Search Results (51)

Background/Objectives: Sleep questionnaires are used as screening tools to estimate the presence and severity of snoring and obstructive sleep apnea (OSA). The aim was to prospectively assess the diagnostic and prognostic accuracy of sleep questionnaires (Epworth Sleepiness Scale (ESS), Visual Analog Scale for snoring loudness (VAS), Short Form Health Survey 36 (SF-36), STOP-Bang, and Pittsburgh Quality of Sleep (PSQI)) in subjects who underwent minimally invasive surgery for snoring and OSA. Methods: A total of 49 participants with primary snoring and/or OSA underwent minimally invasive surgery. Pre- and post-operative sleep study parameters and sleep questionnaire results were analyzed to assess the correlation between the subjective and objective parameters before and after surgery and changes with the surgery. Results: Pre-operative sleep study parameters demonstrated: an apnea–hypopnea index (AHI) of 16.71 ± 9.31, oxygen desaturation index (ODI) of 14.43 ± 9.31, and mean percentage of snoring time (ST) of 17.26 ± 14.5%, ESS of 9.04 ± 5.76, VAS of 8.18 ± 1.93, SF-36 of 42.12 ± 22.86, STOP-Bang of 3.65 ± 1.13, and PSQI of 6.61 ± 3.23. Post-operative sleep study parameters demonstrated an AHI of 10.39 ± 7.86, ODI of 10.17 ± 7.78, and ST of 12.55 ± 13.36%, ESS of 6.61 ± 4.55, VAS of 4.13 ± 2.87, SF-36 of 42.45 ± 24.70, STOP-Bang of 2.49 ± 1.42, and PSQI of 4.98 ± 2.13. Changes with surgery for sleep parameters demonstrated a decrease in AHI: 37.83%, ODI: 29.52%, ST: 27.3%, ESS: 26.86%, VAS: 49.50%, PSQI: 24.69%, and STOP-Bang: 31.84%. The score of SF-36 was not significant. Conclusions: Sleep questionnaires are an essential component of the workup for patients with snoring and OSA. There are differences in their ability to identify the presence and quantify the severity of snoring and OSA when compared to objective sleep parameters. Their sensitivity in assessing changes with treatment also varies. Full article

Background/Objectives: Obstructive sleep apnea is a prevalent, yet often underdiagnosed, condition characterized by recurrent upper airway obstruction during sleep, leading to significant perioperative risks in surgical patients. This systematic review aims to evaluate the incidence and impact of objectively diagnosed obstructive sleep apnea on postoperative outcomes across various surgical specialties—including bariatric, orthopedic, cardiac, and otorhinolaryngologic surgeries—and to assess the effectiveness of preoperative screening and perioperative management strategies. Methods: A comprehensive literature search of PubMed was conducted for studies published between January 2013 and December 2024, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Included studies involved adult surgical patients with OSA confirmed by polysomnography or respiratory polygraphy. Studies were assessed for methodological quality using the Oxford Centre for Evidence-Based Medicine Levels of Evidence framework. Results: The findings consistently indicated that obstructive sleep apnea significantly increases the risk of postoperative complications, such as respiratory depression, atrial fibrillation, acute kidney injury, delirium, and prolonged hospital stay. Continuous positive airway pressure therapy demonstrated a protective effect in bariatric and cardiac surgeries, though its effectiveness in orthopedic and otorhinolaryngologic contexts was inconsistent, largely due to adherence variability and limited implementation. Preoperative screening tools such as the STOP-BANG questionnaire were widely used, but their utility depended on integration with confirmatory diagnostics. Conclusions: Obstructive sleep apnea represents a significant, modifiable risk factor in surgical populations. Preoperative identification and risk-adapted perioperative management, including CPAP therapy and multimodal analgesia, may substantially reduce postoperative morbidity. However, further randomized trials and cost-effectiveness studies are needed to optimize care pathways and ensure consistent implementation across surgical disciplines. Full article

Background: Obstructive Sleep Apnea (OSA) is a common occurrence in the perioperative patient population but is often undiagnosed. Point-of-Care Ultrasound (POCUS) has emerged as a promising tool for perioperative assessment; however, its effectiveness in detecting the presence or severity of OSA needs to be evaluated. Objective: We assessed the ability of airway POCUS as a screening and severity evaluation tool for OSA by examining its correlation with STOP-BANG scores and the Apnea–Hypopnea Index (AHI). Design: Cross-sectional observational study. Setting: A single-center study in a tertiary care hospital between June 2020 to May 2021. Patients: Adult patients aged 18–65 with prior Polysomnography (PSG) for OSA workup were screened. Interventions: The participants completed the STOP-BANG questionnaire and subsequently underwent POCUS examinations, either pre- or post-surgery. Ten different POCUS views previously used for evaluating OSA were acquired in a predefined sequence, with subsequent measurements of airway parameters. Outcome measures: Generalized linear modeling was used to explore and assess the relationships between the measured parameters, STOP-BANG, and AHI scores (modeled continuously and categorized into risk levels of STOP-BANG and AHI). Results: A total of 260 patients were screened, of which 142 were enrolled and 127 completed the scanning studies. The median AHI was 16.71, while the STOP-BANG scores were mostly between 5 and 6, indicating a moderate-to-high OSA risk in the study population. Notably, only neck circumference was significantly associated with AHI severity (p = 0.012), whereas none of the other POCUS measures were. Among the POCUS measures, significant associations with STOP-BANG scores were observed for the Tongue Cross-Sectional Area (T-CSA) (p = 0.002), Retro-Palatal Diameter (RPD) (p = 0.034), Distance Between Lingual Arteries (DLA) (p = 0.034), and Geniohyoid Muscle Thickness (GMT) (p = 0.040). Conclusions: Neck circumference is a more reliable predictor of OSA severity (AHI) compared to other POCUS measurements. Many of the POCUS measures had a good correlation with the STOP-BANG scores, highlighting the utility of POCUS as a screening tool for OSA rather than as a severity evaluation tool. Full article

Background: Obstructive sleep apnea (OSA) and abnormal sleep duration are known risk factors for hypertension. However, evidence regarding their combined effect on hypertension is limited and inconsistent. This study aimed to examine the independent and interactive associations of OSA risk and sleep duration with hypertension in Korean adults. Methods: We analyzed data from 14,579 adults aged ≥40 years who participated in the 2019–2022 Korea National Health and Nutrition Examination Survey. OSA risk was assessed using the STOP-Bang questionnaire and classified as low (0–2), moderate (3–4), or high (5–8). Sleep duration was self-reported and categorized as <6, 6–<7, 7–<8, 8–<9, and ≥9 h. Hypertension was defined based on measured blood pressure and antihypertensive medication use. Multivariate logistic regression was conducted to evaluate the associations. Results: A dose–response association was observed between OSA risk and hypertension prevalence: adjusted ORs (95 CIs) were 9.69 (8.37–11.23) for moderate and 36.58 (29.35–45.59) for high OSA risk. Sleep duration alone was not significantly associated with hypertension. However, interaction models showed a U-shaped relationship, with the lowest hypertension prevalence in those sleeping 7–<8 h. Among participants with high OSA risk, both short (<7 h) and long (≥9 h) sleep durations were associated with significantly higher hypertension risk (OR 48.49, 95% CI 19.68–119.50 for ≥9 h). Conclusions: OSA risk and sleep duration jointly affect hypertension risk. Individuals with high OSA risk who are short or long sleepers may require targeted interventions to improve blood pressure control. Full article

Background: Obstructive sleep apnea (OSA) has been associated with adverse oral function outcomes, yet its association with oral function remains underexplored. This study aims to analyze the association between OSA and oral function problems, and whether these relationships are more pronounced among socioeconomically disadvantaged groups. Methods: Data were derived from the 2022–2023 Korea National Health and Nutrition Examination Survey (KNHANES), including 6349 participants aged 40 and above. OSA risk was assessed using the STOP-Bang questionnaire. Oral function was evaluated through chewing discomfort, speaking discomfort, and dental pain. Complex sample logistic regression was performed, adjusting for demographic, socioeconomic, and health-related covariates. Stratified analyses were conducted to examine whether the association differed across socioeconomic groups. Result: High OSA risk was significantly associated with chewing discomfort (OR: 1.365, 95% CI: 1.121–1.662), speaking discomfort (OR: 1.534, 95% CI: 1.126–2.082), and dental pain (OR: 1.198, 95% CI: 1.006–1.431). Stratified analyses showed stronger associations in low education or income groups. For instance, those in the lowest income group were over five times more likely to report speaking discomfort (OR = 5.207, 95% CI: 2.365–11.462) than those in the highest. Conclusions: OSA risk is significantly associated with impaired oral function, particularly among socioeconomically disadvantaged groups. These findings underscore the need for integrated public health approaches that address both sleep and oral health disparities. Full article

Background/Objectives: Obstructive sleep apnea (OSA) is known to be closely associated with obesity, cardiovascular diseases, stroke, and mortality, and is a growing public health concern in South Korea. While conventional cigarette smoking is an established risk factor for OSA, the impact of electronic cigarette use on OSA remains poorly understood. This cross-sectional study aimed to investigate the association between electronic cigarette use and the risk of OSA among Korean adults. Methods: This study utilized data from the 2019–2023 Korea National Health and Nutrition Examination Survey (KNHANES). Smoking behavior was categorized into four groups: electronic cigarette users (dual users of electronic and conventional cigarettes), conventional cigarette smokers, non-smokers, and ex-smokers. The risk of OSA was assessed using the STOP-Bang questionnaire (score ≥ 5), and multivariable logistic regression was used to examine associations between smoking behaviors and OSA risk, with full adjustment for potential confounders. Results: Of the total participants, 3.3% were electronic cigarette users, 15.0% conventional cigarette smokers, 26.6% ex-smokers, and 55.1% non-smokers. Compared to non-smokers, the odds of being at high risk for OSA were significantly elevated among electronic cigarette users (OR = 2.01, 95% CI: 1.21–3.33), conventional cigarette smokers (OR = 1.84, 95% CI: 1.32–2.57), and ex-smokers (OR = 1.70, 95% CI: 1.25–2.30). This association remained significant even when the analysis was restricted to male participants. Conclusions: The significant association between electronic cigarette use and increased OSA risk highlights the need for targeted smoking cessation strategies and public health interventions that address the underestimated harms of vaping. Full article

Background: Sleep apnea is a breathing affliction that affects sleep quality, with significant implications for overall physical and oral health, as well as mental health. Aim: The aim of this study was to evaluate the validity of the STOP-Bang and Epworth questionnaires as preoperative screening tools for obstructive sleep apnea (OSA) in the adult population from the NE region of Romania. Materials and Methods: A total of 222 participants were selected. The questionnaire method was used, with the subjects completing the STOP-Bang and Epworth questionnaires. A chi-squared test, an ANOVA, and Student’s t-tests were used for the statistical analysis. Results: the STOP-Bang questionnaire revealed an increased risk of OSA among those with a high BMI, an age over 50 years, or a large neck circumference. Regarding the Epworth questionnaire, daytime sleepiness was more frequent among obese individuals and those with associated pathologies. Significant correlations were found between OSA and obesity, age, and associated pathologies, with limited observations on the influence of gender on the risk of OSA. Conclusions: The studied questionnaires are effective and easy-to-use tools for the preoperative screening of OSA, demonstrating a significant correlation between the identified risk factors and the disease severity. Full article

Background: Aging is a well-established independent risk factor for both cognitive impairment and sleep disorders, including obstructive sleep apnea (OSA), a modifiable yet underrecognized condition. OSA has been implicated in biological mechanisms contributing to Alzheimer’s disease, including amyloid-β accumulation, tau phosphorylation, and neuroinflammation. This underscores the need to optimize OSA diagnosis in individuals with an increased risk of dementia. Methods: This cross-sectional observational study enrolled adults aged 60–85 years with a CAIDE dementia risk score ≥6. Subjective sleep was evaluated using validated questionnaires (Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and the Oviedo Sleep Questionnaire), while objective sleep data were obtained through a single-night peripheral arterial tonometry (PAT)-based wearable device, complemented by a 7-day sleep diary. Participants also completed the STOP-BANG and Berlin questionnaires, with clinically relevant findings communicated to participants. Results: Among 322 participants (48.8% women; mean age 71.4 ± 6.4 years), moderate-to-severe OSA (apnea–hypopnea index [AHI] ≥ 15) was identified in 48.49%, despite the absence of prior diagnoses. Subjective screening tools frequently underestimated OSA severity compared to objective assessments. While no significant sex-based differences were noted, higher AHI values correlated strongly with increased body mass index and elevated dementia risk scores. Conclusions: A marked discrepancy between subjective and objective sleep measurements complicates the accurate diagnosis and management of most sleep disorders, including OSA. Sleep disorders remain significantly underdiagnosed in individuals at increased risk for dementia. Integrating wearable technologies and structured tools such as sleep diaries into routine assessments can enhance diagnostic precision, enabling timely interventions for these modifiable risk factors of dementia. Full article

Background: Sleep disturbances are prevalent among stroke survivors, significantly impacting their recovery and quality of life. This study aimed to evaluate the prevalence of sleep disorders, sleep quality, risk of obstructive sleep apnea (OSA), and daytime sleepiness among stroke survivors and to identify potential associations with clinical and demographic factors. Materials and Methods: A retrospective observational study analyzed adult stroke survivors (aged ≥ 18 years) attending neurology clinics at our institution from November 2022 to November 2024. The primary outcome measures included overall sleep quality, sleep apnea and daytime sleepiness assessment. Data were collected using validated Arabic versions of the Pittsburgh Sleep Quality Index (PSQI), STOP-Bang Questionnaire, and Epworth Sleepiness Scale (ESS). Statistical analyses, including Chi-square tests and t-tests, were performed using SPSS version 30.1. Results: A total of 100 stroke survivors, mostly aged 40–60 years, were recruited in our study. The prevalence of sleep disorders was 60.0%, with poor sleep quality reflected by a mean global PSQI score of 9.13 ± 14.40. Additionally, 19.0% were at high risk of OSA, and 24.0% experienced abnormal daytime sleepiness. While no statistically significant associations were found between sleep disorders and clinical or demographic factors, trends indicated higher sleep disorder prevalence in those with hemorrhagic stroke and high-risk OSA profiles. Conclusions: Our study highlights a high prevalence of sleep disorders among stroke survivors, emphasizing the need for regular sleep assessments. Future studies should explore objective assessments and larger sample sizes to validate these findings and to assess their potential implication in stroke recovery and quality of life. Full article

Background/Objectives: Cardiovascular health (CVH) can be conceptualized as encompassing seven health behaviors and metabolic factors that contribute to cardiovascular disease. We explored the relationship between the risk of obstructive sleep apnea (OSA) and CVH among middle-aged Korean adults. Methods: Data from 5909 participants, aged between 40 and 64 years, in the Korea National Health and Nutrition Examination Survey (2019–2021) were analyzed. The risk of OSA was assessed using STOP-Bang questionnaire. CVH metrics, including smoking status, diet, physical activity, body mass index (BMI), blood pressure, total cholesterol level, and fasting glucose concentration, were evaluated using American Heart Association criteria. Multivariate logistic regression analysis was employed to investigate the association between OSA risk and CVH. Results: Among study participants, 78.6% of men and 16.3% of women displayed moderate-to-high risk of OSA, while 45.4% of men and 17.2% of women exhibited poor CVH. The ORs (95% CIs) for poor CVH were 2.69 (2.08–3.49) for men at moderate risk of OSA and 6.54 (4.81–8.90) for those at high risk, compared to men at low risk. For women, the ORs were 3.21 (2.47–4.19) for those with moderate risk and 12.88 (6.29–26.38) for those with high risk of OSA, compared to women at low risk. CVH metrics associated with moderate-to-high OSA risk included high BMI, high blood pressure, elevated fasting glucose, and smoking. Conclusions: The risk of OSA was associated with poor CVH, while various CVH components were linked to moderate-to-high OSA risk. Managing both OSA and components of CVH is essential to minimize poor CVH. Full article

Introduction: Chronic obstructive pulmonary disease (COPD) has a severe impact on patients’ health and can lead to multiple complications. Material and methods: We analyzed the co-occurrence of obstructive sleep apnea (OSA) in COPD patients hospitalized in the Pneumology Clinic of Târgu Mureș, Romania. Results: A total of 150 COPD patients were investigated by clinical examination, STOP-BANG and Epworth questionnaires, ventilatory polygraphy (PG), EKG, cardiac ultrasound, blood lipids, and sugar. Sixty-eight patients (45.3%) had OSA associated with COPD. A total of 61.7% were COPD gr. E, and 30.8% were gr. B. Frequently shown symptoms were snoring and nonrestorative sleep (100%), somnolence (73.5%), nocturnal awakenings (41.17%), morning headache (32.3%), and aggravated dyspnea. Types of OSA included obstructive (97.05%), central (2.5%), and associated obesity–hypoventilation (39.7%). A total of 76.4% were recently diagnosed with OSA. Men predominated at 70.5%, 76.4% were smokers, and 61.7% had experienced alcohol abuse. A total of 25% were overweight, and 71% had obesity. A total of 13.2% belonged to the category of 38–50-year-olds, 55.8% were in the 51–65-year-old category, 17.6% were in the 66–70-year-old category, and roughly 13.2% were in the 71-year-old category. Overlap syndrome (OS) comorbidities and complications were frequently present: 41% experienced respiratory failure, 66.1% experienced blood hypertension, 58.8% experienced ischemic cardiac disease, 32.35% experienced diabetes mellitus, 50% experienced dyslipidemia, and 29.4% experienced cor pulmonale. Conclusions: OS conferred gravity or directly contributed to cardiovascular, respiratory, and metabolic complications. OS was associated with more severe COPD and obesity. The prevalence of smoking in OS patients was higher than the national/European average. Full article

The risk factors of hospitalized COVID-19 and obstructive sleep apnea (OSA) overlap. The aim of this study is to evaluate the prevalence and associated factors of post-COVID-19 OSA in hospitalized adult patients from southeastern Romania. A follow-up study was conducted on patients hospitalized for COVID-19 at the Pneumology Hospital in Galati, Romania, between 2021 and 2022. OSA was evaluated using the Epworth and STOP-BANG questionnaires and nocturnal polygraphy monitoring. Out of 331 patients, 257 were evaluated for sleep apnea in the 12th week. The prevalence of severe OSA was 57.97%. Significant associations were found with male gender, an age over 60, obesity, and cardiovascular co-morbidities. Non-invasive ventilatory therapy (NIV) and a hygienic–dietary regimen were recommended based on severity following a control visit after a month. Developing strategies for diagnosing and monitoring sleep disorders, including home sleep apnea tests and patient education, are the next directions for post-COVID-19 management. Full article

This study aimed to examine the associations between specific sleep parameters and specific aspects of cognitive functioning in individuals diagnosed with mild cognitive impairment (MCI), compared with healthy controls (HCs) by using cognitive, subjective, and objective sleep measures. A total of 179 participants were enrolled, all aged ≥ 65 years (mean age = 70.23; SD = 4.74) and with a minimum of six years of education (mean = 12.35; SD = 3.22). The sample included 46 HCs (36 females), 75 individuals with amnestic MCI (aMCI) (51 females), and 58 individuals with non-amnestic MCI (naMCI) (39 females). Inhibition, cognitive flexibility as a combined application of inhibitory control and set shifting or task/rule switching, and planning were examined. The following D-KEFS subtests were administered for their evaluation: Verbal Fluency Test, Color–Word Interference Test, and Tower Test. Self-reported sleep questionnaires (Athens Insomnia Scale, Stop-Bang questionnaire, and Pittsburg Sleep Quality Index) were used for subjective sleep assessments. Actigraphy was used for objective sleep measurements. Mixed-measures ANOVA, MANOVA, and one-way ANOVA, as well as the Scheffe post hoc test, were applied to the data. The results showed that the three groups exhibited statistically significant differences in the Tower Test (total achievement score, total number of administered problems, and total rule violations). As regards objective sleep measurements, the total sleep time (TST) was measured using actigraphy, and indicated that there are significant differences, with the HC group having a significantly higher mean TST compared to the naMCI group. The relationships evaluated in the TST Tower Test were found to be statistically significant. The findings are discussed in the context of potential parameters that can support the connection between sleep duration, measured as TST, and cognitive planning, as measured using the Tower Test. Full article

Background/Objectives: Obstructive sleep apnea (OSA) impairs quality of life (QoL). However, its disease burden in the general population remains unknown. We aimed to investigate the association between OSA and health-related QoL in the general Korean population. Methods: This study analyzed cross-sectional datasets of adults (≥40 years) in the Korean National Health and Nutrition Examination Survey 2019–2021. QoL was assessed using the 3-level EuroQoL 5-dimension component (EQ-5D-3L). The high risk of OSA was determined using the STOP-Bang questionnaire (score ≥ 3). Demographic and clinical factors were included in linear regression analyses to identify the factors associated with EQ-5D-3L. Results: Of the 8966 total participants, 6792 (75.8%) and 2174 (24.2%) were classified as having a low risk and high risk of OSA, respectively. The high risk OSA group showed significantly lower QoL scores when compared with the low risk OSA group (0.939 ± 0.003 vs. 0.951 ± 0.002, p < 0.001). However, the mean difference was within the minimal clinically important difference (MCID) of EQ-5D-3L. Only females exceeded the MCID for the EQ-5D-3L. Elderly females with a high risk of OSA showed the lowest QoL. The regression coefficient of high risk OSA in the multivariate model was −0.018 (95% CI: −0.025–−0.01, p < 0.001). Patient demographics and comorbidities also showed significant associations with the EQ-5D-3L. Their regression coefficient was higher than that of high risk OSA. Conclusions: The impact of high risk OSA on QoL manifested differently according to age and sex. The impact of comorbidities on QoL was greater than that of high risk OSA, highlighting the important role of comorbidities and the need for their adjustment in the assessment of QoL. Full article

Background/Objectives: Polysomnography and cephalometry have been used for studying obstructive sleep apnea (OSA) etiology. The association between craniofacial skeleton and OSA severity remains controversial. To study OSA’s etiology, cephalometry, fiberoptic pharyngoscopy, polysomnography, and sleep endoscopy have been used; however, airway obstructions cannot be located. Recent research suggested ultrasonography for OSA screening and upper airway obstruction localization. Thus, this study aims to investigate the relationship between specific craniofacial cephalometric and ultrasonic airway parameters in adults at high risk of OSA. Methods: To assess craniofacial structure, lateral cephalograms were taken from thirty-three adults over 18 with a STOP-Bang questionnaire score of three or higher and a waist-to-height ratio (WHtR) of 0.5 or higher. Airway parameters were assessed through submental ultrasound. Results: NSBA correlated with tongue base airspace width, while MP-H correlated with oropharynx, tongue base, and epiglottis airspace width. SNA, SNB, and NSBA correlated with tongue width at the oropharynx. At tongue base, ANB and MP-H correlated with tongue width. SNB and NSBA were associated with deep tissue thickness at the oropharynx, while MP-H correlated with superficial tissue thickness at velum and oropharynx. Conclusions: Cephalometric parameters (SNA, SNB, ANB, NSBA, and MP-H) were correlated with ultrasonic parameters in the velum, oropharynx, tongue base, and epiglottis. Full article