Topic
Polysomnography
About: Polysomnography is a research topic. Over the lifetime, 19527 publications have been published within this topic receiving 858718 citations. The topic is also known as: PSG & polysomnogram.
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TL;DR: Evidence-based knowledge of pediatric obstructive sleep apnea syndrome (OSAS) is reviewed to review the clinical symptoms, syndromes, polysomnographic findings and variables, and treatment options, and the authors' recommendations are reviewed.
Abstract: Objective To review evidence-based knowledge of pediatric obstructive sleep apnea syndrome (OSAS). Data Sources and Extraction We reviewed published articles regarding pediatric OSAS; extracted the clinical symptoms, syndromes, polysomnographic findings and variables, and treatment options, and reviewed the authors’ recommendations. Data Synthesis Orthodontic and craniofacial abnormalities related to pediatric OSAS are commonly ignored, despite their impact on public health. One area of controversy involves the use of a respiratory disturbance index to define various abnormalities, but apneas and hypopneas are not the only abnormalities obtained on polysomnograms, which can be diagnostic for sleep-disordered breathing. Adenotonsillectomy is often considered the treatment of choice for pediatric OSAS. However, many clinicians may not discern which patient population is most appropriate for this type of intervention; the isolated finding of small tonsils is not sufficient to rule out the need for surgery. Nasal continuous positive airway pressure can be an effective treatment option, but it entails cooperation and training of the child and the family. A valid but often overlooked alternative, orthodontic treatment, may complement adenotonsillectomy. Conclusions Many complaints and syndromes are associated with pediatric OSAS. This diagnosis should be considered in patients who report the presence of such symptoms and syndromes.
348 citations
TL;DR: A 43-year-old man presents with heavy snoring; his bed partner reports that he sometimes stops breathing while he sleeps, and he has hypertension controlled by medication but is otherwise healthy.
Abstract: A 43-year-old man presents with heavy snoring; his bed partner reports that he sometimes stops breathing while he sleeps. He has hypertension controlled by medication but is otherwise healthy. He admits to feeling sleepy at times when he drives, although he has not had any motor vehicle accidents. His body-mass index is 33, and he has a large neck circumference (46 cm). How should he be evaluated and treated?
347 citations
01 Jun 2011
TL;DR: This review focuses on updates in the areas of terminology and testing, complications of untreated OSA, perioperative considerations, treatment options, and new developments in this field.
Abstract: Obstructive sleep apnea (OSA) is a breathing disorder during sleep that has implications beyond disrupted sleep. It is increasingly recognized as an independent risk factor for cardiac, neurologic, and perioperative morbidities. Yet this disorder remains undiagnosed in a substantial portion of our population. It is imperative for all physicians to remain vigilant in identifying patients with signs and symptoms consistent with OSA. This review focuses on updates in the areas of terminology and testing, complications of untreated OSA, perioperative considerations, treatment options, and new developments in this field.
347 citations
TL;DR: The data suggest that patients undergoing bariatric surgery should not expect a cure of OSA after surgical weight loss, and will likely need continued treatment for OSA to minimize its complications.
347 citations
TL;DR: The 'hypoxic burden', an easily derived signal from overnight sleep study, predicts CVD mortality across populations and suggests that not only the frequency but the depth and duration of sleep related upper airway obstructions, are important disease characterizing features.
Abstract: Aims Apnoea-hypopnoea index (AHI), the universal clinical metric of sleep apnoea severity, poorly predicts the adverse outcomes of sleep apnoea, potentially because the AHI, a frequency measure, does not adequately capture disease burden. Therefore, we sought to evaluate whether quantifying the severity of sleep apnoea by the 'hypoxic burden' would predict mortality among adults aged 40 and older. Methods and results The samples were derived from two cohort studies: The Outcomes of Sleep Disorders in Older Men (MrOS), which included 2743 men, age 76.3 ± 5.5 years; and the Sleep Heart Health Study (SHHS), which included 5111 middle-aged and older adults (52.8% women), age: 63.7 ± 10.9 years. The outcomes were all-cause and Cardiovascular disease (CVD)-related mortality. The hypoxic burden was determined by measuring the respiratory event-associated area under the desaturation curve from pre-event baseline. Cox models were used to calculate the adjusted hazard ratios for hypoxic burden. Unlike the AHI, the hypoxic burden strongly predicted CVD mortality and all-cause mortality (only in MrOS). Individuals in the MrOS study with hypoxic burden in the highest two quintiles had hazard ratios of 1.81 [95% confidence interval (CI) 1.25-2.62] and 2.73 (95% CI 1.71-4.36), respectively. Similarly, the group in the SHHS with hypoxic burden in the highest quintile had a hazard ratio of 1.96 (95% CI 1.11-3.43). Conclusion The 'hypoxic burden', an easily derived signal from overnight sleep study, predicts CVD mortality across populations. The findings suggest that not only the frequency but the depth and duration of sleep related upper airway obstructions, are important disease characterizing features.
347 citations