1.Analysis the influencing factors and risk warning of the therapeutic efficacy of multi plane low temperature plasma radiofrequency ablation for OSAHS.
Xing LIU ; Kaiwei DONG ; Meng LIU ; Huachao LI ; Bo NING
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(9):871-876
Objective:To analyze the efficacy, influencing factors, and risk warning of multi-plane low-temperature plasma radiofrequency ablation(MLT-RFA) in the treatment of obstructive sleep apnea hypopnea syndrome(OSAHS). Methods:A total of 118 OSAHS patients admitted from October 2022 to June 2024 were selected as the research subjects. They were divided into mild group(n=46), moderate group(n=52), and severe group(n=20) according to the severity of their condition. MLT-RFA treatment was used for all patients. After surgery, the results of polysomnography(PSG) and the changes in the Calier Sleep Apnea Quality of Life Index(SAQLI) were observed before and after treatment. The incidence of complications after treatment was recorded, and the clinical efficacy of the patients was evaluated. At the same time, they were divided into a treatment effective group(n=106) and an ineffective group(n=12) according to their effects. The general clinical data of the two groups were compared, and binary logistics regression analysis was conducted to identify independent factors that affect treatment efficacy and construct a model. ROC curve analysis was used to evaluate the diagnostic efficacy of the model. Results:The treatment effectiveness rate of the mild group was 93.48%, the moderate group was 90.38%, and the severe group was 80.00%. There was no statistically significant difference in the treatment effectiveness rate among the three groups(P>0.05). The AHI of the mild group, moderate group, and severe group increased sequentially, while the LSaO2and SAQLI scores decreased sequentially. After treatment, the AHI of all three groups decreased compared to before treatment, while the LSaO2and SAQLI scores increased compared to before treatment, and the differences were statistically significant(P<0.05). The pre-treatment AHI of the effective group was lower than that of the ineffective group, and the pre-treatment LSaO2and SAQLI were higher than those of the ineffective group, with statistically significant differences(P<0.05). Pre-treatment LSaO2and pre-treatment SAQLI are independent factors affecting the efficacy of MLT-RFA(P<0.05). The AUC of pre-treatment LSaO2, pre-treatment SAQLI, and combined prediction were 0.907, 0.763, and 0.947, respectively, with sensitivities of 0.896, 0.840, and 0.917, and specificities of 0.833, 0.667, and 0.887, respectively. Conclusion:MLT-RFA has a significant effect on the treatment of OSAHS, and the AHI, LSaO2, and SAQLI of patients before treatment can predict the treatment effect, with LSaO2 and SAQLI being independent influencing factors. The combinerd prediction model exhibits high diagnostic efficiency, sensitivity, and specificity.
Radiofrequency Ablation/methods*
;
Plasma Gases
;
Sleep Apnea, Obstructive/surgery*
;
Polysomnography
;
Postoperative Complications/epidemiology*
;
Quality of Life
;
Severity of Illness Index
;
Treatment Outcome
;
Humans
2.Construction of OSA-related hypertension prediction model based on nomogram.
Yewen SHI ; Lina MA ; Simin ZHU ; Yanuo ZHOU ; Zine CAO ; Zitong WANG ; Yuqi YUAN ; Haiqin LIU ; Xiaoyong REN
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2024;38(11):1024-1037
Objective:This study aimed to construct a risk prediction model for obstructive sleep apnea(OSA) related hypertension based on the nomogram, and to explore the independent risk factors for OSA-related hypertension, so as to provide reference for clinical treatment decision-making. Methods:The clinical data of OSA patients diagnosed by polysomnography from October 2019 to December 2021 were collected retrospectively and randomly divided into training sets and validation sets. A total of 1 493 OSA patients with 27 variables were included. The least absolute shrinkage and selection operator(Lasso) logistic regression model was used to select potentially relevant features and establish a nomogram for OSA-related hypertension.The performance and clinical benefits of this nomogram were verified in terms of discrimination, calibration ability and clinical net benefit. Results:Multivariate logistic regression showed that body mass index(BMI), family history of hypertension, lowest oxygen saturation(LSaO2), age and cumulative percentage of total sleep time with oxygen saturation below 90% were independent risk factors for OSA-related hypertension. Lasso logistic regression identified BMI, family history of hypertension, LSaO2 and age as predictive factors for inclusion in the nomogram. The nomogram provided a favorable discrimination, with a C-indexes of 0.835(95% confidence interval[CI ]0.806-0.863) 0.865(95%CI 0.829-0.900) for the training and validation cohort, respectively, and well calibrated. The clinical decision curve analysis displayed that the nomogram was clinically useful. Conclusion:Compared with cumulative percentage of total sleep time with blood oxygen saturation below 90%, LSaO2 may have a greater impact on the incidence of OSA-related hypertension, and the effects of different times and degrees of hypoxia on OSA-related hypertension should be further explored in the future. Apnea hypopnea index involvement is weak in predicting OSA-related hypertension, and the blood oxygen index may be a better predictor variable. Furthermore, we established a risk prediction model for OSA-related hypertension patients using nomogram, and demonstrated that this prediction model was helpful to identify high-risk OSA-related hypertension patients. This model can provide early and individualized diagnosis and treatment plans, protect patients from the serious.
Humans
;
Sleep Apnea, Obstructive/complications*
;
Nomograms
;
Hypertension/epidemiology*
;
Male
;
Female
;
Risk Factors
;
Middle Aged
;
Retrospective Studies
;
Polysomnography
;
Logistic Models
;
Body Mass Index
;
Adult
3.Obstructive Sleep Apnea in Pregnancy.
Acta Academiae Medicinae Sinicae 2022;44(2):299-304
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.
Diabetes, Gestational
;
Female
;
Humans
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Obesity
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Pregnancy
;
Pregnancy Complications/epidemiology*
;
Premature Birth
;
Risk Factors
;
Sleep Apnea, Obstructive/therapy*
4.Epidemiological and pathophysiological evidence supporting links between obstructive sleep apnoea and Type 2 diabetes mellitus.
Chuen Peng LEE ; Clete A KUSHIDA ; John Arputhan ABISHEGANADEN
Singapore medical journal 2019;60(2):54-56
Obstructive sleep apnoea (OSA) and Type 2 diabetes mellitus (T2DM) are common diseases. The global prevalence of OSA is between 2% and 7% in general population cohorts. The worldwide prevalence of T2DM among adults (aged 20-79 years) was estimated to be 6.4%. The concurrent presence of OSA and T2DM can be expected in the same patient, given their high prevalence and similar predisposition. We reviewed the overlapping pathophysiology of OSA and T2DM in this article.
Adult
;
Aged
;
Continuous Positive Airway Pressure
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Diabetes Mellitus, Type 2
;
complications
;
epidemiology
;
physiopathology
;
Female
;
Humans
;
Male
;
Middle Aged
;
Sleep Apnea, Obstructive
;
complications
;
epidemiology
;
physiopathology
;
therapy
;
Young Adult
5.Identification of surgical patients at high risk of OSAS using the Berlin Questionnaire to detect potential high risk of adverse respiratory events in post anesthesia care unit.
Fei LIU ; Li LIU ; Fang ZHENG ; Xiangdong TANG ; Yongxin BAO ; Yunxia ZUO
Frontiers of Medicine 2018;12(2):189-195
Obstructive sleep apnea syndrome (OSAS) increases the risk of post-surgery complications. This study uses Berlin Questionnaire (BQ) to identify Chinese adult surgical patients who are at a high risk of OSAS and to determine if the BQ could be used to detect potential high risk of adverse respiratory events in the post anesthesia care unit (PACU). Results indicated that only 11.4% of the patients were considered at a high risk of OSAS. Age and body mass index are the key factors for the risk of OSAS prevalence in China and also gender specific. Furthermore, the incidence of adverse respiratory events in the PACU was higher in patients with high risk of OSAS than others (6.8% vs. 0.9%, P < 0.001). They also stayed longer than others in the PACU (95 ± 28 min vs. 62 ± 19 min, P < 0.001). Age, high risk for OSAS, and smoking were independent risk factors for the occurrence of adverse respiratory events in the PACU. The BQ may be adopted as a screening tool for anesthesiologists in China to identify patients who are at high risk of OSAS and determine the potential risk of developing postoperative respiratory complications in the PACU.
Adolescent
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Adult
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Age Distribution
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Aged
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Aged, 80 and over
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Anesthesia Recovery Period
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Berlin
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Body Mass Index
;
China
;
epidemiology
;
Female
;
Humans
;
Logistic Models
;
Male
;
Middle Aged
;
Postoperative Complications
;
epidemiology
;
Risk Assessment
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Risk Factors
;
Severity of Illness Index
;
Sex Distribution
;
Sleep Apnea, Obstructive
;
epidemiology
;
Surgical Procedures, Operative
;
adverse effects
;
Surveys and Questionnaires
;
Young Adult
6.Clinical Features of Obstructive Sleep Apnea That Determine Its High Prevalence in Resistant Hypertension.
Hyun Jin MIN ; Yang Je CHO ; Chang Hoon KIM ; Da Hee KIM ; Ha Yan KIM ; Ji In CHOI ; Jeung Gweon LEE ; Sungha PARK ; Hyung Ju CHO
Yonsei Medical Journal 2015;56(5):1258-1265
PURPOSE: Resistant hypertension (HTN) occurs in 15-20% of treated hypertensive patients, and 70-80% of resistant hypertensive patients have obstructive sleep apnea (OSA). The characteristics of resistant HTN that predispose patients to OSA have not been reported. Therefore, we aimed to determine the clinical, laboratory, and polysomnographic features of resistant HTN that are significantly associated with OSA. MATERIALS AND METHODS: Hypertensive patients (n=475) who underwent portable polysomnography were enrolled. The patients were categorized into controlled (n=410) and resistant HTN (n=65) groups. The risk factors for the occurrence of OSA in controlled and resistant hypertensive patients were compared, and independent risk factors that are associated with OSA were analyzed. RESULTS: Out of 475 patients, 359 (75.6%) were diagnosed with OSA. The prevalence of OSA in resistant HTN was 87.7%, which was significantly higher than that in controlled HTN (73.7%). Age, body mass index, neck circumference, waist circumference, and hip circumference were significantly higher in OSA. However, stepwise multivariate analyses revealed that resistant HTN was not an independent risk factor of OSA. CONCLUSION: The higher prevalence and severity of OSA in resistant HTN may be due to the association of risk factors that are common to both conditions.
Adult
;
Aged
;
Body Mass Index
;
Female
;
Humans
;
Hypertension/complications/*epidemiology
;
Male
;
Middle Aged
;
Polysomnography
;
Prevalence
;
Republic of Korea/epidemiology
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Retrospective Studies
;
Risk Factors
;
Sleep Apnea, Obstructive/complications/*epidemiology
;
Waist Circumference
7.Obstructive Sleep Apnea Syndrome is Associated with Metabolic Syndrome among Adolescents and Youth in Beijing: data from Beijing Child and Adolescent Metabolic Syndrome Study.
Xiao-Xue QU ; Issy C ESANGBEDO ; Xiu-Juan ZHANG ; Shu-Jun LIU ; Lian-Xia LI ; Shan GAO ; Ming LI
Chinese Medical Journal 2015;128(17):2278-2283
BACKGROUNDObstructive sleep apnea (OSA) syndrome has a negative impact on the health of millions of adolescents and youth. The aim of this study was to evaluate the associations of OSA syndrome with obesity and cardiometabolic risk factors among adolescents and youth at risk for metabolic syndrome (MS).
METHODSA total of 558 subjects aged 14-28 years were recruited from the Beijing Child and Adolescent Metabolic Syndrome Study. Each underwent a 2-h oral glucose tolerance test (OGTT), echocardiography, and liver ultrasonography. Anthropometric measures, blood levels of glucose, lipids, and liver enzymes were assessed. Subjects with high or low risk for OSA were identified by Berlin Questionnaire (BQ).
RESULTSAmong the subjects in obesity, 33.7% of whom were likely to have OSA by BQ. Subjects with high risk for OSA had higher neck and waist circumference and fat mass percentage compared to those with low risk for OSA (P < 0.001). Moreover, significant differences in levels of lipids, glucose after OGTT, and liver enzymes, as well as echocardiographic parameters were found between the two groups with high or low risk for OSA (P < 0.05). The rates of nonalcoholic fatty liver disease (71.0% vs. 24.2%), MS (38.9% vs. 7.0%), and its components in high-risk group were significantly higher than in low-risk group.
CONCLUSIONSThe prevalence of OSA by BQ was high in obese adolescents and youth. A high risk for OSA indicates a high cardiometabolic risk. Mechanisms mediating the observed associations require further investigation.
Adolescent ; Adult ; Beijing ; Female ; Humans ; Male ; Metabolic Syndrome ; complications ; epidemiology ; Obesity ; complications ; epidemiology ; Risk Factors ; Sleep Apnea, Obstructive ; epidemiology ; etiology ; Waist Circumference ; physiology ; Young Adult
8.High prevalence of obstructive sleep apnea in Marfan's syndrome.
Li MO ; Quanying HE ; Yinna WANG ; Birong DONG ; Jinhan HE
Chinese Medical Journal 2014;127(17):3150-3155
OBJECTIVETo review the current evidence about the prevalence of obstructive sleep apnea in patients with Marfan's syndrome, and discuss some proposed potential mechanisms for this relationship.
DATA SOURCESThe data in this review were mainly from Medline and PubMed articles published in English from 1990 to 2013. The search term was "Marfan's syndrome and sleep apnea".
STUDY SELECTIONClinical evidence about the epidemiology of obstructive sleep apnea in patients with Marfan's syndrome; the mechanism that causes obstructive sleep apnea; interventional therapy for patients with Marfan's syndrome, and coexisting obstructive sleep apnea.
RESULTSA high prevalence of obstructive sleep apnea exists in patients with Marfan's syndrome. The potential reasons are craniofacial abnormalities and lax upper airway muscles, which lead to high nasal airway resistance and upper airway collapse. Obstructive sleep apnea mechanically deteriorates aortic dilatation and accelerates progression of aortic aneurysms. The condition is reversible and rapid maxillary expansion and adequate continuous positive airway pressure therapy are possible effective therapies to delay the expansion of aortic diameter in patients with Marfan's syndrome.
CONCLUSIONSObstructive sleep apnea is strongly associated with Marfan's syndrome. Craniofacial abnormalities and lax upper airway are the main mechanisms. Untreated obstructive sleep apnea accelerates progression of aortic dissection and rupture. Effective therapies for obstructive sleep apnea could postpone the aortic dilatation in patients with Marfan's syndrome.
Humans ; Marfan Syndrome ; epidemiology ; etiology ; Prevalence ; Sleep Apnea, Obstructive ; complications ; epidemiology
9.Associations of Moderate to Severe Asthma with Obstructive Sleep Apnea.
Min Kwang BYUN ; Seon Cheol PARK ; Yoon Soo CHANG ; Young Sam KIM ; Se Kyu KIM ; Hyung Jung KIM ; Joon CHANG ; Chul Min AHN ; Moo Suk PARK
Yonsei Medical Journal 2013;54(4):942-948
PURPOSE: This study aimed to evaluate the correlation between associating factors of moderate to severe asthma with obstructive sleep apnea (OSA). MATERIALS AND METHODS: One hundred and sixty-seven patients who visited the pulmonary and sleep clinic in Severance Hospital presenting with symptoms of sleep-disordered breathing were evaluated. All subjects were screened with ApneaLink. Thirty-two subjects with a high likelihood of having OSA were assessed with full polysomnography (PSG). RESULTS: The mean age was 58.8+/-12.0 years and 58.7% of subjects were male. The mean ApneaLink apnea-hypopnea index (AHI) was 12.7+/-13.0/hr. The mean ApneaLink AHI for the 32 selected high risk patients of OSA was 22.3+/-13.2/hr, which was lower than the sleep laboratory-based PSG AHI of 39.1+/-20.5/hr. When OSA was defined at an ApneaLink AHI > or =5/hr, the positive correlating factors for OSA were age, male gender, and moderate to severe asthma. CONCLUSION: Moderate to severe asthma showed strong correlation with OSA when defined at an ApneaLink AHI > or =5/hr.
Aged
;
Asthma/complications/epidemiology/*etiology
;
Comorbidity
;
Cross-Sectional Studies
;
Female
;
Humans
;
Male
;
Middle Aged
;
Polysomnography/instrumentation
;
Severity of Illness Index
;
Sleep Apnea Syndromes/epidemiology/etiology
;
Sleep Apnea, Obstructive/complications/epidemiology/*physiopathology
10.Prevalence and incidence of hypertension in obstructive sleep apnea patients and the relationship between obstructive sleep apnea and its confounders.
Chinese Medical Journal 2009;122(12):1464-1468
China
;
epidemiology
;
Female
;
Humans
;
Male
;
Prevalence
;
Sleep Apnea, Obstructive
;
complications
;
epidemiology

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