumference, and Gender -STOP-Bang questionnaire was used for the screening of OSAHS. Results: The majority was female (66.3%) and the treatment time average for high blood pressure was 12.51 ± 9.83 years. The study identified the prevalence of 86.5% of positive screening for OSAHS, and male sex and obesity as factors associated with this condition (p <0.01). Conclusion: The systematic screening of OSAHS in PHC services should be incorporated into the practice of health professionals, as itis done for other chronic non-communicable diseases.


Subject(s)
Sleep Apnea Syndromes , Primary Health Care , Blood Pressure , Body Mass Index , Mass Screening , Sleep Apnea, Obstructive , Hypertension
3.
Braz. j. otorhinolaryngol. (Impr.) ; 88(2): 263-278, Mar.-Apr. 2022. tab, graf
Article in English | LILACS | ID: biblio-1374729

ABSTRACT

Abstract Introduction: Obstructive sleep apnea syndrome is a common condition in childhood and if left untreated can result in many health problems. An accurate diagnosis of the etiology is crucial for obstructive sleep apnea treatment success. Functional orthodontic appliances that stimulate mandibular growth by forward mandibular positioning are an alternative therapeutic option in growing patients. Objective: To perform a literature review about the effects of functional orthodontic appliances used to correct the mandibular deficiency in obstructive sleep apnea treatment. Methods: The literature search was conducted in June 2020 using Cochrane Library; PubMed, EBSCO (Dentistry & Oral Sciences Source), LILACS Ovid; SciELO Web of Science; EMBASE Bireme and BBO Bireme electronic databases. The search included papers published in English, until June 2020, whose methodology referred to the types and effects of functional orthopedic appliances on obstructive sleep apnea treatment in children. Results: The search strategy identified thirteen articles; only four articles were randomized clinical studies. All studies using the oral appliances or functional orthopedic appliances for obstructive sleep apnea in children resulted in improvements in the apnea-hypopnea index score. The cephalometric (2D) and tomographic (3D) evaluations revealed enlargement of the upper airway and increase in the upper airspace, improving the respiratory function in the short term. Conclusion: Functional appliances may bean alternative treatment for obstructive sleep apnea, but it cannot be concluded that they are effective in treating pediatric obstructive sleep apnea. There are significant deficiencies in the existing evidence, mainly due to absence of control groups, small sample sizes, lack of randomization and no long-term results.


Resumo Introdução: A síndrome da apneia obstrutiva do sono é uma condição comum na infância e, se não tratada, pode resultar em muitos problemas de saúde. Um diagnóstico preciso da etiologia é crucial para o sucesso do tratamento dessa condição clínica. Aparelhos ortodônticos funcionais que estimulam o crescimento mandibular através do anteroposicionamento mandibular são uma opção terapêutica para pacientes em crescimento. Objetivo: Fazer uma revisão da literatura sobre os efeitos do aparelho ortodôntico funcional usado para corrigir a deficiência mandibular no tratamento da apneia obstrutiva do sono. Método: A pesquisa bibliográfica foi feita em junho de 2020 nos os bancos de dados eletrônicos da Cochrane Library; PubMed, EBSCO (Dentistry & Oral Sciences Source), Lilacs Ovid; SciELO Web of Science; Embase Bireme e BBO Bireme. A busca incluiu artigos publicados em inglês, até junho de 2020, cuja metodologia referia-se aos tipos e efeitos dos aparelhos ortopédicos funcionais no tratamento da apneia obstrutiva do sono em crianças. Resultados: A estratégia de busca identificou 19 artigos; apenas quatro eram estudos clínicos randomizados. Todos os estudos que usaram aparelhos orais ou aparelhos ortopédicos funcionais para apneia obstrutiva do sono em crianças resultaram em melhorias no índice de apneia-hipopneia. As avaliações cefalométrica (2D) e tomográfica (3D) mostraram alargamento das vias aéreas superiores e aumento do espaço das vias aéreas superiores, que melhoraram a função respiratória em curto prazo. Conclusão: Os aparelhos funcionais podem ser um tratamento opcional para apneia obstrutiva do sono, mas não é possível concluir que sejam eficazes na população pediátrica. Existem deficiências significativas nas evidências existentes, principalmente devido à ausência de grupos de controle, tamanho pequeno das amostras, falta de randomização e ausência de resultados em longo prazo.


Subject(s)
Humans , Child , Orthodontic Appliances, Functional , Mandibular Advancement , Sleep Apnea, Obstructive/therapy , Cephalometry , Treatment Outcome
4.
Braz. j. otorhinolaryngol. (Impr.) ; 88(2): 228-234, Mar.-Apr. 2022. tab, graf
Article in English | LILACS | ID: biblio-1374717

ABSTRACT

Abstract Introduction: Obstructive sleep apnea is characterized by a reduced airflow through the upper airways during sleep. Two forms of obstructive sleep apnea are described: the central form and the obstructive form. The obstructive form is related to many factors, such as the craniofacial morphology. Objective: To evaluate the correlation between the morphology of the cranial base, of the mandible and the maxilla, and obstructive sleep apnea severity. Methods: Eighty-four patients, mean age of 50.4 years old; 73 males and 11 females with obstructive sleep apnea were enrolled in the present study. Patients with high body mass index and comorbidities were excluded. Lateral cephalograms and polysomnography were collected for each patient to evaluate the correlation between craniofacial morphology and obstructive sleep apnea severity. A Spearman's rho correlation test between cephalometric measurements and obstructive sleep apnea indexes was computed. Statistical significance was set at p < 0.05. Results: Patients with a severe obstructive sleep apnea presented a reduction of sagittal growth of both effective mandibular length and cranio-basal length. The mandibular length was the only variable with a statistical correlation with apnea-hypopnea index. Vertical dimension showed a weak correlation with the severity of obstructive sleep apnea. No correlation with maxillary sagittal dimension was shown. Conclusion: Obstructive sleep apnea severity may be correlated to mandibular and cranial base growth. Facial vertical dimension had no correlation with obstructive sleep apnea severity.


Resumo Introdução: A apneia obstrutiva do sono é caracterizada por um fluxo de ar reduzido nas vias aéreas superiores durante o sono. Duas formas de apneia são descritas: a forma central e a forma obstrutiva. A forma obstrutiva tem sido relacionada a vários fatores, como a morfologia craniofacial. Objetivo: Avaliar a correlação entre a morfologia da base do crânio, da mandíbula e da maxila e a gravidade da apneia obstrutiva do sono. Método: Foram incluídos no presente estudo 84 pacientes com apneia obstrutiva do sono, com média de 50,4 anos; 73 homens e 11 mulheres. Pacientes com alto índice de massa corpórea e comorbidades foram excluídos. Foram coletados cefalogramas laterais e polissonografia para cada paciente para avaliar a correlação entre a morfologia craniofacial e a gravidade da apneia. Foi computado o coeficiente de correlação de postos de Spearman (rho) entre medidas cefalométricas e índices de apneia obstrutiva do sono. A significância estatística foi estabelecida em p < 0,05. Resultados: Pacientes com apneia obstrutiva do sono grave apresentaram redução do crescimento sagital do comprimento mandibular efetivo e do comprimento crânio-basal. O comprimento mandibular foi a única variável que apresentou correlação estatística com o índice de apneia-hipopneia. A dimensão vertical mostrou uma fraca correlação com a gravidade da apneia. Não foi demonstrada correlação com a dimensão maxilar sagital. Conclusão: A gravidade da apneia obstrutiva do sono pode estar correlacionada ao crescimento da base mandibular e craniana. A dimensão facial vertical não apresentou correlação com a gravidade da apneia.


Subject(s)
Humans , Male , Female , Sleep Apnea, Obstructive/diagnostic imaging , Cephalometry/methods , Polysomnography , Mandible/diagnostic imaging , Maxilla/diagnostic imaging , Middle Aged
5.
Fisioter. Bras ; 23(1): 37-50, Fev 11, 2022.
Article in Portuguese | LILACS | ID: biblio-1358398

ABSTRACT

Introdução: As doenças crônicas são condições complexas de saúde associadas a sintomas variados, que aumentam a propensão a exacerbações, redução da capacidade funcional e piora da qualidade de vida (QV). Assim, restabelecer a capacidade funcional pode ser um importante alvo terapêutico, reduzindo a morbidade e a mortalidade. Para tal, torna-se necessária a monitorização dessa importante variável. Objetivo: Investigar a capacidade funcional de indivíduos com doenças crônicas. Métodos: Estudo transversal de amostra por conveniência com indivíduos adultos com doenças crônicas, o qual analisou o nível de capacidade funcional utilizando o Teste de Caminhada de 6 Minutos (TC6M) e o teste de sentar e levantar. A capacidade cardiorrespiratória por meio do questionário Duke Activity Status Index (DASI) e dispneia pelo Medical Research Council (MRC). Para avaliar o impacto da doença na vida do indivíduo, foi analisada a qualidade de vida (QV) pelo Questionário do Hospital Saint George na Doença Respiratória (SGRQ), o Questionário STOP-BANG para a detecção do risco de Síndrome Apneia Obstrutiva do Sono (SAOS) e para a avaliação da Sonolência Excessiva Diurna (SES) foi utilizado o questionário de Epworth. Os dados foram analisados no programa estatístico SigmaPlot versão 11.0 (Systat Software). Resultados: Foram estudados 77 indivíduos com doenças crônicas, sendo o principal diagnóstico a DPOC. A maior parte apresentou dispneia grau 2, aproximadamente 39% Sonolência Diurna e, aproximadamente, 25% alto risco de SAOS. A QV foi reduzida em todos os domínios, principalmente no domínio que analisou o impacto da doença na vida. A capacidade cardiorrespiratória foi baixa. A distância percorrida média no TC6m correspondeu a 72,72% do valor predito, demonstrando baixa capacidade funcional. Conclusão: Os indivíduos, com doenças crônicas, estudados apresentaram condições de saúde comprometidas de maneira multidimensional, com redução da capacidade funcional. Houve redução da qualidade de vida e da qualidade de sono, com a presença de distúrbio do sono em uma parcela significativa, além da presença de uma variedade de condições que repercutiram negativamente na sua vida. (AU)


Subject(s)
Quality of Life , Respiratory Tract Diseases , Sleep Apnea, Obstructive , Environmental Monitoring , Dyspnea , Walk Test , Disorders of Excessive Somnolence
6.
Arq. neuropsiquiatr ; 80(2): 173-179, Feb. 2022. tab
Article in English | LILACS | ID: biblio-1364376

ABSTRACT

ABSTRACT Background: Loss of teeth has been associated with neurological and sleep disorders. It is considered to be a predictor of stroke and leads to modifications of airway patency and predisposition to obstructive sleep apnea. Objective: To investigate sleep quality, risk of obstructive sleep apnea and excessive sleepiness among post-stroke patients with tooth loss attending the Neurovascular Clinic of the Federal University of São Paulo. Methods: The prevalence rates of different types of stroke were assessed among 130 patients with different degrees of tooth loss, along with the presence of sleep disturbances, risk of obstructive sleep apnea and excessive daytime sleepiness. Results: The prevalence of ischemic stroke was 94.6%, with either no significant disability or slight disability. Our sample had poor sleep quality, and a high risk of obstructive sleep apnea, but without excessive daytime sleepiness. Half of our sample had lost between 9 and 31 teeth, and more than 25% had edentulism. The majority used full removable dental prostheses, and more than half of these individuals slept without removing the prosthesis. Conclusions: We found high prevalence of poor sleep quality and high risk of obstructive sleep apnea among post-stroke patients with tooth loss. This indicates the need for further studies on treating and preventing sleep disturbances in stroke patients with tooth loss.


RESUMO Antecedentes: A perda de dentes tem sido associada a distúrbios neurológicos e do sono. É considerada um preditor de acidente vascular cerebral (AVC), com modificações na permeabilidade das vias aéreas e predisposição à apneia obstrutiva do sono. Objetivo: Investigar a qualidade do sono, o risco de apneia obstrutiva do sono e a sonolência excessiva em pacientes pós-AVC com perda dentária, atendidos na Clínica Neurovascular da Universidade Federal de São Paulo. Métodos: O estudo avaliou a prevalência de diferentes tipos de AVC em 130 pacientes com diferentes graus de perda dentária e a presença de distúrbios do sono, risco de apneia obstrutiva do sono e sonolência excessiva. Resultados: A prevalência de AVC isquêmico foi de 94,6%, sem deficiência significativa ou deficiência leve. Nossa amostra tinha má qualidade de sono e alto risco de apneia obstrutiva do sono, sem sonolência diurna excessiva. Metade de nossa amostra perdeu entre nove e 31 dentes, e mais de 25% tiveram edentulismo. A maioria usava próteses dentárias totalmente removíveis e, desses pacientes, mais da metade dormia com elas. Conclusões: Encontramos alta prevalência de má qualidade do sono e alto risco de apneia obstrutiva do sono em pacientes pós-AVC com perda dentária. Isso indica a necessidade de mais estudos sobre o tratamento e a prevenção de distúrbios do sono em pacientes com AVC e perda dentária.


Subject(s)
Humans , Tooth Loss/complications , Tooth Loss/etiology , Sleep Apnea, Obstructive/complications , Sleep Apnea, Obstructive/epidemiology , Stroke/complications , Disorders of Excessive Somnolence , Sleep
7.
Säo Paulo med. j ; 140(2): 171-181, Jan.-Feb. 2022. tab
Article in English | LILACS | ID: biblio-1366046

ABSTRACT

Abstract BACKGROUND: Sitting time, screen time and low physical activity (PA) levels have been associated with several diseases and all-cause mortality. PA is related to better sleep quality and absence of daytime sleepiness, along with lower risks of obstructive syndrome apnea (OSA). However, studies on the relationship between sitting time, screen time and OSA are scarce in the literature. OBJECTIVE: To analyze associations between PA levels, sitting time, screen time and OSA among adults with suspected sleep disorder. DESIGN AND SETTING: Cross-sectional study conducted at Hospital Israelita Albert Einstein. METHODS: Data were collected from 369 adults with suspected sleep disorders who visited the hospital's neurophysiology clinic between August 2015 and January 2017. RESULTS: Correlations between hypopnea and PA indicators were demonstrated for total sitting time (0.123; P = 0.019) and total screen time (0.108; P = 0.038). There was also a correlation between latency for rapid-eye-movement sleep (REM_LAT) and total sitting time (0.103; P = 0.047) and a negative correlation between mean oxyhemoglobin saturation (SaO_Avg) and total PA time (-0.103; P = 0.048). There were no associations between PA parameters and apnea-hypopnea index. After adjusting for confounding factors (body mass index, age and gender), sitting time and screen time were not associated with OSA. CONCLUSION: After adjusting for anthropometric and clinical factors, excessive sitting time or screen time was not associated with OSA in adults suspected of sleep disorders. Age, gender, hypertension, body mass index and waist circumference were associated with OSA.


Subject(s)
Humans , Adult , Sleep Apnea, Obstructive/complications , Sedentary Behavior , Cross-Sectional Studies , Screen Time , Sitting Position
8.
Article in English | LILACS | ID: biblio-1369047

ABSTRACT

ABSTRACT: Among the treatment options for Obstructive Sleep Apnea (OSA) we have surgery to correct dentofacial deformities. OSA patients are routinely and predictably submitted to surgical treatment for dentofacial deformities. Frequently, orthognathic surgery and osseointegrated implants may be necessary to enable fixed rehabilitation. Patients submitted to orthognathic surgery have a transient decrease in blood supply after maxillary and mandibular osteotomy procedures, which can impair the results in these cases. This case report aimed to present and discuss the conflicting situation of an OSA patient in need of orthognathic surgery and dental implants. The treatment consisted of: (1) extraction of all teeth; (2) complete rehabilitation of the upper and lower jaw with dental implants and prosthesis without compensation; (3) bimaxillary orthognathic surgery to re-establish the maxillomandibular relationship and increase the upper airway volume. This rehabilitation sequence was a safe alternative for a case of Class II OSA, and rapidly achieved a final restoration with enhanced esthetics, functionality, biomechanics, maintenance of oral hygiene, and patient satisfaction. (AU)


RESUMO: Entre as opções de tratamento da Apneia Obstrutiva do Sono (AOS) temos a cirurgia para correção das deformidades dentofaciais. Freqüentemente, a combinação de cirurgia ortognática e implantes osseointegráveis pode ser necessária para permitir a reabilitação dental. Pacientes submetidos à cirurgia ortognática apresentam diminuição transitória do suprimento sanguíneo após procedimentos de osteotomia maxilar e mandibular, o que pode prejudicar os resultados nestes casos. Este relato de caso teve como objetivo apresentar e discutir a situação de um paciente com AOS que necessita de cirurgia ortognática e implantes dentários. O tratamento consistiu em: (1) extração de todos os dentes; (2) reabilitação completa da mandíbula superior e inferior com implantes dentários e próteses sem compensação; (3) cirurgia ortognática bimaxilar para restabelecer a relação maxilomandibular e aumentar o volume das vias aéreas superiores. Essa sequência de reabilitação foi uma alternativa segura para um caso de AOS Classe II, e rapidamente alcançou uma reabilitação com estética, funcionalidade, biomecânica aprimorada, manutenção da higiene oral e satisfação do paciente. (AU)


Subject(s)
Humans , Female , Adult , Sleep Apnea, Obstructive/rehabilitation , Dental Implantation , Orthognathic Surgical Procedures/rehabilitation
9.
In. Soeiro, Alexandre de Matos; Leal, Tatiana de Carvalho Andreucci Torres; Accorsi, Tarso Augusto Duenhas; Gualandro, Danielle Menosi; Oliveira Junior, Múcio Tavares de; Caramelli, Bruno; Kalil Filho, Roberto. Manual da residência em cardiologia / Manual residence in cardiology. Santana de Parnaíba, Manole, 2 ed; 2022. p.728-736, tab, ilus.
Monography in Portuguese | LILACS | ID: biblio-1353103
10.
Ann. afr. méd. (En ligne) ; 15(2): e4577-e4588, 2022. figures, tables
Article in French | AIM | ID: biblio-1366402

ABSTRACT

Contexte et objectif. Le syndrome d'apnées hypopnées obstructives du sommeil (SAHOS) est une pathologie fréquente, mais méconnue. L'objectif de cette enquête était d'évaluer les connaissances ainsi que les habitudes diagnostique et thérapeutique des médecins généralistes (MG) vis-à-vis le SAHOS. Méthodes. Etude transversale, déclarative, observationnelle menée auprès des MG de la ville de Kinshasa, à partir d'un questionnaire anonyme n'ayant pas précisé au préalable l'objet de l'étude. Les réponses aux questions et le nombre des répondants sont exprimés en fréquence et en pourcentage. Résultats. Sur 177 MG ayant répondu au questionnaire, près de 70% avaient obtenu leur diplôme après l'année 2009. Le cursus universitaire avait été la principale source d'information. La majorité des MG de l'enquête (62%) n'était pas familiarisée avec le SAHOS. Les symptômes cardinaux (ronflements, apnées nocturnes, somnolence diurne) avaient été cités par plus de moitié des MG mais sans leur donner de signification réelle dans leur pratique médicale. L'obésité a été largement citée comme un facteur associé au SAHOS par 68 % de MG, cependant les autres facteurs ont été méconnus ou à peine cités. Plus de la moitié des MG (54,2 %) ne connaissait pas les répercussions et les complications des apnées nocturnes sur l'individu et son environnement. La polysomnographie comme examen clé du SAHOS avait été citée par 56 % des MG. Le niveau des connaissances révélé par l'ensemble des résultats s'est avéré globalement faible. Conclusion. Le SAHOS est une pathologie fréquente, méconnue et très peu intégrée dans les pratiques professionnelles médicales à Kinshasa. Cette situation appelle un approfondissement de la formation des médecins par l'enseignement universitaire et la formation médicale continue


Context and objective. Obstructive sleep apneahypopnea syndrome (OSAHS) is a frequent pathology. The objective was to assess the knowledge as well as the diagnostic and therapeutic habits of general practitioners (GPs) concerning the OSAHS. Methods. A crosssectional, observational study was conducted among GPs using an anonymous questionnaire that did not specify the purpose of the study beforehand. Results. Out of 177 GPs who answered the questionnaire, almost 70 % had graduated after 2009. University education had been the main source of information. The majority of GPs in the survey (62%) were not familiar with OSAHS. Cardinal symptoms of OSAHS (snoring, nocturnal apnea, daytime sleepiness) had been cited by more than half of GPs but without giving them any real significance in their medical practice. Half of them had never discussed the diagnosis of OSAHS with their patients. Obesity was widely cited as a factor associated with OSAHS by 68% of GPs, however other factors were either unrecognized or barely mentioned. More than half of GPs (54.2%) did not know the repercussions and complications of night apnea on the individual and his environment. Polysomnography as a key examination for OSAHS was cited by 56% of GPs. The existence of care was also indicated by a large number of them (87%) but without knowing the terms. Conclusion. OSAHS is a pathology affecting the population of Kinshasa, but little integrated into professional medical practices. Its cardinal symptoms, complications and diagnostic and therapeutic modalities are little known to GPs. This situation calls for further training of doctors through university education and continuing medical education.


Subject(s)
Humans , Male , Female , Signs and Symptoms , Health Knowledge, Attitudes, Practice , Sleep Apnea, Obstructive , Diagnosis , General Practitioners
11.
Article in English | WPRIM | ID: wpr-928992

ABSTRACT

OBJECTIVES@#Obstructive sleep apnea hypopnea syndrome (OSAHS) is a common disease that seriously affects health. Continuous positive airway pressure (CPAP) therapy is the preferred treatment for moderate-to-severe OSAHS patients. However, poor adherence to CPAP is a major obstacle in the treatment of OSAHS. Information-motivation-behavioral (IMB) skills, as a kind of mature technology to change the behavior, has been used in various health areas to improve treatment adherence. This study aims to explore the effects of the IMB skills intervention on CPAP adherence in OSAHS patients.@*METHODS@#Patients who were primary diagnosed with moderate-to-severe OSAHS were randomly divided into the IMB group (n=62) and the control group (n=58). The patients in the IMB group received CPAP therapy and the IMB skills intervention for 4 weeks. The patients in the control group received CPAP therapy and a usual health care provided by a registered nurse. We collected the baseline data of the general information, including age, sex, body mass index (BMI), the Epworth Sleepiness Scale (ESS) score, the Hospital Anxiety and Depression Scale (HADS) score, and indicators about disease severity [apnea-hypopnea index (AHI), percentage of time with arterial oxygen saturation SaO2<90% (T90), average SaO2, lowest SaO2, arousal index]. After CPAP titration, we collected CPAP therapy-relevant parameters (optimal pressure, maximum leakage, average leakage, 95% leakage, and residual AHI), score of satisfaction and acceptance of CPAP therapy, and score of willingness to continue CPAP therapy. After 4 weeks treatment, we collected the ESS score, HADS score, CPAP therapy-relevant parameters, effective CPAP therapy time per night, CPAP therapy days within 4 weeks, CPAP adherence rate, score of satisfaction and acceptance of CPAP therapy, and score of willingness to continue CPAP therapy. Visual analog scale (VAS) of 0-5 was used to evaluate the satisfaction and acceptance of IMB intervention measures in the IMB group.@*RESULTS@#There were no significant differences in the baseline level of demographic parameters, ESS score, HADS score, disease severity, and CPAP therapy related parameters between the IMB group and the control group (all P>0.05). There were no significant differences in score of willingness to continue CPAP therapy, as well as score of satisfaction and acceptance of CPAP therapy after CPAP titration between the IMB group and the control group (both P>0.05). After 4 weeks treatment, the ESS score, HADS score, maximum leakage, average leakage, and 95% leakage of the IMB group were significantly decreased, while the score of satisfaction and acceptance of CPAP therapy and willingness to continue CPAP therapy of the IMB group were significantly increased (all P<0.05); while the above indexes in the control group were not different before and after 4 weeks treatment (all P<0.05). Compared with the control group, the ESS score, HADS score, maximum leakage, average leakage, and 95% leakage of the IMB group after 4 weeks treatment were significantly lower (all P<0.05); the effective CPAP therapy time, CPAP therapy days within 4 weeks, score of satisfaction and acceptance of CPAP therapy, score of willingness to continue CPAP therapy of the IMB group were significantly higher (all P<0.05). The rate of CPAP therapy adherence in 4 weeks of the IMB group was significantly higher than that of the control group (90.3% vs 62.1%, P<0.05). The VAS of overall satisfaction with IMB skills intervention measures was 4.46±0.35.@*CONCLUSIONS@#IMB skills intervention measures can effectively improve the adherence of CPAP therapy in OSAHS patients, and is suitable for clinical promotion.


Subject(s)
Continuous Positive Airway Pressure , Humans , Motivation , Oximetry , Patient Compliance , Sleep Apnea, Obstructive/diagnosis , Syndrome
12.
Article in Chinese | WPRIM | ID: wpr-928193

ABSTRACT

Sleep apnea causes cardiac arrest, sleep rhythm disorders, nocturnal hypoxia and abnormal blood pressure fluctuations in patients, which eventually lead to nocturnal target organ damage in hypertensive patients. The incidence of obstructive sleep apnea hypopnea syndrome (OSAHS) is extremely high, which seriously affects the physical and mental health of patients. This study attempts to extract features associated with OSAHS from 24-hour ambulatory blood pressure data and identify OSAHS by machine learning models for the differential diagnosis of this disease. The study data were obtained from ambulatory blood pressure examination data of 339 patients collected in outpatient clinics of the Chinese PLA General Hospital from December 2018 to December 2019, including 115 patients with OSAHS diagnosed by polysomnography (PSG) and 224 patients with non-OSAHS. Based on the characteristics of clinical changes of blood pressure in OSAHS patients, feature extraction rules were defined and algorithms were developed to extract features, while logistic regression and lightGBM models were then used to classify and predict the disease. The results showed that the identification accuracy of the lightGBM model trained in this study was 80.0%, precision was 82.9%, recall was 72.5%, and the area under the working characteristic curve (AUC) of the subjects was 0.906. The defined ambulatory blood pressure features could be effectively used for identifying OSAHS. This study provides a new idea and method for OSAHS screening.


Subject(s)
Blood Pressure , Blood Pressure Monitoring, Ambulatory , Humans , Hypertension/complications , Polysomnography , Sleep Apnea, Obstructive/diagnosis
13.
Article in Chinese | WPRIM | ID: wpr-927879

ABSTRACT

The incidence of obstructive sleep apnea (OSA) is higher in pregnancy than in non-pregnancy,and obesity is a major risk factor.OSA in pregnancy can lead to multiple organ dysfunction and is associated with hypertensive disorders in pregnancy,gestational diabetes mellitus,premature birth,and fetal growth restriction. Therefore,early screening and diagnosis are essential for the prevention and treatment of OSA in pregnancy.


Subject(s)
Diabetes, Gestational , Female , Humans , Obesity , Pregnancy , Pregnancy Complications/epidemiology , Premature Birth , Risk Factors , Sleep Apnea, Obstructive/therapy
14.
Rev. Méd. Inst. Mex. Seguro Soc ; 59(6): 551-559, 01-dic-2021. ilus, tab, graf
Article in Spanish | LILACS | ID: biblio-1357567

ABSTRACT

Introducción: el buen sueño es esencial para la salud física y mental a lo largo de la vida. Sin embargo, existen pocos reportes sobre los problemas del sueño que enferentan las personas mayores que viven en la comunidad. Objetivo: describir la prevalencia de los principales problemas de sueño y su relación con condiciones médicas en las personas mayores que viven en la comunidad. Material y métodos: estudio transversal descriptivo con 1678 personas de 60 años y más, derechohabientes del Instituto Mexicano del Seguro Social (IMSS) en la Ciudad de México. Se evaluó la duración del sueño, la calidad del sueño, la somnolencia diurna, el insomnio y el riesgo de apnea obstructiva de sueño, junto con algunas variables sociodemográficas y condiciones médicas. Resultados: las personas mayores reportaron dormir, en promedio, 6.04 (± 1.5) horas por noche; el 49.1% tenía baja calidad del sueño y el 19.1% experimentaba somnolencia diurna; el 30.8% presentó insomnio y el 27.5% tenía riesgo de apnea obstructiva del sueño. Se observó un patrón de mayor prevalencia de problemas de sueño en las personas mayores con depresión, deterioro cognitivo, dificultades para realizar actividades básicas de la vida diaria y en quienes consumían medicamentos para el sistema nervioso. Conclusiones: este estudio mostró que las personas mayores duermen pocas horas, tienen baja calidad de sueño y prevalencia alta de trastornos del sueño. La identificación y el tratamiento de los problemas del sueño en las personas mayores debe ser una prioridad en el IMSS.


Background: Good sleep is essential for physical and mental health throughout life. However, there are few reports describing the sleep problems experienced by community-dwelling older people. Objective: To describe the prevalence of sleep disorders and their relationship with medical conditions in community-dwelling older people. Methods: Cross-sectional study with 1678 older people (60 years and over) from the Mexican Institute of Social Security (IMSS) in Mexico City. Sleep duration, sleep quality, daytime sleepiness, insomnia and risk of obstructive sleep apnea were evaluated, alongside with sociodemographic variables and medical conditions. Results: Participants self-reported an average sleep duration of 6.04 (± 1.5) hours per night, approximately half had poor sleep quality (49.1%), and 2 out of 10 experienced daytime sleepiness (19.1%); one third had insomnia (30.8%) and risk of obstructive sleep apnea (27.5%). A pattern of higher prevalence of sleep problems was observed in older adults with depression, with cognitive impairment, with difficulties in basic activities of daily living and in those taking medications for the nervous system. Conclusions: This study showed that older people sleep few hours, have low sleep quality, and have a high prevalence of sleep disorders. The identification and treatment of sleep disordes in older people should be a priority in the IMSS.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Mental Health , Cross-Sectional Studies , Sleep Apnea, Obstructive , Geriatrics , Mexico , Sleep Wake Disorders , Aging , Disorders of Excessive Somnolence , Sleep Initiation and Maintenance Disorders , Nervous System
15.
Säo Paulo med. j ; 139(6): 643-647, Nov.-Dec. 2021. tab
Article in English | LILACS | ID: biblio-1352294

ABSTRACT

ABSTRACT BACKGROUND: Obstructive sleep apnea (OSA) is characterized by recurrent pharyngeal wall collapse during sleep caused by anatomical or functional changes associated with obesity or dislocation of maxillofacial structures. OBJECTIVE: To determine the major risk factors for obstructive sleep apnea monitored in the home. DESIGN AND SETTING: Cross-sectional study conducted in a private clinic in Fortaleza (CE), Brazil. METHODS: Between 2015 and 2018, 427 patients were screened for OSA with home-based monitoring, yielding 374 positives. Information was collected on age, sex, body mass index (BMI), hypertension, diabetes (DM), dyslipidemia, coronary artery disease (CAD), arrhythmia, peripheral artery occlusive disease (PAOD), heart failure (HF) and lung disease. The home sleep apnea test result was then compared with the clinical diagnosis. Lastly, parameters identified as significant in the univariate analysis were subjected to multivariate logistic regression. RESULTS: Male sex predominated, although not significantly. OSA was associated with hypertension, DM, dyslipidemia, age and BMI. The risk of OSA being associated with these parameters was 2.195 (hypertension), 11.14 (DM), 2.044 (dyslipidemia) and 5.71 (BMI). The association was also significant for BMI categories (normal, overweight or obese). No significant association was observed for CAD, arrhythmia, PAOD, HF or lung disease. After multivariate logistic analysis, only age and BMI (and its categories) remained significant. CONCLUSION: OSA was associated with hypertension, DM, dyslipidemia, age and BMI in univariate analyses, but only with age and BMI (and its categories) in multivariate logistic analysis.


Subject(s)
Humans , Male , Sleep Apnea, Obstructive/complications , Sleep Apnea, Obstructive/diagnosis , Sleep Apnea, Obstructive/epidemiology , Body Mass Index , Cross-Sectional Studies , Risk Factors , Polysomnography , Overweight
16.
Fisioter. Bras ; 22(5): 757-772, Nov 11, 2021.
Article in Portuguese | LILACS | ID: biblio-1353564

ABSTRACT

Considerando a Síndrome de Hipoventilação da Obesidade (SHO) como potencialmente tratável, encontra-se dificuldade em comparar ensaios clínicos devido às diferentes titulações da ventilação mecânica não invasiva (VNI) e da pressão positiva contínua nas vias aéreas (CPAP). Objetivou-se realizar uma revisão integrativa da literatura com utilização de pressão positiva como método terapêutico. Foram incluídos ensaios clínicos randomizados, utilizando CPAP comparado a VNI como tratamento. A busca ocorreu nas bases de dados PubMed e Web of Science, incluindo-se estudos publicados entre 2008 e 2017. Foram selecionados 4 artigos, dois estudos comparando CPAP e binível. Apresentaram semelhança na melhora entre os grupos. O terceiro estudo comparou com grupo controle, sendo ambas eficientes em relação ao GC com melhora na PaCO2, Bic, sintomas clínicos, parâmetros polissonográficos e efeitos secundários. O quarto estudo apresentou para Suporte de Pressão Assegurada de Volume Médio (AVAPS-AE), eficácia de CPAP e binível na redução de surtos noturnos de pressão arterial. Dessa forma observa-se similar eficácia entre ambas as estratégias, e ambas são mais eficazes quando comparadas a um grupo controle. (AU)


Subject(s)
Obesity Hypoventilation Syndrome , Respiration, Artificial , Continuous Positive Airway Pressure , Sleep Apnea, Obstructive , Obesity
17.
Arq. ciências saúde UNIPAR ; 25(3): 185-191, set-out. 2021.
Article in Portuguese | LILACS | ID: biblio-1348203

ABSTRACT

Distúrbios do sono e as alterações do estado de humor, quando não tratados, estão associados à perda de produtividade e acidentes de trabalho, resultando em lesões e fatalidade. Esses distúrbios são subdiagnosticados e subtratados em contextos clínicos, porque podem ser assintomáticos e o exame de polissonografia tem custo elevado. Por isso, questionários são usados para realizar uma triagem e detectar profissionais com alto risco de síndrome da apneia obstrutiva do sono, de sonolência diurna excessiva e fadiga. Este estudo teve como objetivo aplicar questionários validados para triagem dos distúrbios do sono e do humor em pilotos civis e analisar os resultados obtidos com a aplicação desses instrumentos. Foram coletados dados de 44 pilotos civis por meio de quatro instrumentos: um questionário para a caracterização sociodemográfica e ocupacional da amostra, a Escala de Sonolência de Epworth para avaliar a presença de sonolência diurna excessiva, o Questionário de Berlim para avaliar a Síndrome da Apneia Obstrutiva do Sono e a Escala de Humor de Brunel para avaliar o estado de humor. A Escala de Sonolência de Epworth mostrou que 25% dos pilotos apresentaram pontuação para sonolência diurna excessiva. De acordo com o Questionário de Berlim, 29,5% apresentaram alto risco para a Síndrome da Apneia Obstrutiva do Sono e pela Escala de Humor de Brunel, o domínio vigor, teve a média mais alta (5,09 ±4,06). Portanto, a utilização dos questionários nos exames de admissão e nos periódicos, pode auxiliar na identificação precoce e no monitoramento de distúrbios do sono e dos estados de humor ao longo do tempo em pilotos civis, priorizando aqueles que deverão ser encaminhados para realizarem estudos do sono.


Sleep disorders and mood state changes, when untreated, are associated with loss of productivity and accidents at work, resulting in injuries and fatality. These disorders are underdiagnosed and undertreated in clinical contexts due to them being asymptomatic and the prohibitive cost of polysomnography exams. For this reason, questionnaires are used to screen and detect professionals at high risk for obstructive sleep apnea syndrome, excessive daytime sleepiness, and fatigue. This study aimed at applying validated questionnaires for screening sleep and mood disorders in civilian pilots and analyzing the results obtained with the application of these instruments. Data were collected from 44 civilian pilots using four instruments: a questionnaire for sociodemographic and occupational characterization of the sample; the Epworth Sleepiness Scale to assess the presence of excessive daytime sleepiness; the Berlin Questionnaire to assess Obstructive Sleep Apnea Syndrome; and the Brunel Mood Scale to assess the mood state. The Epworth Sleepiness Scale showed that 25% of the pilots presented scores for excessive daytime sleepiness. According to the Berlin Questionnaire, 29.5% were at high risk for Obstructive Sleep Apnea Syndrome, and according to the Brunel Mood Scale, the vigor domain presented the highest mean (5.09 ± 4.06). Therefore, the use of questionnaires in admission and periodic exams can assist in the early identification and monitoring of sleep disorders and mood states over time in civilian pilots, prioritizing those who should be referred to sleep studies.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Pilots , Disorders of Excessive Somnolence , Sleep Apnea Syndromes , Sleep Deprivation , Polysomnography , Confusion , Wit and Humor , Sleep Apnea, Obstructive , Depression , Fatigue , Sleepiness
18.
Braz. j. otorhinolaryngol. (Impr.) ; 87(4): 422-427, July-Aug. 2021. tab, graf
Article in English | LILACS | ID: biblio-1285716

ABSTRACT

Abstract Introduction There is evidence that trauma caused by snoring in the pharynx could result in dysphagia in patients with obstructive sleep apnea, but the literature is still scarce to define the factors associated with the presence of dysphagia in these patients. Objectives To analyze the occurrence of dysphagia and its clinical and polysomnographic features in patients with moderate and severe obstructive sleep apnea, in addition to verifying the impact of dysphagia on the quality of life of these patients. Methods Seventy patients with moderate or severe apnea (apnea and hypopnea index - AHI > 15/hour) were selected. The patients underwent a sleep questionnaire, a quality of life in dysphagia questionnaire and a fiberoptic endoscopic evaluation of swallowing. Results A total of 70 patients were included in the study, of which 49 were men (70 %), with a mean age of 48.9 years. The fiberoptic endoscopic evaluation of swallowing was altered in 27.3 % and the most frequent alteration was the premature oral leakage with fluid. Comparing the groups with and without dysphagia, the female gender was the only clinical parameter that showed a trend of statistical significance in the group with dysphagia (p = 0.069). There was no statistical difference regarding the polysomnographic features and in the global quality of life score in dysphagia in the comparison between the groups. Conclusions The presence of dysphagia in patients with moderate to severe apnea is frequent and subclinical, reinforcing the need to investigate this symptom in this group of patients. However, the presence of dysphagia did not result in worsening in patients' quality of life, suggesting that, although frequent, its effect is mild. There was no relevance regarding the association of clinical and polysomnographic parameters with the presence of dysphagia.


Resumo Introdução Existem evidências de que o trauma ocasionado pelo ronco na faringe poderia ocasionar disfagia em pacientes com apneia obstrutiva do sono, mas a literatura ainda é escassa para definir quais seriam os fatores associados à presença da disfagia nesses pacientes. Objetivo Avaliar a ocorrência de disfagia e seu perfil clínico e polissonográfico em pacientes com apneia obstrutiva do sono moderada e grave, além de verificar o impacto da disfagia na qualidade de vida desses pacientes. Método Foram selecionados 70 pacientes com apneia moderada ou grave (índice de apneia e hipopneia - IAH > 15 hora). Os pacientes foram submetidos a questionário de sono, qualidade de vida em disfagia e videoendoscopia da deglutição. Resultados Foram incluídos no estudo 70 pacientes, 49 do sexo masculino (70%), com média de 48,9 anos. A videoendoscopia da deglutição apresentou alteração em 27,3% dos pacientes. A alteração mais encontrada foi o escape oral precoce com líquido. Quando comparados os grupos com e sem disfagia, o sexo feminino foi o único parâmetro clínico que mostrou tendência à significância no grupo com disfagia (p = 0,069). Não houve diferença estatística quanto aos achados polissonográficos e quanto ao escore global da qualidade de vida em disfagia na comparação entre os grupos. Conclusão A presença de disfagia em pacientes com apneia moderada a grave é frequente e subclínica, reforça a necessidade de investigação desse sintoma nesse grupo de pacientes. Porém, a presença de disfagia não mostrou pioria na qualidade de vida dos pacientes, sugeriu que, apesar de frequente, sua repercussão é leve. Não houve relevância na associação dos parâmetros clínicos, polissonográficos com a presença de disfagia.


Subject(s)
Humans , Male , Female , Deglutition Disorders/diagnosis , Deglutition Disorders/etiology , Sleep Apnea, Obstructive/complications , Sleep Apnea, Obstructive/diagnosis , Quality of Life , Snoring , Polysomnography , Middle Aged
19.
Arch. argent. pediatr ; 119(3): S67-S76, Junio 2021. tab
Article in Spanish | LILACS, BINACIS | ID: biblio-1248259

ABSTRACT

El síndrome de apneas e hipoapneas obstructivas del sueño se asocia con una disminución de la calidad de vida, bajo rendimiento escolar y, hasta en el 40% de los niños, trastornos de conducta como hiperactividad, enuresis, ansiedad y depresión. Varios estudios demostraron que la adenoamigdalectomía es efectiva para mejorar o resolver los trastornos respiratorios del sueño. Si bien esta cirugía tiene resultados beneficiosos, no está exenta de riesgos. El dolor y el sangrado posoperatorio son las dos causas principales de morbilidad. Otras complicaciones de la cirugía son las náuseas y los vómitos posoperatorios, el retraso en la alimentación, la deshidratación, la otalgia referida, los cambios en la voz y, raras veces, la muerte.En este artículo se realizan recomendaciones sobre el cuidado posoperatorio de los niños con adenoamigdalectomía


Obstructive sleep apnea and hypopnea syndrome is associated with decreased quality of life, poor school performance and, in up to 40% of children, behavioral problems such as hyperactivity, enuresis, anxiety and depression. Several studies have shown that adenoamygdalectomy is effective in improving or resolving sleep-disordered breathing. While this surgery has beneficial results, it is not without risks. Postoperative pain and bleeding are the two main causes of morbidity. Other complications of surgery include postoperative nausea and vomiting, delayed feeding, dehydration, referred earache, voice changes, and, rarely, death. Recommendations on postoperative care for children undergoing adenoamygdalectomy are mentioned in this article.


Subject(s)
Humans , Male , Female , Child , Tonsillectomy , Adenoidectomy , Postoperative Complications , Respiration Disorders , Adenoids/surgery , Sleep Apnea, Obstructive
20.
Rev. Assoc. Med. Bras. (1992) ; 67(6): 878-881, June 2021. tab
Article in English | LILACS | ID: biblio-1346909

ABSTRACT

SUMMARY OBJECTIVE: The aim of this study was to verify the association among obstructive sleep apnea, functional capacity, and metabolic control. METHODS: This was a cross-sectional study involving individuals of both sexes with clinical diagnosis of diabetes mellitus type 2 who were above 18 years of age. The assessment consisted of a volunteer identification form, a 2-minute step test, and the Stop-Bang questionnaire. In order to assess metabolic control, HbA1c and fasting glucose data were collected from medical records. RESULTS: A total of 100 individuals with diabetes mellitus type 2, of whom 61% were women, were included in this study. According to the Stop-Bang instrument, 26, 57, and 17% of patients had low, intermediate, and high risk of developing OSA, respectively. There was no association between the 2-minute step test and metabolic variables and diabetes mellitus type 2 chronicity with Stop-Bang. CONCLUSIONS: We concluded that there is no association among obstructive sleep apnea measured by means of Stop-Bang instrument, functional capacity measured by means of 2-minute step test, and metabolic variables in individuals with diabetes mellitus type 2.


Subject(s)
Humans , Male , Female , Sleep Apnea, Obstructive/epidemiology , Diabetes Mellitus, Type 2/complications , Cross-Sectional Studies , Prospective Studies , Surveys and Questionnaires , Polysomnography
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