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Diagnostics
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Advances in Diagnosis and Treatment of Obstructive Sleep Apnea
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Advances in Diagnosis and Treatment of Obstructive Sleep Apnea

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (30 November 2024) | Viewed by 5602

Special Issue Editor

Dr. Andrea Bruni

E-Mail Website
Guest Editor
Anesthesia and Intensive Care Unit, Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
Interests: obstructive sleep apnea; cephalometric indices; breathing; artificial ventilation

Special Issue Information

Dear Colleagues,

There are several types of sleep apnea, but the most common is obstructive sleep apnea (OSA). It often results in oxygen desaturation and arousal from sleep.

Obstructive sleep apnea occurs when the muscles in the back of your throat relax too much to allow normal breathing. These muscles support structures including the back of the roof of your mouth (soft palate), the triangular piece of tissue hanging from the soft palate (uvula), the tonsils, and the tongue. Several studies have demonstrated that craniofacial and soft tissue abnormalities such as mandibular retrognathia and adenoidal hypertrophy, as well as older age, male gender, and obesity, contribute to loss of airway patency in patients with OSA

Diagnosis of OSA requires a thorough clinical examination, a flexible nasendoscopy, and an overnight sleep study (polysomnogram). However, this is an expensive and time-consuming investigation that cannot precisely localize the site of obstruction. There is growing interest in using lateral cephalograms as a diagnostic tool. Meanwhile, cephalometric measurements like position and length of mandible, tongue, soft plate area, and facial height were also found to be different in OSA patients compared with healthy individuals.

This Special Issue focus on the advances in the pathology, symptom, diagnosis, and treatment of OSA; effective biomarkers of the pathogenesis and development of OSA; quality of life of people with OSA; and mechanisms linking diseases/disorders to OSA.

Dr. Andrea Bruni
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • medical diagnosis
  • obstructive sleep apnea
  • craniofacial structure
  • airway
  • cephalometric indices
  • diagnosis and treatment of OSA

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Published Papers (4 papers)

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Research

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14 pages, 949 KiB  
Article
Development and Validation of a Screening Equation for Obstructive Sleep Apnea
by Antonio Fabozzi, Alessia Steffanina, Matteo Bonini and Paolo Palange
Diagnostics 2025, 15(4), 427; https://doi.org/10.3390/diagnostics15040427 - 10 Feb 2025
Cited by 1 | Viewed by 829
Abstract
Background: The high prevalence of obstructive sleep apnea (OSA), about 30% of people worldwide over 30 years old, underscores the crucial need for early screening. This study aimed to identify key predictive factors for OSA; use these factors to develop a screening equation [...] Read more.
Background: The high prevalence of obstructive sleep apnea (OSA), about 30% of people worldwide over 30 years old, underscores the crucial need for early screening. This study aimed to identify key predictive factors for OSA; use these factors to develop a screening equation for a population at high risk for OSA; and prospectively validate this equation’s application. Methods: The study included two phases: a retrospective phase examining anthropometric data, the Epworth sleepiness scale (ESS), and the home sleep apnea test (HSAT) from 200 patients referred to the Respiratory Sleep Disorder Center at Policlinico Umberto I, Rome, Italy (January 2020–January 2023) to create a predictive equation for OSA using multivariate analysis (with the most predictive data according to scientific literature). A prospective phase testing this equation on 53 patients from May 2023 to September 2024. Results: In the retrospective phase, the most predictive variables for the apnea–hypopnea index (AHI) identified were neck circumference (NC) and the Epworth sleepiness scale (ESS). The predictive equation derived from the multivariate analysis was as follows: AHIp = [−70.498 + (2.196 × NC) + (0.809 × ESS)]. In the prospective phase of the study, we compared the AHI predicted by the equation (AHIp) with the AHI measured via the HSAT (AHIm) in 53 patients recruited. The results showed that AHIp had a sensitivity of 95%, a specificity of 28%, a positive predictive value (PPV) of 46%, and a negative predictive value (NPV) of 90%. Conclusions: This study identified NC and ESS as key predictors of OSA, forming a predictive equation. This equation, showing high sensitivity and high NPV, may be useful as a screening method to rule out OSA. Full article
(This article belongs to the Special Issue Advances in Diagnosis and Treatment of Obstructive Sleep Apnea)
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11 pages, 408 KiB  
Article
Can Galectin-3 Be Used as a Predictor of Obstructive Sleep Apnea Severity: Insights from High-Volume Patient Single Center
by Milica Brajkovic, Sofija Nikolic, Viseslav Popadic, Natasa Milic, Nina Rajovic, Novica Nikolic, Ana Sekulic, Marija Brankovic, Mihailo Stjepanovic, Spasoje Popevic, Branko Milovanovic and Marija Zdravkovic
Diagnostics 2025, 15(3), 375; https://doi.org/10.3390/diagnostics15030375 - 5 Feb 2025
Viewed by 763
Abstract
Background/Objectives: Obstructive sleep apnea (OSA) is a condition characterized by intermittent airway obstructions, leading to reduced oxygen levels and increased sympathetic nervous system activity. OSA can cause a range of health problems, including an increased risk of cardiovascular diseases and mortality. Galectin-3, a [...] Read more.
Background/Objectives: Obstructive sleep apnea (OSA) is a condition characterized by intermittent airway obstructions, leading to reduced oxygen levels and increased sympathetic nervous system activity. OSA can cause a range of health problems, including an increased risk of cardiovascular diseases and mortality. Galectin-3, a member of the galectin family, plays a significant role in inflammation and fibrosis, and studies show that it is elevated in various conditions, including heart and lung diseases. The aim of this study was to determine whether galectin-3 levels are related to the severity of sleep apnea. Methods: A total of 191 participants from the University Clinical Hospital Center Bezanijska Kosa, Belgrade, Serbia, between January 2023 and May 2024, were included in the analyses. All patients were hospitalized under suspicion of OSA, and they all underwent a polysomnography test. Various demographic, respiratory, laboratory, and clinical parameters were obtained. Correlations between numerical variables and galectin-3 were assessed by the Pearson or Spearman correlation coefficients. Univariate and multivariate linear regression models were used to assess the predictors of galectin-3 values. In all analyses, the significance level was set at 0.05. Results: The mean age of the study participants was 56.2 years, mostly male (68.9%). Of the comorbidities, two-thirds of patients had hypertension (66.1%), 46.8% had hyperlipoproteinemia, and 21.1% had diabetes mellitus. Patients who had an AHI of more than fifteen events per hour more often had higher values of galectin-3. OSA severity had a significant positive correlation with galectin-3 (p = 0.014). In multivariate linear regression analysis, significant independent predictors of higher galectin-3 values were older age, presence of coronary disease, hypoventilation syndrome, higher BMI, NTproBNP, lactate, creatinine, lower LDL, and lower FEV1 (p < 0.05). Conclusions: The present study demonstrated that galectin-3 is linked to the severity of OSA and plays a crucial role in inflammation induced by intermittent hypoxia in OSA. Further screening and interventions targeting galectin-3 could aid in preventing inflammatory diseases related to sleep disturbances. Full article
(This article belongs to the Special Issue Advances in Diagnosis and Treatment of Obstructive Sleep Apnea)
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Review

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24 pages, 1196 KiB  
Review
The Global Burden of Obstructive Sleep Apnea
by Giannicola Iannella, Annalisa Pace, Mario Giuseppe Bellizzi, Giuseppe Magliulo, Antonio Greco, Armando De Virgilio, Enrica Croce, Federico Maria Gioacchini, Massimo Re, Andrea Costantino, Manuele Casale, Antonio Moffa, Jerome R. Lechien, Salvatore Cocuzza, Claudio Vicini, Alberto Caranti, Rosario Marchese Aragona, Mario Lentini and Antonino Maniaci
Diagnostics 2025, 15(9), 1088; https://doi.org/10.3390/diagnostics15091088 - 25 Apr 2025
Viewed by 1150
Abstract
This study reviewed the global prevalence, health and socioeconomic impact, and management approaches of obstructive sleep apnea. The narrative review examined three key dimensions: (1) worldwide OSA prevalence across different regions, accounting for variations in diagnostic standards; (2) OSA’s effects on health outcomes [...] Read more.
This study reviewed the global prevalence, health and socioeconomic impact, and management approaches of obstructive sleep apnea. The narrative review examined three key dimensions: (1) worldwide OSA prevalence across different regions, accounting for variations in diagnostic standards; (2) OSA’s effects on health outcomes and socioeconomic conditions across diverse populations and healthcare systems; and (3) current global approaches to OSA diagnosis, treatment, and public health management. Despite advances in diagnosis and treatment, a large proportion of OSA cases remain undiagnosed or inadequately managed. The findings show that untreated OSA significantly increases public safety risks, particularly regarding motor vehicle and occupational accidents, while also creating a substantial pool of patients at high risk for systemic complications with severe impacts on overall health. There is a critical need for increased public awareness, universal screening approaches, and integrated care strategies to address this global health challenge and reduce its considerable socioeconomic burden. Our review uniquely addresses global disparities in OSA prevalence, clarifies the health and socioeconomic impacts that remain underexplored in the current literature, and suggests concrete strategies for public health and clinical management improvement worldwide. Full article
(This article belongs to the Special Issue Advances in Diagnosis and Treatment of Obstructive Sleep Apnea)
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Other

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13 pages, 5039 KiB  
Guidelines
An Interdisciplinary Approach: Presentation of the Pediatric Obstructive Sleep Apnea Diagnostic Examination Form (POSADEF)
by Janine Sambale, Richard Birk, Ulrich Koehler, Wulf Hildebrandt and Heike Maria Korbmacher-Steiner
Diagnostics 2024, 14(15), 1593; https://doi.org/10.3390/diagnostics14151593 - 24 Jul 2024
Cited by 2 | Viewed by 2162
Abstract
This report emphasizes the need for interdisciplinary collaboration in diagnosing and treating pediatric obstructive sleep apnea (OSA). OSA, affecting 1% to 4% of children, often results from adenotonsillar hypertrophy, craniofacial disorders, or obesity. While adenotonsillectomy is the primary treatment, about 75% of children, [...] Read more.
This report emphasizes the need for interdisciplinary collaboration in diagnosing and treating pediatric obstructive sleep apnea (OSA). OSA, affecting 1% to 4% of children, often results from adenotonsillar hypertrophy, craniofacial disorders, or obesity. While adenotonsillectomy is the primary treatment, about 75% of children, especially those with craniofacial disorders or obesity, continue to experience OSA symptoms post-surgery. To address these cases, several medical fields emphasize the necessity and demand for interdisciplinary collaboration in managing pediatric OSA. Therefore, the authors aimed to develop the Pediatric Obstructive Sleep Apnea Diagnostic Examination Form (POSADEF). This form, based on clinical experience and the literature, captures craniofacial and functional characteristics linked to pediatric OSA. A case study of an eight-year-old girl with OSA, who was unsuccessfully treated with adenotonsillectomy, underlines the importance of the diagnostic examination form. The orthodontic assessment revealed craniofacial disorders and subsequent treatment with maxillary expansion and functional appliance therapy resolved her OSA symptoms. This case demonstrates the value of POSADEF in enabling comprehensive evaluation and treatment across medical disciplines. POSADEF is designed to assist health care professionals in diagnosing craniofacial and orofacial anomalies contributing to pediatric OSA. Full article
(This article belongs to the Special Issue Advances in Diagnosis and Treatment of Obstructive Sleep Apnea)
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