ObjectiveTo investigate the knowledge and attitude of medical professionals in various regions of China on obstructive sleep apnea (OSA) and to find out the influence of sleep center setting on the above results.MethodsA self-designed questionnaire based on OSAKA questionnaire was designed. A total of 630 medical staff were investigated in 7 hospitals at different levels in various regions in China. The subjects were divided into two groups according to whether they had sleep center (including sleep monitoring room) or not. Survey data were analyzed.ResultsA total of 630 questionnaires were sent out, and 590 valid questionnaires were received, and the effective response rate was 93.65%. About half of those surveyed had sleep centers in the hospitals where they worked. There was no significant difference in three attitude problems and the choice of continuous positive airway pressure and surgical treatment between the two groups (all P>0.05). Subjects whose hospital had no sleep center were more prone to select weight loss (estimated parameters=0.513, P=0.046), no smoking and wine (estimated parameter=0.472, P=0.040), avoidance of overwork (estimated parameter=0.933, P=0.000), and drug (estimated parameter=0.802, P=0.000). The average correct rate of OSA knowledge was 45.59%±20.68%. Among them, the correct rate of response to treatment measures was the highest, and the correct rate of other knowledge points was poor. The average correct rate of total accuracy, symptoms and target organ damage in subjects whose hospital had sleep center was higher than that in subjects whose hospital had no sleep center, and there were significant differences (P=0.001, P=0.012, P=0.000). There was a positive correlation between the knowledge of OSA and their attitude towards OSA, treatment and further understanding of the knowledge (r=0.247, P=0.000).ConclusionIt is necessary to strengthen propaganda and education of OSA, and the establishment of sleep center is helpful for medical personnel to know more about OSA and to develop sleep medicine.
ObjectiveTo analyse the hundred top-cited articles in obstructive sleep apnea hypopnea syndrome (OSAHS), and summarize the development trend of OSAHS research.MethodsWe searched the Web of Science core collection for all published articles on OSAHS or sleep disorders from January 1st, 1992 to May 23th, 2018. The hundred top-cited articles with the most frequent citation were selected. The publication time, country of origin, journal, institution, professional field of corresponding author, funding type, publication type, etc. were analyzed.ResultsThe hundred top-cited articles were published between 1992 and 2013, with 300～5 980 citations and a total of 65 719 citations. The main types of articles were clinical studies (73 articles), reviews (20 articles), guidelines (4 articles) and basic research (3 articles). Fourteen authors published more than one first-author paper, and fifteen authors published more than one articles as corresponding authors. These authors were distributed across 22 subject areas. The most cited country was the United States (60 articles), and the most cited institution was the University of Wisconsin (10 articles). The hundred top-cited articles were published in 31 journals, most of which were cited less than 1 000 times, and a few articles were cited more than 2 000 times.ConclusionsOSAHS has attracted much attention in respiratory medicine, neurology, epidemiology and other fields, and many articles about clinical research types of OSAHS have been cited. In addition, most of the highly cited articles in the OSAHS field come from the developed countries; our country needs to devote more resources to OSAHS research.
Objective To evaluate the effects of selective serotonin reuptake inhibitors ( SSRIs) on sleep apneas in Sprague-Dawley ( SD) rats. Methods Thirty adultmale SD rats were randomly divided into two groups ( 15 rats in each group) . The treatment group and the control group were injected intraperitoneally with paroxetine ( 10 mg· kg- 1 · d - 1 ) and sterile distilled water ( 2 mL· kg- 1 · d - 1) for 7 days respectively. Parameters about sleep apnea and sleep structure were measured before and after the treatment. Results In the treatment group, there was a significant reduction of apnea index ( AI) from ( 12. 4 ±3. 7)times /hour to ( 7. 4 ±2. 2) times/ hour ( P = 0. 000) . Both post sigh apnea index ( PSAI) and spontaneous apnea index ( SPAI) were decreased significantly ( P = 0. 000 and 0. 021 respectively) in non-rapid eye movement ( NREM) sleep, but not in REM sleep. REM sleep was reduced from 8. 6% to 8. 0% ( P =0. 013) and its latency was increased from ( 54. 1 ±48. 4) min to ( 110. 9 ±43. 4) min ( P = 0. 001) in the treatment group, as well as the sleep-onset latency [ from ( 20. 7 ±9. 1) min to ( 30. 0 ±15. 7) min, P =0. 038] . Conclusion Paroxetine can reduce sleep apneas in SD rats during NREMsleep. Its effects on sleep structure include reducing REM time, increasing REM latency and sleep-onset latency.
Objective To assess the clinical effectiveness and safety of uvulopalatopharyngoplasty （UPPP） in the treatment of snoring and obstructive sleep aponea syndrome （OSAS ）. Methods MEDLINE （1966 -2005 ）, EMBASE （1984 - 2005 ）, The Cochrane Library （Issue 1, 2005 ）, CBM （1979 - 2005 ）, CNKI （1994 - 2005 ）, VIP （ 1989 - 2005 ）, CMCC （1994-2005） ,Wanfang Database and Internet were searched in English and Chinese versions. Randomized controlled trials（ RC,Ts）, quasi-randomized controlled trials and prospective cohort studies were included. Study quality was evaluated by two researchers independently. RevMan4.2.7 was used for meta-analysis.Results Twelve studies were included, of which 5 were RCTs, 7 were prospective cohort studies. Compared with dental appliance（DA）, PSG （polysomnography） changes of DA group were larger than UPPP group, but patients of UPPP group had better quality of life and compliance. Comparing UPPP with LAUP （laser-assisted uvulopalatpharyngoplasty ） and RFTVR （radiofrequency tissue volume reduction）, the postoperative pain of the latter two was less than UPPP. About complications, UPPP and LAUP had no difference except for nasal reflux at 1 week after operation, there was no statistical difference between UPPP and RFTVR. There was no study to compare the PSG change among the three groups. Comparing UPPP with CPAP （continuous positive airway pressure）, PSG changes were larger in CPAP. Conclusions At present, there is no evidence to assure that UPPP is better than other treatments for snoring and OSAS or to suggest which type of surgery is most effective.The literature search is restricted to the publications of English and Chinese language, which may have resulted in missing some studies; the evidence is still weak due to the poor quality and a small number of included studies. There is an urgent need for high quality RCTs to be carried out.
ObjectiveTo investigate the diagnostic value of oximetry in sleep apnea hypopnea syndrome (SAHS). MethodsAdult patients suspected for SAHS were enrolled between May 2010 and May 2013. The patients underwent both polysomnography (PSG) and oximetry for further diagnosis. Apnea hyponea index (AHI) and oxygen desaturation index four (ODI4) were calculated on a single night. The relationship between AHI and ODI4 were analyzed. ResultsA total of 628 adult patients were recruited.ODI4 was linearly correlated with AHI with a regression coefficient of almost 1. The cut-off values of ODI4 for indentifing SAHS and moderate to severe SAHS were 10 events per hour and 20 events per hour, with specificities of 99.9% and 99.3%, and AUCs of 0.931 and 0.934, respectively. Female, lower weight and less severe SAHS patients were easily misdiagnosed. ConclusionsThere is a high agreement between AHI and ODI4. Oximetry is less likely misdiagnose SAHS.
ObjectiveThe aim of this study was to investigate the value of Artificial Neural Networks (ANNs) in predicting the occurrence of Venous Thromboembolism (VTE) in patients with Obstructive Sleep Apnea (OSA), and to compare it with traditional Logistic regression models to assess its predictive efficacy, providing theoretical basis for the prediction of VTE risk in OSA patients. MethodsA retrospective analysis was conducted on patients diagnosed with OSA and hospitalized in the Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Kunming Medical University, from January 2018 to August 2023. Patients were divided into OSA combined with VTE group (n=128) and pure OSA control group (n=680). The dataset was randomly divided into a training set (n=646) and an independent validation set (n=162). The Synthetic Minority Oversampling Technique (SMOTE) was employed to address the issue of data imbalance. Artificial Neural Networks and Logistic regression models were then built on training sets with and without SMOTE. Finally, the performance of each model was evaluated using accuracy, sensitivity, specificity, Youden's index, and Area Under the Receiver Operating Characteristic Curve (AUC). Results When oversampling was conducted using SMOTE on the training set, both the Artificial Neural Network and Logistic regression models showed improved AUC. The Artificial Neural Network model with SMOTE performed the best with an AUC value of 0.935 (95%CI: 0.898–0.961), achieving an accuracy of 90.15%, specificity of 87.32%, sensitivity of 93.44%, and Youden’s index of 0.808 at the optimal cutoff point. The Logistic regression model with SMOTE yielded an AUC value of 0.817 (95%CI: 0.765–0.861), with an accuracy of 77.27%, specificity of 83.80%, sensitivity of 69.67%, and Youden's index of 0.535. The difference in AUC between the Artificial Neural Network model and Logistic regression model was statistically significant after employing SMOTE (P<0.05). Conclusions The Artificial Neural Network model demonstrates high effectiveness in predicting VTE formation in OSA patients, particularly with the further improvement in predictive performance when utilizing SMOTE oversampling technique, rendering it more accurate and stable compared to the traditional Logistic regression model.
Patients with autoimmune encephalitis are mainly characterized by behavioral, mental and motor abnormalities, neurological dysfunction, memory deficits and seizures. Different antibody types of autoimmune encephalitis its pathogenesis, clinical characteristics are different, in recent years found immune related epilepsy is closely related to autoimmune encephalitis, based on autoimmune encephalitis type is more, we choose more common autoimmune encephalitis, expounds its characteristics, to help clinical diagnosis.
ObjectiveTo systematically review the risk factors associated with sleep disorders in ICU patients.MethodsWe searched The Cochrane Library, PubMed, EMbase, Web of Science, CNKI, Wanfang Data, VIP and CBM databases to collect cohort studies, case-control studies and cross-sectional studies on the risk factors associated with sleep disorders in ICU patients from inception to October, 2018. Two reviewers independently screened literature, extracted data and evaluated the bias risk of included studies. Then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 9 articles were included, with a total of 1 068 patients, including 12 risk factors. The results of meta-analysis showed that the combined effect of equipment noise (OR=0.42, 95%CI 0.26 to 0.68, P=0.000 4), patients’ talk (OR=0.53, 95%CI 0.42 to 0.66, P<0.000 01), patients’ noise (OR=0.39, 95%CI 0.21 to 0.74, P=0.004), light (OR=0.29, 95%CI 0.18 to 0.45, P<0.000 01), night treatment (OR=0.36, 95%CI 0.26 to 0.50, P<0.000 01), diseases and drug effects (OR=0.17,95%CI 0.08 to 0.36, P<0.000 01), pain (OR=0.37, 95%CI 0.17 to 0.82, P=0.01), comfort changes (OR=0.34,95%CI 0.17 to 0.67,P=0.002), anxiety (OR=0.31,95%CI 0.12 to 0.78, P=0.01), visit time (OR=0.72, 95%CI 0.53 to 0.98, P=0.04), economic burden (OR=0.63, 95%CI 0.48 to 0.82, P=0.000 5) were statistically significant risk factors for sleep disorders in ICU patients.ConclusionCurrent evidence shows that the risk factors for sleep disorders in ICU patients are environmental factors (talking voices of nurses, patient noise, and light), treatment factors (night treatment), disease factors (disease itself and drug effects, pain,) and psychological factors (visiting time, economic burden). Due to the limited quality and quantity of included studies, more high quality studies are needed to verify the above conclusions.
Objective To systematically review the correlation between obstructive sleep apnea syndrome (OSAS) and the incidence of carotid atherosclerosis. Methods PubMed, EMbase, CNKI, WanFang Data, CBM, and VIP databases were electronically searched to collect studies on the correlation between OSAS and carotid atherosclerosis and carotid intima-media thickness (CIMT) from inception to August 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using Stata 16.0 software and RevMan 5.3 software. Results A total of 32 studies, including 2 915 patients were included. The results of the meta-analysis showed a higher incidence of carotid atherosclerotic plaque in OSAS patients than in the control group (OR=5.56, 95%CI 0.27 to 8.38, P<0.000 01); subgroup analysis revealed that, compared with the control group, patients who were male (OR=5.38, 95%CI 2.79 to 10.38, P<0.000 01) or had mild-to-moderate OSAS (OR=3.9, 95%CI 1.66 to 9.15, P=0.002) or severe OSAS (OR=19.86, 95%CI 6.49 to 60.82, P<0.000 01) had a higher risk of carotid atherosclerosis. The CIMT of the OSAS group was significantly higher than that of the control group (SMD=1.24, 95%CI 0.97 to 1.51, P<0.000 01). There was a positive correlation between the apnea hypopnea index (AHI) and CIMT in OSAS patients (r=0.52, 95%CI 0.44 to 0.60, <0.000 1), and the CIMT increased with OSAS severity. Conclusion OSAS is associated with a high incidence of carotid atherosclerotic plaque that is highly correlated with CIMT, which increases with an increase in the AHI. These findings are required to be verified in prospective high-quality studies to overcome the limitations of quantity and quality of studies included in this systematic review.
Objective To systematically review the rate of sleep deprivation in children and adolescents in China from 2004 to 2019. Methods PubMed, The Cochrane Library, EMbase, Web of Science, CBM, CNKI and WanFang Data databases were searched to collect cross-sectional studies on the sleep deprivation rate of children and adolescents in China from inception to July 15th, 2021. Two researchers independently screened literature, extracted data and evaluated the risk of bias of the included studies. Meta-analysis was then performed by using Stata 15.0 software. Results A total of 45 cross-sectional studies were included, with a total sample size of 769 918 participants, of whom 587 457 reported sleep deprivation. The results of meta-analysis showed that the sleep deprivation rate of Chinese children and adolescents was 61% (95%CI 55% to 68%). Subgroup analysis indicated that the sleep deprivation rates were 62% for female children and 59% for male children. The rate was 84% in junior high school, 80% in high school and 64% in primary school. The rates in south China, southwest China, northwest China, north China, east China and central China were 68%, 62%, 61%, 57%, 57% and 54%, respectively. The rate of sleep deficiency based on "health requirements for daily study time of primary and junior school students" was the highest at 74% (95% CI 70% to 79%). The cumulative meta-analysis by time showed that the sleep deprivation rate had gradually stabilized and approached 60% since 2011. Conclusion Current evidence shows that the sleep deprivation rate of Chinese children and adolescents is high. Due to the limited quality and quantity of included studies, more high-quality studies are needed to verify the above conclusion.