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Orofacial myofunctional evaluation with scores in subjects with obstructive sleep apnea
Abstracts / Sleep Medicine 14S (2013) e18–e92
Orofacial myofunctional evaluation with scores in subjects with obstructive sleep apnea G. Aparecida Folha, F. Cardoso Pereira Valera, L. Dantas Giglio, L. Vitaliano Voi Trawizki, C. Maria De Felício Faculty of Medicine of Ribeirão Preto, University of São Paulo, Brazil Introduction: Orofacial myofunctional disorders (OMD) are common in patients with Obstructive Sleep Apnea (OSA), thus, it is necessary a detailed and precise clinical instrument for assessment of the OMD in this population, since the orofacial exercise has been recommended with positive results in patients with OSA. The Expandend Protocol of Orofacial Myofunctional Evaluation with Scores (OMES-E) is a validity instrument for the clinical evaluation of the orofacial myofunctional condition, that permit the examiner to express numerically the perception of the characteristics and behaviors observed in children. Thus, the aim of this study was to verify if the OMES-E protocol can discriminate the myofunctional orofacial characteristics in healthy adults and with OSA. Materials and methods: Participated 133 subjects (19–60 years old), both genders (99 with untreated OSA, diagnosed by polysomnography - group OSA) and 34 healthy subjects, without OSA signs or symptoms (group C). Exclusion criteria were neurological or cognitive deficit, tumors or traumas in the head and neck, and use of analgesic, anti-inflammatory and psychiatric drugs. One speech therapist with experience in orofacial myofuncional evaluation performed the examination. The subjects were evaluated individually with the OMES-E protocol, according to the previously described methodology. To verify if the OMES-E protocol would be able to discriminate the myofunctional orofacial characteristics in the subjects with and without OSA, the analysis of covariance adjusted for the mean, with two variation factors (Group and Gender) was performed for the protocol Categories (Appearance/Posture, Mobility, Respiration, Deglutition and Mastication). Multiple Regression Analysis was calculated to verify the possible association between the variables Age and Body Mass Index (BMI) with the protocol Categories. Statistica software was used, significance level at 0.05. Results: There was a higher percentage of OMD in group OSA compared to C (p < 0.001). There were no differences regarding Gender to Categories of the protocol or interaction effect between Gender and Categories, but between Group and Categories. There was association between BMI with the Categories Appearance/Posture, Respiration (p < 0.01) and Mobility (p < 0.05), and between Age with Mobility (p < 0.05). Conclusion: Thus, the OMES-E protocol is able to discriminate the orofacial myofunctional characteristics in health adults and in patients with OSA. Acknowledgements: This work received support from CAPES, the Brazilian Federal Agency for Support and Evaluation of Postgraduate Education.
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disorders. Most previous studies used self-reported sleep duration or quality, but little is known about the objective sleep parameters underlying these associations. The aim of this study was to explore the association between sleep structure measured by polysomnography (PSG) and cardiometabolic disorders in a large unselected middle-aged general population sample. Materials and methods: 2019 subjects (49.9% males, 57.6 11.1 years old, BMI 25.4 4.4 kg/m2) participating in an ongoing population- based sleep cohort (HypnoLaus, Lausanne, Switzerland) underwent full PSG recordings at home. All subjects had an extensive clinical workup including medical history, fasting glucose, morning systolic (SBP) and diastolic (DBP) blood pressure measurements. PSG were scored according to AASM 2007 scoring criteria. Results: For the whole group there was, after adjustment for age, statistically significant correlations between cardiometabolic disorders and sleep parameters. The highest correlation coefficient values were obtained for % of slow wave sleep (SWS) and SBP (r2 = 0.18, p < 0.001), DBP (r2 = 0.13, p < 0.01), glycemia (r2 = 0.18, p < 0.001) and BMI (r2 = 0.17, p < 0.001); and for total arousal index (AI) and SBP (r2 = 0.16, p < 0.001), DBP (r2 = 0.13, p<0.01), glycemia (r2 = 0.19, p < 0.001) and BMI (r2 = 0.19, p<0.001). After excluding subjects with sleep disordered breathing and periodic limb movements (those with an apnea/hypopnea index -AHI- >15/h and a periodic leg movement index -PLMSI- >15/h) significant correlations remained between: SWS and SBP (r2 = 0.17, p < 0.05), glycemia (r2 = 0.22, p < 0.01) and BMI (r2 = 0.25, p<0.01). Significant associations (age-adjusted) were found between: SWS and BMI categories (p < 0.001), diabetes (p = 0.01), hypertension (p = 0.004) and metabolic syndrome (MetSynd,p = 0.002); and between AI and BMI categories (p < 0.001), diabetes (p<0.001), hypertension (p < 0.001) and MetSynd (p < 0.001). After excluding subjects with abnormal AHI/PLMI significant associations remained between: SWS and BMI categories (p < 0.001) and hypertension (p = 0.01); and between AI and BMI categories (p = 0.003), diabetes (p < 0.001) and MetSynd (p = 0.02). Conclusion: Objectively measured sleep fragmentation and reduced SWS are associated with cardiometabolic disturbances in the general population. Acknowledgements: Funding: Fondation Leenaards, FNS, GSK, Ligue Pulmonnaire Vaudoise and CIRS. http://dx.doi.org/10.1016/j.sleep.2013.11.085
Morbidity and mortality in children with obstructive sleep apnea: a controlled national study P. Jennum Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Denmark
http://dx.doi.org/10.1016/j.sleep.2013.11.084
Sleep structure and cardiometabolic disorders in the general population J. Haba-Rubio 1, P. Marques-Vidal 2, D. Andries 1, N. Tobback 1, M. Tafti 1, R. Heinzer 1 1 Center for investigation and research in sleep (CIRS), University Hospital (CHUV), Switzerland 2 Institute of social and preventive medicine (IUMSP), University Hospital (CHUV), Switzerland
Introduction: Recent research has identified relationships between sleep duration and quality and increased risk of cardiometabolic
Introduction: As there is little information regarding consequences of obstructive sleep apnea (OSA) in children, the aim of this study was to evaluate morbidity and mortality in childhood OSA. Materials and methods: A total of 2998 patients with a diagnose of OSA were identified from the Danish National Patient Registry aged 0–19-years. For each patient, we randomly selected four citizens matched for age, sex and socioeconomic status, thus providing 11974 controls. Results: The five-year mortality was 0.993 (0.989–0.996) versus 0.999 (0.998–9.999) in controls. The hazard ratio was 0.15 (p < 0.001). Patients with OSA had greater morbidity at least three years before their diagnosis. The most common contacts with the health system (odds ratio, OR; confidence interval, CI): infections (OR:1.19; CI:1.01–1.40), endocrine, nutritional and metabolic
Orofacial myofunctional evaluation with scores in subjects with obstructive sleep apnea G. Aparecida Folha, F. Cardoso Pereira Valera, L. Dantas Giglio, L. Vitaliano Voi Trawizki, C. Maria De Felício Faculty of Medicine of Ribeirão Preto, University of São Paulo, Brazil Introduction: Orofacial myofunctional disorders (OMD) are common in patients with Obstructive Sleep Apnea (OSA), thus, it is necessary a detailed and precise clinical instrument for assessment of the OMD in this population, since the orofacial exercise has been recommended with positive results in patients with OSA. The Expandend Protocol of Orofacial Myofunctional Evaluation with Scores (OMES-E) is a validity instrument for the clinical evaluation of the orofacial myofunctional condition, that permit the examiner to express numerically the perception of the characteristics and behaviors observed in children. Thus, the aim of this study was to verify if the OMES-E protocol can discriminate the myofunctional orofacial characteristics in healthy adults and with OSA. Materials and methods: Participated 133 subjects (19–60 years old), both genders (99 with untreated OSA, diagnosed by polysomnography - group OSA) and 34 healthy subjects, without OSA signs or symptoms (group C). Exclusion criteria were neurological or cognitive deficit, tumors or traumas in the head and neck, and use of analgesic, anti-inflammatory and psychiatric drugs. One speech therapist with experience in orofacial myofuncional evaluation performed the examination. The subjects were evaluated individually with the OMES-E protocol, according to the previously described methodology. To verify if the OMES-E protocol would be able to discriminate the myofunctional orofacial characteristics in the subjects with and without OSA, the analysis of covariance adjusted for the mean, with two variation factors (Group and Gender) was performed for the protocol Categories (Appearance/Posture, Mobility, Respiration, Deglutition and Mastication). Multiple Regression Analysis was calculated to verify the possible association between the variables Age and Body Mass Index (BMI) with the protocol Categories. Statistica software was used, significance level at 0.05. Results: There was a higher percentage of OMD in group OSA compared to C (p < 0.001). There were no differences regarding Gender to Categories of the protocol or interaction effect between Gender and Categories, but between Group and Categories. There was association between BMI with the Categories Appearance/Posture, Respiration (p < 0.01) and Mobility (p < 0.05), and between Age with Mobility (p < 0.05). Conclusion: Thus, the OMES-E protocol is able to discriminate the orofacial myofunctional characteristics in health adults and in patients with OSA. Acknowledgements: This work received support from CAPES, the Brazilian Federal Agency for Support and Evaluation of Postgraduate Education.
e51
disorders. Most previous studies used self-reported sleep duration or quality, but little is known about the objective sleep parameters underlying these associations. The aim of this study was to explore the association between sleep structure measured by polysomnography (PSG) and cardiometabolic disorders in a large unselected middle-aged general population sample. Materials and methods: 2019 subjects (49.9% males, 57.6 11.1 years old, BMI 25.4 4.4 kg/m2) participating in an ongoing population- based sleep cohort (HypnoLaus, Lausanne, Switzerland) underwent full PSG recordings at home. All subjects had an extensive clinical workup including medical history, fasting glucose, morning systolic (SBP) and diastolic (DBP) blood pressure measurements. PSG were scored according to AASM 2007 scoring criteria. Results: For the whole group there was, after adjustment for age, statistically significant correlations between cardiometabolic disorders and sleep parameters. The highest correlation coefficient values were obtained for % of slow wave sleep (SWS) and SBP (r2 = 0.18, p < 0.001), DBP (r2 = 0.13, p < 0.01), glycemia (r2 = 0.18, p < 0.001) and BMI (r2 = 0.17, p < 0.001); and for total arousal index (AI) and SBP (r2 = 0.16, p < 0.001), DBP (r2 = 0.13, p<0.01), glycemia (r2 = 0.19, p < 0.001) and BMI (r2 = 0.19, p<0.001). After excluding subjects with sleep disordered breathing and periodic limb movements (those with an apnea/hypopnea index -AHI- >15/h and a periodic leg movement index -PLMSI- >15/h) significant correlations remained between: SWS and SBP (r2 = 0.17, p < 0.05), glycemia (r2 = 0.22, p < 0.01) and BMI (r2 = 0.25, p<0.01). Significant associations (age-adjusted) were found between: SWS and BMI categories (p < 0.001), diabetes (p = 0.01), hypertension (p = 0.004) and metabolic syndrome (MetSynd,p = 0.002); and between AI and BMI categories (p < 0.001), diabetes (p<0.001), hypertension (p < 0.001) and MetSynd (p < 0.001). After excluding subjects with abnormal AHI/PLMI significant associations remained between: SWS and BMI categories (p < 0.001) and hypertension (p = 0.01); and between AI and BMI categories (p = 0.003), diabetes (p < 0.001) and MetSynd (p = 0.02). Conclusion: Objectively measured sleep fragmentation and reduced SWS are associated with cardiometabolic disturbances in the general population. Acknowledgements: Funding: Fondation Leenaards, FNS, GSK, Ligue Pulmonnaire Vaudoise and CIRS. http://dx.doi.org/10.1016/j.sleep.2013.11.085
Morbidity and mortality in children with obstructive sleep apnea: a controlled national study P. Jennum Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Denmark
http://dx.doi.org/10.1016/j.sleep.2013.11.084
Sleep structure and cardiometabolic disorders in the general population J. Haba-Rubio 1, P. Marques-Vidal 2, D. Andries 1, N. Tobback 1, M. Tafti 1, R. Heinzer 1 1 Center for investigation and research in sleep (CIRS), University Hospital (CHUV), Switzerland 2 Institute of social and preventive medicine (IUMSP), University Hospital (CHUV), Switzerland
Introduction: Recent research has identified relationships between sleep duration and quality and increased risk of cardiometabolic
Introduction: As there is little information regarding consequences of obstructive sleep apnea (OSA) in children, the aim of this study was to evaluate morbidity and mortality in childhood OSA. Materials and methods: A total of 2998 patients with a diagnose of OSA were identified from the Danish National Patient Registry aged 0–19-years. For each patient, we randomly selected four citizens matched for age, sex and socioeconomic status, thus providing 11974 controls. Results: The five-year mortality was 0.993 (0.989–0.996) versus 0.999 (0.998–9.999) in controls. The hazard ratio was 0.15 (p < 0.001). Patients with OSA had greater morbidity at least three years before their diagnosis. The most common contacts with the health system (odds ratio, OR; confidence interval, CI): infections (OR:1.19; CI:1.01–1.40), endocrine, nutritional and metabolic