Sleep & breathing = Schlaf & Atmung
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Comparative Study
Comparison of a simple obstructive sleep apnea screening device with standard in-laboratory polysomnography.
Obstructive sleep apnea (OSA) is a common underdiagnosed sleep disorder. Various strategies have been employed to easily screen for OSA. The ApneaStrip® (AS - S.L.P. Ltd, Tel Aviv, Israel) is an FDA approved OSA screening device applied to the upper lip at home. We evaluated the performance of this device against simultaneous in-laboratory polysomnography (PSG) in a group of well-characterized OSA patients. ⋯ The AS has a high sensitivity for detection of OSA with AHI ≥ 15, but only modest specificity. The AS could be a useful component of an OSA screening program; however, negative results should be interpreted cautiously.
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Recently, we noticed a considerable development in alleviating problems related to positive airway pressure (PAP) masks. In this study, we report on the initial PAP mask acceptance rates and the effects of mask switching on mask-related symptoms. ⋯ The initial PAP mask acceptance rate was high. Patients who switched their masks are at greater risk for abandoning PAP therapy.
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STOP-Bang is a tool for predicting the likelihood for sleep-disordered breathing (SDB). In the conventional score, all variables are dichotomous. Our aim was to identify whether modifying the STOP-Bang scoring tool by weighting the variables could improve test characteristics. ⋯ Modifying the STOP-Bang score by weighting the variables and using continuous variables for BMI, age, and neck circumference can maintain sensitivity while improving specificity, positive likelihood ratio, and area under the receiver operating characteristic curve.
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Observational Study
High-resolution wrist-worn overnight oximetry has high positive predictive value for obstructive sleep apnea in a sleep study referral population.
Reducing the need for diagnostic sleep studies for obstructive sleep apnea (OSA) would reduce direct and opportunity costs while expediting time to treatment for this common and morbid disorder. We sought to determine if an established sleep apnea screening questionnaire (STOP-BANG) and wrist-worn overnight oximetry data could provide high positive predictive value for the presence of OSA. ⋯ Among patients with a high prevalence of OSA, high ODI is common and its presence has high PPV for OSA. These data suggest that overnight oximetry prior to sleep testing could significantly reduce the number of patients requiring sleep studies, thereby reducing costs and time to treatment.
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Our aim was to determine the pathway underlying the effects of continuous positive airway pressure (CPAP) adherence on intimate relationship with bed partner in men with obstructive sleep apnea (OSA). We hypothesized that CPAP with good adherence affected the intimate relationship with bed partner directly and indirectly, and it was mediated through daytime sleepiness and activity level in men with OSA. ⋯ CPAP therapy with good adherence is related directly and indirectly to a better intimate relationship with bed partner in men with OSA. It was possibly attributed to reduced daytime sleepiness and increased activity level.