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Hipoksi parametreleri, fiziksel değişkenler ve obstrüktif uyku apnesinin şiddet derecesi

Yıl 2016, Cilt: 6 Sayı: 2, 55 - 63, 30.08.2016

Öz

Objective: To determine the relation between hypoxia and physical parameters in patients who had different levels of severity of obstructive sleep apnea (OSA).
Methods: This was a retrospective, cross-sectional study of 259 men who were evaluated with overnight polysomnography. Severity of OSA was graded based on the apnea-hypopnea index (AHI): normal/simple snoring (n=31); mild OSA (n=70); moderate OSA (n=63); severe OSA (n=95). Patients with different severity were divided into subgroups, based on having the lowest or highest values of the total sleep time with oxygen saturation <90% (ST90) or minimum
oxygen saturation (min SaO2).
Results: Median AHI was 20.4 events/hour. Univariate analysis showed that ST90 was correlated with AHI (r=0.772; p≤0.001) and Epworth sleepiness scale (ESS) (r=0.344; p≤0.001), and min SaO2 was inversely correlated with AHI (r=-0.748; p≤0.001) and ESS (r=-0.319; p≤0.001). Multivariate linear regression showed that ST90 was independently
associated with AHI, ESS, and neck circumference, and min SaO2 was independently inversely associated with AHI, ESS, and body mass index (BMI). In patients who had severe OSA, the subgroups which had lowest and highest min SaO2 differed significantly in BMI, modified Mallampati score, neck and waist circumferences, and retroglossal
Müller grade. In patients with percentage of sleep time with oxygen saturation below 90% (CT90) <10%, the upper limit of ST90 was 36 minutes and corresponded to 70% lower limit of min SaO2.
Conclusion: Hypoxia parameters show significant variation in OSA severity categories. None of the physical parameters had clinically useful relations with hypoxia parameters in OSA patients except patients who had severe OSA.

Kaynakça

  • 1. Schwab RJ, Goldberg AN. Upper airway assessment: radiographic and other imaging techniques. Otolaryngol Clin North Am 1998;31:931–68.
  • 2. Thakkar K, Yao M. Diagnostic studies in obstructive sleep apnea. Otolaryngol Clin North Am 2007;40:785–805.
  • 3. Ryan CM, Bradley TD. Pathogenesis of obstructive sleep apnea. J Appl Physiol (1985) 2005;99:2440–50.
  • 4. Pang KP. Preface. In: Pang KP, Rotenberg BW, Woodson BT, editors. Textbook of advanced surgical techniques in snoring and obstructive sleep apnea. San Diego, CA: Plural Publishing; 2013. p. ix–x.
  • 5. Dreher A, de la Chaux R, Klemens C, et al. Correlation between otorhinolaryngologic evaluation and severity of obstructive sleep apnea syndrome in snorers. Arch Otolaryngol Head Neck Surg 2005;131:95–8.
  • 6. Bostanci A, Turhan M, Bozkurt S. Factors influencing sleep time with oxygen saturation below 90% in sleep-disordered breathing. Laryngoscope 2015;125:1008–12.
  • 7. Roeslani RU, Woodson BT. Pathophysiology, signs, and symptoms of OSA. In: Pang KP, Rotenberg BW, Woodson BT, editors. Textbook of advanced surgical techniques in snoring and obstructive sleep apnea. San Diego, CA: Plural Publishing; 2013. p. 1–14.
  • 8. Lavie L. Obstructive sleep apnoea syndrome – an oxidative stress disorder. Sleep Med Rev 2003;7:35–51.
  • 9. Prabhakar NR, Kumar GK. Oxidative stress in the systemic and cellular responses to intermittent hypoxia. Biol Chem 2004;385: 217–21.
  • 10. Iber C, Ancoli-Israel S, Chesson AL Jr, Quan SF. The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications. Westchester, IL: American Academy of Sleep Medicine; 2007.
  • 11. Kulkas A, Tiihonen P, Julkunen P, Mervaala E, Töyräs J. Novel parameters indicate significant differences in severity of obstructive sleep apnea with patients having similar apnea-hypopnea index. Med Biol Eng Comput 2013;51:697–708.
  • 12. Li JR, Sun JJ, Zhang R, Li CF, Hu Y, Sun YM. Clinical value of TS90% in evaluation of hypoxemia in patients with obstructive sleep apnea/hypoventilation syndrome. [Article in Chinese] Zhonghua Yi Xue Za Zhi 2005;85:3115–7.
  • 13. Li Q, Jin XJ. Correlations between the duration and frequency of sleep apnea episode and hypoxemia in patients with obstructive sleep apnea syndrome. [Article in Chinese] Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2009;44:825–30.
  • 14. Zhang XB, Zen HQ, Lin QC, Chen GP, Chen LD, Chen H. TST, as a polysomnographic variable, is superior to the apnea hypopnea index for evaluating intermittent hypoxia in severe obstructive sleep apnea. Eur Arch Otorhinolaryngol 2014;271: 2745–50.
  • 15. Berry RB, Budhiraja R, Gottlieb DJ, et al.; American Academy of Sleep Medicine. Rules for scoring respiratory events in sleep: update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med 2012;8:597–619.
  • 16. Gunnarsson SI, Peppard PE, Korcarz CE, et al. Minimal nocturnal oxygen saturation predicts future subclinical carotid atherosclerosis: the Wisconsin sleep cohort. J Sleep Res 2015;24:680–6.
  • 17. Turhan M, Bostanci A, Bozkurt S. Predicting the outcome of modified tongue base suspension combined with uvulopalatopharyngoplasty. Eur Arch Otorhinolaryngol 2015;272: 3411–6.
  • 18. Zhang J, Li Y, Cao X, et al. The combination of anatomy and physiology in predicting the outcomes of velopharyngeal surgery. Laryngoscope 2014;124:1718–23.
Yıl 2016, Cilt: 6 Sayı: 2, 55 - 63, 30.08.2016

Öz

Kaynakça

  • 1. Schwab RJ, Goldberg AN. Upper airway assessment: radiographic and other imaging techniques. Otolaryngol Clin North Am 1998;31:931–68.
  • 2. Thakkar K, Yao M. Diagnostic studies in obstructive sleep apnea. Otolaryngol Clin North Am 2007;40:785–805.
  • 3. Ryan CM, Bradley TD. Pathogenesis of obstructive sleep apnea. J Appl Physiol (1985) 2005;99:2440–50.
  • 4. Pang KP. Preface. In: Pang KP, Rotenberg BW, Woodson BT, editors. Textbook of advanced surgical techniques in snoring and obstructive sleep apnea. San Diego, CA: Plural Publishing; 2013. p. ix–x.
  • 5. Dreher A, de la Chaux R, Klemens C, et al. Correlation between otorhinolaryngologic evaluation and severity of obstructive sleep apnea syndrome in snorers. Arch Otolaryngol Head Neck Surg 2005;131:95–8.
  • 6. Bostanci A, Turhan M, Bozkurt S. Factors influencing sleep time with oxygen saturation below 90% in sleep-disordered breathing. Laryngoscope 2015;125:1008–12.
  • 7. Roeslani RU, Woodson BT. Pathophysiology, signs, and symptoms of OSA. In: Pang KP, Rotenberg BW, Woodson BT, editors. Textbook of advanced surgical techniques in snoring and obstructive sleep apnea. San Diego, CA: Plural Publishing; 2013. p. 1–14.
  • 8. Lavie L. Obstructive sleep apnoea syndrome – an oxidative stress disorder. Sleep Med Rev 2003;7:35–51.
  • 9. Prabhakar NR, Kumar GK. Oxidative stress in the systemic and cellular responses to intermittent hypoxia. Biol Chem 2004;385: 217–21.
  • 10. Iber C, Ancoli-Israel S, Chesson AL Jr, Quan SF. The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications. Westchester, IL: American Academy of Sleep Medicine; 2007.
  • 11. Kulkas A, Tiihonen P, Julkunen P, Mervaala E, Töyräs J. Novel parameters indicate significant differences in severity of obstructive sleep apnea with patients having similar apnea-hypopnea index. Med Biol Eng Comput 2013;51:697–708.
  • 12. Li JR, Sun JJ, Zhang R, Li CF, Hu Y, Sun YM. Clinical value of TS90% in evaluation of hypoxemia in patients with obstructive sleep apnea/hypoventilation syndrome. [Article in Chinese] Zhonghua Yi Xue Za Zhi 2005;85:3115–7.
  • 13. Li Q, Jin XJ. Correlations between the duration and frequency of sleep apnea episode and hypoxemia in patients with obstructive sleep apnea syndrome. [Article in Chinese] Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2009;44:825–30.
  • 14. Zhang XB, Zen HQ, Lin QC, Chen GP, Chen LD, Chen H. TST, as a polysomnographic variable, is superior to the apnea hypopnea index for evaluating intermittent hypoxia in severe obstructive sleep apnea. Eur Arch Otorhinolaryngol 2014;271: 2745–50.
  • 15. Berry RB, Budhiraja R, Gottlieb DJ, et al.; American Academy of Sleep Medicine. Rules for scoring respiratory events in sleep: update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med 2012;8:597–619.
  • 16. Gunnarsson SI, Peppard PE, Korcarz CE, et al. Minimal nocturnal oxygen saturation predicts future subclinical carotid atherosclerosis: the Wisconsin sleep cohort. J Sleep Res 2015;24:680–6.
  • 17. Turhan M, Bostanci A, Bozkurt S. Predicting the outcome of modified tongue base suspension combined with uvulopalatopharyngoplasty. Eur Arch Otorhinolaryngol 2015;272: 3411–6.
  • 18. Zhang J, Li Y, Cao X, et al. The combination of anatomy and physiology in predicting the outcomes of velopharyngeal surgery. Laryngoscope 2014;124:1718–23.
Toplam 18 adet kaynakça vardır.

Ayrıntılar

Konular Sağlık Kurumları Yönetimi
Bölüm Makaleler
Yazarlar

Suat Avcı

Aynur Yılmaz Avcı Bu kişi benim

Hüseyin Lakadamyalı Bu kişi benim

Erdinç Aydın Bu kişi benim

Yayımlanma Tarihi 30 Ağustos 2016
Gönderilme Tarihi 24 Temmuz 2017
Yayımlandığı Sayı Yıl 2016 Cilt: 6 Sayı: 2

Kaynak Göster

APA Avcı, S., Avcı, A. Y., Lakadamyalı, H., Aydın, E. (2016). Hipoksi parametreleri, fiziksel değişkenler ve obstrüktif uyku apnesinin şiddet derecesi. ENT Updates, 6(2), 55-63.
AMA Avcı S, Avcı AY, Lakadamyalı H, Aydın E. Hipoksi parametreleri, fiziksel değişkenler ve obstrüktif uyku apnesinin şiddet derecesi. ENT Updates. Ağustos 2016;6(2):55-63.
Chicago Avcı, Suat, Aynur Yılmaz Avcı, Hüseyin Lakadamyalı, ve Erdinç Aydın. “Hipoksi Parametreleri, Fiziksel değişkenler Ve obstrüktif Uyku Apnesinin şiddet Derecesi”. ENT Updates 6, sy. 2 (Ağustos 2016): 55-63.
EndNote Avcı S, Avcı AY, Lakadamyalı H, Aydın E (01 Ağustos 2016) Hipoksi parametreleri, fiziksel değişkenler ve obstrüktif uyku apnesinin şiddet derecesi. ENT Updates 6 2 55–63.
IEEE S. Avcı, A. Y. Avcı, H. Lakadamyalı, ve E. Aydın, “Hipoksi parametreleri, fiziksel değişkenler ve obstrüktif uyku apnesinin şiddet derecesi”, ENT Updates, c. 6, sy. 2, ss. 55–63, 2016.
ISNAD Avcı, Suat vd. “Hipoksi Parametreleri, Fiziksel değişkenler Ve obstrüktif Uyku Apnesinin şiddet Derecesi”. ENT Updates 6/2 (Ağustos 2016), 55-63.
JAMA Avcı S, Avcı AY, Lakadamyalı H, Aydın E. Hipoksi parametreleri, fiziksel değişkenler ve obstrüktif uyku apnesinin şiddet derecesi. ENT Updates. 2016;6:55–63.
MLA Avcı, Suat vd. “Hipoksi Parametreleri, Fiziksel değişkenler Ve obstrüktif Uyku Apnesinin şiddet Derecesi”. ENT Updates, c. 6, sy. 2, 2016, ss. 55-63.
Vancouver Avcı S, Avcı AY, Lakadamyalı H, Aydın E. Hipoksi parametreleri, fiziksel değişkenler ve obstrüktif uyku apnesinin şiddet derecesi. ENT Updates. 2016;6(2):55-63.