1.Relationships between hypertensive disorders in pregnancy and obstructive sleep apnea syndrome.
Rui BAI ; Jing Yu WANG ; Chi ZHANG ; Shen Da HONG ; Lin Yan ZHANG ; Jun WEI ; Yan WANG ; Jing Jing YANG ; Xiao Song DONG ; Fang HAN ; Guo Li LIU
Chinese Journal of Obstetrics and Gynecology 2023;58(9):658-663
Objective: To investigate the impact of obstructive sleep apnea syndrome (OSAS) on pregnancy outcomes, especially the relationship between OSAS and hypertensive disorders in pregnancy (HDP). Methods: A total of 228 pregnant women with high risk of OSAS who underwent sleep monitoring during pregnancy in Peking University People's Hospital from January 2021 to April 2022 were collected by reviewing their medical records for retrospective analysis. According to the diagnosis of OSAS, the pregnant women were divided into OSAS group (105 cases) and non-OSAS group (123 cases). The non-parametric Mann-Whitney U test, χ2 test or Fisher's exact test were used to compare the general data and maternal and fetal outcomes between the two groups, and the occurrence of each type of HDP was further compared. Results: (1) Compared with the non-OSAS group, the median pre-pregnancy body mass index (23.6 vs 27.6 kg/m2) and the proportion of snoring [28.9% (33/114) vs 59.2% (61/103)] in the OSAS group were higher, and the differences were both statistically significant (both P<0.001). (2) The incidence of HDP [67.6% (71/105) vs 39.0% (48/123)] and gestational diabetes mellitus [GDM; 40.0% (42/105) vs 26.8% (33/123)] of pregnant women in the OSAS group were higher than those in the non-OSAS group, and the median delivery week was shorter than that in the non-OSAS group (38.4 vs 39.0 weeks). The differences were all statistically significant (all P<0.05). Between-group differences for the delivery way, postpartum hemorrhage, the rate of intensive care unit admission, preterm birth, small for gestational age infants, neonatal asphyxia, the rate of neonatal intensive care unit admission, newborn birth weight and the proportion of umbilical artery blood pH<7.00 were not statistically significant (all P>0.05). (3) Compared with the non-OSAS group, the incidence of chronic hypertension [11.4% (14/123) vs 22.9% (24/105)] and chronic hypertension with superimposed pre-eclampsia [11.4% (14/123) vs 30.5% (32/105)] were higher in the OSAS group, and the differences were both statistically significant (both P<0.01). Conclusion: OSAS is related to HDP (especially chronic hypertension and chronic hypertension with superimposed pre-eclampsia) and GDM, which could provide a practical basis for the screening, diagnosis and treatment of OSAS in pregnant women at high risk.
Infant, Newborn
;
Pregnancy
;
Infant
;
Humans
;
Female
;
Pre-Eclampsia/epidemiology*
;
Hypertension, Pregnancy-Induced/epidemiology*
;
Retrospective Studies
;
Premature Birth
;
Sleep Apnea, Obstructive/epidemiology*
;
Diabetes, Gestational/epidemiology*
2.Research progress on correlation between childhood obesity and obstructive sleep apnea.
Jing LI ; Quyang YANG ; Ying XU ; Fugen HAN ; Jing ZHAO
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(4):318-322
Prevalence of childhood obesity is progressively increasing, reaching worldwide levels of 5.6% in girls and of 7.8% in boys. This also leads to a corresponding increase in the prevalence of obesity-associated morbidities particularly those involving obstructive sleep apnea(OSA). Obesity is an independent risk factor and regulator of OSA in children. There is a bidirectional causal relationship between OSA and obesity in children. The factors involved in the association between OSA and obesity are systemic inflammation, oxidative stress, and gut microbiota etc. However, a causal link between obesity-related inflammatory state and OSA pathogenesis still needs to be properly confirmed. The present review aimed to investigate the links between childhood obesity and OSA.
Male
;
Female
;
Humans
;
Child
;
Pediatric Obesity/epidemiology*
;
Sleep Apnea, Obstructive/epidemiology*
;
Risk Factors
;
Inflammation
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
;
Obesity
;
Pregnancy
;
Pregnancy Complications/epidemiology*
;
Premature Birth
;
Risk Factors
;
Sleep Apnea, Obstructive/therapy*
4.Obstructive sleep apnea and metabolic syndrome: an association study based on a large sample clinical database.
Wen Bin GUO ; Yu Pu LIU ; Hua Jun XU ; Li Li MENG ; Hua Ming ZHU ; Hong Min WU ; Jian GUAN ; Hong Liang YI ; Shan Kai YIN
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2021;56(12):1263-1269
Objective: To investigate the prevalence and associated risk factors of metabolic syndrome (MS) in patients with obstructive sleep apnea (OSA). Methods: From July 2007 to June 2017, a total of 8 155 adult subjects, including 6 484 males and 1 671 females, aged 18-90 (43.13±12.28), body mass index 14.61~59.56 (25.59±3.98) kg/m2,who were admitted to the Department of Otorhinolaryngology head and Neck surgery of The Sixth People's Hospital affiliated to Shanghai Jiao Tong University, were retrospectively analyzed. All patients underwent polysomnography and biochemical tests. Subjects were divided into four groups (non-OSA, mild OSA, moderate OSA, and severe OSA) according to OSA severity. The prevalence of MS was expressed as percentage, and the correlation between OSA and MS and its characteristic pathophysiological indicators was evaluated by logistic regression model after adjusting for factors such as gender, age, BMI, neck circumference, hip circumference, smoking and alcohol consumption, and was expressed by odds ratio (OR). SPSS 25.0 software was used for statistical analysis. Results: The overall prevalence of MS was 43.6%, and that of non-/mild/moderate/severe OSA group was 18.6%, 30.4%, 43.8%, 57.1%.Logistic regression showed that patients with mild/moderate/severe OSA had an increased risk of MS compared with non-OSA patients, with adjusted OR values and confidence intervals of 1.27 (1.05-1.54), 1.84 (1.53-2.22), and 2.08 (1.76-2.46), respectively (P<0.01).In addition, indicators of OSA anoxic burden [oxygen drop index(Toxygen=7.1), minimum blood oxygen(Tminimum=56.3), blood oxygen saturation below 90% cumulative time ratio (TCT90=10.6) ]were closely associated with MS disease(P<0.01), but sleep fragmentation index (arousals index) was not significantly associated with MS disease. Conclusion: The risk of MS gradually increases with the severity of OSA, and the indicators reflecting OSA hypoxia burden are closely related to MS disease.
Adolescent
;
Adult
;
Aged
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Aged, 80 and over
;
China
;
Female
;
Humans
;
Male
;
Metabolic Syndrome/epidemiology*
;
Middle Aged
;
Oxygen Saturation
;
Retrospective Studies
;
Sleep Apnea, Obstructive/epidemiology*
;
Young Adult
5.Clinical study on obstructive sleep apnea following pharyngeal flap surgery.
Ning ZHAO ; Zhen-Guo LIU ; Yao-Xiang XU ; Jin YUE ; Ling-Fa XUE ; Wen-Lin XIAO
West China Journal of Stomatology 2021;39(5):566-569
OBJECTIVES:
This study aims to investigate the incidence and severity of obstructive sleep apnea (OSA) in cleft patients with velopharyngeal insufficiency (VPI) after pharyngeal flap surgery (PFS) and explore the influence of operation age.
METHODS:
A retrospective study was conducted in 82 cleft patients after PFS. The patients were divided into two groups according to their age at the time of surgery. The incidence and severity of OSA were assessed at least 1.2 years (mean 6.0 years) postoperatively by polysomnography (PSG).
RESULTS:
The incidence rates of OSA were 20% in the adult group and 31% in the child group. No significant difference was found between the two groups (
CONCLUSIONS
Some patients still have OSA average of 6.0 years after PFS, and operation ageis unrelated to the incidence and severity of OSA.
Adult
;
Child
;
Humans
;
Pharynx
;
Polysomnography
;
Retrospective Studies
;
Sleep Apnea, Obstructive/epidemiology*
;
Velopharyngeal Insufficiency/etiology*
6.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
;
Diabetes Mellitus, Type 2
;
complications
;
epidemiology
;
physiopathology
;
Female
;
Humans
;
Male
;
Middle Aged
;
Sleep Apnea, Obstructive
;
complications
;
epidemiology
;
physiopathology
;
therapy
;
Young Adult
7.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
;
Adult
;
Age Distribution
;
Aged
;
Aged, 80 and over
;
Anesthesia Recovery Period
;
Berlin
;
Body Mass Index
;
China
;
epidemiology
;
Female
;
Humans
;
Logistic Models
;
Male
;
Middle Aged
;
Postoperative Complications
;
epidemiology
;
Risk Assessment
;
Risk Factors
;
Severity of Illness Index
;
Sex Distribution
;
Sleep Apnea, Obstructive
;
epidemiology
;
Surgical Procedures, Operative
;
adverse effects
;
Surveys and Questionnaires
;
Young Adult
8.Clinical Implications of Snoring.
Journal of Rhinology 2016;23(2):75-80
Snoring is the most common symptom, along with increased daytime sleepiness, in patients with obstructive sleep apnea (OSA). However, doctors often neglect snoring in clinical practice, and snoring is not addressed in the treatment guidelines of OSA. Therefore, study about snoring and its clinical implications in sleep medicine are needed. The natural history of snoring shows that snoring can evolve into OSA, and the most important risk factors for this continuum are obesity and male sex. Snoring can be a social problem causing annoyance and family difficulties. Animal and human studies have shown that snoring involves the four injury mechanisms of upper airway inflammation, peripheral neuropathy, parasympathetic hypofunction, and endothelial injury. Previous studies have reported that systemic diseases such as atherosclerosis, metabolic syndrome, hypertension, and cardiac diseases were comorbid with snoring. However, most of these studies enrolled patients characterized by survey or questionnaire; therefore, data were biased with effects of OSA. Thus, consensus on the definition and detection of snoring is lacking. Additional studies are required to determine the exact clinical implications of snoring.
Animals
;
Atherosclerosis
;
Bias (Epidemiology)
;
Comorbidity
;
Consensus
;
Heart Diseases
;
Humans
;
Hypertension
;
Inflammation
;
Male
;
Natural History
;
Obesity
;
Peripheral Nervous System Diseases
;
Risk Factors
;
Sleep Apnea, Obstructive
;
Snoring*
;
Social Problems

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