SEARCH · PubMed Health

Results for “OSA”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 667 records · Page 37Linked to original sources

PubMed2006

Oxidative stress and oxidant signaling in obstructive sleep apnea and associated cardiovascular diseases.

Obstructive sleep apnea (OSA) has emerged as a major public health problem and increasing evidence indicates that untreated OSA can lead to the development of various cardiovascular disorders. One important mechanism by which OSA may promote cardiovascular diseases is intermittent hypoxia, in which patients are subjected to repeated episodes of brief oxygen desaturation in the blood, followed by reoxygenation. Such cycles of hypoxia/reoxygenation may result in the generation of reactive oxygen species. Some studies have demonstrated the presence of oxidative stress in OSA patients as well as in animals subjected to intermittent hypoxia. Further, modulations of nitric oxide and biothiol status might also play important roles in the pathogenesis of OSA-associated diseases. Reactive oxygen species and redox events are also involved in the regulation of signal transduction for oxygen-sensing mechanisms. This review summarizes currently available information on the evidence for and against the occurrence of oxidative stress in OSA and the role of reactive oxygen species in cardiovascular changes associated with OSA.

Animals↗

PubMed2005

Videonasopharyngoscopy is useful for identifying children with Pierre Robin sequence and severe obstructive sleep apnea.

INTRODUCTION: Obstructive sleep apnea syndrome (OSAS) commonly appears in patients with Pierre Robin sequence (PR). Polysomnography (PS) is the gold standard for the diagnosis of OSAS. Videonasopharyngoscopy (VNP) is the best diagnostic tool for visualizing the vocal tract and detecting structural abnormalities which can be associated with OSAS. OBJECTIVE: The purpose of this paper is to study whether VNP can be useful for identifying severe OSAS in a population of children with PR. MATERIALS AND METHODS: Fifty-two children with PR who were present with sleep-disordered breathing were studied. All the parents completed a questionnaire concerning the children's sleeping habits and sleep complaints before consultation. Each child underwent a general pediatric examination and an evaluation of craniofacial features and upper airway permeability. In all children, a PS was performed. Also, all children underwent a VNP. RESULTS: The diagnosis of OSAS was confirmed by PS in 31 patients. VNP showed 87% sensitivity and 100% specificity for the detection of OSAS. VNP findings showed a significant correlation with apnea-hypopnea index, arousal index, snoring time, percentage of sleep time spent at saturation of oxygen <90% and a significant inverse correlation with total sleep time, sleep efficiency and the mean saturation of oxygen during sleep. CONCLUSION: This study shows that in children with PR, airway obstruction as detected by VNP seems to be a risk factor for OSAS. VNP appears to be a safe and reliable tool for the evaluation of sleep-disordered breathing in children with PR.

Child, Preschool↗

PubMed2026

Opioid-sparing anesthesia based on opioid-free principles for early recovery after total knee arthroplasty: A randomized controlled trial.

OBJECTIVE: To evaluate whether an opioid-sparing anesthesia strategy (OSA), based on opioid-free anesthesia (OFA), improves early postoperative recovery quality and optimizes functional outcomes after total knee arthroplasty (TKA), compared with conventional opioid-based anesthesia (OBA). DESIGN: A randomized controlled trial with blinding of patients, surgeons, and outcome assessors. SETTING: Single center, July 2025 to February 2026. PATIENTS: 98 adult patients scheduled for elective unilateral TKA. INTERVENTION: Patients were randomized to the OSA or OBA group. The OSA regimen used esketamine and dexmedetomidine as the primary analgesic backbone, whereas the OBA regimen was opioid-based. Both groups received preoperative femoral nerve block and were administered oxycodone at skin incision and closure. Postoperatively, both groups received the same multimodal analgesia and patient-controlled analgesia. MEASUREMENTS: The primary outcome was the 24-h postoperative Quality of Recovery-15 (QoR-15) score. Secondary outcomes included 48-h QoR-15; Oxford Knee Score (OKS) and EQ-5D-3L at 1 and 3 months; high pain at 1 month and chronic postsurgical pain at 3 months. Exploratory outcomes included postoperative C-reactive protein (CRP), and postoperative nausea and vomiting (PONV), among others. RESULTS: At 24 h postoperatively, QoR-15 was higher in the OSA group than in the OBA group (118.4 ± 11.5 vs 113.3 ± 12.2; adjusted difference 5.12, 95% CI 0.51-9.74; P = 0.029), and this advantage persisted at 48 h (adjusted difference 5.54, 95% CI 1.57-9.52; P = 0.007). The OSA group had a lower incidence of PONV (P = 0.025) and lower postoperative CRP levels (P = 0.001). At 1 month, OKS was higher in the OSA group (adjusted difference 2.31, 95% CI 0.34-4.27; P = 0.022), with no significant differences in other secondary outcomes. CONCLUSION: In TKA, this OFA-based OSA strategy improved early postoperative QoR-15 scores. However, the QoR-15 difference did not reach the minimal clinically important difference, so its clinical relevance remains uncertain.

Humans↗

PubMed2006

Early investigation and treatment of obstructive sleep apnoea after acute stroke.

Obstructive sleep apnoea (OSA) is an independent risk factor for hypertension, which is a major cause of stroke. The prevalence and associations of OSA in a cohort of stroke patients were studied. The safety and tolerability of early treatment with nasal continuous airways pressure (nCPAP) was also assessed. Consecutive subjects admitted with acute stroke were assessed clinically, radiologically and with scales assessing prior OSA risk, dysphagia and disability. Sleep studies were performed within the first few days of admission using a portable diagnostic system. Twenty-nine of 55 (53%) subjects had evidence of OSA, using an apnoea-hypopnoea index (AHI) of 10 or greater. The AHI was significantly associated with an index of prior OSA symptoms, but not with history of hypertension, degree of dysphagia, or type and severity of stroke. Use of a portable diagnostic system for detecting OSA in the acute stroke setting was well tolerated. OSA is common after acute stroke and exceeds rates seen in control populations of similar age (53% vs. 11%). Early treatment with nCPAP was effective and well tolerated.

Acute Disease↗

PubMed2006

Rapid screening test for sleep apnea using a nonlinear and nonstationary signal processing technique.

It is hypothesized that obstructive sleep apnea (OSA) can be detected from a short-time, daytime recording of the nasal airway pressure, resulting in a screening tool to identify adult patients at risk for OSA. A nonlinear and nonstationary signal analysis technique based on the Hilbert-Huang transform was used to extract signals intrinsic to OSA, using the first two intrinsic mode functions from the empirical mode decomposition. The Hilbert spectrum was centered around 1.5Hz for normal subjects and shifted upward in frequency scale with increased likelihood of OSA. The histogram of the 1.5Hz signal from the Hilbert spectrum was used to compute the apnea percentage for assessing OSA. The proposed method was tested with two data sets. Data set 1 consisted of 18 human subjects with 3 OSA cases from retrospective diagnosis. Data set 2 consisted of 16 subjects who went through a prospective study of the all-night polysomnographic test and the 5-min nasal airway pressure test. The proposed OSA detection method achieved 100% sensitivity and 100% specificity for data set 1, 85.7% sensitivity and 100% specificity for data set 2. While further tests will be needed to insure robustness and standardize the instrumentation, the study has demonstrated the feasibility of a rapid screening test for obstructive sleep apnea.

Adult↗

PubMed2006

Deficits in involuntary attention switching in obstructive sleep apnea syndrome.

Cognitive functions are altered in patients with obstructive sleep apnea syndrome (OSAS) and it has been proposed that vigilance and attentional deficits play a pivotal role in all aspects of these deficits. One way to assess attentional system integrity is the study of event-related-potentials (ERP), but only a few ERP studies have been conducted in patients with OSAS. The aim of the study was to use ERP to further assess attentional impairments in these patients. Thirteen OSAS patients and 13 age-matched controls underwent a night of polysomnographic recording. Each subject was also tested with an ERP paradigm where standard (95%, 1000Hz), high deviant (2.5%, 1250Hz) and low deviant (2.5%, 1050Hz) tones were presented. Subjects were asked to ignore the stimuli and read during the task. Mismatch negativity (MMN) and P3a amplitudes and latencies were measured. No between-group difference was observed for sleep stages, except a lower percentage of rapid eye movement (REM) sleep in patients with OSAS (p<0.01). Moreover, the OSAS group showed a higher micro-arousal index and more sleep transitions than the control group (p<0.05). A significant group effect was found for the amplitude of the P3a component (p<0.05) that was lower in patients with OSAS for both high and low deviant tones. No between-group difference was found for the MMN and the P3a latencies. In conclusion, patients with OSAS have specific alterations of the P3a component that reflects involuntary attention switching, but automatic auditory processing assessed by MMN appears to be preserved.

Adult↗

PubMed2006

Severity of obstructive sleep apnea: correlation with clinical examination and patient perception.

OBJECTIVE: To correlate clinical history, patient self-perception of obstructive sleep apnea, and physical examination with the severity of OSA. METHODS: One hundred and two consecutive patients were prospectively enrolled over a 6-month period. All patients underwent a comprehensive history and clinical examination, nasopharyngoscopy, and an overnight-attended polysomnogram. RESULTS: There were 65 males and 37 females with a mean age of 50.2 +/- 11.3 years (range, 24 to 76 years). The mean apnea-hypopnea index (AHI) was 37.9 +/- 27.7 (range, 0.7 to 111.2). There was a strong correlation between patient self-perception of OSA severity and AHI (r = 0.499, P < 0.0001), and the correlation with AI was 0.577 (P < 0.0001). OSA severity strongly correlated with Friedman Tongue Position grade, (r = 0.389, P < 0.0001), Friedman clinical staging, (r = 0.331, P = 0.0007). Of significance, only 6.9% of patients with mild OSA had a >50% collapse of the base of tongue region, as compared to 65.9% of patients with severe OSA. CONCLUSION: There is good correlation between clinical examination parameters and the severity of OSA. An algorithm for surgical treatment of OSA should acknowledge both the site of obstruction and the severity of disease.

Adult↗

PubMed2025

Exploring the shared genetic basis of attention-deficit/hyperactivity disorder and obstructive sleep apnea: A multi-omics analysis.

BACKGROUND: Observational studies have suggested an association between attention-deficit/hyperactivity disorder (ADHD) and obstructive sleep apnea (OSA), but these findings are often inconsistent due to potential biases from medication use, and varying diagnostic criteria. Genetic analyses can help mitigate these confounding factors, providing additional evidence. METHODS: This study evaluated the genetic correlations between ADHD and OSA using Genome-wide association study (GWAS) summary data, applying linkage disequilibrium score regression (LDSC) and SUPER GeNetic cOVariance Analyzer (SUPERGNOVA). Cross-trait association and colocalization analysis identify potential pleiotropic loci. Tissue enrichment analysis and gene-level analysis of shared genes between OSA and ADHD was conducted. Additionally, bidirectional Mendelian randomization was used to assess potential causal relationships. RESULTS: We found significant genetic correlations between ADHD and OSA (rg = 0.309, p = 3.252E-27), and identified 8 novel pleiotropic loci through cross-trait association analysis. Tissue enrichment analysis showed that these shared genes were primarily concentrated in brain tissues, particularly in deep gray matter regions, and were associated with immune and inflammatory pathways. Forward Mendelian Randomization analysis showed that ADHD was significantly associated with the risk of OSA (OR 1.070, 95 % CI 1.013-1.130, p = 0.016), and reverse analysis showed that OSA was significantly associated with the risk of ADHD (OR 1.240, 95 % CI 1.106-1.390, p = 2.213E-4). CONCLUSION: The findings of this study show a significant positive genetic correlation between ADHD and OSA and each is a risk factor for the other. Inflammation in specific brain regions may be the underlying mechanism for their comorbidity.

Humans↗

PubMed2003

Functional magnetic resonance imaging responses to expiratory loading in obstructive sleep apnea.

Obstructive sleep apnea (OSA) is characterized by diminished upper airway muscle phasic and tonic activation during sleep, but enhanced activity during waking. We evaluated neural mechanisms underlying these patterns with functional magnetic resonance imaging procedures during baseline and expiratory loading conditions in nine medication-free OSA and 16 control subjects. Both groups developed similar expiratory loading pressures, but appropriate autonomic responses did not emerge in OSA cases. Reduced neural signals emerged in OSA cases within the frontal cortex, anterior cingulate, cerebellar dentate nucleus, dorsal pons, anterior insula and lentiform nuclei. Signal increases in OSA over control subjects developed in the dorsal midbrain, hippocampus, quadrangular cerebellar lobule, ventral midbrain and ventral pons. Fastigial nuclei and the amygdala showed substantially increased variability in OSA subjects. No group differences were found in the thalamus. OSA patients show aberrant responses in multiple brain areas and inappropriate cardiovascular responses to expiratory loading, perhaps as a consequence of previously-demonstrated limbic, cerebellar and motor area gray matter loss.

Adult↗

PubMed2006

Sleep apnoea inducing hypoxemia is associated with early signs of carotid atherosclerosis in males.

The intima-media thickness (IMT) of carotid arteries as a marker of preclinical atherosclerosis was measured by ultrasonography in 49 subjects to determine, how strongly the obstructive sleep apnoea (OSA) syndrome is associated with atherosclerosis. Maximal IMT was higher in patients with cardiovascular diseases and with or without risk factors of atherosclerosis, presenting also OSA (apnoea-hypopnoea index=26.1+/-15.6/h) compared to controls without OSA (0.91+/-0.21 mm versus 0.77+/-0.18 mm, p<0.05). The prevalence of IMT > or = 0.85 mm was also higher in patients with cardiovascular pathology presenting OSA than without it (p<0.05). IMT(max) was increased in subjects with mild to moderate OSA alone (AHI=20.4+/-8.7/h) versus healthy controls (0.83+/-0.14 mm versus 0.63+/-0.08 mm, p<0.01). Regression analysis revealed a correlation of IMT(max) with the frequency, intensity and duration of intermittent hypoxemia reflected by AHI (p<0.01), minimal oxygen saturation (p<0.01) and time spent with Sa(O2) < 90% (p<0.05) in patients presenting OSA. The results indicate clear association between early signs of carotid atherosclerosis and moderate OSA in males with and without concomitant cardiovascular pathology.

Adult↗

PubMed2005

Serum homocysteine levels and cardiovascular morbidity in obstructive sleep apnea syndrome.

BACKGROUND: Obstructive sleep apnea syndrome (OSAS) is associated with cardiovascular morbidity and mortality. Elevated levels of serum homocysteine are also associated with cardiovascular morbidity and mortality. We aimed to investigate serum homocysteine levels and conventional cardiovascular risk factors (cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides) in OSAS patients with and without cardiovascular diseases (CVD). METHODS AND RESULTS: Levels of homocysteine, cholesterol, LDL, HDL and triglycerides were measured in 114 obese, male participants after overnight fasting. The presence of OSAS was determined by standard overnight polysomnography. The cases included OSAS patients (apnea-hypopnea index: AHI5) with CVD (OSAS+CVD group) (n:25) and without CVD (OSAS-CVD group) (n:47). Control group was patients without OSAS (AHI<5) with CVD (CVD group) (n:42). The serum homocysteine levels were significant.

Adult↗

PubMed2003

Obstructive sleep apnea in epilepsy patients: the Sleep Apnea scale of the Sleep Disorders Questionnaire (SA-SDQ) is a useful screening instrument for obstructive sleep apnea in a disease-specific population.

OBJECTIVE: To determine useful cutoffs on the Sleep Apnea scale of the Sleep Disorders Questionnaire (SA-SDQ) in an epilepsy population. BACKGROUND: Epilepsy and obstructive sleep apnea (OSA) frequently coexist, and treating OSA in epilepsy patients may reduce seizure frequency and improve daytime sleepiness. The SA-SDQ, a 12-item validated measure of sleep-related breathing disorders, may be a useful tool to screen epilepsy patients for OSA, although appropriate cutoff points have not been established in this population. Previously suggested SA-SDQ cutoff points for OSA in a non-epilepsy population were 32 for women and 36 for men. PATIENTS AND METHODS: One hundred twenty-five subjects with epilepsy undergoing polysomnography completed a survey about their sleep, including the 12-item SA-SDQ scale. Receiver-operating characteristics curves were constructed to determine optimal sensitivity and specificity. RESULTS: Sixty-nine of the 125 subjects (45%) had apnea-hypopnea indices greater than five, indicating OSA. The area under the curve was 0.744 for men and 0.788 for women. For men, an SA-SDQ score of 29 provided a sensitivity of 75% and a specificity of 65%. For women, an SA-SDQ score of 26 provided a sensitivity of 80% and a specificity of 67%. CONCLUSIONS: The SA-SDQ is a useful screening instrument for OSA in an epilepsy population. Our results indicate that the previously suggested cutoffs for OSA (36 for men and 32 for women) may be too high for this specific population. We suggest screening cutoffs of 29 for men and 26 for women.

Disorders of Excessive Somnolence↗

PubMed2004

Effect of nasal continuous positive airway pressure on edema in patients with obstructive sleep apnea.

BACKGROUND AND PURPOSE: Previous research has identified an association between idiopathic edema and obstructive sleep apnea (OSA) in women, but a causal relationship between OSA and edema has not been established. This study was undertaken to determine whether nasal continuous positive airway pressure (CPAP) lessens edema in patients with idiopathic edema and OSA. PATIENTS AND METHODS: This was a case-series study that enrolled eight ambulatory, obese, adults with bilateral, pitting pre-tibial edema and OSA from an inner city family practice and a suburban family practice from July 1995 until March 2003. Enrollees underwent subjective and physical examination assessment of changes in edema after initiation of nasal CPAP. RESULTS: All but one of the subjects had severe OSA. The edema was typically 1+ to 2+, and the duration of the edema ranged from 6 months to more than 20 years. Seven of the eight subjects experienced a reduction in the amount of edema following nasal CPAP (P=0.04). CONCLUSIONS: In subjects with OSA and idiopathic edema, nasal CPAP reduces the amount of edema. If valid, these results indicate that OSA can cause edema.

Case-Control Studies↗

PubMed2005

Examining the construct of depression in obstructive sleep apnea syndrome.

BACKGROUND AND PURPOSE: Depression is commonly reported by patients suffering from Obstructive Sleep Apnea Hypopnea Syndrome (OSAS). We used the factor structure of the Beck Depression Inventory-2nd edition (BDI-II) to examine the unique contributions of OSAS severity and obesity to depressive symptoms in OSAS. We predicted that the Somatic and Cognitive dimensions of the BDI-II would be more strongly associated with apnea severity and obesity, respectively. PATIENTS AND METHODS: Ninety-three moderate to severe OSAS patients (61 men, 32 women) were seen for psychological testing prior to initiating CPAP treatment. They completed the BDI-II and Epworth Sleepiness Scale (ESS). Measures of apnea severity (RDI, percent of sleep time below 90% oxygen saturation) and BMI were also collected. RESULTS: RDI was significantly related to BMI and BDI-II total score, but not to ESS score. BMI was related to BDI-II total score and ESS score. Partial correlations indicated that RDI was independently related to the Somatic dimension on the BDI-II. By contrast, BMI was uniquely associated with the Cognitive dimension. Although there was no difference in depression scores between men and women, the relationship between the Somatic factor and apnea severity was significant in men, whereas obesity and the Cognitive factor were significantly associated in women. CONCLUSIONS: OSAS severity and obesity contribute differentially to symptoms of depression in OSAS. In addition, symptoms of depression in OSAS manifest differently in men than in women.

Adult↗

PubMed2005

Erectile dysfunction, obstructive sleep apnea syndrome and nasal CPAP treatment.

BACKGROUND AND PURPOSE: To evaluate the effect of one month of continuous positive airway pressure (CPAP) in a subgroup of obstructive sleep apnea (OSA) patients with erectile dysfunction (ED) and compare this subgroup with age- and body mass index (BMI)-matched OSA patients without ED. PATIENTS AND METHODS: Prospective general, sleep, psychiatric and sexologic evaluations were conducted. Epworth Sleepiness Scale (ESS), Beck Depression Inventory (BDI), Sleep Disorders Questionnaire (SDQ), Quality of Life SF-36, and polysomnography were used. Seventeen OSA patients with ED were compared prior to CPAP treatment and during CPAP treatment with age- and BMI-matched OSA patients without ED. Parametric and non-parametric statistics, chi-square, Fisher exact test and multiple regression analyses were performed. RESULTS: Ninety-eight men (BMI=28.8 kg/m2, apnea-hypopnea index (AHI)=49.6 events/h, ESS=14.8, BDI=8.4, and lowest SaO2=75.3%) were divided into subgroups of lowest SaO2>80% (A) and lowest SaO2< or =80% (B). (A) Forty-six men had a mean lowest SaO2 of 85.7%+/-2.9, AHI=29.5+/-17.6, age=46.3+/-9.3 years, ESS=13.6+/-4.2, BMI=25.8+/-4.8. Seven of the patients had ED. (B) Fifty-two men had a mean lowest SaO2=60.10+/-10.0%, AHI=67.4+/-24.5, BDI=9.0+/-6.9, age=47.4+/-9.4 years, ESS=16.2+/-4.4, BMI=31.4+/-5.1. Twenty-one of the patients had ED (chi2: P=0.006). Significant variables for ED were lowest SaO2 and age (r=0.17). CPAP-treated subgroup: ED subjects had significantly lower SaO2, ESS, BDI and SF-36 subscale scores than OSA controls. Nasal CPAP eliminated the differences between groups, and ED was resolved in 13 out of 17 cases. CONCLUSIONS: ED in OSAS is related to nocturnal hypoxemia, and about 75% of OSAS patients with ED treated with nasal CPAP showed remission at one-month follow-up, resulting in significant improvement in quality of life.

Body Mass Index↗

PubMed2006

Half of patients with obstructive sleep apnea have a higher NREM AHI than REM AHI.

BACKGROUND AND PURPOSE: To determine the percentage of sequential patients with obstructive sleep apnea with a higher non-rapid eye movement (NREM) apnea-hypopnea index (AHI) than rapid eye movement (REM) AHI and those with a higher REM AHI than NREM AHI, and to look for factors that might influence the AHI to be higher in one of these two groups versus the other and thus ascertain the factors that cause an AHI to be higher in NREM than REM. A high body mass index (BMI) and a supine body position are well known as exacerbating factors for obstructive sleep apnea (OSA). Males, as well as older individuals, are generally more predominantly affected with OSA than females. Usually OSA is worse in REM sleep than in NREM sleep, although this is not always true. METHODS: A retrospective study of sequential patients from one month's admission to a single sleep laboratory was conducted. We determined the age, sex, BMI, body position, duration of apnea, amount of time spent in REM and oxygen desaturation in patients who had a higher NREM AHI than REM AHI versus those who had a higher REM AHI than NREM AHI. To minimize variability, the sleep studies were scored by a single individual. RESULTS: A higher NREM AHI than REM AHI was found in 50% of the 66 patients with OSA. Males predominated in each group and there was no age difference between the groups. Although AHI for both groups tended to become higher with an increase in BMI, the BMI was not statistically different between the two experimental groups. OSA was worse in the supine position in both experimental groups consistent with previous literature. Percentage of time spent in REM or the duration of the apnea did not determine whether a patient fell into the NREM AHI>REM AHI group versus the REM AHI>NREM AHI. The severity of oxygen desaturation was not significantly different between the NREM AHI>REM AHI versus the REM AHI>NREM AHI group. However, when we combined and analyzed the two groups as a whole, the apneas were longer in REM, consistent with previous literature. CONCLUSIONS: Although it is well known that OSA is generally worse in REM sleep because of the degree of desaturation and duration of apnea, a higher NREM AHI than REM AHI is found in up to one half of individuals. Most of the usual predictors for severity of OSA as a whole did not discriminate these groups. Further work needs to be done to determine the factors that discriminate these two groups and thus make AHI higher in NREM than REM.

Adult↗

PubMed2005

Ethnicity and obstructive sleep apnoea.

There is a scarcity of adult prevalence studies of OSA outside the Caucasian populations of North America, Europe and Australia, and comparisons have been complicated by methodological differences in sleep study settings, respiratory events definition, measured risk factors and clinical outcomes, and the lack of objective parameters for the measurement of ethnicity itself. Comparing studies with the same methodological design and respiratory events definition, recent large-scale prevalence studies from Hong Kong, Korea and India show similar OSA rates to populations of mainly Caucasian composition. OSA is a very complex disorder determined by several phenotypes such as obesity, craniofacial structure and abnormalities in neuromuscular and ventilatory control. Genetics may partially explain some of the ethnic clustering of these phenotypes, modulated by cultural and environmental factors. The exact contribution of these component phenotypes to overall OSA risk will be determined by their varying prevalence and relative risk conferred across ethnic groups. For lesser degrees of obesity, Asians are at risk for a more severe degree of illness compared with Caucasians. Inter-ethnic studies suggests that African-American ethnicity may also be a significant risk factor for OSA. The increased prevalences of OSA among American Indians and Hispanic adults, and increased severity among Pacific Islanders and Maoris, were mainly explained by increased obesity parameters. Most cephalometric studies have largely been conducted without specific regard to ethnicity and comparisons of findings across studies have been mainly limited by differences in sampling methods and the varying selection and definition of measured cephalometric variables. The limited number of studies with inter-ethnic comparative data suggest cephalometric variables and their degree of contribution to OSA vary across ethnic groups.

Adult↗

PubMed2007

Potential mechanisms connecting asthma, esophageal reflux, and obesity/sleep apnea complex--a hypothetical review.

Obstructive sleep apnea (OSA) and asthma are potentially linked at several levels. The pathophysiology of these two conditions seems to overlap significantly, as airway obstruction, inflammation, obesity, and several other factors are implicated in the development of both diseases. Gastroesophageal reflux disease (GERD), cardiovascular complications, obesity itself, and the underlying inflammatory processes are all complex contributory factors that provide hypothetical links. Furthermore, a collateral rise in prevalence of both OSA and asthma has been noticed during the past few years, occurring in association with the emerging epidemic of obesity, a common risk factor for both conditions. OSA and asthma share many other risk factors as well. We propose a hypothetical OSA-asthma relationship that has implications on the diagnosis and management of patients presenting with either condition singly. Clinicians should be aware that OSA might complicate asthma management. Based on this hypothesis, we suggest that the treatment of the individual patient who experiences both asthma and OSA needs to be multidisciplinary and comprehensive. This hypothetical association of asthma and OSA, though described anecdotally, has not been systematically studied. In particular, the influence of continuous positive airway pressure therapy (for sleep apnea) on asthma outcomes (such as quality of life, steroid utilization, emergency room visits) and fatality needs to be studied further.

Airway Obstruction↗