Biomedical subjects

Odile Romero

Publications and source records attributed to Odile Romero.

4 recordsLinked to original sources

PubMed2006

Adherence to nCPAP in patients with coronary disease and sleep apnea without sleepiness.

Many patients with obstructive sleep apnea (OSA) do not have sleepiness and adherence to nasal continuous positive airway pressure (nCPAP) is unknown when this treatment is primarily recommended for a cardiovascular concern. The aim of this study was to determine the adherence to nCPAP in patients with coronary artery disease (CAD) and OSA without sleepiness. nCPAP was recommended in 75 patients with CAD and OSA, 29 without and 46 with sleepiness. The daily use of nCPAP and changes in sleepiness (Epworth Sleepiness Scale), in other OSA symptoms and in SF-36 quality-of-life questionnaires were evaluated at 1 yr of follow-up. Sixty-seven patients (89%) were still using nCPAP at the end of follow-up. The absence of sleepiness at diagnosis did not imply a greater number of nCPAP refusals and nCPAP adherence was similar in both groups, 5.1 (1.5) h in patients without versus 5.4 (1.6) h in patients with sleepiness. In patients with sleepiness at diagnosis, the use of nCPAP was associated with reduced sleepiness and improvement in the OSA symptoms and quality-of-life questionnaires; in contrast, only the symptoms questionnaire improved in patients without sleepiness. In conclusion, in our experience adherence to nCPAP treatment in patients with CAD and OSA is not influenced by the absence of sleepiness.

Aged↗

PubMed2005

[Effects of functional septoplasty in obstructive sleep apnea syndrome].

BACKGROUND AND OBJECTIVE: To evaluate the efficacy of functional septoplasty in a group of patients with septal dysmorphy and obstructive sleep apnea syndrome (OSAS). PATIENTS AND METHOD: 34 patients with nasal respiratory insufficiency and chronic snore were included from 1997 to 2003. All of them were diagnosed of OSAS by nocturnal polysomnography (PSG) and of septal dysmorphy by ORL physical examination. Patients were clinically followed-up at 1, 3 and 6 months after surgery. PSG was also evaluated at 6 months postsurgery. RESULTS: A significant objective reduction of the apnea-hypopnea index (AHI) (45.8 vs 31.9), severity of OSAS, and minimal mean oxygen saturation (76.4 to 83.1) was found. Moreover, we observed a significant improvement of subjective scales of sleepiness (13 vs 6) and the patients' satisfaction degree (72% of patients improved). CONCLUSIONS: Functional septoplasty is an effective treatment in patients with OSAS and septal dysmorphy.

Humans↗

PubMed2004

Comparison of conventional nighttime with automatic or manual daytime CPAP titration in unselected sleep apnea patients: study of the usefulness of daytime titration studies.

Daytime CPAP titration studies with full polysomnography have been successfully performed in patients with severe sleep apnea-hypopnea syndrome (SAHS). The implementation of daytime studies in unselected SAHS patients could help to reduce the waiting lists for CPAP titrations. The main purpose of this study was to compare the effectiveness of conventional versus manual or automatic daytime CPAP titration in unselected patients with SAHS. Ninety-three consecutive patients with SAHS in whom CPAP was indicated were assigned to conventional titration or to manual or automatic (AutoSet) daytime CPAP titration, after sleep deprivation. The number of valid studies, sleep architecture, final pressure selected and mean pressure in the different sleep stages were compared. Changes in sleepiness (Epworth sleepiness score) and hours of CPAP use were assessed after 3 months of treatment. Four patients did not sleep (3 AutoSet, 1 conventional daytime groups). Sleep latency was shorter during automatic daytime titration whereas REM latency was shorter in daytime studies; the percentage of sleep stages was similar during all types of titration. CPAP requirements were significantly higher during REM sleep in conventional and manual daytime titrations while mean pressure was unchanged throughout sleep stages during AutoSet titration. CPAP pressure selected with conventional or daytime manual titration (7.5(2.2) cm H2O and 7.4(1.5) cm H2O, ns) were significantly lower (P< 0.001) than with AutoSet (9.4(1.6) cm H20. All groups showed similar decrease of sleepiness and hours of use of CPAP at 3 months of follow-up. Automatic and manual daytime PSG studies after sleep deprivation are useful for CPAP titration in unselected patients with SAHS. Pressure selected with AutoSet is significantly higher than with conventional daytime or nighttime titration, although not significant in terms of treatment compliance and symptom improvement.

Adult↗

PubMed2003

Obstructive sleep apnea and thoracic aorta dissection.

Obstructive sleep apnea syndrome (OSAS) is a process that is associated with the development of arterial hypertension, the main risk factor for aortic dissection and during obstructive episodes of the upper airways with marked increases in transmural pressure of the aorta wall. The aim of this work was to study the association between aortic dissection and OSAS. Nineteen consecutive patients with thoracic aorta dissection and 19 hypertensive patients of similar age, sex, and body mass index were studied by clinical questionnaire and polysomnography. Snoring and nonrefreshing sleep were common in both groups. Thirteen patients (68%) from each group showed an apnea-hypopnea index of more than 5 per hour. However, patients with aortic dissection presented a higher apnea-hypopnea index (28 [30.3] versus 11.1 [10.4], p=0.032). Seven patients with dissection presented an apnea-hypopnea index of more than 30 versus 1 patient in the control group (p=0.042). Patients with thoracic aorta dissection presented a high prevalence of previously undiagnosed and frequently severe OSAS. Further studies, including this diagnosis as a prognostic variable in the follow-up of patients with aortic dissection, are required. Our results suggest that in patients with aortic dissection and symptoms consistent with OSAS, a sleep study should be considered in their clinical management.

Adult↗