OBJECTIVE: To study the clinical value of polysomnography (PSG) and ApneaGraph (AG200) in the diagnosis evaluation of obstructive sleep apnea hypopnea syndrome (OSAHS). METHOD: From January to December in 2012, 67 OSAHS patients diagnosed by PSG were examined by AG200. The apnea hypopnea index (AHI), hypopnea index (HI), apnea index (AI), the lowest oxygen saturation (LSaO2) was were detected and the results were analyzed statistically. RESULT: Significant differences were observed in AI, AHI, LSaO2 between AG200 and PSG (P < 0.05, respectively). No statistically significant difference was found in HI. The differences in HI between AG200 and PSG were not significant (P > 0.05). AHI, HI and LSaO2 was were significantly correlated between AG200 and PSG (r = 0.870, 0.743, 0.374, 0.716, P < 0.01). CONCLUSION AG200 could not replace PSG but could identify the level of upper airway obstruction.
Female ; Humans ; Male ; Polysomnography ; methods ; Sleep Apnea, Obstructive ; diagnosis ; physiopathology

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

OBJECTIVETo get a comprehensive understanding about the relationship between obstructive sleep apnea (OSA) and asthma by reviewing the epidemiology, pathophysiology, and clinical manifestation and then summarizing the latest progress on diagnosis and treatment.

DATA SOURCESArticles referred in this review were mainly collected from a comprehensive search of the PubMed published in English from 1990 to 2015 with the terms "OSA" and "asthma" as the main keywords. Highly regarded older publications were also included.

STUDY SELECTIONInformation about the features of the two diseases in common, the pathophysiologic association between them and their current treatments from the literature search were identified, retrieved, and summarized.

RESULTSBoth OSA and asthma are very prevalent conditions. The incidences of them have kept on rising in recent years. Asthma is often accompanied by snoring and apnea, and OSA often combines with asthma, as well. They have many predisposing and aggravating factors in common. Possible shared direct mechanistic links between them include mechanical effects, intermittent hypoxia, nerve reflex, inflammation, leptin, etc. Indirect mechanistic links include medication, nose diseases, smoking, obesity, and gastroesophageal reflux disease. Since OSA presents many similar features with nocturnal asthma, some scholars termed them as a sole syndrome - "alternative overlap syndrome," and proved that asthma symptoms in those patients could be improved through the treatment of continuous positive airway pressure.

CONCLUSIONSOSA and asthma are closely associated in pathogenesis, symptoms, and therapies. With the growing awareness of the relationship between them, we should raise our vigilance on the coexistence of OSA in those difficult-to-control asthmatic patients. Further studies are still needed to guide the clinical works.

Asthma ; diagnosis ; physiopathology ; Humans ; Risk Factors ; Sleep Apnea, Obstructive ; diagnosis ; physiopathology

Enuresis ; diagnosis ; pathology ; physiopathology ; Female ; Humans ; Middle Aged ; Polysomnography ; Sleep Apnea, Obstructive ; diagnosis ; pathology ; physiopathology

OBJECTIVE: to investigate the origin characters of snore in simple snorers and provide the basis for its treatment. METHOD: Thirty-two simple snorers diagnosed by polysomnography were induced to sleep by propofol and dexmedetomidine, then we observed the vibration sites, pattern and concomitant collapse of soft tissue in pharyngeal cavity by nasendoscopy. RESULT: Thirteen cases showed palatal fluttering only, and 1 case showed vibration of epiglottis only. Six cases showed palatal fluttering with vibration of epiglottis, and 2 cases showed palatal fluttering with vibration of epiglottis and tongue base. Five cases showed palatal fluttering with vibration of pharyngeal lateral wall, and 5 cases showed palatal fluttering with vibration of lateral wall, epiglottis and tongue base together. Palate and pharyngeal lateral wall vibrated strongly and always collapsed with vibrating, but epiglottis and tongue base usually vibrated slightly and seldom collapsed. CONCLUSION The palatal fluttering is the main source of snoring sounds for most simple snorers, then followed by vibration of palatal and pharyngeal lateral wall together. The site of collapse in pharyngeal cavity is consistent with the main site of vibration.
Endoscopy ; Epiglottis ; physiopathology ; Humans ; Palate ; physiopathology ; Pharynx ; physiopathology ; Polysomnography ; Propofol ; Sleep ; Sleep Apnea, Obstructive ; Snoring ; diagnosis ; Tongue ; physiopathology

OBJECTIVETo study the value of Epworth sleepiness scale in assessment of obstructive sleep apnea hypopnea syndrome (OSAHS) severity.

METHODSThe polysomnography (PSG) data of 620 suspected OSAHS patients from Jan. 2000 to Dec. 2003 were retrospectively analyzed. There were 556 males and 64 females, and their age ranged from 21 to 79 years (median 45.0 years). Of the all 620 patients, the median of the weight was 82.0 kg ( range 50 to 130 kg), median of height was 172.0 cm (range 147 to 178 cm), median of body mass index was 28.0 (range 18.5 to 42.9), median of apnea-hypopnea index (AHI) was 37.2 (range 0 to 126.1), median of lowest arterial oxygen saturation (LSAT) was 0.75 (range 0.21 to 0.93), median of ESS was 13.0 (range 0 to 24). OSAHS was diagnosed in 513 patients and simple snorer was diagnosed in 107 patients by PSG. All the patients filled in ESS questionnaire in sleep disorder centre before PSG.

RESULTSThe correlation coefficients of the ESS and AHI, LSAT was -0.314 and -0.312 respectively (P <0. 05). The median of ESS in severe OSAHS group was higher than that in simple snorer, mild and moderate OSAHS groups (P < 0.001), but no difference was found among the simple snorer, mild and moderate OSAHS groups (P < 0.05). The median of ESS in severe hypoxemia group was higher than that in no, mild and moderate hypoxemia groups (P < 0.001), but no difference was found among no, mild and moderate hypoxemia groups (P > 0.05).

CONCLUSIONSThe Epworth sleepiness scale has little value in assessment of OSAHS severity. A new sleepiness scale method which is suitable for Chinese should be made.

Adult ; Aged ; Female ; Humans ; Lethargy ; physiopathology ; Male ; Middle Aged ; Polysomnography ; methods ; Retrospective Studies ; Sleep Apnea Syndromes ; diagnosis ; Sleep Apnea, Obstructive ; diagnosis ; physiopathology ; Sleep Stages ; Surveys and Questionnaires ; Young Adult

OBJECTIVETo determine the clinical value of portable sleep testing by Watch-PAT (PAT) in children with obstructive sleep apnea syndrome (OSAS).

METHODFifty cases of snoring children aged 3-11 years were randomly selected to undergo the polysomnography (PSG) and PAT simultaneously at the same night. The consistency of sleep parameters in OSAS and non - OSAS children were compared with PSG as reference standard, and ROC curve analysis was performed to assess the sensitivity and specificity in the diagnosis of OSAS with PAT portable sleep monitor.

RESULTFourteen cases were diagnosed as OSAS in 6-11 years group by PAT and PSG. But in 3-5 years group, only six children were diagnosed as OSAS, there was significant difference between PAT and PSG (P < 0.05). Among those 6-11 years old children, compared with non-OSAS, PAT study showed that III+IV stage sleep ((30.5 ± 2.4)% vs. (38.2 ± 2.3)%, χ(2)=4.31, P<0.05), REM sleep duration ((8.9 ± 2.5)% vs. (18.3 ± 2.1)%, χ² =4.31, P<0.05), TST ((458 ± 78) min vs. (522 ± 56) min, t=4.85, P<0.05) and sleep efficiency ((83.5 ± 3.1)% vs. (93.5 ± 3.5)%, t=3.75, P<0.05) decreased, I+II stage sleep ((61.5 ± 4.4)% vs. (44.1 ± 3.5)%, χ² =6.07, P<0.05), arousal index ((29.5 ± 8.2)/h vs. (10.6 ± 5.6)/h, t=3.70, P<0.05), AHI ((7.6 ± 5.3)/h vs. (2.1 ± 2.0)/h, t=2.40, P<0.05), RDI((18.2 ± 5.1)/h vs. (6.5 ± 3.9)/h, t=3.85, P<0.05) increased in OSAS children. Furthermore, the total sleep time (TST) ((458 ± 78) min vs. (430 ± 76) min, t=2.90, P<0.05) and sleep efficiency ((83.5 ± 3.1) % vs. (81.9 ± 4.3) %, t=2.45, P<0.05) were higher by PAT than scored by PSG. ROC curve analysis showed the best threshold selection of AHI 5.0, the sensitivity was 0.952, the specificity was 0.858. AHI 7.0, the sensitivity was 0.968, the specificity was 0.985. AHI 10, the sensitivity was 0.985 and the specificity was 0.99, but AHI 1.0, the sensitivity was 0.852 and the specificity was 0.785.

CONCLUSIONPAT can be used at home in school age children due to the high consistency with PSG and the high compliance.

Child ; Child, Preschool ; Humans ; Polysomnography ; methods ; ROC Curve ; Sensitivity and Specificity ; Sleep ; Sleep Apnea, Obstructive ; diagnosis ; Sleep Stages ; Snoring ; physiopathology

OBJECTIVETo analyze polysomnogram characteristics of children with suspected obstructive sleep apnea hypopnea syndrome (OSAHS) and to explore the role of obstructive apnea index (OAI), apnea hypopnea index (AHI) and arousal index for pediatric OSAHS diagnosis.

METHODSSixty one suspected pediatric OSAHS cases had overnight polysomnography for at least 8 h in a quiet, dark room. Sleep studies were interpreted according to diagnostic criteria of Guangzhou Children's Hospital (Obstructive apnea was defined as cessation of nose and mouth airflow, while the respiratory effort continues for any duration. Hypopnea was defined as reduction of oronasal flow > 50% accompanied by a desaturation of 0. 04 or greater) and Urumqi diagnostic criteria (Obstructive apnea was defined as cessation of airflow at the nose and the mouth, while the respiratory effort continues for at least two breaths. Hypopnea was defined as reduction of oronasal flow > 50% accompanied by a desaturation of more than 0.03, or/and by an arousal) respectively. The OAI, AHI and arousal index were recorded and analyzed according to the two different diagnostic criteria respectively.

RESULTS(1) Forty - one children (67.2%) had 206 obstructive apneas. Fifty - four children (88.5%) had 2249 obstructive hypopneas. Apnea - hypopnea events mainly occurred during rapid eye movement sleep. (2) OAI and AHI were analyzed by diagnostic criteria of Guangzhou Children's Hospital and Urumqi diagnostic criteria respectively. OAI < 1 was observed in 68. 9% and 75.4% children respectively and AHI < 5 occurred in 34.4% and 24.6% children respectively. (3) Statistically significant difference found between spontaneous arousal index and respiratory - related arousal index (z = -5.787, P = 0.000).

CONCLUSIONSAs the criteria of pediatric OSAHS, arbitrary OAI number should be determined on the basis of large sample investigation, the significance of spontaneous arousal index still needs further investigation.

Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Polysomnography ; Sleep Apnea, Obstructive ; diagnosis ; physiopathology

OBJECTIVETo explore the clinical features and diagnosis of obstructive sleep apnea syndrome (OSAS) in children.

METHODSSixty children with OSAS were reviewed, every patient was monitored with polysomnography (PSG) for 7 hours at night for 11 parameters, including the longest apnea time (LAT), apnea and hypopnea index (AHI), the lowest oxygen saturation (SaO(2)), and snore index etc., the parameters of the 2 groups were compared. Meanwhile, tonsillectomy and adenoidectomy were performed for 40 cases of OSAS, and the parameters obtained before and after operation were analyzed.

RESULTSAdenotonsillar hypertrophy and the loud snoring during sleep were found in all cases. The mean values of the PSG parameters were as follows: the longest apnea time was 53 (8-178) seconds (s); the total time of apnea was 310.5 (26-5,260) s; the time of apnea was 26 (3-240) s; the longest hypopnea time was 41 (5-94) s; the total times of hypopnea was 170 (5-2,860) s; the time of hypopnea was 10 (1-85); the apnea index was 4.1 (0.5-25.9); the hypopnea index was 1.4 (0-16.1); the apnea and hypopnea index (AHI) was 6.8 (0.5-38.2); the snore index was 81.7 (1.3-414.8); the lowest saturation of oxygen was 0.78 (0.25-0.93). There was not statistically significant difference in the parameters between 2-7 year group and over 7 year group (P > 0.05). The parameters of postoperation group: the mean value of the longest apnea time was 15.5 (0-60) s; the total time of apnea was 56.4 (60-205) s; the time of apnea was 10.33 (0-40); the longest hypopnea time was 13.25 (0-30) s; the total times of hypopnea was 44.6 (0-73); the hypopnea time was 4.32 (0 - 30) s; the apnea index was 0.6 (0-12); the hypopnea index was 0.62 (0-4); the apnea and hypopnea index (AHI) was 1.25 (0.1-12); the snore index was 30.08 (1.8-102); the lowest oxygen saturation was 93.5% (64%-97%). Compared with preoperation groups there was a statistically significant difference (P < 0.01). Clinically effective rate of the surgeries was over 90%.

CONCLUSIONAdenotonsillar hypertrophy seemed to be an important cause of OSAS in children. Snoring, dyspnea, apnea and low ventilation are the major clinical characteristics of OSAS in children. Confirmed diagnosis of the syndrome in children requires PSG recordings.

Child ; Child, Preschool ; Female ; Humans ; Male ; Monitoring, Ambulatory ; Polysomnography ; Sleep Apnea, Obstructive ; diagnosis ; physiopathology ; Time Factors

OBJECTIVE: To investigate the dynamic changes in the upper airway that cause the obstructive sleep apnea-hypopnea syndrome by measuring the variations of upper airway pressures in the palatal segment of oropharynx and in segment of laryngopharynx. METHOD: The two pressure sensors of the manometer: Apnea Graphs were positioned below uvula and upper esophagus. By comparing the difference between the two sites with the reference of outer atmospheric pressure and using two temperature sensors to determine the air flow through the nose and mouth, we got apnea and hypopnea index (AHI) of 21 patients of obstructive sleep apnea-hypopnea syndrome at the supine position and siding position and obtained the information about the site of upper airway collapse and obstruction. RESULT: 1. The AHI was (47.83 +/- 18.05) per hour for supine position, while (35.11 +/- 18.88) per hour for lateral position in the studying group. The difference between these two groups is statistically significant (P < 0.05). 2. The apnea events were mainly caused by the collapse and obstruction of palatal segment of oropharynx which constitute 84.48% of the obstruction. The collapse at the segment of laryngopharynx was responsible for 12.58% of the obstruction. CONCLUSION The upper airway pressure measurements could provide direct informations about the obstructive sleep apnea-hypopnea syndrome. These informations help choosing appropriate operation for apneic patients.
Adult ; Apnea ; physiopathology ; Humans ; Male ; Middle Aged ; Palate ; physiopathology ; Pressure ; Respiratory System ; physiopathology ; Sleep Apnea, Obstructive ; diagnosis ; physiopathology ; therapy ; Uvula ; physiopathology