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Fulltext Cor pulmonale due to obstructive sleep apnoea

Liam CK

Med J Malaysia, 1993 Sep;48(3):347-50.

A 47 year old man with a long history of chronic loud snoring and daytime sleepiness presented with hypercapnic respiratory failure and right ventricular failure. The diagnosis of obstructive sleep apnoea (OSA) leading to the 'obesity-hypoventilation syndrome', was supported by the findings of an overnight cardio-respiratory monitoring during sleep. His symptoms and arterial blood gases improved following treatment with nocturnal nasal continuous positive airway pressure (CPAP).

Matched MeSH terms: Sleep Apnea Syndromes/complications*

Fulltext The Site of Airway Collapse in Sleep Apnea, Its Associations with Disease Severity and Obesity, and Implications for Mechanical Interventions

Sung CM, Tan SN, Shin MH, Lee J, Kim HC, Lim SC, et al.

Am J Respir Crit Care Med, 2021 07 01;204(1):103-106.

PMID: 33826879 DOI: 10.1164/rccm.202011-4266LE

Matched MeSH terms: Sleep Apnea Syndromes/complications*

Fulltext Predictive performance of oximetry in detecting sleep apnea in surgical patients with cardiovascular risk factors

Waseem R, Chan MTV, Wang CY, Seet E, Chung F

PLoS One, 2021;16(5):e0250777.

PMID: 33956830 DOI: 10.1371/journal.pone.0250777

INTRODUCTION: In adults with cardiovascular risk factors undergoing major noncardiac surgery, unrecognized obstructive sleep apnea (OSA) was associated with postoperative cardiovascular complications. There is a need for an easy and accessible home device in predicting sleep apnea. The objective of the study is to determine the predictive performance of the overnight pulse oximetry in predicting OSA in at-risk surgical patients.

METHODS: This was a planned post-hoc analysis of multicenter prospective cohort study involving 1,218 at-risk surgical patients without prior diagnosis of sleep apnea. All patients underwent home sleep apnea testing (ApneaLink Plus, ResMed) simultaneously with pulse oximetry (PULSOX-300i, Konica Minolta Sensing, Inc). The predictive performance of the 4% oxygen desaturation index (ODI) versus apnea-hypopnea index (AHI) were determined.

RESULTS: Of 1,218 patients, the mean age was 67.2 ± 9.2 years and body mass index (BMI) was 27.0 ± 5.3 kg/m2. The optimal cut-off for predicting moderate-to-severe and severe OSA was ODI ≥15 events/hour. For predicting moderate-to-severe OSA (AHI ≥15), the sensitivity and specificity of ODI ≥ 15 events per hour were 88.4% (95% confidence interval [CI], 85.7-90.6) and 95.4% (95% CI, 94.2-96.4). For severe OSA (AHI ≥30), the sensitivity and specificity were 97.2% (95% CI, 92.7-99.1) and 78.8% (95% CI, 78.2-79.0). The area under the curve (AUC) for moderate-to-severe and severe OSA was 0.983 (95% CI, 0.977-0.988) and 0.979 (95% CI, 0.97-0.909) respectively.

DISCUSSION: ODI from oximetry is sensitive and specific in predicting moderate-to-severe or severe OSA in at-risk surgical population. It provides an easy, accurate, and accessible tool for at-risk surgical patients with suspected OSA.

Matched MeSH terms: Sleep Apnea Syndromes/complications*

Fulltext Recurrent acute pulmonary oedema associated with obstructive sleep apnoea

Liam CK, Liao CM, Kannan P

Singapore Med J, 1994 Aug;35(4):411-3.

PMID: 7899906

A patient had recurrent acute nocturnal pulmonary oedema following an anterior myocardial infarction despite a normal maximal stress electrocardiogram. He had a history of chronic heavy snoring and other symptoms to suggest a diagnosis of obstructive sleep apnoea (OSA) which was supported by an overnight sleep study. The recurrent acute pulmonary oedema was most likely due to a combination of poor left ventricular function and obstructive sleep apnoea.

Matched MeSH terms: Sleep Apnea Syndromes/complications*

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