Attitudes of Pulmonologists about Obstructive Sleep Apnea Syndrome and its Treatment in Izmir

Objective We aimed to evaluate pulmonary medicine physicians’ attitudes about obstructive sleep apnea syndrome (OSAS) and its treatment in Izmir. Materials and Methods About 78 of 120 pulmonary medicine physicians in Izmir answered the questionnaire containing 24 items (demographics: 6, education: 4, attitudes: 9, knowledge: 5). Results 67.9% of the participants were female. Mean age was 41.06±5.63, mean working year was 11.16±6.09. 52.6% worked in training and research hospitals, 32.1% in state hospitals, and the rest in private and university hospitals. Monthly patient number was 714.10±3.24, patients number with OSA symptoms was 14.85±2.15. 64.1% had completed speciality education in hospitals with sleep disorders centers and this ratio was higher in physicians whose working year was less than 10. 24.4% had practiced sleep study during this education. Participation in sleep study courses after speciality education was 48.7%. 26.9% worked as sleep specialist. 67.9% usually asked patients OSA symptoms and 38.5% asked preoperative OSA symptoms. 97.4% usually referred patients to sleep centers. 65.4% had been working in hospitals with sleep disorders centers. The ratio of correct answers in knowledge part of the questionnaire was 95%. Conclusion OSAS is a major pulmonary disease and it is important in order to find out the patients with OSA risk. 2.07% of patients in clinics have OSA symptoms. Physicians’ confidence in diagnosis is more than managing patients with OSA. Practical part of sleep study is not enough in speciality education. Asking OSA symptoms is not common in pre-operative examination

Evaluation of Sleep Related Breathing Disorders and Obstructive Sleep Apne Syndrome in Interstitial Lung Patients

Objective: Interstitial lung disease (ILD) may create sleep disturbances due to chronic disease-related stress, respiratory abnormalities and adverse effects of treatment. We aimed to determine the quality of sleep in ILD patients, and the incidence of Obstructive sleep apnea syndrome (OSAS) in these patients. Materials and Methods: Taken to this study were 52 patients who were followed up in our center due to ILD. Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI) were applied to the patients. Spirometry and diffusion test were performed. Polysomnography (PSG) was performed to 27 patients whose ESS were more than or equal to 10. Results: Demographic characteristics, body mass index, spirometry and diffusion measurements, PSQI global score and the sub-components of it didn’t show difference according to ESS daytime sleepiness. Sleep quality of 44% of the patients was determined to be poor by PSQI. PSQI global score and sub-components weren’t correlated with apnea-hypopnea index, stage 1 latency, sleep efficiency and nocturnal desaturation (p>0.05) in 27 patients who underwent PSG. We observed increased stage 1 sleep and decreased stage 2-3 and rapid eye movement sleep. As nocturnal hypoxemia was seen arousals (p=0.000, r=0.698) increased. OSAS was diagnosed in 19 (70%) of subjects. Conclusion: Although ILD patients don’t have daytime hypoxemia; they may have nocturnal hypoxemia and OSAS, which may effect their sleep quality. Therefore ILD patients should be evaluated for daytime sleepiness, and sleep-related breathing disorders

C-REACTIVE PROTEIN LEVELS IN OBSTRUCTIVE SLEEP APNEA PATIENTS

Amaç: Obstrüktif Uyku Apne Sendromu (OUAS)'u olan hastalarda C-Reaktif Protein (CRP)'in erken ateroskleozun saptanmasında kullanılması. Yöntemler: Çalışmaya Dokuz Eylül Üniversitesi Tıp Fakültesi uyku bozukluğu polikliniğine başvuran, yaşları 20-66 arasında olan toplam 45 obez hasta alındı. Hastaların cinsiyet, yaş, boy, kilo değerleri saptandı. Vücut kitle indeksleri, bel / kalça oranları hesaplandı. Polisomnografi tetkiki yapıldı. OUAS'u olan hasta grubu ve OUAS'u olmayan kontrol grubu olarak iki gruba ayrıldı. Her iki grup hastadan açlık venöz kan örneği alınarak yüksek duyarlılıklı CRP düzeyleri ve lipid profilleri çalışıldı. B-mode dopler ultrasonografiyle karotis intima madia kalınlıkları ölçüldü. Bulgular: Kontrol grubunda yd-CRP düzeyleri 0,22 (0,01-0,57) mg/dl, OUAS'lı hasta grubundaysa 0,30 (0,05-1,52) mg/dl olarak bulundu, iki grup arasında istatiksel olarak anlamlı fark saptanmadı (p=0,300). Karotis İntima Media Kalınlığı (KİMK) ölçümleri değerlendirildiğinde her iki grup arasında istatistiksel olarak anlamlı fark saptandı (p=0,01). Bel / kalça oranları belirlenip, abdominal obezite açısından değerlendirildiğinde iki grup arasında istatistiksel olarak anlamlı fark gözlendi (p<0,01). AKŞ, TK ve LDL-K düzeylerinde de anlamlı fark saptandı (p=0,049, p=0,01 ve p=0,03). Sonuç: OUAS'lı hastalarda abdominal obezite, AKŞ, TK ve LDL-K düzeylerinde istatistiksel olarak anlamlı fark saptanması OUAS metabolik sendrom ilişkisi için varolan kanıtları doğruladı. Bununla birlikte, ölçülen CRP düzeylerinin OUAS'u hastalarında erken aterosklerozun gösterilmesinde iyi bir gösterge olmayabileceği belirlendi. Objective: To determine whether CRP can detect subclinic atherosclerosis in obstructive sleep apnea patients. Methods: Ages between 20-66, 45 obese patient who was have application to D.E.Ü. Medical Faculty sleep laboratory recruited to study. We determine sex, age, height and weight for all patients and calculate body mass index, waist / hip raito. Polisomnographia was done. Patient's divided in to two group's, whose PSG detected OSA constitute patients group and whose PSG not detected OSA constitude control group. We obtained fasting venous blood sample and measure HSCRP and lipid profiles. Carotis intima media thickness measured with B-mode doppler ultrasonography. Results: HSCRP found 0,22 (0,01-0,57) mg/dl in control group and 0,30 (0,05-1,52) mg/dl in OSA patients group, we didn't detect statistical significancy (p=0,300). When Carotid İntima Media Thickness (CIMT) measurements evaluated for each group, statistical significancy find (p=0,01). WHR determined and evaluated for abdominal obesity, statistical significancy found between two group (p<0,01). Also significant differece detected for FBG, TK and LDL-K (p=0,049, p=0,01 and p=0,03). Conclusion: Detected significant difference for abdominal obesity, FBG, TK and LDL-K levels in OSA patients confirmed existing evidence of relation eith sleep apnea and metabolic syndrome. Although we determined, measured HSCRP levels may not be a good marker for presenting subclinic atherosclerosis in OSA patients

Evaluation of Obstructive Sleep Apnea in Menopausal Women

Objective: To demonstrate a correlation between neuroendocrine hormone changes in menopause and obstructive sleep apnea syndrome (OSAS), excluding risk factors, i.e., depression, and treatment of cases where the disease has been diagnosed

The effect of oropharyngeal exercise in patients with moderate and severe obstructive sleep apnea using CPAP: a randomized controlled study

Purpose Obstructive sleep apnea (OSA) is an important public health problem. Beyond common treatment options, solution-oriented options are needed. Oropharyngeal exercise training may be a research area in this respect. This study aimed to evaluate the effects of oropharyngeal exercise (OPE) in addition to continuous positive airway pressure (CPAP) therapy in patients diagnosed with OSA. Methods Patients with moderate and severe OSA were screened from the electronic database of our hospital and 41 patients (20: exercise group; 21: control group) were included in the study. Each patient was assessed with CPAP usage time, maximal voluntary ventilation (MVV), maximum inspiratory and expiratory pressure (MIP-MEP), neck circumference, body mass index (BMI), waist-hip ratio, Epworth sleepiness score, Pittsburgh sleep quality index (PSQI), and short-form health survey (SF-36) in the first visit. The OPE was prescribed in addition to CPAP for the exercise group and performed by the patients for 3 months. At the end of the third month, groups were re-assessed with the same parameters. Results Most of the patients were men, and the mean age of the study population was 51.9 +/- 7.4; the mean apnea-hypopnea index (AHI) in the last polysomnography report was 53.3 +/- 27.4. In the exercise group, MVV (p = 0.003), MIP (p = 0.002), MEP (p = 0.024), and SF-36 energy/fatigue (p = 0.020) were observed to increase while the total PSQI score (p = 0.036) decreased. The neck circumference (p = 0.006) and BMI (p = 0.013) were found to be significantly decreased in the exercise group. Conclusions We found that OPE training may have improved respiratory muscle strength as well as sleep quality and health-related quality of life in the exercise group. OPE along with CPAP therapy may be recommended in moderate and severe OSA patients who are willing to participate