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Heart Rhythm O2 2020 Apr 27;1(1):10-13. Epub 2020 Apr 27.

Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York.

Background: Various methods have been implemented for screening of patients for atrial fibrillation (AF), but the yield has generally been low. Targeting high-risk patients may improve detection of asymptomatic AF, which could be of value if appropriate treatment could be initiated before a potential thromboembolic event.

Objective: The purpose of this study was to test screening of high-risk nursing home residents having ≥2 risk factors for AF and no previous history of AF using a smartphone-based electrocardiographic (ECG) monitoring device to determine whether it is an accurate, easy-to-use method of screening for asymptomatic AF. Read More

Sensors (Basel) 2021 May 26;21(11). Epub 2021 May 26.

Institute for Bioengineering of Catalonia (IBEC), Barcelona Institute of Science and Technology (BIST), 08028 Barcelona, Spain.

Poor sleep quality is a risk factor for multiple mental, cardiovascular, and cerebrovascular diseases. Certain sleep positions or excessive position changes can be related to some diseases and poor sleep quality. Nevertheless, sleep position is usually classified into four discrete values: supine, prone, left and right. Read More

Diagnostics (Basel) 2021 May 19;11(5). Epub 2021 May 19.

Biomedical Engineering Graduate Program, University of Manitoba, Winnipeg, MB R3T 5V6, Canada.

Background: The apnea/hypopnea index (AHI) is the primary outcome of a polysomnography assessment (PSG) for determining obstructive sleep apnea (OSA) severity. However, other OSA severity parameters (i.e. Read More

Diagnostics (Basel) 2021 May 11;11(5). Epub 2021 May 11.

Department of Medicine, The Warren Alpert Medical School of Brown University, Providence, RI 02903, USA.

Sleep disordered breathing (SDB) and depression are both common complications of pregnancy and increase risk for adverse maternal and neonatal outcomes. SDB precedes onset of depression in non-pregnant adults; however, the longitudinal relationship has not been studied in pregnancy. The present research examined temporal associations between SDB and depressive symptoms in 175 pregnant women at risk for SDB (based on frequent snoring and obesity), but without an apnea hypopnea index of ≥5 events per hour at enrollment. Read More

J Clin Sleep Med 2021 May 20. Epub 2021 May 20.

Women's Medicine Collaborative-Division of Research, The Miriam Hospital, Providence, RI.

None: Obstructive sleep apnea (OSA) is a common disorder characterized by multiple episodes of airflow limitations and intermittent hypoxia. Pregnancy is a risk factor for developing OSA and OSA is associated with multiple adverse pregnancy outcomes and maternal morbidities, even beyond the gestational period. Despite the high prevalence of OSA and its impact on perinatal outcomes, there are no standard methods and optimal timing to screen for this disorder. Read More

Sleep Breath 2021 May 19. Epub 2021 May 19.

Reproductive Medical Center, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing, 100191, China.

Purpose: To investigate the proportion and clinical characteristics of obstructive sleep apnea (OSA) in Chinese patients with polycystic ovarian syndrome (PCOS) through home sleep apnea test (HSAT) and to evaluate the reproductive endocrine and metabolic characteristics in these patients.

Methods: The study was a cross-sectional analysis of infertile PCOS patients who underwent sleep respiratory monitoring between January and December 2019 at Peking University Third Hospital Reproductive Medical Center and respiratory and critical care medicine department. The prevalence of OSA, body mass index (BMI), menstruation, reproductive endocrine, and metabolic characteristics were collected in patients with PCOS. Read More

Sleep Breath 2021 May 15. Epub 2021 May 15.

Center for Cardiovascular Medicine, Interdisciplinary Center for Sleep Medicine, Charité-Universitätsmedizin Berlin, Luisenstraße 13, 10117, Berlin, Germany.

Purpose: Diagnosis and treatment of obstructive sleep apnea are traditionally performed in sleep laboratories with polysomnography (PSG) and are associated with significant waiting times for patients and high cost. We investigated if initiation of auto-titrating CPAP (APAP) treatment at home in patients with obstructive sleep apnea (OSA) and subsequent telemonitoring by a homecare provider would be non-inferior to in-lab management with diagnostic PSG, subsequent in-lab APAP initiation, and standard follow-up regarding compliance and disease-specific quality of life.

Methods: This randomized, open-label, single-center study was conducted in Germany. Read More

J Med Econ 2021 Jan-Dec;24(1):757-763

Sleep Alliance, Sleep Data, LLC, San Diego, CA, USA.

Aim: Produce empirical support for further enhancements to a therapy selection protocol for obstructive sleep apnea (OSA) patients intolerant of positive airway pressure.

Methods: A retrospective analysis was conducted in 101 men and 69 women patients. Two-night home sleep apnea studies were conducted at baseline and with a trial oral appliance. Read More

BMJ Open 2021 05 10;11(5):e044499. Epub 2021 May 10.

Department of Respiratory Diseases, Univ Montpellier, CHU Montpellier, Montpellier, France.

Introduction: To date, continuous positive airway pressure (CPAP) remains the cornerstone of obstructive sleep apnoea treatment. CPAP data describing residual sleep-disordered breathing events (ie, the CPAP-measured apnoea-hypopnoea indices (AHI-CPAP)) is difficult to interpret because it is an entirely different metric than the polysomnography (PSG) measured AHI gold standard (AHI-PSG). Moreover, manufacturer definitions for apnoea and hypopnoea are not only different from those recommended for PSG scoring, but also different between manufacturers. Read More

J Sleep Res 2021 May 5:e13358. Epub 2021 May 5.

Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Korea.

The fine structure of sleep electrocortical activity reflects health and disease. The current study provides normative data for sleep structure and electroencephalography (EEG) spectral power measures derived from overnight polysomnography (PSG) and examines the effect of age and sex among Korean middle-aged and older adults with or without obstructive sleep apnea (OSA). We analysed home PSG data from 1,153 adult participants of an ongoing population-based cohort study, the Korean Genome and Epidemiology Study. Read More

Indian Pediatr 2021 May 3. Epub 2021 May 3.

Pediatric Pulmonology and Sleep Medicine, Great Ormond Street Hospital for Children, London.

Sleep-related breathing disorders (SRBD), also referred to as sleep-disordered breathing (SDB), are common sleep disorders in children. They can be broadly divided between central and obstructive sleep-disordered breathing with or without associated hypoventilation. In most cases, SRBD are associated with adenotonsillar hypertrophy (obstructive SDB) which are classified as simple. Read More

Sensors (Basel) 2021 Apr 26;21(9). Epub 2021 Apr 26.

Faculty of Computer Science and Engineering, Ss. Cyril and Methodius University, 1000 Skopje, Macedonia.

Pneumonia caused by COVID-19 is a severe health risk that sometimes leads to fatal outcomes. Due to constraints in medical care systems, technological solutions should be applied to diagnose, monitor, and alert about the disease's progress for patients receiving care at home. Some sleep disturbances, such as obstructive sleep apnea syndrome, can increase the risk for COVID-19 patients. Read More

Sensors (Basel) 2021 Apr 22;21(9). Epub 2021 Apr 22.

Department of Pulmonary Medicine, CHU Brugmann, Université Libre de Bruxelles (ULB), 1020 Brussels, Belgium.

This article presents an overview of the advancements that have been made in the use of photoplethysmography (PPG) for unobtrusive sleep studies. PPG is included in the quickly evolving and very popular landscape of wearables but has specific interesting properties, particularly the ability to capture the modulation of the autonomic nervous system during sleep. Recent advances have been made in PPG signal acquisition and processing, including coupling it with accelerometry in order to construct hypnograms in normal and pathologic sleep and also to detect sleep-disordered breathing (SDB). Read More

Clin Neurol Neurosurg 2021 Apr 12;205:106639. Epub 2021 Apr 12.

Community Center, the Atahualpa Project, Atahualpa, Ecuador.

Objective: In view of the high prevalence of obstructive sleep apnea (OSA) and the increasing global pandemic of SARS-CoV-2 infection, it is likely that many patients with OSA get exposed to this virus. Besides theoretical assumptions, there is no evidence that OSA may favor SARS-CoV-2 acquisition or may lead to a more severe disease. Taking the opportunity of the Atahualpa Project cohort, we aimed to assess the relationship between previously diagnosed OSA and SARS-CoV-2 infection in older adults living in rural Ecuador. Read More

J Sleep Res 2021 Apr 22:e13370. Epub 2021 Apr 22.

Flinders Health and Medical Research Institute - Sleep Health, Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.

Evidence linking obstructive sleep apnea with cognitive dysfunction predominantly comes from clinical or select community samples. We investigated the independent cross-sectional association of obstructive sleep apnea and sleep macroarchitecture parameters with cognitive function in unselected community-dwelling middle-aged and older men. Four hundred and seventy-seven Florey Adelaide Male Ageing Study participants underwent successful home-based polysomnography. Read More

Respir Res 2021 Apr 21;22(1):117. Epub 2021 Apr 21.

Division of Respiratory Diseases, Ospedale L. Sacco, ASST-Fatebenefratelli-Sacco, Department of Biomedical and Clinical Sciences "Luigi Sacco", Università degli Studi di Milano, Milan, Italy.

Background: Epidemiology of dysphagia and its drivers in obstructive sleep apnea (OSA) are poorly understood. The study aims to investigate the prevalence of dysphagia symptoms and their association with demographic and clinical factors in patients with OSA.

Methods: Patients with OSA referring to an Academic Sleep Outpatient Clinic were enrolled in a prospective study. Read More

Sleep Med 2021 May 1;81:457-462. Epub 2021 Mar 1.

FHKAM(Otolaryngology), Department of Otolaryngology, Tuen Mun Hospital, Hong Kong.

Objective: Obstructive sleep apnea syndrome in children is associated with significant morbidity. Polysomnography is the main diagnostic tool but is time consuming and requires skilled manpower to supervise the patient overnight and hence long referral to diagnosis time. However, there are limitations and underestimation of the apnoea hyponea index (AHI) with alternative home sleep apnoea testing (HSAT), such as type 3 respiratory polygraphy (RP). Read More

J Asthma Allergy 2021 6;14:325-334. Epub 2021 Apr 6.

Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, 960-1295, Japan.

Background: Nocturnal asthma symptoms are a well-known feature of sleep disturbance. However, there are few reports on the association between sleep-related characteristics and asthma exacerbation. The aim of the current prospective observational study was to explore the factors while sleeping associated with future asthma exacerbation. Read More

Respir Med 2021 May 3;181:106388. Epub 2021 Apr 3.

Respiratory Diseases, Allergy and CF Unit, Pediatric Department, University Hospital Charles Nicolle, 76000, Rouen, France.

Objective: To describe the characteristics of children treated with long term continuous positive airway pressure (CPAP) or noninvasive ventilation (NIV) in France.

Design: Cross-sectional national survey.

Setting: Paediatric CPAP/NIV teams of 28 tertiary university hospitals in France. Read More

J Sleep Res 2021 Apr 12:e13352. Epub 2021 Apr 12.

Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.

Due to the high prevalence of obstructive sleep apnea (OSA), it is recommended to use in-laboratory polysomnography (PSG) or a home sleep apnea test (HSAT) in uncomplicated adult subjects at high risk of OSA. The aims of the present study were to compare a HSAT device, a wrist worn peripheral arterial tone signal device (WatchPAT™-200 [WP]) with PSG and respiratory polygraphy (RP) in a low-risk population of OSA. A total of 47 adult subjects at low risk of OSA were simultaneously examined with the three different approaches in a single night. Read More

J Thorac Dis 2021 Mar;13(3):1746-1759

Interdisciplinary Center of Sleep Medicine, Charité University Hospital, Berlin, Germany.

Background: Anthropometric measurements are simple and reachable tools for self-evaluating and screening patients with a high risk of obstructive sleep apnea (OSA). However, the accumulated relationship of obesity on the anthropometric characteristics of OSA is not well understood. The aim of the study was to show the time-dependent trend of OSA patients and compare overall and regional anthropometric between two ethnicities. Read More

Sleep Breath 2021 Apr 10. Epub 2021 Apr 10.

Neuro-Sono Sleep Center, Neurology Department, Unifesp, São Paulo, Brazil.

Aim: There are no studies comparing tests performed at home with those carried out in the laboratory, using the same device. The only studies that have been performed have compared the device used at home with the standard polygraph used in the laboratory. The purpose of this study was therefore to verify the accuracy of the home diagnosis of obstructive sleep apnea syndrome (OSAS) via unassisted type 2 portable polysomnography, compared with polysomnography using the same equipment in a sleep laboratory. Read More

Syst Rev 2021 Apr 9;10(1):104. Epub 2021 Apr 9.

Department of Health Economics, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.

Background: Obstructive sleep apnoea (OSA) is a significant public health problem affecting a large proportion of the population and is associated with adverse health consequences and a substantial economic burden. Despite the existence of effective treatment, undiagnosed OSA remains a challenge. The gold standard diagnostic tool is polysomnography (PSG), yet the test is expensive, labour intensive and time-consuming. Read More

Sleep Breath 2021 Apr 3. Epub 2021 Apr 3.

Department of Family Medicine, Tainan Municipal Hospital (Managed by Show Chwan Medical Care Corporation), 670 Chung-Te Road, Tainan, 70173, Taiwan.

Purpose: Snoring is closely related to obstructive sleep apnea in adults. The increasing abundance and availability of smartphone technology has facilitated the examination and monitoring of snoring at home through snoring apps. However, the accuracy of snoring detection by snoring apps is unclear. Read More

J Clin Sleep Med 2021 Mar 30. Epub 2021 Mar 30.

Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital Baselland, Liestal, Switzerland.

Study Objectives: Night-to-night variability of obstructive sleep apnea severity (OSA) is considerable and may depend on the diagnostic modality used. We investigated the night-to-night variability using peripheral arterial tonometry (PAT).

Methods: Home sleep apnea testing was performed in 51 patients during three consecutive nights using PAT. Read More

J Clin Sleep Med 2021 Mar 19. Epub 2021 Mar 19.

Respiratory & Epidemiology and Clinical Research Unit, Translational Research in Respiratory Diseases Program, McGill University Health Centre, Montreal, Quebec, Canada.

Study Objectives: Sleep-disordered breathing (SDB) is common in patients with neuromuscular disorders (NMD), developing before chronic hypercapnia appears. Polysomnography (PSG) is the diagnostic gold standard but is often impractical and poorly accessible for individuals with NMD. We sought to determine diagnostic accuracy, feasibility and patient preference of Home Sleep Apnea Testing (HSAT) compared with PSG for detection of SDB in NMD. Read More

J Clin Sleep Med 2021 Mar 19. Epub 2021 Mar 19.

Department of Medicine, University of Washington.

Study Objectives: Sleep quality in patients studied with laboratory-based polysomnography (PSG) may differ from sleep quality in patients studied at home, but remains clinically relevant and important to describe. We assessed objective sleep quality and explored factors associated with poor sleep in patients undergoing laboratory-based PSG.

Methods: We reviewed diagnostic PSG studies from a 10-year period at a single sleep center. Read More

Lung 2021 04 13;199(2):87-101. Epub 2021 Mar 13.

Division of Pulmonary & Critical Care Medicine, University of Utah, 26 N 1900E, Salt Lake City, UT, 84112, USA.

Obstructive sleep apnea syndrome (OSAS) is a common and underdiagnosed medical condition characterized by recurrent sleep-dependent pauses and reductions in airflow. While a narrow, collapsible oropharynx plays a central role in the pathophysiology of OSAS, there are other equally important nonanatomic factors including sleep-stage dependent muscle tone, arousal threshold, and loop gain that drive obstructive apneas and hypopneas. Through mechanisms of intermittent hypoxemia, arousal-related sleep fragmentation, and intrathoracic pressure changes, OSAS impacts multiple organ systems. Read More

J Clin Sleep Med 2021 Jun;17(6):1287-1293

American Academy of Sleep Medicine, Darien, Illinois.

Introduction: Obstructive sleep apnea is an important and common disorder with associated health risks. Assuring successful longitudinal management is vital to patient health and sleep-related quality of life. This paper provides guidance from the American Academy of Sleep Medicine (AASM) regarding the use of polysomnography (PSG) and home sleep apnea tests (HSATs) after a diagnosis of obstructive sleep apnea has been established and, in most cases, treatment implemented. Read More

J Clin Sleep Med 2021 Mar 9. Epub 2021 Mar 9.

Wits Sleep Laboratory, Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa.

Study Objectives: The association between obstructive sleep apnea (OSA) and increased cardiometabolic risk (CMR) has been well documented in higher-income countries. However, OSA and its association with CMR have not yet been investigated, based on objective measures, in Southern Africa. We measured polysomnography (PSG)-derived sleep characteristics, OSA prevalence and its association with cardiometabolic diseases in a rural, low-income, aging African-ancestry sample in South Africa. Read More