Aging effect on sleepiness and apneas severity in patients with obstructive sleep apnea syndrome: a meta-analysis study

Iannella, Giannicola; Vicini, Claudio; Colizza, Andrea; Meccariello, Giuseppe; Polimeni, Antonella; Greco, Antonio; Vincentiis, Marco de; Vito, Andrea De; Cammaroto, Giovanni; Gobbi, Riccardo Gomes; Bellini, Chiara; Firinu, Elisabetta; Pelucchi, Stefano; Gulotta, Giampiero; Visconti, Irene Claudia; Luca, Milena Di; Magliulo, Giuseppe

doi:10.1007/s00405-019-05616-0

Cited by 37 publications

(23 citation statements)

References 39 publications

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“…In the patient group, as expected, the sleep apnea variables were highly correlated, with a high AHI and high BMI predicting a low SpO 2 and increasing age predicting lower sleepiness, SpO 2, and lower subjective nasal obstruction. These findings are in line with previous findings of a positive correlation between AHI and BMI [29] and a negative correlation between BMI and the lowest SpO 2 [30], between AHI and SpO 2 min [31], and between age and ESS scores [32].…”

Section: Discussionsupporting

confidence: 93%

Assessment of Screening for Nasal Obstruction among Sleep Dentistry Outpatients with Obstructive Sleep Apnea

et al. 2020

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Oral appliances (OA), a common treatment modality for obstructive sleep apnea (OSA), are not suitable for patients with nasal obstruction. Rhinomanometry, the gold standard technique to assess nasal airway resistance, is not readily available in sleep dentistry clinics. We demonstrate the use of a portable lightweight peak nasal inspiratory flow (PNIF) rate meter to objectively assess nasal airflow and utilized the Nasal Obstruction Symptom Evaluation (NOSE) scale to subjectively assess nasal obstruction in 97 patients with OSA and 105 healthy controls. We examined the correlations between the following variables between the groups: demographics, body mass index, PNIF, NOSE scale scores, apnea–hypopnea index (AHI), minimum SpO2 (SpO2min), Mallampati classification, and Epworth Sleepiness Scale (ESS) scores. Patients with OSA had significantly lower PNIF values and higher NOSE scores than controls. In the patient group, PNIF was not significantly correlated with AHI, SpO2min, Mallampati classification, or NOSE or ESS scores. Lower PNIF values and higher NOSE scores suggested impaired nasal airflow in the OSA group. As daytime PNIF measurement bears no relationship to AHI, this cannot be used alone in predicting the suitability of treatment for OSA with OA but can be used as an adjunct for making clinical decisions.

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Section: Discussionsupporting

confidence: 93%

Assessment of Screening for Nasal Obstruction among Sleep Dentistry Outpatients with Obstructive Sleep Apnea

et al. 2020

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“…Potentially protective mechanisms show deterioration with age, and the elderly population is therefore more vulnerable to hypoxemia. 44 Increased arousal 45 and decreased slow wave sleep have also been well established 46 In addition, the older population less commonly report daytime sleepiness, 47 whereas younger people with OSA tend to report sleepiness more often. We established the association of more pronounced daytime sleepiness with shorter reaction time in our OSA patients, when age is not controlled for.…”

Section: Discussionmentioning

confidence: 98%

“…We established the association of more pronounced daytime sleepiness with shorter reaction time in our OSA patients, when age is not controlled for. Indeed, it has been reported that OSA has a more prominent effect on daytime sleepiness in young or middle-aged patients than in elderly patients, 47 which might explain the possible moderating effect of age on this relationship. This was additionally confirmed with our results showing the lack of association of daytime sleepiness and psychomotor performance when age was accounted for.…”

Section: Discussionmentioning

confidence: 99%

<p>Psychomotor Performance in Patients with Obstructive Sleep Apnea Syndrome</p>

Kalcina¹,

Dodig²,

Pecotić³

et al. 2020

NSS

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Purpose: Determinants of obstructive sleep apnea (OSA) are hypoxemia and hypercapnia, as well as (micro) arousals from sleep, resulting in chronic sleep fragmentation, sleep deprivation, and excessive daytime sleepiness (EDS). All of the above-mentioned factors might contribute to psychomotor impairment seen in OSA patients. Additionally, this study aimed to assess the contribution of BMI, age, EDS assessed with Epworth sleepiness scale (ESS), and severity of OSA assessed with apnea-hypopnea index (AHI) to the reaction time on chronometric tests in OSA patients and controls. It is hypothesized that moderate and severe OSA have adverse effects on reaction time of perception to visual stimulus, of solving simple arithmetic operations, and of psychomotor limbs coordination assessed by chronometric psychodiagnostic test battery. Patients and Methods: This study was conducted on 206 male participants; 103 of them had moderate or severe OSA diagnosed by whole-night polysomnography/polygraphy. Control participants (N=103), matched to patients with OSA by age and BMI, had no reported OSA in their medical history, no increased risk for OSA, nor EDS. All participants were assessed with three chronometric psychodiagnostic tests, measuring the reaction time of perception to visual stimulus, of solving simple arithmetic operations, and of psychomotor limbs coordination. Results: Participants from the OSA group achieved impaired results compared to control participants in minimum single task solving time in speed of solving simple arithmetic operations (3±0.9 and 2.6±0.6, P<0.001), and in minimum solving time of a single task in complex psychomotor limbs coordination (0.69±0.2 and 0.61±0.1, P=0.007). Regression analysis revealed no significant contribution of daytime sleepiness to the results achieved in each of the tests. Conclusion: It is concluded that severe OSA impaired speed of perception, convergent, and operative thinking. Moreover, it is suggested that EDS did not contribute to poor psychomotor outcome in patients with OSA in this study, when age was controlled for.

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“…"Obstructive Sleep Apnea (OSA) syndrome is a respiratory sleep disorder characterized by partial or complete recurrent episodes of upper airway collapse, that occurs during the night" [1,2]. OSA manifests with a reduction (hypopnea) or complete cessation (apnea) of airflow in the upper airways [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Long-Term Subjective Outcomes of Barbed Reposition Pharyngoplasty for Obstructive Sleep Apnea Syndrome Treatment

Iannella

Vallicelli

Magliulo

et al. 2020

IJERPH

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Background: The purpose of this study was to evaluate long-term subjective outcomes of barbed reposition pharyngoplasty for obstructive sleep apnea syndrome (OSAS) treatment using a specific questionnaire, the Palate Postoperative Problem Score (PPOPS). Methods: 140 patients who underwent barbed reposition pharyngoplasty (BRP) surgery in the Morgagni Pierantoni Hospital of Forlì, Italy were enrolled in the study. Postoperative outcomes were evaluated in a short- and long-term follow-up using the PPOPS questionnaire. The average period of follow-up was 26 months. All patients received the PPOPS questionnaire by telephone in a period between April and August 2019. Results: 51% of patients complained of swallowing problems after surgery. In 91% of cases, the problem cleared up spontaneously. At the time of the interview, only 9% of patients had a residual swallowing difficult. At the time of PPOPS evaluation, rhinolalia was observed in 8% of patients, whereas nose regurgitation was present in 2% of patients. In 20% of patients, the foreign body sensation was present during follow-up. The value of apnea–hypopnea index (AHI) reduced from the preoperative value of 31.5 to the postoperative value of 11.4. Conclusions: BRP surgery proved to be an effective technique, appreciated by the majority of patients. Use of the PPOPS questionnaire has demonstrated that the BRP technique seems to ensure efficacy and lower morbidity, with few complications after surgery.

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Aging effect on sleepiness and apneas severity in patients with obstructive sleep apnea syndrome: a meta-analysis study

Abstract: Different authors have reported that aging could be associated with changes in Obstructive Sleep Apnea (OSA) related parameters (Apnea/hypopnea index, SpO2, reduction of daytime sleepiness, etc.), type of sleep and pattern of collapse. Regarding

Cited by 37 publications

References 39 publications

Assessment of Screening for Nasal Obstruction among Sleep Dentistry Outpatients with Obstructive Sleep Apnea

Assessment of Screening for Nasal Obstruction among Sleep Dentistry Outpatients with Obstructive Sleep Apnea

<p>Psychomotor Performance in Patients with Obstructive Sleep Apnea Syndrome</p>

Long-Term Subjective Outcomes of Barbed Reposition Pharyngoplasty for Obstructive Sleep Apnea Syndrome Treatment

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