Processing obstructive sleep apnea syndrome (OSAS) data

In this study, the EEG signals were processed. Thirteen ICA algorithms were tested to verify the performance efficiency. The EEG signals were recorder using 10/20 international system, based on a 20 minute sleep recording of a severe Obstructive Sleep Apnea Syndrome (OSAS) during NREM and REM sleep. Seven channels were used to record the EEG signals which are sampled at 100 Hz. The performance analysis of the algorithms were investigated to eliminate the loss of the informative EEG signal during the data processing. The denoising results were magnified with the purpose of evaluating the robustness of the denoising algorithms. From the result we obtained, we are able to understand the denoising algorithm is more suitable to process the EEG signal with lower amplitude.

A Very Severe Obstructive Sleep Apnea Syndrome: In a Cause of Resistant Hypertension with One Sample Case

When blood pressure values remain above the target in a hypertensive patient treated concomitantly with three anti-hypertensive drugs including a diuretic, maximum well-tolerated doses, this is a resistant arterial hypertension. In this case, it is advisable to look for a secondary cause such as a drug intake that influencing the blood pressure or the presence of obstructive sleeping syndrome (OSAS). We report a clinical case of a patient with a high cardiovascular risk at the age of 50, hypertensive and diabetic, with dyslipidemia and obesity. He was on anti-hypertensive triple therapy at an optimal dose. Her diabetes was balanced with 6.4% glycated hemoglobin. Dyslipidemia has being treated. Despite healthy diet including a low sodium diet and weight loss, blood pres- sure target was not reached. With self-measurement, the mean arterial pressure was 180/110 mmHg and on ABPM it was 167/113 mmHg. The ventilatory polygraphy finds a severe OSA with an IAH = 56.6. Treatment with PCP (Con- tinuous positive pressure) allowed this patient to control blood pressure. The search for OSA should be systematic in face of resistant hypertension, in par- ticular in overweight or obese patients.

Meta-analysis of randomized controlled trials of traditional Chinese medicine in the treatment of obstructive sleep apnea syndrome

Objective:Though Chinese medicine(CM)has showed its clinical efficacy for the treatment of obstructive sleep apnea(OSA)in China,no systematic reviews or meta-analyses provide evidences for its therapeutic effects on OSA and the long-term safety.The aim of the present study is to evaluate the effectiveness and safety of CM on OSA using meta-analysis.Methods:We used search items of"Chinese Medicine"AND"obstructive sleep apnea"to retrieve the randomized control trials(RCTs)of CM treatments for OSA in PubMed,Embase,Cochrane Library,China National Knowledge Infrastructure(CNKI),VIP database,and Wanfang database from their respective inception dates to December 2019.Only RCTs of CM therapy versus no treatment which could be quantitatively synthesized were included.Finally,20 studies representing 1,297 participants were included after extraction.Two investigators independently extracted and analyzed the data using RevMan5.3 software.Results:The treatment group using CM decoctions or CM granules presented significantly ameliorative effects on apnoea-hypopnoea index(AHI)compared with the control group(MD:-2.58,95%CI:-3.59 to-1.56,P<0.00001 and MD:-5.47,95%CI:-6.75 to-4.19,P<0.00001,respectively)in the sensitivity analysis.However,there were non significant differences in the duration of treatment between subgroups,indicating that the duration of treatment has no impacts on the therapeutic effects on AHI.CM granules also showed significantly ameliorative effects on the lowest nocturnal oxygen saturation(LSaO2)(MD:2.76,95%CI:1.85 to 3.68,P<0.00001).CM decoctions exhibited significantly improved Epworth Sleepiness Scale(ESS)scores compared with the control group in a sensitivity analysis(MD:-1.50,95%CI:-2.13 to-0.88,P<0.00001).CM granules showed a better improvement of ESS than the control group(MD:-1.35,95%CI:-1.92 to-0.78,P<0.00001).Mild adverse reactions occurred only in five patients and disappeared without special treatment.Conclusion:This study showed favorable therapeutic efficacy of CM on OSA.However,in consideration of the low methodological quality of the included RCTs,more rigorous designed,large sample size RCTs are recommended for providing more high-quality evidences.

Secreted Frizzled-Related Protein 5 (SFRP5) in Patients with Obstructive Sleep Apnea

Objective Obstructive sleep apnea (OSA) is closely related to obesity, insulin resistance and inflammation. Secreted frizzled-related protein 5 (SFRP5) is a recently discovered adipokine. It is involved in insulin resistance and inflammation in obesity. This study aimed at evaluating the association between SFRP5and sleeping characteristics as well as biochemical parameters of OSA patients.Methods This was a prospective case control study. Nondiabetic OSA patients and controls were consecutively recruited and divided into three groups: OSA group, apnea–hypopnea Index (AHI)≥5/h; healthy controls with normal body mass index (BMI); obese controls without OSA, and BMI > 24.0 kg/m2. All participants underwent polysomnography (PSG). Plasma SFRP5 was examined using enzyme-linked immunosorbent assay (ELISA). Blood biochemical examinations, including fasting blood glucose (FBG), lipid profile, hypersensitive Creactive protein (hsCRP), were performed early in the morning after PSG. Patients with severe OSA were treated with nasal continuous positive airway pressure (nCPAP), and plasma SFRP5 was repeatedly measured for comparison.Results Sixty-eight subjects were enrolled in the study, including 38 patients of OSA, whose medium AHI was 58.70 /h (36.63, 71.15), 20 obese controls, and 10 healthy controls. The plasma SFRP5 level of OSA patients was not significantly different from that of healthy controls or obese controls. In OSA patients, SFRP5 level correlated positively with triglyceride level (r=0.447, P=0.005) and negatively with LDL-cholesterol level and HDLcholesterol level (r=?0.472 and P=0.003; r=?0.478 and P=0.002; respectively). SFRP5 level was not found correlating with FBG, AHI, or any of nocturnal hypoxia parameters. After overnight nCPAP treatment, plasma SFRP5 levels of OSA patients did not change significantly (t=1.557, P = 0.148) compared to that of pretreatment.Conclusions In nondiabetic OSA patients, plasma SFRP5 is associated with the lipid profile. However,no correlation was observed between SFRP5 and FBG or sleep parameters. The SFRP5 level of OSA patients did not differ from that of non-OSA individuals in our study.

Obstructive sleep apnea increases heart rhythm disorders and worsens subsequent outcomes in elderly patients with subacute myocardial infarction

OBJECTIVE Obstructive sleep apnea(OSA)is a potential cardiovascular risk.We aimed to investigate the association of OSA with heart rhythm disorders and prognosis in elderly patients with new-onset acute myocardial infarction(AMI).METHODS We prospectively enrolled 252 AMI elderly patients(mean age,68.5±6.9 years)who were undergoing revascularization and completed a sleep study during their hospitalization.All subjects were categorized into non-OSA(apnea–hypopnea index(AHI)<15,n=130)and OSA(AHI≥15,n=122)groups based on the AHI.The changes in the autonomic nervous system,incidence of arrhythmia during nocturnal sleep,and major adverse cardiovascular and cerebrovascular events(MACCEs)were compared between the groups.RESULTS The mean AHI value in all AMI patients was 22.8±10.9.OSA patients showed higher levels of body mass index and peak high-sensitivity C-reactive protein and lower levels of minimum nocturnal oxygen saturation(Min Sa O2),as well as greater proportion of multivessel coronary artery disease(all P<0.05).The OSA group also showed significant increases in heart rate variability and heart rate turbulence onset(both P<0.05)and higher incidence of arrhythmia(including sinus,atrial,and ventricular in origin).At a median follow-up of 6 months(mean 0.8–1.6 years),OSA(AHI≥15)combined with hypoxia(Min Sa O2≤80%)was independently associated with the incidence of MACCEs(hazard ratio[HR]:4.536;95%confidence interval[CI]:1.461-14.084,P=0.009)after adjusting for traditional risk factors.CONCLUSIONS OSA and OSA-induced hypoxia may correlate with the severity of myocardial infarction,increase the occurrence of heart rhythm disorders in elderly subacute MI patients,and worsen their short-term poor outcomes.

Obstructive Sleep Apnea and Cardiovascular Disease in Women

Obstructive Sleep Apnea(OSA)is a common chronic disorder that affects 5–10%of the US population with a higher prevalence in men compared to women by 2:1 in population studies.By contrast,in patients with cardiovascular disease,its prevalence can exceed 50%depending on the specifi c disorder surveyed.Although sex differences have been well described for cardiovascular risk factors;existing data regarding the impact of sex on the relationship between OSA and cardiovascular outcomes is controversial.Similarly,while there is strong evidence for increased prevalence of cardiovascular conditions,such as systemic hypertension,atrial fibrillation,as well as heart failure amongst patients suffering from OSA;confl icting evidence exists regarding the incidence and bidirectional relationship between them as well as the impact of treatment of OSA on cardiovascular outcomes.In this paper,we will review the associations between OSA and cardiovascular diseases in women.The data on sex differences is limited,due to a number of reasons,including,but not limited to late presentation of OSA in women,diffi culties in diagnosing both OSA and cardiovascular diseases in women and still suboptimal inclusion of adequate number of women in clinical trials.More studies are needed to better delineate sex differences in the clinical presentation as well as the pathophysiology of the associations between OSA and cardiovascular diseases so that we can provide patients with more personalized care.

Obstructive sleep apnea among commercial vehicle drivers in Malaysia: Issues and initiatives

Obstructive Sleep Apnea (OSA) has been identified by many studies as one of the significant contributing factors for motor vehicle accidents. However, only a small number of studies have been conducted in Malaysia. Objective: This paper aims to highlight the prevalence of OSA among truck drivers and express bus drivers in Malaysia and efforts being undertaken to address issues related to OSA among commercial vehicle drivers. Methodology: Two separate studies were conducted: a cross sectional study among truck drivers and secondly among express bus drivers. The screening process for identifying the high risk group for OSA was done using Berlin questionnaire. Meanwhile, among express bus drivers, OSA was confirmed with sleep study using polysomnography test. Result: Screening of risk group of OSA among truck drivers revealed that 14.6% (19) of drivers were categorized as having high risk of OSA while 85.4% (111) having low risk of OSA. While, in another study, polysomnography test among express bus drivers showed that 83 (28.7%) had mild OSA, 26 (9.0%) had AHI moderate OSA, and 19 drivers (6.6%) severe OSA. Conclusion: This paper highlighted the issues of OSA among commercial vehicle drivers in Malaysia. With an alarming high prevalence, OSA should be a major road safety concern in this country. A special study focusing on sleep and fatigue related crashes may need to be conducted to complement the current studies and full implementation of existing efforts and initiatives to address OSA in road crashes should be realized by the relevant authorities.

Does Obstructive Sleep Apnea (OSA) Increase the Risk of Post-Operative Respiratory Complications after Bariatric Surgery?

Background: OSA affects up to quarter of general population. It is associated with morbid obesity with a higher morbidity and mortality rates. STOP Bang questionnaire is a validated method for OSA screening. OSA patients are at high risk of developing airway obstruction, cardiac events, congestive heart failure, stroke and desaturation post operatively. The aim of this study is to evaluate adverse respiratory events in patients undergoing bariatric surgery in relation to risk of OSA using Stop Bang questionnaire. Methods: This prospective double cohort study was conducted in Tanta University Hospital from Marchto August 2017. During the preoperative assessment, STOP-BANG questionnaire was performed. After extubation, patients were transferred to PACU unit. Respiratory complications were assessed thereafter. Based on STOP-BANG score, patients were divided into two groups, high risk of OSA with STOP-BANG > 3 (Group I) and low risk of OSA with STOP-BANG Results: 104 patients were included in this study. Group I had more comorbidities in the form of CAD (15% versus 2%, P 0.001). Higher number of respiratory complications was noted in high-risk group (31 patients, 59%) compared to (24 patients, 46%) in group II yet, it was not significant. Conclusion: Obese patients with STOP-BANG score > 3 undergoing bariatric surgery are associated with hypertension, dyslipidemia, CAD, and renal insufficiency. High-risk OSA obese patients are at higher risk of developing respiratory compilations like inability to breathe deeply and hypoxia in postoperatively.

成人下颌发育不足的外科矫治

下颌发育不足是牙颌面畸形的常见类型之一,严重影响患者的面部美观和咬合功能。外科矫治是目前最有效的治疗方法,可以通过手术治疗改变下颌骨位置和形态,恢复患者正常面部外形。本文从外科治疗的角度,将颞下颌关节这一关键因素纳入成人下颌发育不足的诊疗设计中,阐述成人下颌发育不足的常用矫治方法,包括正颌外科手术、颞下颌关节外科手术、正畸-正颌联合治疗和牵张成骨技术等,总结不同类型成人下颌发育不足的治疗流程。为临床医生治疗该疾病提供参考,提高这一疾病的治疗水平。

Serum adiponectin level in patients with obstructive sleep apnea hypopnea syndrome

Abstract Background Adiponectin, secreted by adipocytes, has been found to be associated with diabetes, obesity and some cardiovascular diseases. Obstructive sleep apnea hypopnea syndrome (OSAHS) is also closely related to obesity and easily complicated with diabetes and some cardiovascular diseases. This study was carried out to explore the change of serum adiponectin level in patients with OSAHS.Methods Polysomnography was performed in 71 patients with OSAHS (OSAHS group) and 26 simple obese controls (control group). The two groups had no significant difference in age and body mass index (BMI). Radioimmunoassy was used to test serum adiponectin level.Results Serum adiponectin level was significantly lower in OSAHS group [(5.03±1.01) mg/L] than that in the control group [(7.09±1.29) mg/L, P<0.05]. The differences between two groups were independent of gender. In OSAHS groups, serum adiponectin levels were negatively correlated with apnea hypopnea index (AHI) (r=-0.78, P<0.01), BMI (r=-0.13, P<0.05), waist circumsference (r=-0.36, P<0.01), and neck circumference (r=-0.42, P<0.01), but positively correlated with the minimal pulse oxyhemoglobin saturation (r=0.48, P<0.01). Conclusion OSAHS may contribute to the decrease of serum adiponectin level independent of obesity.

Ambulatory blood pressure monitoring in children with obstructive sleep apnea syndrome

Importance:The incidence of obstructive sleep apnea syndrome(OSAS)in children has increased year by year recently.Blood pressure research of OSAS children can help understand the occurrence of OSAS related complications.Early detection and intervention of blood pressure changes in children with OSAS can reduce the incidence of cardiovascular disease in later adulthood.Objective:To investigate the differences in blood pressure among different groups of snoring children and different sleep stages.Methods:Habitually snoring children(snoring frequency of≥3 nights per week)aged3 to 11 years were recruited from Beijing Children's Hospital from 1 January 2017 to 30 June 2018.All children underwent polysomnography,and their blood pressure was monitored and calculated by the pulse transit time.The children were divided into those with primary snoring(PS),mild OSAS,and moderate to severe OSAS according to their obstructive apnea-hypopnea index(OAHI).Results:In total,140 children were included.Ninety-seven had PS,24 had mild OSAS,and 19 had moderate to severe OSAS.There were no differences in age,sex,or body mass index z-score among the groups.Statistieally significant differences were found in the OAHI,oxygen desaturation index 3%,respiratory arousal index,and lowest oxygen saturation among the three groups.Children with moderate to severe OSAS had higher systolic and diastolic blood pressure than those with mild OSAS andPS(P<0.001).In all children,systolic and diastolic blood pressure was higher in the rapid eye movement(REM)sleep stage than in the non-REM sleep stage(P<0.05).Interpretation:Children with moderate to severe OSAS had higher blood pressure than those with PS and mild OSAS in all sleep stages.Blood pressure in the REM sleep stage was higher than that in other sleep stages in all groups of children.

全球阻塞性睡眠呼吸暂停指南质量评价

目的·对全球范围内已发表的阻塞性睡眠呼吸暂停(obstructive sleep apnea,OSA)临床实践指南进行质量评价。方法·检索PubMed、Embase、中国知网、万方数据知识服务平台、中国生物医学文献数据库、梅斯医学、The Cochrane Library、医脉通、美国预防服务工作组网站、英国国家卫生与临床优化研究所网站、新西兰指南工作组网站、苏格兰校际指南网络、国际指南协作网等中的OSA相关指南,检索时间限定为建库至2022年12月。由2名研究人员独立筛选文献和提取信息,采用指南研究和评估工具Ⅱ(Appraisal of Guidelines for Research and EvaluationⅡ,AGREEⅡ)和国际实践指南报告标准(Reporting Items for Practice Guidelines in Healthcare,RIGHT)对纳入的指南进行质量评价,并按不同指南发布地区进行亚组分析;评价者间一致性采用组内相关系数(intra-class correlation coefficient,ICC)进行检验。对所有纳入指南进行全文阅读,汇总其提出的临床问题。结果·共纳入35篇OSA相关指南。评价者ICC为0.975,显示评价者间一致性较好。AGREEⅡ的评价结果显示:纳入指南的平均整体质量分值为(63.60±16.45)%,最低为23.40%,最高为91.67%;6个领域中严谨性[(56.07±25.89)%]和应用性[(53.57±15.52)%]得分较低。RIGHT的评价结果显示,纳入指南的平均总报告率为(67.84±20.03)%,最低为14.29%,最高为94.29%,其中平均报告率较低的领域为评审和质量保证[(31.40±45.51)%]、资金资助和利益冲突声明与管理[(56.43±33.95)%]和其他方面[(56.19±36.85)%]。亚组分析表明,亚洲地区的指南在AGREEⅡ的严谨性及整体的质量得分显著低于美洲和欧洲地区的指南(均P<0.05),在RIGHT的证据和其他方面2个领域的报告率也均显著低于美洲和欧洲地区的指南(P<0.05)。纳入的35部指南主要关注了OSA的筛查诊断、治疗及疾病管理3个方面42个临床问题。结论·目前全球OSA指南质量差异较大,各个地区的指南在严谨性、应用性、评审和质量保证、资金资助和利益冲突声明与管理等方面都有待加强,尤其是亚洲地区的指南。

基于鼾声分析技术的手机软件在成人阻塞性睡眠呼吸暂停筛查中的应用价值研究

目的评价基于鼾声分析技术的智能手机软件“睡好了么”(Sleepok)在成人阻塞性睡眠呼吸暂停(OSA)筛查中的应用价值,并与常用OSA筛查量表进行比较。方法纳入2022年7月至2023年4月因打鼾就诊于北京大学人民医院呼吸睡眠医学科进行多导睡眠监测(PSG)的成人受试者173例,在行PSG时同步使用Sleepok监测鼾声,受试者于监测当晚在研究者指导下填写纸质问卷(包括基本信息和常用OSA筛查量表)。结果Sleepok与PSG测得呼吸暂停低通气指数(AHI)差异无统计学意义(P>0.05)。Pearson相关分析结果显示,Sleepok_AHI与PSG_AHI具有较好的相关性(r=0.80,P<0.001)。Bland-Altman一致性检验结果显示,Sleepok_AHI与PSG_AHI有较高的一致性(P=0.118),两者之间的平均差异仅为-1.82次/h。ROC曲线分析结果显示,Sleepok_AHI对OSA、中重度OSA和重度OSA均有较好的诊断价值,其最佳截断值分别为16.6次/h、18.9次/h和28.0次/h。单纯鼾症组与OSA组6种量表(No-Apnea、GOAL、NoSAS、STOP、STOP-Bang、CNCQ-OSA)的评分值以及Sleepok_AHI水平比较差异均有统计学意义(P<0.05)。ROC曲线分析结果显示,6种量表均有诊断OSA的应用价值(P<0.05)。结论基于鼾声分析技术的智能手机软件Sleepok能有效识别睡眠中的呼吸事件,对于OSA高风险患者有较好的灵敏度和特异度,可用于OSA筛查。

孕早中期阻塞性睡眠呼吸暂停患者生命质量的现状及影响因素分析

目的 探讨阻塞性睡眠呼吸暂停(obstructive sleep apnea, OSA)对妊娠期女性生命质量(quality of life, QOL)的影响。方法 选取2020年9月至2022年3月首都医科大学附属北京妇产医院单胎孕早中期妊娠女性,根据睡眠呼吸暂停低通气指数(apnea hypopnea index, AHI),采用SF-36简明健康调查量表(简称SF-36量表)评估QOL。比较SF-36量表总分及各维度得分与睡眠监测各参数、BMI、年龄之间的相关性。结果 共纳入单胎孕早中期妊娠女性171例,年龄25~45岁,平均(34.0±3.9)岁。SF-36总分与非快速眼动期(non rapid eye movement, NREM)呼吸暂停最大时长呈负相关,躯体疼痛与NREM期呼吸暂停平均时长呈负相关,精力与最长氧减时间呈负相关。年龄对QOL影响不明显,但BMI与生理机能维度得分呈负相关。结论 OSA对妊娠期女性QOL均存在一定影响,肥胖能显著影响妊娠期OSA患者的QOL,临床医生在关注母婴并发症和结局的同时,更应关注其身心健康,并提供相应生活方式指导和心理干预;与AHI相比,呼吸暂停低通气持续时间对妊娠期OSA女性QOL影响更大,临床上可将AHI、最低血氧饱和度程度、呼吸暂停低通气持续时间综合考虑,为OSA患者评估提供一种新思路。

重度阻塞性睡眠呼吸暂停患者脑电能量密度分布及变化规律分析

目的阻塞性睡眠呼吸暂停(obstructive sleep apnea,OSA)是一种在临床有较高病发率的睡眠障碍,其病发机制为上气道在睡眠期间反复阻塞,会引发低氧血症、频繁低通气、睡眠唤醒、呼吸暂停等病理生理改变。多导睡眠监测(polysomography,PSG)是临床上诊断OSA的金标准,可以监测患者睡眠期间的脑电波变化。本文通过分析重度OSA男性患者睡眠规律和脑电(electroencephalogram,EEG)能量密度分布及变化规律,探究重度OSA患者的睡眠脑电变化。方法选取30名男性重度OSA患者和30名男性正常对照组,对60名受试者进行整夜(8 h左右)的多导睡眠监测,对得到的睡眠特征和脑电参数进行整理,提取睡眠与脑电特征。对比睡眠监测得到的睡眠特征和其前额区的脑电能量密度。结果在睡眠特征方面,重度OSA患者睡眠期时间为370.20 min,睡眠效率平均为86.90%,非快速眼动1期平均占比19.90%,非快速眼动2期平均占比42.55%,对比正常人睡眠时间、睡眠效率以及非快速眼动1期、2期占比明显降低。在脑电特征方面,重度OSA患者整夜睡眠θ波的绝对能量密度、总能量密度、相对能量密度delta波、K复合波的相对能量密度高于对照组,β波相对功率低于对照组。OSA患者脑电低频活动增加明显。结论随着OSA患者严重程度的加重,患者的脑电能量与低频活动增加明显,为OSA患者疾病的发展趋势和评估疗效提供了重要的参考依据。

无创经皮电刺激仪治疗OSAS的实验研究和临床疗效

研究采用经皮双向电流脉冲刺激舌下颏舌肌作为治疗阻塞性睡眠呼吸暂停综合征(O bstructive sleepapnea syndrom e,O SA S)的一种新方法。采用多导睡眠图同步监测患者,当发生睡眠呼吸暂停时及时给予最佳参数的电刺激,使得以颏舌肌为主的上气道扩张肌促使舌体向前运动,扩大舌咽气道,降低上气道阻力,改善夜间低氧血症,改善睡眠结构。临床疗效结果表明,22名O SA S患者经我们治疗后显效17名,好转2名,无效3名,有效率77.27%。初步证明这是一种的治疗O SA S的新方法。

CPAP对OSAS小型猪睡眠生理学影响

研究持续气道正压通气(CPAP)对阻塞性睡眠呼吸暂停综合征(OSAS)小型猪睡眠生理的影响。12只成年雄性小型猪随机分为A、B两组,均予22d、6h/d间歇性低压低氧处理。之后A组再给予30d、6h/d的CPAP治疗,B组饲养30d。低压低氧处理及CPAP治疗后,均行睡眠监测、咽部吸气负压检查。由软件得出呼吸暂停低通气指数(Apnea hypopnea index,AHI)、呼吸暂停指数(Apnea index,AI)、低通气指数(Hypopnea index,HI)、平均血氧饱和度(SpO2)。A组CPAP治疗后较治疗前AHI、AI均显著减少(P<0.05);而SpO2显著提高(P<0.05);HI无显著改变。A组CPAP治疗后AHI、AI、HI均显著低于B组(P<0.05);SpO2则显著高于B组(P<0.05)。B组饲养30d前后AHI、AI、HI、SpO2无显著差异。A组CPAP治疗后咽部吸气负压较治疗前显著降低(P<0.05),并低于B组(P<0.05);B组30d后吸气负压增大(P<0.05)。结果提示CPAP治疗可显著改善OSAS小型猪的睡眠生理学指标。

腭咽成形术对OSAS伴心血管病并发症疗效的临床观察

严重的睡眠期打鼾、呼吸暂停可引起明显的心血管系统并发症。报告34例右明显心血管病,同时患有严重OSAS的患者,通过腭咽成形术治疗后,鼾声、呼吸暂停治愈或基本治愈,不服药高血压恢复正常或近正常水平,冠心病、心律失常症状消失或基本消失。并能有效地颅防心性猝死,降低了心血管病的病死率。对OSAS与高血压、心律失常的关系进行了讨论。

CPAP对OSAS小型猪上气道结构和功能的影响

观察持续气道正压通气(Continuous positive airway pressure,CPAP)对阻塞性睡眠呼吸暂停综合征(OSAS)小型猪上气道结构和功能的影响。12只雄性成年小型猪随机分为A、B两组,给予连续22d、6h/d低压低氧处理。之后A组再给予30d、6h/d的CPAP治疗,B组饲养30d。低压低氧处理和CPAP治疗后,小型猪均行咽部CT扫描、口咽部呼吸压力检查,之后处死动物,取咽部组织行光镜检查。咽部CT扫描显示,A组CPAP治疗后舌骨前区,舌骨后区咽腔左右径显著增大(P<0.05),咽腔前后径无显著变化(P>0.05);舌骨前区后壁厚度较治疗前显著增加(P<0.05),侧壁厚度无显著差异(P>0.05);A组CPAP治疗后较B组咽腔前后径数值减小,左右径数值增大,但均无统计学意义(P>0.05)。A组CPAP治疗后软腭区、舌骨前区咽腔后壁显著较B组厚(P<0.05),侧壁厚度较B组无显著差异(P>0.05)。A组CPAP治疗后,咽部吸气负压较治疗前显著减小(P<0.05),亦低于B组(P<0.05)。光镜下,A组CPAP治疗后局部上皮组织增生,固有层炎症细胞浸润;咽肌横纹不清,局部肌纤维结构模糊,肌间隙有脂肪;B组病变程度较A组重。结果提示CPAP治疗使可OSAS小型猪上气道结构和功能趋于正常。

阻塞性睡眠呼吸暂停和前列腺癌发生风险:一项队列研究的Meta分析

目的通过Meta分析探讨阻塞性睡眠呼吸暂停(Obstructive sleep apnea,OSA)与前列腺癌发生风险的关系。方法检索PubMed、EMBase、Web of Science、The Corchrane Library、中国知网(CNKI)、中国生物医学文献(CBM)、万方数据库,收集所有符合纳入标准的中英文文献,再根据已发表文献中的参考文献追溯进行手工检索,检索年限自建库至2023年12月,均由2位评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.4软件进行Meta分析。为了计算患前列腺癌和阻塞性睡眠呼吸暂停的风险比(HR),只纳入了多变量队列研究进行分析。结果该研究包括从2164篇文章中提取的7项队列研究,其结果显示患有睡眠呼吸暂停的男性患前列腺癌的风险明显更高(HR:1.61,95%CI:1.02~2.53,P=0.04)。亚组分析显示:与非老年男性相比,患有OSA的老年男性的前列腺癌风险显著增加(调整HR:2.57,95%CI:2.18~3.03,P<0.01),亚组内无异质性(I^(2)=0,P>0.1),各亚组间的差异有统计学意义(I^(2)=95.9%,P<0.1),其余亚组分析无法区分这种关联的差异。结论OSA患者患前列腺癌的风险显著增加并存在显著的异质性,且这种相关性在老年男性中更为显著。