Sleep & breathing = Schlaf & Atmung
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The apnea-hypopnea index (AHI) is used to grade obstructive sleep apnea (OSA) into mild, moderate, and severe forms. Obstructive events are most common in the supine position. The amount of supine sleep thus influences total AHI. Our aim was to determine the prevalence of position-dependent OSA (POSA) and its relation to OSA severity classification as recommended by the American Academy of Sleep Medicine (AASM). ⋯ POSA was common both in subjects that by AASM classification had OSA as well as those without. The severity of OSA, as defined by AASM, could be dependent on supine time in a substantial amount of subjects.
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The purpose of this study was to evaluate associations between obstructive sleep apnea (OSA) severity and self-reported sleepiness and daytime functioning in patients considering bariatric surgery for treatment of obesity. ⋯ Subjective sleepiness and functional impairment were not associated significantly with OSA severity in our sample of patients considering surgery for obesity. Further research is needed to understand individual differences in sleepiness in patients with OSA. If bariatric patients underreport symptoms, self-report measures are not an adequate substitute for objective assessment and clinical judgment when evaluating bariatric patients for OSA. Patients with severe obesity need evaluation for OSA even in the absence of subjective complaints.
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Risk for obstructive sleep apnea in obese, nondiabetic adults varies with insulin resistance status.
Obstructive sleep apnea (OSA) is an increasingly common sleep disorder, especially among obese adults. Early identification of adults at risk for OSA would be of substantial benefit; however, the magnitude of the obesity epidemic requires that screening be performed judiciously. The study's aim was to utilize questionnaires that assess OSA risk and symptoms to test the hypothesis that the most insulin-resistant subset of obese individuals is at highest risk for OSA. ⋯ High risk for OSA and excessive daytime sleepiness is prevalent among the insulin-resistant subgroup of obese individuals. Surrogate estimates of insulin resistance based on fasting insulin, triglycerides, and/or HDL-C can be used to help identify those obese adults who would benefit most from OSA screening and referral for polysomnography.
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Comparative Study Clinical Trial
Validation of ApneaLink Ox™ for the diagnosis of obstructive sleep apnea.
The aim of the study was to validate the automatic and manual analysis of ApneaLink Ox™ (ALOX) in patients with suspected obstructive sleep apnea (OSA). ⋯ The AHI obtained automatically from the ApneaLink Ox™ using oxygen desaturation ≥3 % as a criterion of hypopnea had a good performance to diagnose OSA. The manual scoring from ApneaLink Ox™ was better than the automatic scoring to discriminate patients with OSA.
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Previous studies addressing the question of whether continuous positive airway pressure (CPAP) could improve the insulin resistance and glucose control in patients with obstructive sleep apnea (OSA) have led to conflicting results. Therefore, we conducted the meta-analysis to evaluate the effects of CPAP on glycemic control and insulin resistance in OSA patients. ⋯ Our analysis showed that CPAP significantly improved insulin resistance in non-diabetic patients with moderate to severe OSA, while no significant change in body mass index was detected. Compared with fasting blood glucose at baseline, there was no change in glycemic control with CPAP. Further large-scale, randomized, and controlled studies are needed to evaluate the longer treatment and its possible effects on weight loss and glycemic homeostasis.