No Abstract available.
Diagnosis* ; Sleep Apnea, Obstructive*

Humans ; Polysomnography ; methods ; Sleep Apnea, Obstructive ; diagnosis

Anthropometry ; methods ; Humans ; Sleep Apnea, Obstructive ; diagnosis

Humans ; Sleep Apnea, Obstructive ; diagnosis ; pathology

The sleep breathing disorders (SDB) include obstructive sleep apnea (OSA), central sleep apnea disorders, sleep related hypoventilation disorders, and sleep related hypoxemia disorder in international classification of sleep diseases 3rd edition (ICSD-3). Latest diagnosis criteria are introduced. Treatments, which target to Individual contributors, should be applied. Thus identification of the phenotype in patients with OSA is important. The methods of evaluation patients' arousal thresholds, loop gain as well as neuromyopathy in clinical setting are reported. Several new treatment strategies are developed and applied for OSA. Long term follow up and more data are needed for evaluation the outcomes of hypoglossal nerve stimulation, bariatric surgery as well as medicine as treatments for OSA.
Humans ; Sleep Apnea Syndromes ; diagnosis ; therapy ; Sleep Apnea, Central ; Sleep Apnea, Obstructive

BACKGROUND AND OBJECTIVES: The polysomnography is essential for diagnosis of obstructive sleep apnea-hypopnea (OSAH) and provides important objective information. But, in fact, there are some difficulties for comprehensive interpretation of multiple indices from the polysomnogram. This study was designed to find out which polysomnogram indices were significant to respiratory distress indices (RDI) and apnea index (AI) on statistical correlation and which other indices should be considered together for proper management plan apart from RDI and AI (respiratory index). SUBJECTS AND METHOD: We evaluated 40 patients whose RDI were over 5 as the result of overnight polysomnography before any management from February 2003 to September 2003 at Eulji medical center. By multiple linear regression analysis, we studied the relationship of RDI and AI as dependent variables to ST, O2 desaturation events (O2DE), lowest O2 saturation (LoO2), slow wave sleep portion (S3&S4), arousal index (ArI), body-mass index (BMI) and age. We also studied the relationship of ST as an dependent variable to O2DE, LoO2, S3&S4, ArI, BMI, and age. RESULTS: 1) There were significant correlations between RDI and O2DE, ArI as was true between AI and O2DE, ArI (p<0.05). And there was no significant difference in the degree of the correlation between RDI and AI. 2) Other variables such as ST, LoO2, S3&S4, BMI and age were not significant. 3) ST had no significant correlation with respiratory index and any other variables (p<0.05). CONCLUSION: Because the respiratory index may not the entire physical status during sleep for OSAH patients, multiple indices (such as LoO2, BMI, ST, S3&S4, age) should be considered together apart from the respiratory index for proper management plan.
Apnea ; Arousal ; Diagnosis ; Humans ; Linear Models ; Polysomnography* ; Sleep Apnea, Obstructive

OBJECTIVES: The sensitivity and accuracy of thermistor airflow signal has been debated. The purposes of this study were to compare apnea-hypopnea index(AHI) detected from a conventional thermistor signal and a nasal pressure transducer of airflow(NPT), to evaluate the value of NPT for the diagnosis of upper airway resistance syndrome (UARS), and to measure airway pressure fluctuations which produced respiratory arousals in UARS by naso-oro-esophageal manometer catheter. The subjects were 30 patients with obstructive sleep apnea syndrome [mild(540), 10), and 6 UARS patients. Airway resistance arousal in this study was defined as arousals which were not associated with apnea or hypopnea of thermistor signal, but showed significant decrease of nasal airflow pressure just before arousal and a prompt recovery of nasal airflow pressure after arousal, The airway pressure fluctuations were measured during 260 airway resistance arousals observed in 10 patients with OSAS, 2 with UARS. RESULTS: Mean AHIs of patients with OSAS were 33.4 by thermistor and 48.4 by NPT. The AHIs of mild, moderate and severe OSAS group were 10.2, 32.1, 65.4 respectively by thermistor and 23.1, 45.9, 76.4 by NPT. The mean AHI of patients with UARS was 3.2 by tehrmistor and 108 by NPT. The mean AHI of patients with nonspecific arousals was 2.7 by thermistor and 4.4 by NPT. The mean airway pressure changes during resiratory arousals of different groups were 8.7 cmH2O in mild OSAS, 11.4 cmH2O in moderate OSAS, 24.7 cmH2O in severs OSAS and 6.6 cmH2O in UARS. CONCLUSION: The nasal pressure transducer of airflow was more sensitive and accurate for assessing respiratory disturbances of patients with OSAS and was extremely helpful for the diagnosis of UARS without esophageal pressure monitoring. From the results, we would like to propose carefully the NPT diagnostic criteria for sleep disordered breathing as follows : NPT-AHI 5-15->UARS, 15-35->mild OSAS, 35-55->moderate OSAS and >55 ->severe OSAS.
Airway Resistance* ; Apnea ; Arousal ; Catheters ; Diagnosis ; Humans ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Transducers, Pressure

BACKGROUND AND OBJECTIVES: Most of the patients with upper airway resistance syndrome (UARS) remain undiagnosed and are left untreated because of the disagreement with diagnostic criteria of obstructive sleep apnea syndrome (OSAS). The aim of this study is to help understanding UARS through evaluating differences of polysomnographic findings and subjective symptoms between UARS and OSAS. SUBJECTS AND METHOD: One hundred nineteen patients, who visited for snoring and/or apnea, excessive daytime sleepiness, were included. All patients underwent full night polysomnography (PSG) and performed tests on the 10 cm visual analogue scale (VAS) for 14 symptoms and Epworth sleepiness scale (ESS). PSG results and VAS score were compared between UARS group and OSAS group. RESULTS: Among 119 patients, 4 patients had simple snoring, 19 patients had UARS and 96 patients had OSAS. Patients with UARS were younger and had lower BMI than OSAS. Apnea index, hypopnea index, respiratory disturbance index, arousal index, portion of slow wave sleep, mean and lowest oxygen saturation were more severe in patients with OSAS than UARS. But subjective symptoms and ESS were similar in both groups. CONCLUSION: Although significant differences were found in PSG results in patients with UARS and OSAS, complaints and symptoms were similar in both groups. We suggest that diagnosis and treatment for sleep-disordered breathing should not be based solely upon the presence of apnea/hypopnea. We also suggest that more consideration should be given to UARS diagnosis and treatment.
Airway Resistance* ; Apnea ; Arousal ; Diagnosis ; Humans ; Oxygen ; Polysomnography ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Snoring

Obstructive sleep apnea (OSA) is a common disorder. It usually results from the structural compromise of the upper airway. In patients with OSA, the obstruction predominantly occurs along the pharyngeal airway, and also a variety of tumors have been reported to cause such a condition. We present here the case of a thyroglossal duct cyst causing OSA in adult. This case demonstrates that thyroglossal duct cyst or some kind of mass lesions in the airway lesions should be considered in the differential diagnosis of OSA patients.
Adult ; Diagnosis, Differential ; Humans ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive ; Thyroglossal Cyst ; Sleep Wake Disorders

OBJECTIVE: To realize the characteristics of clinical symptoms and PSG in elderly patients with obstructive sleep apnea hypopnea syndrome (OSAHS). METHOD: The clinical presentations, epworth sleepiness scale (ESS) and polysomnography findings were compared between elderly patients with OSAHS and middle age patients with OSAHS. RESULT: There were no significantly differences in clinical presentations including snoring, apnea and daytime sleepiness complaint between the elderly and middle aged patients with OSAHS, but the incidences of complications such as hypertension and other cardiovascular diseases was significantly higher in elderly patients than those in the middle aged patients (P<0.01). The sleep architecture disturbance was significantly worse in elderly OSAHS patients compared with the middle age patients. The percentages of non-rapid eye movement (NREM) stage I sleep were significantly increased, the rapid eye movement (REM) sleep were significantly decreased in elderly OSAHS patients than those in middle aged group (P<0.01 or P<0.05), but the percentages of awake, NREM stage II sleep and NREM stage II-IV sleep had no significantly difference in the two groups. The apnea hypopnea index (AHI), apnea index (AI), hypopnea index (HI), snoring index, ESS and body mass index (BMI) were significantly decreased, the lowest oxygen saturation (LSO2) and micro-arousal index were significantly increased in elderly OSAHS patients than those in middle aged group (P<0.01 or P<0.05). CONCLUSION The elderly OSAHS patients are less sever than the middle age, but the elderly patients have worse sleep architecture disturbance and more complications such as hypertension and other cardiovascular diseases.
Aged ; Humans ; Middle Aged ; Polysomnography ; Sleep ; Sleep Apnea, Obstructive ; diagnosis ; physiopathology ; Sleep Stages ; Sleep, REM