NWO SEM Sleep Society

LITERATURE WATCH

D. Sleep Disorders Breathing Disorder: Epidemiology, Diagnosis, Treatment

• Mortality in obstructive sleep apnea-hypopnea patients treated
  with positive airway pressure.
  

Chest. 2005 Aug;128(2):624-33.

• Symptoms of Depression in Individuals With Obstructive Sleep
  Apnea May Be Amenable to Treatment With Continuous
  Positive Airway Pressure
  

Chest. 2005 Sep;128(3):1304-9

• Changes in Symptoms of Sleep-Disordered Breathing During
  Pregnancy
  

Sleep 2005; 28: 1299-1305

Mortality in obstructive sleep apnea-hypopnea patients treated with positive airway pressure.
Chest. 2005 Aug;128(2):624-33.

• The 5-year cumulative survival rates were significantly lower in
  patients who did not use PAP (compliance < 1 h) than in those
  who used the device for > 6 h/d (85.5% vs 96.4%) and 1 to 6
  h/d (85.5% vs 91.3%), respectively.
  
• The main cause of death in 19 cases was cardiovascular
  disease (CVD).
  
• Mortality rates in OSAHS patients who did not receive PAP
  therapy were higher compared with those treated with PAP and
  were moderately or highly compliant with therapy.
  
• Categories of PAP compliance, AHT, age, and FEV1 percent
  predicted were the variables that independently predicted
  mortality.
  

Symptoms of Depression in Individuals With Obstructive Sleep Apnea May Be Amenable to
Treatment With Continuous Positive Airway Pressure
Chest. 2005 Sep;128(3):1304-9
•        Patients referred to our center for evaluation of OSA who had
a respiratory disturbance index (RDI)  15 and who demonstrated a
significant response to CPAP (  50% drop in RDI) were evaluated
for the symptoms of depression using the Beck Depression
Inventory (BDI), and then reassessed after 4 to 6 weeks of
treatment with CPAP at home.
•        In this group of patients, the institution of CPAP therapy
resulted in a significant (p < 0.0001) decrease in those symptoms of
depression as assessed by the BDI (BDI at baseline, 4.1 ± 3.7; BDI
after CPAP, 1.0 ± 2.0). This change in BDI was noted both in those
individuals who had received an antidepressant prescription prior to
referral, and in those who had not.

Changes in Symptoms of Sleep-Disordered Breathing During Pregnancy
Sleep 2005; 28: 1299-1305
•        Although incident snoring is common in pregnant women and
has been proposed as a potential risk factor for adverse maternal
fetal outcomes, the development of sleep-disordered breathing
during pregnancy has not been prospectively described.
•        We found that sleep-disordered breathing symptoms (Apnea
Symptom Score, 0.44 (SEM 0.58) vs 0.95 (0.09, P < .001) and the
degree of daytime somnolence (Epworth Sleepiness Scale, 8.6 (0.3)
vs 10.2 (0.4), P = .0003) increased significantly during pregnancy.
•        Women with higher baseline body mass indexes and greater
increases in neck circumference during pregnancy reported higher
apnea symptom scores.
•        Symptoms  of sleep-disordered breathing increase during
pregnancy and that more than 10% of our subjects may be at risk
for developing sleep apnea during pregnancy. Excessive daytime
somnolence was highly prevalent even early in pregnancy and
became increasingly common as pregnancy progressed.