Wyniki wyszukiwania - Biblioteka Nauki

1

Hypoglossal nerve stimulation [HGNS] for Obstructive Sleep Apnea [OSA] treatment – a review

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Bilińska M. , Niemczyk K.

Polski Przegląd Otorynolaryngologiczny

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2017

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tom 6(3)

67-72

EN

Obstructive sleep apnea (OSA) is characterized by recurrent periods of upper airway obstruction (hypopneas and apneas) during sleep. It leads to repeated oxyhemoglobin desaturations, nocturnal hypercapnia, and arousals. Common symptoms include loud snoring with breathing interruptions. Excessive daytime sleepiness and cognitive impairment occur. Obstructive sleep apnea is a major cause of morbidity and mortality in Western society. Its association with an increased risk of development and progression of neurocognitive, metabolic, cardiovascular and oncologic diseases and complications is well described. The significant factor in OSA pathogenesis is reduced muscle tone in the tongue and upper airway. In the recent years, devices providing neurostimulation of the hypoglossal nerve (HGNS) were developed as an alternative for noncompliant CPAP (continuous positive airway pressure) patients. Clinical trials suggest that electrical stimulation of the hypoglossal nerve is effective. This is considered to be one of the targets of neurostimulation in the treatment of obstructive sleep apnea (OSA).

2

Aparaty do terapii obturacyjnego bezdechu sennego

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Bańkowski A. , Rudnicka A. , Zaar C.

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2006

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tom Vol. 12, nr 1

10-10

PL

Leczenie chorych z obturacyjnym bezdechem sennym (OBS) polega na udrożnieniu górnych dróg oddechowych w czasie snu. Można to uzyskać metodami chirurgicznymi lub postępowaniem zachowawczym. Efekty kliniczne leczenia chirurgicznego są często niedostateczne (wynoszą ok. 20%) i dlatego leczeniem z wybru jest postępowanie zachowawcze: odchudzanie, pozycja ciała na boku w czasie snu, unikanie spożywania alkoholu, a przede wszystkim leczenie za pomocą aparatów wytwarzających stałe dodatnie ciśnienie w drogach oddechowych CPAP (Continuous Positive Air Pressure).

3

BMI in patients with obstructive sleep apnea

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Dobrowolska-Zarzycka M. , Dunin-Wilczynska I. , Mitura I. , Szymanska J.

Current Issues in Pharmacy and Medical Sciences

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2015

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tom 28

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nr 4

244-246

EN

Obstructive sleep apnea (OSA) is a disease of multicasual etiology. The risk factors include obesity, among other issues. Hence, it is extremely important to determine the effect of body weight on the severity of OSA. The aim of the study was to evaluate the influence of the body weight expressed as body mass index (BMI), on the value of upper airways diameter and on the AHI (Apnea-Hypopnea Index) value. The study was comprised of 41 patients diagnosed with OSA by way of polysomnography. Each patient was first examine via a lateral cephalometric image of the skull, which served to measure the upper and lower diameter of the upper airways. BMI was also calculated for each patient. Statistical analysis was carried out in accordance with Pearson’s correlation coefficient test. Our work demonstrated a negative correlation between BMI and the diameter of the upper airways, and a positive correlation between BMI and AHI value. We thus put forward that the increase in body weight in patients with OSA can contribute to the severity of the disease, regardless of the fact that it may not lead to a reduction of the lumen of the upper airways.

4

Agreement between Epworth Sleepiness Scale and objective sleep parameters in patients with excessive daytime sleepiness

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Daniłosio M. , Wysocki J. , Prus M.

Polski Przegląd Otorynolaryngologiczny

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2017

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tom 6(3)

10-18

EN

Obstructive sleep apnea (OSA) is a disease with a broad social impact. Excessive daytime sleepiness raises suspicion of OSA and together with polysomnography (PSG) is the basis for diagnosis. The Epworth Sleepiness Scale (ESS) is used for objective assessment of daytime sleepiness. Many authors underline a high predictive value of this scale in selecting patients at risk of OSA. Moreover, there is a high agreement between the ESS and PSG. However, some authors oppose the use of this scale. We wanted to verify this issue based on our own data. We enrolled 120 patients who were referred to the Polysomnographic Laboratory, Department of Otolaryngology, Medical University of Warsaw with a suspicion of obstructive sleep apnea. All patients filled out the Epworth Sleepiness Scale. Overnight PSG was performed with 14-channel recordings (Grassm USA), including EEG, EMG, and recordings of the movements of the chest and abdomen. Airflow through the airways was recorded with a nasal-oral temperature probe. PSG was assessed automatically and manually; sleep stages were coded manually for each 30-second interval by a technician. Severity of OSA was assessed based on AHI. There were 96 patients with confirmed OSA and a control group of 24 patients with exclusion of OSA but with different disorders causing excessive daytime sleepiness. The average ESS scores were not significantly different between the subgroups, between genders, and in patients with different severity of OSA. ESS scores did not correlate significantly with any of the tested PSG parameters. In conclusion, the ESS should be used as an additional and only ancillary tool in assessing patients with suspected OSA.

5

Occurrence of insomnia among patients with diagnosed obstructive sleep apnea

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Daniłosio M. , Wysocki J. , Prus M.

Polski Przegląd Otorynolaryngologiczny

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2018

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tom 7(1)

16-23

EN

Obstructive sleep apnea (OSA) is a common problem. Excessive daytime sleepiness raises a suspicion of OSA, which can be confirmed by polysomnography (PSG). Insomnia, in patients with OSA, often manifests itself as excessive daytime drowsiness. The incidence of insomnia among patients with OSA differs in different studies. Thus, we investigated the incidence of insomnia among our patients. We included 120 patients who underwent a workup due to a suspicion of OSA in the Polysomnography Laboratory, Department of Otolaryngology, Medical University of Warsaw, Poland. Patients completed the Athens Insomnia Scale (AIS). All-night PSG was done with 14-channel recordings (Grass®, USA). The severity of OSA was classified according to the apnea-hypopnea index (AHI) values. There were 96 patients with OSA and 24 patients without OSA who served as controls (their sleep disorders and daytime drowsiness were not caused by OSA). The total AIS scores tended to indicate insomnia in the entire sample and in all different subgroups. The mean AIS score was significantly different between the subgroups differing in the severity of apnea. The mean AIS score correlated significantly with sleep latency, latent sleep, and N2 latency. The mean AIS score did not correlate significantly with the AHI. In conclusion, in patients with OSA, insomnia, measured with the AIS, was associated with the severity of apnea, although this relationship was weak.

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Sleep apnea and dry eye: how sleep apnea affects the eye surface

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Bommert C. M. , Grupcheva C. N. , Radeva M. N. , Grupchev D. I. , Boyadzieva M. R.

OphthaTherapy

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2020

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tom 7

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nr 2

103-107

EN

Purpose: The purpose of this study was to determine the presence of dry eye disease and possible treatment options in patients with obstructive sleep apnea and continuous positive airway pressure. Materials and methods: A total of 72 patients (midlife age) with obstructive sleep apnea and continuous positive airway pressure therapy underwent a comprehensive eye examination. Fluorescein staining of the anterior ocular surface and tear break-up test were performed. All of the patients who were diagnosed with dry eye disease received personalized therapy. One month later, re-examination was performed using the same methodology and clinical settings. Results: On the first examination, 48 of 72 patients (66.67%) were diagnosed with dry eye disease. Floppy eyelid syndrome was reported in 26 patients (54.17%) with dry eye disease. The treatment of 40 patients included artificial tear supplements during the day in combination with high-viscosity topical gels before bedtime. In more severe cases (10.42% of all participants), the application of bandage contact lenses for 3 months was necessary. Because of excessive lid laxity, surgical reconstruction of the eyelids was performed in three patients (6.25%). Conclusions: A multidisciplinary approach is essential for obstructive sleep apnea. Practitioners from different specialties must be well acquainted with risk factors, signs, and symptoms. The early detection of dry eye disease in patients with obstructive sleep apnea and appropriate treatments are important for improving the quality of life in this patient group.

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Obturacyjny bezdech podczas snu u pacjentów zakwalifikowanych do endarterektomii tętnic szyjnych – badanie wstępne

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Migacz E. , Proczka R. , Krzeski A. , Kukwa W.

Otolaryngologia Polska

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2018

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tom 72(4)

17-20

PL

Wstęp: Związek między obturacyjnym bezdechem podczas snu (OBPS) a miażdżycą jest potwierdzony od wielu lat, choć patomechanizm tego zjawiska nadal nie jest poznany. Celem badania było określenie częstości OBPS u pacjentów zakwalifikowanych do endarterektomii oraz określenie wpływu tej procedury na parametry badania snu i występowanie senności dziennej. Materiał i metody: Do badania włączono 46 pacjentów zakwalifikowanych do endarterektomii otwartej. Przed zabiegiem wykonano badanie snu i zastosowano skalę senności Epworth. U 11 z 46 osób przeprowadzono badania snu także po operacji. Wyniki: Średnia wieku w grupie badanej wyniosła 69,9 lat (± SD = 8,6), 21 pacjentów (45,7%) stanowiły kobiety. Średnia wartość pAHI, ODI, pRDI i procent czasu chrapania wyniosły odpowiednio 16.2 (± SD=15.2), 10.4 (± SD=12.2), 18.9 (± SD=14.9) oraz 9,9 (± SD=17). Prawidłowe wartości pAHI uzyskało 14 pacjentów (30%), podczas gdy łagodny OBPS (pAHI 5–15) zaobserwowano u 13 pacjentów (38%), umiarkowany OBPS (pAHI 15–30) u 11 pacjentów (24%), a ciężki OBPS (pAHI >30) u pacjentów 8 (18%). Średnia wartość skali senności Epworth u 27 z 46 pacjentów wyniosła 6,3 (± SD = 5,6). Pooperacyjne wartości parametrów badania snu u 11 pacjentów nie zmieniły się statystycznie znamiennie. Wnioski: Badanie wykazało występowanie OBPS w stopniu umiarkowanym i ciężkim u 42% pacjentów zakwalifikowanych do endarterektomii, natomiast nie stwierdzono nadmiernej senności w tej grupie. Pokazuje to, że u pacjentów kwalifikowanych do endarterektomii tętnic szyjnych należy wykonać diagnostykę snu w celu wykluczenia OBPS.

8

Obturacyjny bezdech podczas snu u pacjentów zakwalifikowanych do endarterektomii tętnic szyjnych – badanie wstępne

88%

Migacz E. , Proczka R. , Krzeski A. , Kukwa W.

Polish Journal of Otolaryngology

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2018

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tom 72

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nr 4

17-20

PL

Wstęp: Związek między obturacyjnym bezdechem podczas snu (OBPS) a miażdżycą jest potwierdzony od wielu lat, choć patomechanizm tego zjawiska nadal nie jest poznany. Celem badania było określenie częstości OBPS u pacjentów zakwalifikowanych do endarterektomii oraz określenie wpływu tej procedury na parametry badania snu i występowanie senności dziennej. Materiał i metody: Do badania włączono 46 pacjentów zakwalifikowanych do endarterektomii otwartej. Przed zabiegiem wykonano badanie snu i zastosowano skalę senności Epworth. U 11 z 46 osób przeprowadzono badania snu także po operacji. Wyniki: Średnia wieku w grupie badanej wyniosła 69,9 lat (± SD = 8,6), 21 pacjentów (45,7%) stanowiły kobiety. Średnia wartość pAHI, ODI, pRDI i procent czasu chrapania wyniosły odpowiednio 16.2 (± SD=15.2), 10.4 (± SD=12.2), 18.9 (± SD=14.9) oraz 9,9 (± SD=17). Prawidłowe wartości pAHI uzyskało 14 pacjentów (30%), podczas gdy łagodny OBPS (pAHI 5–15) zaobserwowano u 13 pacjentów (38%), umiarkowany OBPS (pAHI 15–30) u 11 pacjentów (24%), a ciężki OBPS (pAHI >30) u pacjentów 8 (18%). Średnia wartość skali senności Epworth u 27 z 46 pacjentów wyniosła 6,3 (± SD = 5,6). Pooperacyjne wartości parametrów badania snu u 11 pacjentów nie zmieniły się statystycznie znamiennie. Wnioski: Badanie wykazało występowanie OBPS w stopniu umiarkowanym i ciężkim u 42% pacjentów zakwalifikowanych do endarterektomii, natomiast nie stwierdzono nadmiernej senności w tej grupie. Pokazuje to, że u pacjentów kwalifikowanych do endarterektomii tętnic szyjnych należy wykonać diagnostykę snu w celu wykluczenia OBPS.

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Floppy eyelid syndrome as an ocular condition associated with increased body mass index - classification, diagnostics and treatment

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Szabelska P. , Ofman W. , Białas D. , Różycki R. , Gołębiewska J.

OphthaTherapy

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2022

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tom 9

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nr 4

219-224

EN

Floppy eyelid syndrome is a common ophthalmic condition characterized by a sagging eyelid, which causes its spontaneous wrinkling during sleep. It can be a result of local and systemic diseases. A characteristic group of patients who suffer from floppy eyelid syndrome are middle aged men with an increased body mass index. Obesity in this group of patients is recognized as the strongest risk factor for the occurrence of obstructive sleep apnea syndrome. The aim of the article is to review the diagnostic methods that are used in the case of floppy eyelid syndrome. The paper also discusses therapeutic methods including surgical techniques.

10

Lung volumes, airflow limitations, and the level of arterial oxygen saturation during sleep in obstructive sleep apnea patients

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Brzecka A. , Piesiak P. , Kosacka M. , Jankowska R.

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tom Vol. 26, no. 2

39-51

EN

The aim of the study was to find out whether the level of arterial oxygen saturation (Sa02) during sleep in obstructive sleep apnea (OSA) patients can be predicted on the basis of the static or dynamic lung volumes measurements or respiratory resistance measurements performed during wakefulness in the sitting and supine positions. Nineteen OSA patients were divided into 2 groups depending on the high and low Sa02 during sleep apneas (85:3% vs 78:9%). In the patients with the high Sa02 there was a bigger vital capacity (both in the sitting and supine positions), a lower residual volume/ total lung capacity ratio in the supine position and a smaller decrease of the expiratory reserve volume on adopting the supine posture, a higher mid-expiratory-flow, both in the sitting and supine positions, and a higher peak-expiratory-flow in the supine position as compared with patients with the low Sa02 during sleep apneas. The respiratory resistance and forced-expiratory-volume 1sec/vital capacity ratio were similar in both groups. Conclusion: the measurements of the lung volumes and capacities in the both the sitting and supine position allow predicting the level of the arterial oxygen desaturation during the episodes of sleep apnea in the OSA patients. Small-airways disease (that can be detected in the sitting and especially, in the supine position) leads to a more severe arterial oxygen desaturation during sleep in the OSA patients. The respiratory resistance does not influence the arterial oxygen desaturation in the OSA patients.