The results of this study suggest an association between OSA and Hs-CRP concentrations (mainly mediated by overweight and obesity), but not between OSA and subclinical atherosclerosis.
Although the majority of the studies included in this review showed a significant association between AR and SDB, all of the studies were evidence level 3b and 4, for an overall grade of B– evidence.
Although the evidence generally supports a connection between SDB and allergic rhinitis, this connection is not definitive and the mechanism linking these two diseases remains poorly understood.
These results demonstrate that asthma is associated with REM-related breathing abnormalities in children with moderate-severe OSA. The link between asthma and REM-related OSA is independent of asthma control and obesity.
This is the first report to quantify volumetric changes in the upper airway in obese children with OSAS after adenotonsillectomy showing significant residual adenoid tissue and an increase in the volume of the tongue and soft palate. These findings could explain the low success rate of AT reported in obese children with OSAS and are important considerations for clinicians treating these children.
Sleep endoscopy is a consistently reliable tool for identifying the site of obstruction in children with persistent OSA. Though anesthetic induced sleep is not a perfect model for real sleep, the technique demonstrably guides further therapy better than awake endoscopy.
In 1984, Cartwright suggested that physicians should differentiate between patients with either positional obstructive sleep apnoea (POSA) or non-positional OSA. He introduced the arbitrary cut-off point of a difference of 50 % or more in apnoea index between supine and non-supine positions. In this study, a panel of three field experts developed consensus on Amsterdam Positional OSA Classification resulting in the consensus standard used to calibrate the new classification.
OSA was associated with increased odds of pregnancy-related morbidities including preeclampsia (OR, 2.5; 95% CI, 2.2–2.9), eclampsia (OR, 5.4; 95% CI, 3.3–8.9), cardiomyopathy (OR, 9.0; 95% CI, 7.5–10.9), and pulmonary embolism (OR, 4.5; 95% CI, 2.3–8.9). Women with OSA experienced a more than fivefold increased odds of in-hospital mortality (95% CI, 2.4–11.5). Obstructive sleep apnea is associated with severe maternal morbidity, cardiovascular morbidity, and in-hospital death.
In pregnancy, a positive screen on the STOP-BANG Questionnaire was associated with preeclampsia. Future studies are needed to validate the performance of this tool against polysomnography during pregnancy, which most participants stated they would be willing to complete
A STOP-BANG in which all information is self-reported may be as effective as the original version, and has potential to facilitate research or community screening where good negative predictive value is required for an effective screening tool.