目的利用儿童阻塞性睡眠呼吸暂停疾病特异性生活质量调查表（disease-specific quality of life for chidren with obstructive sleep apnea 1 8 items survey,OSA-1 8）,对手术治疗前后儿童阻塞性睡眠呼吸障碍（obstructive sleep diso...目的利用儿童阻塞性睡眠呼吸暂停疾病特异性生活质量调查表（disease-specific quality of life for chidren with obstructive sleep apnea 1 8 items survey,OSA-1 8）,对手术治疗前后儿童阻塞性睡眠呼吸障碍（obstructive sleep disordered breathing,OSDB）患者的生活质量进行评估,探讨OSA-18的临床应用意义。方法对30例因扁桃体和（或）腺样体肥大的OSDB患者,采用OSA-18法在术前和术后6个月进行调查,评价手术治疗对OSDB患者生活质量的影响,并对评估结果以及相关问题进行讨论。结果OSDB患儿术后生活质量总分及各维度总评分较术前明显下降（P均〈0.0 1）,改善明显。其中睡眠障碍、身体症状、病情对患儿监护人的影响3个维度的变化值〉1.50,达到显著改善;情绪不佳、白天功能两个维度的变化值在0.50~0.99,为轻度改善。在所有的18个条目中,手术前后平均积分的比较,其差别均具有统计学意义（P〈0.05）。结论OSA-18调查表法可以全面反映儿童OSDB患者的生活质量,OSA-18调查在儿童OSDB的临床诊断、治疗选择和疗效评估均有较好的实用价值,是儿童OSDB疗效评价的可靠方法。展开更多
Objective:To determine the level of agreement among experienced operators of candidacy for upper airway stimulation (UAS) based on evaluation of drug-induced sleep endoscopy (DISE).Methods:The trial was designed as a ...Objective:To determine the level of agreement among experienced operators of candidacy for upper airway stimulation (UAS) based on evaluation of drug-induced sleep endoscopy (DISE).Methods:The trial was designed as a single-blinded cross-sectional study.Four otolaryngologists with extensive DISE experience were given 63 video clips from the STAR trial video library.These videos were graded using the VOTE classification.Percentage agreement and Cohen's k (for inter-rater reliability) were calculated between pairs of reviewers,assessing palatal complete concentric collapse (CCC) and determining UAS eligibility.Subjects were also grouped based on collapse severity for each reviewer.Results:The reviewers had excellent (approximately 90％) agreement on findings at the level of the soft palate and tongue base.The inter-rater reliability for palatal CCC ranged from mod erate to substantial The agreement on determining the criteria for UAS implantation ranged from poor to moderate.All 4 upper airway structures as classified by the criteria of the VOTE were graded by all the reviewers as contributing to obstruction in a majority of subjects who were performed via application of DISE.Conclusion:Application of DISE remains a subjective examination,even among those experienced operators,therefore more studies need to be performed for evaluation of improvement in inter-rater reliability after implantation of training videos.展开更多
Patients with interstitial lung disease commonly exhibit abnormal sleep architecture and increased sleep fragmentation on polysomnography. Fatigue is a frequent complaint, and it is likely that poor sleep quality is a...Patients with interstitial lung disease commonly exhibit abnormal sleep architecture and increased sleep fragmentation on polysomnography. Fatigue is a frequent complaint, and it is likely that poor sleep quality is a significant contributor. A number of studies have shown that sleep disordered breathing is prevalent in this population, particularly in the idiopathic pulmonary fibrosis subgroup. The factors that predispose these patients to obstructive sleep apnoea are not well understood, however it is believed that reduced caudal traction on the upper airway can enhance collapsibility. Ventilatory control system instability may also be an important factor, particularly in those with increased chemo-responsiveness, and in hypoxic conditions. Transient, repetitive nocturnal oxygen desaturation is frequently observed in interstitial lung disease, both with and without associated obstructive apnoeas. There is increasing evidence that sleep-desaturation is associated with increased mortality, and may be important in the pathogenesis of pulmonary hypertension in this population.展开更多
Sleep disordered breathing (SDB) is an independent risk factor for cardiovascular disease. It is known to be associated more frequently with men than women, particularly in the premenopausal age range. The goal of thi...Sleep disordered breathing (SDB) is an independent risk factor for cardiovascular disease. It is known to be associated more frequently with men than women, particularly in the premenopausal age range. The goal of this study is to evaluate gender differences among Korean patients diagnosed with SBD. This study included 309 patients who visited our Sleep Clinic due to sleep-related symptoms and were diagnosed with SDB by overnight polysomnography (PSG). We analyzed age, gender, body mass index, various PSG indices including sleep stages, apnea-hypopnea index (AHI) and AHI ratio in rapid eye movement (REM) versus non-REM (NREM) sleep stages (R:N ratio). Of those 309 patients diagnosed with obstructive sleep apnea, 217 (70.2%) were men (mean age 51.05 ± 12.64 years) and 92 (29.8%) were women (mean age 64.53 ± 10.43 years). The mean AHI during total sleep time was 30.34 ± 21.17 in men and 21.47 ± 17.14 in women (P P P = 0.402). REM SDB with R:N ratio higher than 2.0 was more frequently observed in women than in men, 34.8% (32/92) of women, compared with 11.9% (26/217) in men (P 60 years old. These findings suggest the possibility of different pathophysiologic mechanisms of SDB between genders and also between NREM versus REM sleep, which can be partly explained by the influence of female sex hormones.展开更多
文摘目的利用儿童阻塞性睡眠呼吸暂停疾病特异性生活质量调查表（disease-specific quality of life for chidren with obstructive sleep apnea 1 8 items survey,OSA-1 8）,对手术治疗前后儿童阻塞性睡眠呼吸障碍（obstructive sleep disordered breathing,OSDB）患者的生活质量进行评估,探讨OSA-18的临床应用意义。方法对30例因扁桃体和（或）腺样体肥大的OSDB患者,采用OSA-18法在术前和术后6个月进行调查,评价手术治疗对OSDB患者生活质量的影响,并对评估结果以及相关问题进行讨论。结果OSDB患儿术后生活质量总分及各维度总评分较术前明显下降（P均〈0.0 1）,改善明显。其中睡眠障碍、身体症状、病情对患儿监护人的影响3个维度的变化值〉1.50,达到显著改善;情绪不佳、白天功能两个维度的变化值在0.50~0.99,为轻度改善。在所有的18个条目中,手术前后平均积分的比较,其差别均具有统计学意义（P〈0.05）。结论OSA-18调查表法可以全面反映儿童OSDB患者的生活质量,OSA-18调查在儿童OSDB的临床诊断、治疗选择和疗效评估均有较好的实用价值,是儿童OSDB疗效评价的可靠方法。
文摘Objective:To determine the level of agreement among experienced operators of candidacy for upper airway stimulation (UAS) based on evaluation of drug-induced sleep endoscopy (DISE).Methods:The trial was designed as a single-blinded cross-sectional study.Four otolaryngologists with extensive DISE experience were given 63 video clips from the STAR trial video library.These videos were graded using the VOTE classification.Percentage agreement and Cohen's k (for inter-rater reliability) were calculated between pairs of reviewers,assessing palatal complete concentric collapse (CCC) and determining UAS eligibility.Subjects were also grouped based on collapse severity for each reviewer.Results:The reviewers had excellent (approximately 90％) agreement on findings at the level of the soft palate and tongue base.The inter-rater reliability for palatal CCC ranged from mod erate to substantial The agreement on determining the criteria for UAS implantation ranged from poor to moderate.All 4 upper airway structures as classified by the criteria of the VOTE were graded by all the reviewers as contributing to obstruction in a majority of subjects who were performed via application of DISE.Conclusion:Application of DISE remains a subjective examination,even among those experienced operators,therefore more studies need to be performed for evaluation of improvement in inter-rater reliability after implantation of training videos.
基金Supported by An Australian Postgraduate Award through the University of Sydney(Troy LK is supported)
文摘Patients with interstitial lung disease commonly exhibit abnormal sleep architecture and increased sleep fragmentation on polysomnography. Fatigue is a frequent complaint, and it is likely that poor sleep quality is a significant contributor. A number of studies have shown that sleep disordered breathing is prevalent in this population, particularly in the idiopathic pulmonary fibrosis subgroup. The factors that predispose these patients to obstructive sleep apnoea are not well understood, however it is believed that reduced caudal traction on the upper airway can enhance collapsibility. Ventilatory control system instability may also be an important factor, particularly in those with increased chemo-responsiveness, and in hypoxic conditions. Transient, repetitive nocturnal oxygen desaturation is frequently observed in interstitial lung disease, both with and without associated obstructive apnoeas. There is increasing evidence that sleep-desaturation is associated with increased mortality, and may be important in the pathogenesis of pulmonary hypertension in this population.
文摘Sleep disordered breathing (SDB) is an independent risk factor for cardiovascular disease. It is known to be associated more frequently with men than women, particularly in the premenopausal age range. The goal of this study is to evaluate gender differences among Korean patients diagnosed with SBD. This study included 309 patients who visited our Sleep Clinic due to sleep-related symptoms and were diagnosed with SDB by overnight polysomnography (PSG). We analyzed age, gender, body mass index, various PSG indices including sleep stages, apnea-hypopnea index (AHI) and AHI ratio in rapid eye movement (REM) versus non-REM (NREM) sleep stages (R:N ratio). Of those 309 patients diagnosed with obstructive sleep apnea, 217 (70.2%) were men (mean age 51.05 ± 12.64 years) and 92 (29.8%) were women (mean age 64.53 ± 10.43 years). The mean AHI during total sleep time was 30.34 ± 21.17 in men and 21.47 ± 17.14 in women (P P P = 0.402). REM SDB with R:N ratio higher than 2.0 was more frequently observed in women than in men, 34.8% (32/92) of women, compared with 11.9% (26/217) in men (P 60 years old. These findings suggest the possibility of different pathophysiologic mechanisms of SDB between genders and also between NREM versus REM sleep, which can be partly explained by the influence of female sex hormones.
