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Undiagnosed obstructive sleep apnea in hypertensive outpatients in primary care—Associations with sleep complaints, depressive symptoms and global perceived health

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Open Journal of Nursing 2013年第6期3卷 445-452页

作者： Anders Brostrom Ola Sunnergren Kristofer Arestedt Peter Johansson Per Nilsen Bengt Fridlund Eva Svanborg Department of Nursing Science School of Health SciencesJonkoping UniversityJonkopingSweden Department of Clinical Neurophysiology Linkoping University HospitalLinkopingSweden Department of Clinical and Experimental Medicine Division of Clinical NeurophysiologyFaculty of Health SciencesLinkoping UniversityLinkopingSweden Department of ENT Ryhov HospitalJonkopingSweden School of Health and Caring Sciences Faculty of HealthSocial Work and Behavioural SciencesLinnaeus UniversityKalmarSweden Department of Medicine and Health Sciences Division of Nursing SciencesFaculty of Health SciencesLinkoping UniversityLinkopingSweden Department of Cardiology Linkoping University HospitalLinkopingSweden. Department of Medicine and Health Sciences Division of Cardiovascular MedicineFaculty of Health SciencesLinköping UniversityLinkopingSweden Division of Health Care Analysis Faculty of Health SciencesDepartment of Health and SocietyLinkoping UniversityLinkopingSweden

Objective: 1) To describe the prevalence of undiagnosed obstructive sleep apnea (OSA) and depressive symptoms in hypertensive men and women below 65 years of age, and 2) to describe the association of OSA to subjective sleep complaints, depressive symptoms and global perceived health. Design: Cross-sectional design focusing on nursing care outcomes of obstructive sleep apnea. Setting: Four primary care health centres in Sweden. PATIENTS: 411 consecutive patients (52% women), mean age 57.9 years (SD 5.9 years), with diagnosed hypertension (BP > 140/90). Main Outcome Measures: Prevalence of OSA and depressive symptoms, and association of OSA to sleep complaints, depressive symptoms and global perceived health. RESULTS: Mild, moderate and severe OSA was seen among 29%, 16% and 14% of patients, respectively. Depressive symptoms were seen in 16% of the total group, with a higher prevalence among men, compared to women, 21% vs. 12%. No differences were found regarding blood pressure, estimated sleep need, sleep sufficiency index, insomnia symptoms, daytime sleepiness or depressive symptoms with respect to different degrees of OSA. Apnea-hypopnea index was significantly associated to perceived health after adjustment for gender and comorbidities, but when depressive symptoms and non-restorative sleep were added to the model, 33% of the variance in global perceived health was explained. Conclusion: OSA is highly prevalent among patients with hypertension in primary care and does together with sleep complaints and depressive symptoms have a negative impact on global perceived health. Hypertensive patients without subjective sleep complaints or depressive symptoms may still have OSA.

关键词： Depression Global Perceived Health Hypertension Nursing Care Obstructive sleep Apnea sleep disordered breathing sleep

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Polysomnographic findings of obstructive sleep apnea in children with adenotonsillar hypertrophy

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Health 2013年第8期5卷 44-48页

作者： Erico Campos Moreira Silva Vinicius SMoraes Helena Protetti Silke TWeber Ophtalmology Otorhinolaryngology and Head&Neck Surgery DepartmentBotucatu School of MedicineSao Paulo State UniversityBotucatuBrazil Neurology Neuro ClinicsBotucatuBrazil

Serous Background: There are few studies assessing the clinical manifestations of sleep breathing disorders and polysomnograms in several pediatric age ranges. This studied aimed to assess polysomnography results such as apnea-hypopnea index, mean oxygen saturation and sleep efficiency in children presenting with airway obstruction and adenotonsillar hypertrophy complaints, and to establish whether they are correlated to age and sex. Methods: A retrospective study with children of both sexes, aged between 2 and 12 years, with clinically suspected obstructive sleep apnea syndrome and adenotonsillar hypertrophy, who underwent polysomnography before surgery. The children were allocated to groups according to their age range (Group I: 2 to 4 years old;Group II: 5 to 8 years old;Group III: 9 to 12 years old). Apnea-hypopnea index, mean oxygen saturation and sleep efficiency data were compared between sexes and among the three groups (Student’s t test, p sleep efficiency). As regards mean oxygen saturation, Group I showed the lowest value (89.9 ± 6.2). Apnea-hypopnea indexes were higher in male children aged between 2 and 4 years (9.9 ± 5.2). Group III had the lowest sleep efficiency (84.1 ± 9.2). Conclusion: There was a predilection of more severe cases of obstructive sleep apnea syndrome for children younger than four years, shown by higher apnea-hypopnea index per hour and lower mean oxygen saturation in this age range.

关键词： Polysomnogram sleep Architecture Children Obstructive sleep Apnea sleep disordered breathing

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Obstructive sleep apnea hypopnea syndrome and alveolar hypoventilation syndrome in motor neuron disease:a case report and literature review

Obstructive sleep apnea hypopnea syndrome and alveolar hypov...

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2017全国睡眠呼吸障碍学术大会暨睡眠呼吸疾患新进展学...

作者：周莉欧阳若芸陈平罗红刘贵钱中南大学湘雅二医院呼吸内科

Objective:To analyze the clinical characteristics of a patient with motor neuron disease which caused obstructive sleep apnea hypopnea syndrome（OSAHS）and alveolar hypoventilation syndrome,and raise the understanding and diagnosis rate of this ***:Retrospectively analyze the diagnosis and treatment process of a 52 year-old male patient who was accepted by The Second Xiangya Hospital,Central South University because of dyspnea,shortness of breath and malaise for 4 months,and eventually was diagnosed as motor neuron disease associated with OSAHS and alveolar hypoventilation syndrome,which is an intractable and significant ***,we searched HowNet,WanFang and PubMed databases to review related ***:The major clinical manifestation of motor neuron disease is impaired upper and lower motor neuron which appeared as proximal muscle weakness,muscle tremor,amyotrophy,bulbar symptoms and pyramidal *** it is a chronic,progressive disease with worse prognosis,low survival and more intractable to diagnose most of time in which electroneuromyography is an vital examination for ***’s more,sleep disordered breathing is common in patients with motor neuron disease which is featured as decreased rapid eye movement sleep,increased awaking time and frequency,apnea and *** main mechanism of sleep disordered breathing in motor neuron disease is disturbed central nervous system and paralysis of diaphragm and respiratory ***,the patient is susceptible to suffer with restrictive ventilatory dysfunction and alveolar hypoventilation and subsequent partial pressure of carbon dioxide and ***,respiratory failure is the most frequent cause of death in patients of motor neuron ***-invasive positive pressure ventilation is suggested to apply in such patients who forced vital capability is less than 75 percent of predicted ***:sleep disordered breathing is common in patients with motor neuron dise

关键词： motor neuron disease sleep disordered breathing alveolar hypoventilation syndrome diagnosis and treatment clinical feature

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Relationship between metabolic syndrome and hypercapnia among obese patients with sleep apnea Relationship between metabolic syndrome and hypercapnia among obese patients with sleep apnea

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World Journal of Respirology 2020年第1期10卷 1-10页

作者： Yuka Kimura Takatoshi Kasai Yasuhiro Tomita Satoshi Kasagi Hisashi Takaya Mitsue Kato Fusae Kawana Koji Narui sleep Center Clinical PhysiologyToranomon HospitalTokyo 105-8470Japan Department of Cardiovascular Medicine Cardiovascular Respiratory Sleep MedicineJuntendo University Graduate School of Medicine sleep and sleep disordered breathing Center Juntendo University HospitalTokyo 113-8421Japan Department of Cardiovascular Medicine Juntendo University Graduate School of MedicineTokyo 113-8421Japan sleep Center Toranomon HospitalTokyo 105-8470Japan sleep Center and Department of Respiratory MedicineRespiratory CenterToranomon HospitalTokyo 105-8470Japan Cardiovascular Respiratory sleep Medicine Juntendo University Graduate School of MedicineTokyo 113-8421Japan

BACKGROUND In the obese patient population,some patients have severe obstructive sleep apnea(OSA)with daytime *** patients are generally identified on the basis of the presence or absence of daytime hypercapnia,and the condition is called obesity hypoventilation ***,mechanisms for such daytime hypoventilation remain *** To investigate metabolic syndrome and daytime hypercapnia association based on hypercapnia prevalence in obese OSA patients in a nested case-control *** Consecutive obese patients(body mass index≥30 kg/m2)who underwent polysomnography due to suspected OSA were *** them,patients with severe OSA(apnea hypopnea index≥30/h)were divided into two groups according to the presence or absence of hypercapnia during wakefulness(arterial partial pressure of carbon dioxide≥orsleepiness Scale scores between the two ***,patients with hypercapnia had a significantly lower arterial partial pressure of oxygen level(75.8±8.2 torr vs 79.9±8.7 torr,P=0.042)and higher arterial partial pressure of carbon dioxide level(46.6±2.5 torr vs 41.0±2.9 torr,P<0.001).Additionally,patients with hypercapnia were more likely to have metabolic syndrome(72.0%vs 48.6%,P=0.043)and a higher metabolic score(the number of satisfied criteria of metabolic syndrome).In multivariate logistic regression analysis,the presence of metabolic syndrome was associated with the presence of hypercapnia(OR=2.85,95%CI:1.04-7.84,P=0.042).CONCLUSION Among obese patients with severe OSA,26%of patients had hypercapnia during *** presence of metabolic syndrome was independently correlated with the presence of daytime hypercapnia.

关键词： Arterial partial pressure of carbon dioxide Hypercapnia Metabolic syndrome Obesity hypoventilation syndrome Obstructive sleep apnea sleep disordered breathing

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