Obstructive sleep apnea syndrome is associated with impaired pulmonary artery distensibility and right ventricular systolic dysfunction

Conclusion: PAD is a significant tool to evaluate pulmonary vasculature stiffening and is well correlated with disease severity in OSAS. Further, impaired PAD may lead to RV systolic dysfunction

Gender Difference in Apnea and Hypopnea Component in Obstructive Sleep Apnea

Introduction We aimed to analyze the apnea and hypopnea structure separately with demographic parameters and sleep architecture in men and women with sleep apnea. Materials and Methods Patients referred for snoring, witnessed apnea and/or day time sleepiness to Dışkapı Yıldırım Beyazıt Research and Educational Hospital Sleep Center and gone under polysomnography (PSG) between December 2010 and June 2012 were taken in order. PSG reports were analyzed retrospectively. The patients with sleep efficiency less than 40% were excluded. The BMI, neck circumference (NC), abdominal circumference (AC) and PSG values were recorded. Results Totally 406 patients (250 male, 156 female patients) were studied. NC was found more in males whereas AC and BMI were found significantly more in females. Mean age, apne-hypopnea index (AHI), oxygen desaturation index (ODI) for 3% were similar in two genders. Percentage of total light sleep (Stage 1+2) was significantly more in males while Stage 3 (slow wave sleep: SWS) was more in females. Total apneas were significantly more in males and hypopneas were significantly more in females. The factors associated with AHI were NC and BMI in males and AC and BMI in females. Discussion We found that, females are more hypopneic and men are more apneic, in a study group of similar apne-hypopnea indexed patients. The different distribution of fat in genders seems to effect the apnea/hypopnea predominance. The clinical significance of the apnea and hypopnea indexes separately can be related with SWS percentage. Prospective studies are needed to evaluate the effect of apneas and hypopneas on morbidity and mortality in both genders

Ectopic adrenal tissues at orchidopexy in children: A case series

Ectopic adrenal tissue is rare in children. Although its excision is recommendedwhen found incidentally during inguinal surgical procedures, routine explorationis not indicated for the detection of its presence. Here, we present eight cases ofectopic adrenal tissue in pediatric patients who underwent orchidopexy

Importance of Labarotory Parameters in Obstructive Sleep Apnea

Objective Obstructive sleep apnea (OSA) is associated with intermittent hypoxia. OSA leads to increased sympathetic activation, oxidative stress, vascular endothelial dysfunction, coagulation disorders and metabolic dysregulation. These disturbances increase the the risk of inflammation and cardiovascular diseases. The purpose of this article is to review the laboratory parameters of OSA patients without any comorbidities. Materials and Methods This retrospective study of consecutive 675 patients who had polysomnography, was conducted on one hundred and thirty patients who did not have any comorbidities. Laboratory values of patients were evaluated. Patients were grouped according to apnea-hypopnea index (AHI). Group 1 (n=17) AHI 30. Results There were 88 men (67.7%) and 42 women (32.3%) in the study. Mean age, body mass index, Epworth score and AHI were 41.6±11.3 (16-75), 29.6±6.3 (17.1-65.7) 9.9±5.5, 6.2±11.34, respectively. Serum glucose, cholesterol and triglyceride levels were higher in group 4 (p=0.03, p=0.04, p=0.02, respectively). Uric acid and fibrinogen levels were higher in patients with higher AHI (p=0.038). Conclusion Our study indicates that increased blood glucose, uric acid and dyslipidemia are associated with OSA regardless of comorbidities

Sleep Apnea in a Sample of Patients with Treatment Resistant Depression Referred for Electroconvulsive Therapy

Objective Symptoms of sleep apnea (SA) often overlap with symptoms of depression. Without extensive exploration of a patient’s history it is possible that SA could complicate depression leading to treatment resistant depression (TRD) which is then referred for electroconvulsive therapy (ECT). To date no study has reported on prevalence of SA within this population. Materials and Methods We conducted a retrospective chart review of patients referred for ECT for TRD from 2008 to 2011 (N=118) at the Central Arkansas Veteran’s Healthcare System. Patients were placed into categories of known SA (diagnosed with polysomnography and recorded on chart), high risk SA (suspected SA documented in the chart by a physician), or unknown/low risk SA (negative polysmonography). Results Average age was 54.5±12 years. Average body mass index (BMI) was 30.3±7.3 kg/m2. 36% had either known SA (27%) or were at high risk of having SA (9%). Those with known SA were more likely to have hypertension (9.4 CI 3-29.5), BMI≥30 kg/m2 (5.4 CI 2.2-13.5), and hyperlipidemia (4.2 CI 1.6-11.4). Known SA was not significantly associated with diabetes mellitus (2.2 CI 0.8-5.6), complaints of pain (2.4 CI 0.9-5.9), or headache (1.5 CI 0.6-3.8). Conclusion A diagnosis of SA should be considered in patients referred for ECT for TRD. BMI≥30 kg/m2, presence of hypertension, and hyperlipidemia are more likely in patients with SA and should raise suspicion of the disorder in patients within this population

Prevalence of sleep disorders in the Turkish adult population epidemiology of sleep study

Sleep disorders constitute an important public health problem. Prevalence of sleep disorders in Turkish adult population was investigated in a nationwide representative sample of 5021 Turkish adults (2598 women and 2423 men, response rate: 91%) by an interviewer‐administered questionnaire. Insomnia was defined by the DSM‐IV criteria, habitual snoring and risk for sleep‐related breathing disorders (SDB) by the Berlin questionnaire, excessive daytime sleepiness (EDS) by the Epworth sleepiness scale score, and restless legs syndrome (RLS) by the complaints according to the International Restless Legs Syndrome Study Group criteria. Mean age of the participants was 40.7 ± 15.1 (range 18 to 90) years. Prevalence rates (men/women) were insomnia 15.3% (10.5%/20.2%; P < 0.001), high probability of SDB 13.7% (11.1%/20.2%; P < 0.001), EDS 5.4% (5.0%/5.7%; P: 0.09), RLS 5.2% (3.0%/7.3%; P < 0.001). Aging and female gender were associated with higher prevalence of sleep disorders except for habitual snoring. Prevalence rates of the sleep disorders among Turkish adults based on the widely used questionnaires were close to the lower end of the previous estimates reported from different parts of the world. These findings would help for the assessment of the health burden of sleep disorders and addressing the risk groups for planning and implementation of health care

Left atrial remodelling may predict exercise capacity in obstructive sleep apnoea patients

Conclusions: Left ventricular diastolic dysfunction is more prevalent in severe OSA and is associated with impaired exercise performance. Additionally, LA remodelling may predict exercise capacity in this subgroup of patients

Reliability and validity of the Turkish version of the morningness - Eveningness questionnaire

Background: People are divided into different chronotypes in relation to their circadian rhythm features. The Morningness-Eveningness Questionnaire (MEQ), developed by Horne and ostberg, was the first and is the most used questionnaire for determining the chronotype of people. The reliability and validity of MEQ were tested in this study due to some deficiencies and inconsistencies in previous reliability and validity studies for the Turkish versions of MEQ and deficiencies regarding the validity and reliability of other versions of MEQ. Subjects and Methods: MEQ was translated into Turkish based on the opinions of five academics who were experts in their respective fields and the suitability and content validity of the questionnaire were ensured. The Turkish MEQ was administered to 419 undergraduate students aged 18-34 years. Robust minimum rank factor analysis (MRFA) was used to reveal the construct validity of the questionnaire. Results: As a result of the analyses, the questionnaire was examined in three factors. None of the items were excluded from the study and all items were collected under three factors. The explained total variance value was 42.7%, and the factors explained 64% of common (shared) variance in MRFA. According to the reliability analysis, Cronbach's alpha value for the MEQ Turkish version was satisfactory for the overall questionnaire (0.765). Conclusions: The MEQ version developed in this study is more valid and reliable compared with other versions. However, these results support that a more detailed instrument for morningness and eveningness can be developed