1
|
Chaves Junior CM, Adriano Araújo VM, Estanislau IMG, Candéa JDJ, Moro A, de Bruin VMS, Bruin PFC, Fonteles CS. A retrospective study of the influence of obesity on polysomnography and cephalometric parameters in males with obstructive sleep apnea. Cranio 2024; 42:387-393. [PMID: 34511055 DOI: 10.1080/08869634.2021.1977055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Evaluate the influence of obesity on the polysomnographic and cephalometric parameters in obstructive sleep apnea (OSA). METHODS Fifty records of male patients with OSA, containing information on dental, medical, polysomnographic, and cephalometric exams were selected. The degree of obesity was based on Body Mass Index (BMI). Group I comprised normal or overweight individuals (BMI ≤ 29.9 kg/m2), whereas Group II consisted of obese individuals (BMI ≥ 29.9 kg/m2). RESULTS BMI significantly correlated with apnea and hypopnea index (p < 0.0005), minimal oxyhemoglobin saturation (p < 0.0005), and two cephalometric variables (soft palate length, p = 0.01 and width, p = 0.01). Group II showed a significant correlation with the position of the hyoid bone (p = 0.02). Soft palate length and width significantly differed between groups (p = 0.014; 0.016). CONCLUSION Obese males present wider and longer soft palate dimensions, and patients with a greater BMI present a more inferiorly positioned hyoid bone.
Collapse
Affiliation(s)
- Cauby Maia Chaves Junior
- Postgraduate Program in Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Brazil
| | - Vilana Maria Adriano Araújo
- Postgraduate Program in Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Brazil
| | - Ilanna Mara Gomes Estanislau
- Postgraduate Program in Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Brazil
| | - Juliana de Jesus Candéa
- Department of Clinical Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Brazil
| | - Alexandre Moro
- Postgraduate Program in Dentistry, Federal University of Paraná, Curitiba, Brazil
| | | | | | - Cristiane S Fonteles
- Postgraduate Program in Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Brazil
| |
Collapse
|
2
|
Studart-Pereira LM, Bianchini EMG, Assis M, Bussi MT, Corrêa CDC, Cunha TCA, Drager LF, Ieto V, Lorenzi-Filho G, de Luccas GR, Brasil EL, Sovinski SRP, Zancanella E, Pires GN. Brazilian Consensus on Sleep-Focused Speech-Language-Hearing Sciences - 2023 Brazilian Sleep Association. Sleep Sci 2023; 16:489-506. [PMID: 38370880 PMCID: PMC10869236 DOI: 10.1055/s-0043-1776109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 09/21/2023] [Indexed: 02/20/2024] Open
Abstract
Introduction This consensus aimed to develop a structured document presenting the role of sleep-focused Speech-Language-Hearing (SPH) Sciences (SPHS). The recommendations were based on the expertise of specialists and on evidence in the literature, aiming to guide the coverage of this area and the consequent improvement in the quality of the professionals' approach. Methods A Delphi method was conducted with 49 SLH pathologists (SLHP), four sleep physicians, one dentist, one physical therapist, and one methodologist. Four Delphi panel rounds were conducted in Google Forms. The items were analyzed based on the panelists' percentage of agreement; consensuses were reached when ⅔ (66.6%) of valid responses were on a same on a same answer (either "agree" or "disagree"). Results Participants voted on 102 items. The mean consensus rate was 89.9% ± 10.9%. The essential topics were the importance of professional training, the SLH diagnosis, and the SLH treatment of sleep disorders. It was verified that all fields of the SLHS are related to the area of sleep; that sleep-focused SLH pathologists (SLHP) are the responsible for assessing, indicating, and conducting specific orofacial myofunctional therapy for sleep-disordered breathing alone or in combination with other treatments; that SLHP are included in interdisciplinary teams in the area of sleep in public and private services. Discussion The Brazilian consensus on sleep-focused SLHS is a landmark in this area. This consensus described the scope of action of sleep-focused SLHP and systematized recommendations being useful as a reference for the professional practice in the area of sleep.
Collapse
Affiliation(s)
- Luciana Moraes Studart-Pereira
- Brazilian Sleep Association, São Paulo Brazil.
- Department of Speech-Language-Hearing Science, Federal University of Pernambuco, Recife Brazil.
| | | | - Márcia Assis
- Brazilian Sleep Association, São Paulo Brazil.
- Clínica do Sono de Curitiba, Hospital São Lucas, Curitibá, Brazil.
| | - Marieli Timpani Bussi
- Institute of Otorhinolaryngology & Head and Neck Surgery at UNICAMP, IOU, São Paulo Brazil.
| | | | - Thays Crosara Abrahão Cunha
- Brazilian Association of Sleep Dentistry, São Paulo Brazil.
- Núcleo de Ensino, Odontologia do Sono, São Paulo, Brazil.
| | - Luciano Ferreira Drager
- Brazilian Sleep Association, São Paulo Brazil.
- Hypertension Units, Institute of the Heart (InCor), and Course on Nephrology, University of São Paulo, São Paulo Brazil.
| | - Vanessa Ieto
- Speech-Language-Hearing Council, Brazilian Sleep Association, São Paulo Brazil.
| | | | - Gabriele Ramos de Luccas
- Department of Speech-Language Pathology and Audiology, Bauru School of Dentistry, University of São Paulo, Bauru Brazil.
| | - Evelyn Lucien Brasil
- Brazilian Sleep Association, São Paulo Brazil.
- Department of Critical Care Medicina, Hospital Israelita Albert Einstein, São Paulo Brazil.
| | | | - Edilson Zancanella
- Brazilian Association of Sleep Medicine, São Paulo Brazil.
- State University of Campinas, Campinas, São Paulo Brazil.
| | - Gabriel Natan Pires
- Departamento de Psicobiologia, Universidade Federal de São Paulo – São Paulo Brazil.
- Sleep Institute, São Paulo Brazil.
| | | |
Collapse
|
3
|
de Menezes Júnior LAA, Fajardo VC, de Freitas SN, Machado-Coelho GLL, de Oliveira FLP, do Nascimento Neto RM, Meireles AL. Rotating shift workers with vitamin D deficiency have a higher risk of obstructive sleep apnea. Sleep Breath 2022; 27:727-735. [DOI: 10.1007/s11325-022-02603-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 03/04/2022] [Accepted: 03/17/2022] [Indexed: 11/29/2022]
|
4
|
Salzano G, Maglitto F, Bisogno A, Vaira LA, De Riu G, Cavaliere M, di Stadio A, Mesolella M, Motta G, Ionna F, Califano L, Salzano FA. Obstructive sleep apnoea/hypopnoea syndrome: relationship with obesity and management in obese patients. ACTA ACUST UNITED AC 2021; 41:120-130. [PMID: 34028456 PMCID: PMC8142730 DOI: 10.14639/0392-100x-n1100] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 12/28/2020] [Indexed: 02/07/2023]
Abstract
Obstructive sleep apnoea/hypopnoea syndrome (OSAHS) is a disease characterised by upper airway obstruction during sleep, quite frequent in the general population, even if underestimated. Snoring, sleep apnoea and diurnal hypersomnia are common in these patients. Central obesity plays a key role: it reduces the size and changes the conformation of the upper airways, besides preventing lung expansion, with consequent reduction of lung volumes. Furthermore, obese people are also resistant to leptin, which physiologically stimulates ventilation; as a result, this causes scarce awakening during apnoea. OSAHS diagnosis is based on the combination of clinical parameters, such as apnoea/hypopnoea index (AHI), medical history, physical examination and Mallampati score. The first objective reference method to identify OSAHS is polysomnography followed by sleep endoscopy. Therapy provides in the first instance reduction of body weight, followed by continuous positive airway pressure (CPAP), which still remains the treatment of choice in most patients, mandibular advancement devices (MAD) and finally otolaryngology or maxillofacial surgery. Among surgical techniques, central is barbed reposition pharyngoplasty (BRP), used in the field of multilevel surgery.
Collapse
Affiliation(s)
- Giovanni Salzano
- Maxillo-Facial and ENT Surgery Unit, INT- IRCCS "Fondazione G. Pascale", Naples, Italy
| | - Fabio Maglitto
- Maxillo-Facial and ENT Surgery Unit, INT- IRCCS "Fondazione G. Pascale", Naples, Italy
| | - Antonella Bisogno
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi (Salerno), Italy
| | - Luigi Angelo Vaira
- Maxillofacial Surgery Unit, University Hospital of Sassari, Sassari, Italy
| | - Giacomo De Riu
- Maxillofacial Surgery Unit, University Hospital of Sassari, Sassari, Italy
| | - Matteo Cavaliere
- Department of Otolarhinolaryngology, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Fisciano, Salerno, Italy
| | | | - Massimo Mesolella
- Department of Neuroscience, Reproductive and Odontostomatological Science, Ear Nose and Throat Unit, University of Naples "Federico II", Naples, Italy
| | - Gaetano Motta
- Clinic of Otorhinolaryngology, Head and Neck Surgery Unit, Department of Anesthesiology, Surgical and Emergency Science, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Franco Ionna
- Maxillo-Facial and ENT Surgery Unit, INT- IRCCS "Fondazione G. Pascale", Naples, Italy
| | - Luigi Califano
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Naples, Italy
| | - Francesco Antonio Salzano
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi (Salerno), Italy
| |
Collapse
|
5
|
Are the International Classification of Functioning, Disability and Health (ICF) domains considered in the obstructive sleep apnea instruments? An integrative review. Sleep Breath 2020; 25:1089-1100. [PMID: 32865728 DOI: 10.1007/s11325-020-02173-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 08/10/2020] [Accepted: 08/19/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Obstructive Sleep Apnea (OSA) is related to cardiovascular, metabolic, and neurocognitive diseases. Furthermore, OSA symptoms, such as excessive sleepiness, fatigue, and mood disorders, may interfere in functioning. The assessment of this aspect in patients with OSA is not frequent and no specific instrument is available in the literature. Our aim is to identify if the International Classification of Functioning, Disability and Health (ICF) domains are considered in the validated instruments used to assess patients with OSA. METHODS In this integrative literature review, three databases were searched: Pubmed, Embase, and LILACS. Bibliographic survey was carried out in 2020, between March and July. Articles published in English, Portuguese, and Spanish with validated tools to assess OSA in adults were included. RESULTS Thirty instruments have undergone a process of concept extraction and coding according to the ICF, generating a total of 769 significant concepts. It was observed that the function domain was the most prevalent, making 42% (n = 323) of the concepts, followed by domains of activity (16%), participation (10%), environmental factors (5%), personal factor (5%), and structure (1%). Only one instrument, the "Sleep Apnea Quality of Life Index (SAQLI)," encompasses all domains of the ICF in its constructs. CONCLUSION In the analyzed instruments, the function domain prevails, with most concepts related to sleep functions. Only one validated instrument included in this research covered all the ICF domains. This instrument closely matched the recommended way of assessing functioning, though it approached the domains in an unbalanced way.
Collapse
|