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Biomedical subjects

Katsuhisa Banno

Publications and source records attributed to Katsuhisa Banno.

13 recordsLinked to original sources
PubMed2006

Healthcare utilization in women with obstructive sleep apnea syndrome 2 years after diagnosis and treatment.

UNLABELLED: SUBJECTIVE OBJECTIVES: To document healthcare utilization 2 years after diagnosis in women with obstructive sleep apnea syndrome (OSAS). DESIGN: Retrospective observational cohort study. SETTING: Tertiary university-based medical center. PATIENTS AND CONTROLS: Four hundred and fourteen women with OSAS were matched with 1404 women from the general population who served as controls. INTERVENTIONS: Patients were treated with continuous positive airway pressure (CPAP) or were recommended weight loss alone. MEASUREMENTS AND RESULTS: There were 231 treatment compliant (TC) patients, 91 patients not using CPAP (NCU), and 92 patients who were only recommended weight loss (WL). In the entire group, there was increase in fees of $123.43+/-$25.01 in the 2 years before diagnosis and a reduction of fees of $37.96+/-$21.35 in the 2 years after diagnosis (p < .0001). Physician claims increased in the 2 years before diagnosis by $111.22+/-31.35 in TC and by $152.77+/-59.55 in the NCU groups and then decreased in TC by $20.96+/-$26.60 (p < .01) and NCU by $72.20 +/-45.91 in the 2 years after diagnosis (p < .01). The fees in WL group did not change significantly. The number of clinic visits of the entire group increased in the 2 years before diagnosis by 2.32+/-0.43 and decreased over the next 2 years by 1.48+/-0.42 visits (p < .0001). There was an increase of clinic visits in the 3 subgroups in the 2 years before diagnosis (2.30+/-0.57 in TC, 2.55+/-0.99 in NCU, and 2.18+/-0.82 in WL groups) followed by a reduction of clinic visits over the next 2 years (1.56+/-0.55 fewer visits in TC [p < .0001], 1.70+/-0.90 in NCU [p < .01], and 1.04+/-0.90 in the WL group [p < .05] ). CONCLUSIONS: Healthcare utilization in women with OSAS increased in the years before sleep-clinic evaluation and then decreased in the following 2 years.

Body Mass Index↗
PubMed2006

Metabolic syndrome in Japanese patients with obstructive sleep apnea syndrome.

We investigated the prevalence of metabolic syndrome in patients with obstructive sleep apnea syndrome (OSAS) referred to a tertiary university-based medical center. A cross-sectional study of patients with a definite diagnosis of OSAS was performed using new diagnostic criteria for metabolic syndrome that were designed for the Japanese population. Clinical features and comorbidities related to metabolic syndrome were compared between 819 patients with OSAS (719 men and 100 women) and 89 control subjects without OSAS. Metabolic syndrome was significantly more common in the patients with OSAS than in the controls (49.5% vs. 22.0% for men, p < 0.01; 32.0% vs. 6.7% for women, p < 0.01). Men with OSAS (apnea-hypopnea index [AHI] > or =5/h) had a higher risk of metabolic syndrome compared with controls (odds ratio [OR]: 3.47; 95% confidence interval [CI]: 1.84-6.53). There was a significantly increased risk of metabolic syndrome in men with moderate OSAS (AHI: 15-29.9/h) (OR: 2.83; 95% CI: 1.42-5.66) and men with severe OSAS (AHI > or =30/h) (OR: 5.09; 95% CI: 2.67-9.71). Women with OSAS (AHI> or =5/h) also had an increased risk of metabolic syndrome (OR: 6.59; 95% CI: 1.47-29.38), and the risk was significantly higher in women with severe OSAS (AHI > or =30/h) (OR 14.00; 95% CI: 2.93-66.82). Risk factors for metabolic syndrome differed by gender: in men, age, body mass index (BMI), and OSAS (AHI > or =15/h) were significantly associated with metabolic syndrome, whereas, in women, BMI was the only risk factor for metabolic syndrome. The increase of metabolic syndrome in Japanese OSAS patients suggests that this patient population is burdened with multiple risk factors for cardiovascular disease.

Adult↗
PubMed2005

Long-term treatment of sleep breathing disorder in a patient with Huntington's disease.

Huntington's disease (HD) is an autosomal dominant neurodegenerative disorder. An association with sleep breathing disorder has not previously been established in the literature. We report the case of a 45-year-old woman with HD, presenting with snoring and observed apnea. Polysomnography showed obstructive sleep apnea with an apnea-hypopnea index (AHI) of 6.6 per hour including events up to 57 s long during rapid eye movement (REM) sleep. A trial of continuous positive airway pressure (CPAP) resulted in significant improvement in sleep structure, nocturnal respiration, daytime alertness, and subjective memory. Snoring, apneas, and respiratory arousals were abolished on CPAP. HD patients may suffer from sleep breathing disorder, and in spite of potential chorea, CPAP is feasible and may significantly improve their quality of life.

Continuous Positive Airway Pressure↗
PubMed2005

Experience in using split-day studies for suspected obstructive sleep apnea syndrome.

BACKGROUND: Because in many locations the demand for sleep studies exceeds resources, we evaluated the utility of split-day in-laboratory studies (SDS) in highly selected patients. METHODS: We studied 100 eligible cases: 68 males (age 48.6+/-1.3 [standard error, se] years, body mass index (BMI): 32.6+/-0.8 kg/m(2)) and 32 females (age 50.9+/-2.4 years, BMI: 36.3+/-1.3 kg/m(2)) with severe subjective sleepiness (Epworth sleepiness scale: ESS 16) and suspected obstructive sleep apnea syndrome (OSAS). RESULTS: There were 86 conclusive studies that yielded both a diagnosis and sufficient information for management (86.0%) and 14 inconclusive studies that did not yield sufficient information for management (14.0%). In six cases (6.0%) with an inconclusive study a diagnosis was made, however, no titration data was obtained. Thus a definitive diagnosis was obtained in 92.0% of all cases. Those with inconclusive studies had additional assessment, and eight of them ultimately had a final diagnosis of a sleep breathing disorder (SBD) and six had another sleep disorder: four had narcolepsy, one had a movement disorder, one had sleep deprivation. Thus there were six patients (6.0%) in whom SDS yielded only an SBD diagnosis but there was insufficient data for titration; two patients (2.0%) who ultimately had severe OSAS who were not diagnosed on SDS. CONCLUSIONS: SDS was found to be useful in the evaluation and treatment of highly selected patients with severe daytime sleepiness (ESS 16) and suspected OSAS.

Delivery of Health Care↗
PubMed2005

Utilization of healthcare resources in obstructive sleep apnea syndrome: a 5-year follow-up study in men using CPAP.

STUDY OBJECTIVES: Patients with untreated obstructive sleep apnea syndrome (OSAS) have higher healthcare utilization than matched controls. However, the long-term impact of continuous positive airway pressure (CPAP) use on healthcare utilization is unknown. DESIGN: Retrospective observational cohort study. SUBJECTS: There were 342 eligible men with OSAS and matched controls on whom there were utilization data for 5 years prior to initial OSAS diagnosis and for the 5 years on CPAP treatment of the cases. INTERVENTIONS: Patients were treated with CPAP. RESULTS: Patients with OSAS were typical cases (mean +/- SD): age, 48.2 +/- 0.6 years; body mass index, 35.6 +/- 0.4 kg/m2; Epworth Sleepiness Scale score, 14.2 +/- 0.3; apnea-hypopnea index, 47.1 +/- 1.8 events per hour. The number of physician visits were higher by 3.46 +/- 0.2 (95% confidence interval [CI]: 2.57 to 4.36) in cases in the year before diagnosis, compared with the fifth year before diagnosis, then decreased over the next 5 years by 1.03 +/- 0.49 (95% CI: -1.99 to -0.07)(P<.0001). Physician fees, in Canadian dollars, were higher by dollars 148.65 +/- dollars 27.27 (95% CI: 95.12 to 202.10) in cases in the year before diagnosis, compared with the fifth year before diagnosis, and then decreased over the next 5 years by dollars 13.92 +/- dollars 27.94(95%CI: -68.68 to 40.83)(P=.0009). Preexisting ischemic heart disease at the time of OSAS diagnosis predicted about a 5-fold increase in healthcare utilization between the second and fifth year of treatment. CONCLUSIONS: Treatment of OSAS reversed the trend of increasing healthcare utilization seen prior to diagnosis. Preexisting ischemic heart disease results in a negative impact on healthcare utilization. CPAP results in a long-term health benefit, as measured by the use of healthcare services.

Adult↗
PubMed2005

Differences between men and women in the clinical presentation of patients diagnosed with obstructive sleep apnea syndrome.

STUDY OBJECTIVES: Obstructive sleep apnea syndrome (OSAS) results from recurrent episodes of breathing cessation during sleep. Epidemiologic studies have shown that OSAS is more prevalent in men than women (4% vs 2%). Previous studies have explored gender-related differences in upper airway anatomy and function, hormone physiology, and polysomnographic findings. The aim of this study is to assess differences in clinical presentation between women and men with OSAS. DESIGN: Retrospective chart review analysis. SETTING: Tertiary university-based medical center PARTICIPANTS: 130 randomly selected women with OSAS matched individually with 130 men with OSAS for age, body mass index, apnea-hypopnea index, and Epworth Sleepiness Scale score. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: Data were obtained from questionnaires and in-laboratory polysomnographic studies. There were no differences between the genders for age (48.0 +/- 1.1 years [mean +/- SEM] for women vs 47.6 +/- 1.0 years for men), body mass index (40.4 +/- 0.7 kg/m2 for women vs 40.0 +/- 0.6 kg/m2 for men), apnea-hypopnea index (36.8 +/- 3.3/hour for women vs 36.0 +/- 3.0/hour for men), or Epworth Sleepiness Scale score (12.45 +/- 0.53 for women vs 12.84 +/- 0.47 for men). Although snoring and sleepiness were similarly common in women and men, women more often described their main presenting symptoms as insomnia (odds ratio: 4.20; 95% confidence interval: 1.54-14.26) and were much more likely to have a history of depression (odds ratio: 4.60; 95% confidence interval: 1.71-15.49) and hypothyroid disease (odds ratio: 5.60; 95% confidence interval: 2.14-18.57). Women presented less often with a primary complaint of witnessed apnea (odds ratio: 0.66; 95% confidence interval: 0.38-1.12), consumed less caffeine per day (3.3 cups in women vs 5.2 cups in men; P = .0001), and admitted to less alcohol consumption (odds ratio: 0.36; 95% confidence interval: 0.18-0.70). CONCLUSIONS: At the time of OSAS diagnosis, women with OSAS are more likely to be treated for depression, to have insomnia, and to have hypothyroidism than are men with the same degree of OSAS.

Adult↗
PubMed2004

Sleep-disordered breathing in patients with idiopathic cardiomyopathy.

BACKGROUND: Sleep-disordered breathing may adversely affect heart function, and thereby contribute to the progression of heart failure. A study was undertaken in patients with idiopathic cardiomyopathy to document the characteristics of sleep-disordered breathing. METHODS AND RESULTS: Thirty-five patients with a diagnosis of idiopathic cardiomyopathy, comprising 20 patients with dilated cardiomyopathy (DCM) and 15 patients with hypertrophic cardiomyopathy (HCM), underwent overnight polysomnography. Of these 35, 16 (80%) of the DCM patients and 7 (47%) of the HCM patients had sleep-disordered breathing. Central sleep apnea-hypopnea syndrome (CSAHS) was seen in 10 DCM patients, but not in the HCM patients, and obstructive sleep apnea-hypopnea syndrome (OSAHS) was seen in 6 DCM patients and 7 HCM patients. CSAHS was seen in DCM patients with a low left ventricular ejection fraction. HCM patients with OSAHS had a significantly greater body mass index (BMI) than those without OSAHS and CSAHS (27.6 +/- 3.8 vs 22.0 +/- 4.0 kg/m2, p<0.05). DCM patients with OSAHS had a larger BMI than those with CSAHS (29.3 +/- 5.8 vs 24.2 +/- 4.0 kg/m2, p<0.05) and those without OSAHS and CSAHS (29.3 +/- 5.8 vs 21.3 +/- 3.1 kg/m2, p<0.05). CONCLUSIONS: Sleep-disordered breathing is common in patients with idiopathic cardiomyopathy; half of DCM patients had CSAHS, which was closely associated with obesity.

Adult↗
PubMed2002

Pulmonary hypertension in patients with severe obstructive sleep apnea.

Thirty-seven patients (35 men and two women) with obstructive sleep apnea-hypopnea syndrome (OSAHS) without any known cardiovascular and lung diseases were examined by Doppler echocardiography. Eight of the 37 (21.6%) patients experienced daytime pulmonary hypertension (PH), and all of them had severe OSAHS with an apnea-hypopnea index of > 30. The study suggested that one-third of patients with severe OSAHS had daytime PH.

Echocardiography↗
PubMed2002

Falling asleep while driving and automobile accidents among patients with obstructive sleep apnea-hypopnea syndrome.

Among 448 patients with obstructive sleep apnea-hypopnea syndrome (OSAHS), 40 patients (8.9%) had been involved in one or more automobile accidents during the preceding 5 years. The main cause of these accidents was falling asleep while driving. Excessive sleepiness during driving was associated with an Epworth sleepiness scale (ESS) score of > 11 and/or an apnea-hypopnea index (AHI) of > 15. The automobile accident rate among 182 patients with severe OSAHS (AHI > 30) was significantly higher than the rate among 106 simple snorers (AHI < 5). Although four of the simple snorers were involved in automobile accidents, their ESS scores were all very high (15 or more).

Accidents, Traffic↗