Causal role of immune cells in obstructive sleep apnea hypopnea syndrome:Mendelian randomization study

BACKGROUND Despite being one of the most prevalent sleep disorders,obstructive sleep apnea hypoventilation syndrome(OSAHS)has limited information on its immunologic foundation.The immunological underpinnings of certain major psychiatric diseases have been uncovered in recent years thanks to the extensive use of genome-wide association studies(GWAS)and genotyping techniques using highdensity genetic markers(e.g.,SNP or CNVs).But this tactic hasn't yet been applied to OSAHS.Using a Mendelian randomization analysis,we analyzed the causal link between immune cells and the illness in order to comprehend the immunological bases of OSAHS.AIM To investigate the immune cells'association with OSAHS via genetic methods,guiding future clinical research.METHODS A comprehensive two-sample mendelian randomization study was conducted to investigate the causal relationship between immune cell characteristics and OSAHS.Summary statistics for each immune cell feature were obtained from the GWAS catalog.Information on 731 immune cell properties,such as morphologic parameters,median fluorescence intensity,absolute cellular,and relative cellular,was compiled using publicly available genetic databases.The results'robustness,heterogeneity,and horizontal pleiotropy were confirmed using extensive sensitivity examination.RESULTS Following false discovery rate(FDR)correction,no statistically significant effect of OSAHS on immunophenotypes was observed.However,two lymphocyte subsets were found to have a significant association with the risk of OSAHS:Basophil%CD33dim HLA DR-CD66b-(OR=1.03,95%CI=1.01-1.03,P<0.001);CD38 on IgD+CD24-B cell(OR=1.04,95%CI=1.02-1.04,P=0.019).CONCLUSION This study shows a strong link between immune cells and OSAHS through a gene approach,thus offering direction for potential future medical research.

Investigation on Risk Factors of Cerebrocardiac Vascular Thrombotic Diseases in Patients with Obstructive Sleep Apnea Hypopnea Syndrome

Objective: To observe the risk factors of thrombosis in patients with obstructive sleep apnea hypopnea syndrome (OSAHS).Methods: From February 2001 to April 2003, 24 patients with moderate and severe OSAHS (OSAHS group) and 19 healthy adults (control group) were recruited. Their blood samples were drawn at 6∶00 and 16∶00 respectively for testing hemocrit, platelet aggregation (PAG), whole blood viscosity (WBV), prothrombin time (PT), activated partial thromboplastin time (APTT), plasma fibrinogen (Fng) and endothelin (ET).Results: There was a significantly higher hemocrit, WBV, Fng and ET as well as a significant shortening of PT and APTT at 6∶00 than that at 16∶00 in OSAHS group. However, there was no significant difference in all testing items between 6∶00 and 16∶00 in control group. The hemocrit, WBV, PAG, plasma Fng and ET were significantly higher, and PT and APTT were obviously shorter at 6∶00 in OSAHS group than those at 6∶00 in control group. A higher hemocrit, PAG, plasma Fng and ET, a longer PT and APTT were observed at 16∶00 in OSAHS group, compared with those at 16∶00 in control group.Conclusion: In OSAHS patients there were striking risk factors of thrombosis, which is more remarkable in the early morning than in the afternoon.

Detection of cognitive impairment in patients with obstructive sleep apnea hypopnea syndrome using mismatch negativity

In this experiment, 97 patients with obstructive sleep apnea hypopnea syndrome were divided into three groups （mild, moderate, severe） according to minimum oxygen saturation, and 35 healthy subjects were examined as controls. Cognitive function was determined using the mismatch negativity paradigm and the Montreal Cognitive Assessment. The results revealed that as the disease worsened, the mismatch negativity latency was gradually extended, and the amplitude gradually declined in patients with obstructive sleep apnea hypopnea syndrome. Importantly, mismatch negativity latency in severe patients with a persistent time of minimum oxygen saturation 〈 60 seconds was significantly shorter than that with a persistent time of minimum oxygen saturation 〉 60 seconds. Correlation analysis revealed a negative correlation between minimum oxygen saturation latency and Montreal Cognitive Assessment scores. These findings indicate that intermittent night-time hypoxemia affects mismatch negativity waveforms and Montrea Cognitive Assessment scores. As indicators for detecting the cognitive functional status of obstructive sleep apnea hypopnea syndrome patients, the sensitivity of mismatch negativity is 82.93%, the specificity is 73.33%, the accuracy rate is 81.52%, the positive predictive value is 85.00%, the negative predictive value is 70.21%, the positive likelihood ratio is 3, and the negative likelihood ratio is 0.23. These results indicate that mismatch negativity can be used as an effective tool for diagnosis of cognitive dysfunction in obstructive sleep apnea hypopnea syndrome patients.

Clinical observation of soft palate-pharyngoplasty in the treatment of obstructive sleep apnea hypopnea syndrome in children

BACKGROUND Childhood obstructive sleep apnea hypopnea syndrome(OSAHS)is a common clinical disease that can cause serious complications if not treated in time.The preferred treatment for OSAHS in children is surgery.AIM To observe the effects of soft palate-pharyngoplasty on postoperative outcome,pharyngeal formation,and possible complications.METHODS A total of 150 children with snoring,hernia,and mouth breathing were selected.A polysomnography test was performed to confirm the diagnosis of OSAHS.The children were randomly divided into experimental and control groups.The experimental group underwent adenoidectomy,tonsillectomy,and soft palatepharyngoplasty.The control group underwent adenoidectomy and tonsillectomy.The t-test and chi-square test were used to compare conditions such as postoperative fever,postoperative hemorrhage,and pharyngeal reflux.Postoperative efficacy and complications were interrogated and observed in the form of outpatient follow-up and telephone follow-up at 6 mo and 1 year after surgery.The curative effects were divided into two groups:Cure(snoring,snoring symptoms disappeared)and non-cure.RESULTS The effective rate of the experimental group was significantly higher than that of the control group,but the difference was not statistically significant(P>0.05).The incidence of postoperative bleeding was lower in the experimental group.There was no postoperative pharyngeal reflux in either group.In the experimental group,the incidence of hyperthermia(body temperature exceeded 38.5°C)was lower than that in the control group.The difference in postoperative swallowing pain scores between the experimental and control groups was significant.CONCLUSION Soft palate-pharyngoplasty can more effectively enlarge the anteroposterior diameter and transverse diameter of the isthmus faucium.Compared with surgery alone,it can better treat OSAHS in children,improve the curative effect,reduce the risk of perioperative bleeding,close the surgical cavity,reduce the risk of postoperative infection,reduce the proportion of postoperative fever,and accelerate healing.Although this process takes more time,it is simple,safe,and effective.

Correlation of obstructive sleep apnea hypopnea syndrome with metabolic syndrome in snorers

Though obstructive sleep apnea hypopnea syndrome（OSAHS） and metabolic syndrome（MS） are correlated;the contributing factors for the occurrence of MS in Chinese snorers remain largely undefined.We aimed to investigate the associated pathogenesis of coexistence of OSAHS and MS in Chinese snorers.A total of 144 Chinese habitual snorers were divided into 3 groups,the control group（simple snorers）（n = 36）,the mild OSAHS group（n= 52）and the moderate-to-severe OSAHS group（n = 56）.The incidence of MS in the moderate-to-severe OSAHS group（26.8%） was significantly higher than that in the control group（8.3%）,the mild OSAHS group（11.1%） and all the OSAHS patients（19.45%）（all P 〈 0.05）.Homeostatic model assessment（HOMA） index and proinsulin（PI） were negatively correlated with nocturnal meanSpO2 and miniSpO2.Meanwhile,nocturnal SpO2 were negatively correlated with body mass index,waist and neck circumferences and diastolic blood pressure,but positively correlated with total cholesterol and high-density lipoprotein cholesterol.The study indicated that in Chinese snorers,moderate-to-severe OSAHS was closely associated with MS via nocturnal hypoxemia.

Relationship between obstructive sleep apnea hypopnea syndrome and cardiovascular disorders in adult snorers

Objective：To investigate the relationship between sleep apnea hypopnea syndrome（OSAHS） and some cardiovascular disorders in adult habitual snorers as well as the effectiveness of nasal continuous positive airway pressure（NCPAP） on those with OSAHS. Methods： With the use of polysomnography, 262 adult habitual snorers were examined and divided into the OSAHS group and the Non-OSAHS group （control）. Using ambulatory electrocardiogram and blood pressure measurement, daily nocturnal rhythm of blood pressure, hypertension, heart rate variability, some arrythmias and angina pectoris of coronary heart disease were monitored and compared between the two groups, before and after 14 days of treatment with NCPAP in the OSAHS group. Results.This study indicated a higher incidence （39.6%） of OSAHS in adult snorers and demonstrated that there was a significantly higher incidence of hypertension, disappearance of the daily nocturnal rhythm of blood pressure, poor effectiveness of nitrate on angina pectoris of coronary heart disease, decreased heart rate variability during sleep, increased arrythmias and lower SpO2 levels in the OSAHS group than in the Non-OSAHS group. After NCPAP treatment during sleep, snoring control, significantly higher SpO2 and lower apnea hypopnea indices were achieved in the OSAHS group; heart rate variability and daily nocturnal rhythm of blood pressure returned to normal levels. Conclusion：The results of this research suggested that there was a close relationship between the development of OSAHS and some cardiovascular disorders. Furthermore, NCPAP treatment was effective not only on OSAHS but also on coexisting cardiovascular disorders.

Clinical analysis of obstructive sleep apnea hypopnea syndrome in children

A case of obstructive sleep apnea hypopnea syndrome(OSAHS)in the Department of Otolaryngology of the Third Affiliated Hospital of Inner Mongolia Medical School was collected.The incidence of this disease is high,which seriously threatens the physical and mental health of children,but it has not been paid enough attention by medical workers and parents.We hope we can make early discovery and treatment,relieve upper airway obstruction factors,prevent and treat complications for children with OSAHS through the case analysis,so as to improve their quality of life.

Serum Level of Vascular Endothelial Growth Factor in Patients with Obstructive Sleep Apnea Hypopnea Syndrome

To explore the relationship between the serum vascular endothelial growth factor （VEGF） level and the severity of obstructive sleep apnea hypopnea syndrome （OSAHS）, the concentrations of serum VEGF in 40 OSAHS patients and 9 healthy controls were measured by using ELISA method. Meanwhile the correlation between the concentration of VEGF and parameters of polysomnography （PSG） was examined. Our results showed that the concentrations of VEGF were significantly higher in OSAHS patients with severe hypoxia （536.8±334.7 pg/mL） than in those with mild hypoxia （329.2±174.7 pg/mL） and healthy controls （272. 8±211.0 pg/mL） （P〈0.05 for both）. The concentrations of VEGF were also significantly higher in OSAHS patients with hypertension （484.5±261.4 pg/mL） than in those without hypertension （311.0±158.4 pg/mL） and healthy controls （272. 8±211.0 pg/mL） （P〈0.05 for both）. There was a positive correlation between the concentration of VEGF and the apnea hypopnea index （AHI） （r=0.34, P〈0.05）. It is concluded that the concentration of the serum VEGF is positively related to the severity of OSAHS. The elevated serum VEGF level may be involved in the pathogenesis of the complications of obstructive sleep apnea hypopnea syndrome.

Numerical analysis for the effcacy of nasal surgery in obstructive sleep apnea hypopnea syndrome

In the present study, we reconstructed upper airway and soft palate models of 3 obstructive sleep apnea-hypopnea syndrome（OSAHS） patients with nasal obstruction. The airflow distribution and movement of the soft palate before and after surgery were described by a numerical simulation method. The curative effect of nasal surgery was evaluated for the three patients with OSAHS. The degree of nasal obstruction in the 3 patients was improved after surgery. For 2 patients with mild OSAHS, the upper airway resistance and soft palate displacement were reduced after surgery. These changes contributed to the mitigation of respiratory airflow limitation. For the patient with severe OSAHS, the upper airway resistance and soft palate displacement increased after surgery, which aggravated the airway obstruction. The effcacy of nasal surgery for patients with OSAHS is determined by the degree of improvement in nasal obstruction and whether the effects on the pharynx are beneficial. Numerical simulation results are consistent with the polysomnogram（PSG） test results, chief complaints, and clinical findings, and can indirectly reflect the degree of nasal patency and improvement of snoring symptoms, and further,provide a theoretical basis to solve relevant clinical problems.

The Clinical effect of the Acupuncture treatment on the Patients with Obstructive sleep apnea hypopnea syndrome combined with Hypertension

Objective:To research the effect of conventional treatment(Gingko biloba extract(GBE)+continuous positive airway pressure(CPAP)ventilation)combined with acupuncture on the changes of blood pressure,respiratory efficiency,oxidative index,and clinical effect in patients with OSAHS combined with hypertension.Method Selecting 80 patients with OSAHS combined with hypertension,then they were randomly divided into observation group(n=40)and control group(n=40).The patients in the control group were given conventional drug therapy(GBE)and rehabilitation and CPAP,and the observation group were given acupuncture on this basic,they were treated 14 days.The primary endpoints were the changes from baseline to day 14 in blood pressure;the secondary endpoints were changes from baseline to day 14 in the respiratory efficiency(PSG);the tertiary endpoints were changes from baseline to day 14 in the oxidative related substances(SOD,GSH-Px,ROS,and MDA).Results After 14-day treatment,the respiratory efficiency index were better than pretherapy(p<0.05),and the observation group were better than control group(p<0.05);the blood pressure were lower than pretherapy(p<0.05),and the observation group were lower than control group(p<0.05);the ROS and MDA were lower than pretherapy(p<0.05),and the observation group were lower than control group(p<0.05);the SOD,GSH-Px were higher than pretherapy(p<0.05),and the observation group were higher than control group(p<0.05);the clinical effect of hypotensive in the observation group were better control group(p<0.05).Conclusion 14-day treatment of conventional treatment combined with acupuncture can improve the imbalance of oxidation and antioxidation and blood pressure.

Association of adiponectin genotype polymorphisms at positions 45 and 276 with obstructive sleep apnea hypopnea syndrome

Objective： To investigate the relationship between adiponectin genotype polymorphisms and obstructive sleep apnea hypopnea syndrome （OSAHS）. Methods： Using the TaqMan polymerase chain reaction（PCR） method, the single nucleotide polymorphisms（SNP） at positions 45 and 276 in the adiponectin gene were determined in Chinese of the Han nationality in the Nanjing district. The OSAHS group consisted of 78 patients, and the control group contained 40 subjects. The association of adiponectin genotype polymorphisms at positions 45 and 276 with obstructive sleep apnea hypopnea syndrome was analyzed. Results： No evidence of a direct association was found between OSAHS and adiponectin genotype SNP at positions 45 and 276（P〉 0.05）. However, compared with those OSAHS patients having G/T＋T/T genotype at position 276, the OSAHS patients with the G/G genotype showed a greater neck circumference（NC）, a prolonged duration of the longest apnea event, and elevated levels of blood cholesterol and low-density lipoprotein cholesterol（P 〈 0.05）. Conclusion： No direct association was detected between OSAHS and adiponectin genotype distribution at positions 45 and 276 in Chinese of Han nationality in the Nanjing district. However, OSAHS patients with the adiponectin G/G genotype at position 276 had a larger NC and the longest apnea event compared to those having the adiponectin SNP276 G/T ＋T/T genotype. This may have an indirect influence on the development of OSAHS,

Obstructive sleep apnea-hypopnea syndrome immunological relationship

Obstructive sleep apnea-hypopnea syndrome(OSAHS)is a complex disorder cha-racterized by symptoms resulting from intermittent hypoxia and hypopnea,with research indicating a crucial role of immune system dysregulation and genetic variations in its pathogenesis.A recent Zhao et al study utilizes Mendelian ran-domization analysis to explore the causal relationship between immune cell characteristics and OSAHS.The study identifies specific lymphocyte subsets as-sociated with OSAHS,providing valuable insights into the disease's pathophy-siology and potential targets for therapeutic intervention.The findings underscore the significance of genetic and immunological factors in sleep disorders,offering a fresh perspective on OSAHS's complexities.Compared to existing literature,Zhao et al's study stands out for its focus on genetic markers and specific immune responses associated with OSAHS,expanding upon previous research primarily centered on systemic inflammation.In conclusion,the study represents a signi-ficant advancement in the field,shedding light on the causal role of immune cells in OSAHS and paving the way for future research and targeted treatments.

Risk factors and management countermeasures for obstructive sleep apnea hypoventilation syndrome in children

BACKGROUND Obstructive sleep apnea hypoventilation syndrome(OSAHS)in children is a sleep respiratory disorder characterized by a series of pathophysiologic changes.Statistics in recent years have demonstrated an increasing yearly incidence.AIM To investigate the risk factors for OSAHS in children and propose appropriate management measures.METHODS This study had a case–control study design.Altogether,85 children with OSAHS comprised the case group,and healthy children of the same age and sex were matched at 1:1 as the control group.Basic information,including age,sex,height,weight and family history,and medical history data of all study participants were collected.Polysomnography was used to detect at least 8 h of nocturnal sleep.All participants were clinically examined for the presence of adenoids,enlarged tonsils,sinusitis,and rhinitis.RESULTS The analysis of variance revealed that the case group had a higher proportion of factors such as adenoid grading,tonsil indexing,sinusitis,and rhinitis than the control group.CONCLUSION A regression model was established,and glandular pattern grading,tonsil indexing,sinusitis,and pharyngitis were identified as independent risk factors affecting OSAHS development.

Forced Inspiratory Flow Volume Curve in Patients with Obstructive Sleep Apnea-Hypopnea Syndrome

Objective: Obstructive sleep apnea-hypopnea syndrome (OSA) is a disease of obstructive apnea or hypopnea caused by a repeated partial or complete collapse of the upper airway during sleep. The inspiratory part of the flow-volume curve (F-V curve) can be used as an auxiliary means to evaluate upper airway obstruction in adults. This study is to evaluate the ability of the F-V curve to predict the OSA and explore inspiratory indicators related to airway obstruction during sleep. Methods: There were 332 patients included in this cross-sectional study, who were accompanied by snoring, daytime sleepiness and other symptoms, with suspicion of OSA. According to the nocturnal polysomnography, the subjects were distributed into mild to moderate OSA group, severe OSA group and non-OSA group. A pulmonary function test was used to collect the subjects’ spirometry and F-V curves. Results: There was no significant difference in a variety of indices derived from the F-V curve between OSA and normal subjects, including 25% inspiratory flow rate, middle inspiratory flow rate, 75% inspiratory flow rate, peak flow rate, and forced inspiratory flow rate in the first second. The pulmonary function parameters were significantly correlated with the weight, age and sex of the subjects. Conclusion: These findings suggest that the inspiratory curve of pulmonary function cannot evaluate the upper airway abnormalities in patients with obstructive apnea-hypopnea syndrome.

Burdened breaths:The influence of depression on obstructive sleep apnea

Depression and metabolic syndrome could exacerbate the risks of the other,leading to a series of severe coexisting conditions.One notable comorbidity that must be mentioned is obstructive sleep apnea(OSA).Current studies suggested that depression increases susceptibility to OSA.As the prevalence of depression rises,it becomes critical to prevent and manage its complications or comorbidities,including OSA.Predictive models,non-invasive electroencephalogram moni-toring,genetic research,and other promising technologies are being applied to the prevention,diagnosis,and personalized treatment of depression and OSA.

Obstructive Sleep Apnea Hypopnea Syndrome as a Reason for Active Management of Pulmonary Embolism

Background：Obstructive sleep apnea hypopnea syndrome （OSAHS） constitutes an independent factor for high warfarin dose for patients with pulmonary embolism （PE）.The aim of this study was to investigate whether the 6-month anticoagulation treatment by warfarin is enough for patients with PE complicated by OSAHS.Methods：We investigated 97 PE patients,32 of them had OSAHS and 65 non-OSAHS.Warfarin was administered for 6-month if no abnormal circumstances occurred.All patients were followed up for 18 months.Adverse events （AE） included death,major bleeding,hospitalization due to heart failure or pulmonary hypertension,and recurrence or aggravation of PE （including deep vein thrombosis）.Recurrence rate of PE after warfarin cessation was compared between the two groups.Results：OSAHS patients required a significantly higher dose of warfarin than their non-OSAHS counterparts （4.73 mg vs.3.61 mg,P 〈 0.001）.During warfarin treatment,no major bleeding and aggravation of PE occurred among OSAHS patients,and the rates of various AE were not significantly different between the OSAHS and non-OSAHS groups.PE recurrence was higher in OSAHS than non-OSAHS groups after withdrawal of warfarin （21.43% vs.6.78%,P =0.047）.Compared with non-OSAHS patients,OSAHS group had lower international normalized ratio （INR） value but higher plasminogen on baseline and INR resumed to a relatively low level after warfarin discontinuation.Conclusions：OSAHS patients may present with hypercoagulation and relatively high-risk of recurrence of PE after cessation of 6-month warfarin treatment.

Correlation of Epworth Sleepiness Scale with multiple sleep latency test and its diagnostic accuracy in assessing excessive daytime sleepiness in patients with obstructive sleep apnea hypopnea syndrome

Background Excessive daytime sleepiness （EDS） is often associated with obstructive sleep apnea hypopnea syndrome （OSAHS） and contributes to a number of comorbidities in these patients. Therefore, early detection of EDS is critical in disease management. We examined the association between Epworth Sleepiness Scale （ESS） and multiple sleep latency test （MSLT） and diagnostic accuracy of ESS in assessing EDS in OSAHS patients. Methods The ESS, MSLT and overnight polysomnography were administered to 107 Chinese patients to assess EDS and its correlations with polysomnographic parameters. The diagnostic accuracy of ESS in classifying EDS （mean sleep latency （MSL） 〈10 minutes） was evaluated by calculating the area under ROC curve. Results As the severity of OSAHS increased, MSL decreased with increase in ESS score. Conversely, patients with worsening EDS （shorter MSL） were characterized by advanced nocturnal hypoxaemia and sleep disruption compared to those with normal MSL, suggesting EDS is associated with more severe OSAHS. There was a negative correlation between ESS score and MSL and both moderately correlated with some polysomnographic nocturnal hypoxaemic parameters. The area under ROC curve of ESS for identifying EDS was 0.80 （95% CI： 0.71 to 0.88） and ESS score 〉12 provided the best predictive value with a sensitivity of 80% and specificity of 69%. Conclusion The ESS score moderately correlates with MSL and our ROC study supports ESS as a screening strategy for assessing EDS in OSAHS.

STOP-Bang questionnaire is superior to Epworth sleepiness scales,Berlin questionnaire, and STOP questionnaire in screening obstructive sleep apnea hypopnea syndrome patients

Background Obstructive sleep apnea hypopnea syndrome （OSAHS） is underdiagnosed.Screening patients at high risk of OSAHS is extremely important.Using the standard questionnaire to screen OSAHS is a practical method.This study aimed to evaluate the value of the STOP-Bang questionnaire （SBQ） in screening OSAHS in sleep-disordered breathing clinic by comparing it with the Epworth sleepiness scales （ESS）,Berlin questionnaire,and STOP questionnaire.Methods In this study,212 patients at the sleep-disordered breathing clinic of the Peking Union Medical College Hospital between May 2011 and January 2012 were prospectively included.They were asked to fill in the SBQ,ESS,Berlin questionnaire,and STOP questionnaire before overnight polysomnography （PSG）.Using PSG as gold standard,the sensitivities and specificities of SBQ were compared with those of ESS,Berlin questionnaire,and STOP questionnaire.Results There was no significance in applying ESS score ≥11 to screen OSAHS and detect moderate and severe OSAHS （P ＞0.05）.SBQ was superior to Berlin questionnaire and STOP questionnaire in screening OSAHS and detecting the severity of OSAHS patients.The sensitivities of SBQ score ≥3 with apnea hypopnea index （AHI） ≥5/h,AHI ≥15/h,and AHI ≥30/h as gold standards were 94.9％,96.5％,and 97.7％,respectively.The specificities were 50.0％,28.6％,and 17.9％,respectively.The area upper curves were 0.815 （0.706-0.925,P ＜0.01）,0.746 （0.665-0.828,P ＜0.01）,and 0.751 （0.686-0.817,P ＜0.01）,respectively.According to SBQ,the population was classified into high-risk group and low-risk group.The gender,BMI,neck circumference,AHI,LSpO2,and number of subjects ofAHI ≥5/h,AHI ≥15/h,and AHI ≥30/h of these two groups were significantly different.Conclusions The SBQ has superior predictive value compared with ESS,Berlin questionnaire,and STOP questionnaire.It should be used further in screening for OSAHS in the general population.

Value of STOP-Bang questionnaire in screening patients with obstructive sleep apnea hypopnea syndrome in sleep disordered breathing clinic

Background Obstructive sleep apnea hypopnea syndrome （OSAHS） is the most common sleep-disordered breathing and is still underdiagnosed.This study was designed to evaluate the value of the STOP-Bang questionnaire （SBQ） in screening OSAHS in sleep-disordered breathing clinics in order to extend it into the general Chinese population.Methods Two hundred and twelve patients undergoing overnight polysomnography （PSG） in the sleep-disordered breathing clinic of Pecking Union Medical College Hospital between May 2011 and January 2012 were prospectively included and were asked to fill in the SBQ.A score of 3 or more of the SBQ indicated a high risk of OSAHS.We analyzed the sensitivities and specificities of SBQ in screening OSAHS.Logistic regression analysis was used to evaluate the probabilities of the severity of OSAHS based upon the apnea hypopnea index （AHI）.Results The patients at high risk of OSAHS had higher AHI,higher oxygen desaturation index （ODI）,lower pulse oxygen saturation （LSpO2） during sleep time and less sleep time in stage N3.SBQ scores were positively correlated with AHI,ODI and the ratio of SpO2 lower than 90％,and negatively correlated with LSpO2 during sleep.The sensitivities of the SBQ with AHI ≥5/h,AHI ≥15/h,AHI ≥30/h as cut-offs were 94.9％,96.5％,and 97.7％,respectively,and the specificities were 50.0％,28.6％,and 17.9％,respectively.The Logistic regression analysis showed the probability of severe OSAHS increased and the probability of normal subjects decreased with increasing SBQ score.Conclusions The STOP-Bang questionnaire has excellent sensitivity in screening OSAHS patients and can predict the severity of OSAHS.More studies will be required to determine the value of SBQ in the general Chinese population.

Effect of continuous positive airway pressure treatment on vascular endothelial function in patients with obstructive sleep apnea hypopnea syndrome and coronary artery disease

Background Continuous positive airway pressure (CPAP) treatment has been proven to be effective in improving the symptoms of coexisting coronary heart disease (CHD) in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). However,it is still unclear whether such improvements are linked to changes in vascular endothelial function. This research was carried out to investigate the effects of CPAP treatment on vascular endothelial function in patients with OSAHS and CHD.Methods Thirty-six patients with moderate or severe OSAHS and CHD undergoing three months of CPAP treatment were recruited for this study. The changes in their morning plasma nitric oxide (NO) and endothelin (ET) levels,NO/ET ratio,total ischemic burden (TIB) of the myocardium,apnea hypopnea index (AHI),and minimal and mean pulse oxygen saturation (SpO_2) were compared and analyzed before and during CPAP treatment. Results Compared with the plasma levels of ET [(51.39±11.69) ng/L] and NO [(36.67±11.86) μmol/L],NO/ET (0.71±0.14),AHI (32.4±7.9),minimal SpO_2 [(68.9±11.4)%],and myocardial TIB [(66.29±16.37) mm·min] before treatment,there were significant decreases in ET [(33.41±10.03) ng/L] ( P <0.05),increases in NO [(59.89±10.26) μmol/L] and NO/ET (1.79±0.38) ( P <0.01),decreases in AHI (1.9±0.5),and increases in minimal SpO_2 [(90.6±1.8) %] (all P <0.01) and myocardial TIB [(36.42±10.87) mm·min] ( P <0.05) after three months of CPAP treatment.Conclusion CPAP treatment may play an important role in the improvement and protection of vascular endothelial dysfunction and myocardial ischemia in OSAHS patients with CHD.