Research

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10 pages, 1573 KiB

Open AccessArticle

Parapharyngeal Fat Tissue Accumulation and Its Association with Carotid Intima-Media Thickness in Discordant Twin Pairs

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Adam Domonkos Tarnoki

Appl. Sci. 2023, 13(17), 9953; https://doi.org/10.3390/app13179953 - 03 Sep 2023

Viewed by 375

Abstract

Background: Recurrent upper airway obstruction during sleep is a common feature of obstructive sleep apnea (OSA). Risk factors for the development of OSA include obesity, male gender and smoking. In addition, anatomical factors contribute to the development of the disease; however, the heritability [...] Read more.

Background: Recurrent upper airway obstruction during sleep is a common feature of obstructive sleep apnea (OSA). Risk factors for the development of OSA include obesity, male gender and smoking. In addition, anatomical factors contribute to the development of the disease; however, the heritability of the anatomical structures that determine upper airway narrowing is poorly understood. In this study, we aimed to investigate the background of anatomical structures associated with upper airway narrowing in discordant monozygotic (MZ) twin pairs. Methods: 33 adult MZ twin pairs (median age and Q1-Q3: 50 (42–56) years) from the Hungarian Twin Registry underwent head and neck MR (Philips Ingenia 1.5 T). T1- and T2-weighted images in sagittal, coronal and axial planes were used to measure cephalometric, soft tissue and adipose tissue structures. In addition, the twin pairs underwent carotid and femoral ultrasound scans (Samsung RS85) and full-body composition measurements (OMRON BF500). The analysis of discordant MZ twins for anatomical markers in relation to clinical background, blood test, vascular ultrasound and body composition results was performed using a paired permutation test. Results: We found a significant association between parapharyngeal adipose tissue area and body weight, waist circumference and metabolism (p < 0.05). Submental adipose tissue thickness showed an association with lower body muscle percentage (<0.05). Carotid intima-media thickness showed a negative association with parapharyngeal adipose tissue, tongue volume and submental adipose tissue thickness (<0.05). Conclusions: Our study found a significant association between anatomical structures potentially involved in upper airway narrowing and obesity-related markers such as weight, BMI, hip and waist circumference, and whole body composition analysis results (body fat percentage, visceral fat percentage, muscle percentage). This study may help to better understand the background of anatomical structures potentially involved in upper airway narrowing and the possible development of obstructive sleep apnea. Full article

(This article belongs to the Special Issue Obstructive Sleep Apnoea Syndrome and Its Management)

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18 pages, 316 KiB

Open AccessArticle

Evaluation of the Applicability of Artificial Intelligence for the Prediction of Obstructive Sleep Apnoea

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Appl. Sci. 2023, 13(7), 4231; https://doi.org/10.3390/app13074231 - 27 Mar 2023

Viewed by 1142

Abstract

Background Due to the large number of undiagnosed obstructive sleep apnoea (OSA) patients, our aim was to investigate the applicability of artificial intelligence (AI) in preliminary screening, based on simple anthropometric, demographic and questionnaire parameters. Methods Based on the results of the polysomnography [...] Read more.

Background Due to the large number of undiagnosed obstructive sleep apnoea (OSA) patients, our aim was to investigate the applicability of artificial intelligence (AI) in preliminary screening, based on simple anthropometric, demographic and questionnaire parameters. Methods Based on the results of the polysomnography performed, the 100 patients in the study were grouped as follows: non-OSA, mild OSA and moderately severe–severe OSA. Anthropometric measurements were performed, and the Berlin and Epworth questionnaires were completed. Results OSA prediction based on body mass index (BMI), gender and age was accurate in 81% of cases. With the completion of the questionnaires, accuracy rose to 83%. The Epworth questionnaire alone yielded a correct OSA prediction in 75%, while the Berlin questionnaire was correct in 62% of all cases. The best results for categorization by severity were obtained by combining BMI, gender and age parameters, together with responses to the questionnaires (71%). Supplemented with neck circumference, this result improves slightly (73%). Conclusion Based on the results, it can be concluded that OSA can be effectively and easily categorized using AI by combining anthropometric and demographic parameters, as well as questionnaire data. Full article

(This article belongs to the Special Issue Obstructive Sleep Apnoea Syndrome and Its Management)

13 pages, 1241 KiB

Open AccessArticle

Sleep Disorder Prevalence among Brazilian Children and Adolescents with Down Syndrome: An Observational Study

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Luiza Torres-Nunes

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Patrícia Prado da Costa-Borges

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Laisa Liane Paineiras-Domingos

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José Alexandre Bachur

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Danúbia da Cunha de Sá-Caputo

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Mario Bernardo-Filho

Appl. Sci. 2023, 13(6), 4014; https://doi.org/10.3390/app13064014 - 21 Mar 2023

Viewed by 855

Abstract

Background: Down syndrome (DS) is the most common chromosomal disorder and is related to congenital heart disease, sleep disorders and obesity. Sleep problems are common in DS children, including obstructive sleep apnea. This study aimed to investigate the prevalence of sleep disorders in [...] Read more.

Background: Down syndrome (DS) is the most common chromosomal disorder and is related to congenital heart disease, sleep disorders and obesity. Sleep problems are common in DS children, including obstructive sleep apnea. This study aimed to investigate the prevalence of sleep disorders in a group of 41 DS children and adolescents, by two validated questionnaires. Methods: This is a qualitative observational study. The guardians of DS individuals (1–17 years old) answered two questionnaires (sleep questionnaire by Reimão and Lefévre–QRL and sleep disorders scale for children–SDSC) using the Google forms tool. Results: Most DS children wake up at least once during the night (68.28%), sleep during the day (56%) and fall asleep within 15 to 30 min (36.58%), urinate in the sleep at night (53.65%), move around a lot while sleeping at night (78.04) and snore at night (53.66%). In SDSC, 36.59% (n = 15) have some sleep disorder and 29.3% (n = 12) have sleep-disordered breathing. Conclusions: The DS children and adolescents present sleep-compromising factors. Moreover, obstructive sleep apnea is the most prevalent sleep-disordered breathing. Considering the findings of the current study, Google forms is an important tool to evaluate the sleep disorders of DS children and adolescents. Full article

(This article belongs to the Special Issue Obstructive Sleep Apnoea Syndrome and Its Management)

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11 pages, 261 KiB

Open AccessArticle

Reliability of the Polygraphic Home Sleep Test for OSA Determined by the Severity and Pattern Changes of Two Consecutive Examinations

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Appl. Sci. 2023, 13(1), 667; https://doi.org/10.3390/app13010667 - 03 Jan 2023

Viewed by 874

Abstract

Diagnosis and effective treatment of obstructive sleep apnea syndrome (OSA) in adults is an important health priority. Home respiratory polygraphy is a cost-effective alternative to polysomnography in OSA. The aim of this study was to investigate the variability of two consecutive home respiratory [...] Read more.

Diagnosis and effective treatment of obstructive sleep apnea syndrome (OSA) in adults is an important health priority. Home respiratory polygraphy is a cost-effective alternative to polysomnography in OSA. The aim of this study was to investigate the variability of two consecutive home respiratory polygraphic examinations by comparing the severity characteristics and pattern (supine dominant, continuous, etc.) variability. We examined 100 patients with clinically suspected OSA on two consecutive nights by home respiratory polygraphy. The correlation of time in bed (TIB), apnea-hypopnea index (AHI), oxygen desaturation index (ODI), and T90 of the two examinations were compared by the Pearson test. The severity ranks and nocturnal apnea patterns of the two periods were compared using Spearman and Wilcoxon tests. Pearson’s correlations represented a strong correlation of the AHI, ODI, and T90, but only moderate for TIB. The severity-specific correlation was the highest for AHI in the severe group. Out of 100 pairs of polygraphic examinations, 25 cases showed change in the severity ranking (decreased in 11, increased in 14); 15 cases showed a change in the polygraphic pattern (supine, non-supine, etc.), with severity change in 6 cases. Therapy change based on the second examination was initiated in 6 cases. Our results revealed a good intra-individual correlation between the severity grades of the two nights, with the highest value in the severe cases. In some cases, the nightly variation in the polygraphic pattern may explain the change in the severity. From a therapeutic point of view, the low number of severity changes between moderate and severe groups revealed good reliability. Full article

(This article belongs to the Special Issue Obstructive Sleep Apnoea Syndrome and Its Management)

18 pages, 5911 KiB

Open AccessArticle

The Relationship between Atherosclerosis and Gut Microbiome in Patients with Obstructive Sleep Apnoea

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Adam Domonkos Tarnoki

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David Laszlo Tarnoki

Appl. Sci. 2022, 12(22), 11484; https://doi.org/10.3390/app122211484 - 11 Nov 2022

Cited by 2 | Viewed by 1326

Abstract

Background: Obstructive sleep apnoea (OSA) and gut dysbiosis are known risk factors for atherosclerosis. However, only very few studies have been focused on the relationship between OSA, atherosclerosis, and the intestinal microbiome, all in animal models. Methods: Twenty-two patients with OSA, 16 with [...] Read more.

Background: Obstructive sleep apnoea (OSA) and gut dysbiosis are known risk factors for atherosclerosis. However, only very few studies have been focused on the relationship between OSA, atherosclerosis, and the intestinal microbiome, all in animal models. Methods: Twenty-two patients with OSA, 16 with and 6 without carotid atherosclerosis were involved in the study. After a diagnostic sleep examination, the intima media thickness (IMT) was measured and plaques were found using carotid ultrasound. Blood was also drawn for metabolic profile, and a stool sample was provided for 16S ribosomal RNA microbiome investigation. Results: An increased maximal common carotid artery (CCA) IMT was significantly associated with decreased phylum-level diversity. The level of Peptostreptococcaceae was significantly lower in atherosclerotic subjects. Some other candidate microbes appeared in the two groups at the genus level as well: Bilophila, Romboutsia, Slackia, and Veillonella in the non-atherosclerotic group; and Escherichia-Shigella, Prevotella, and Ruminococcaceae in the atherosclerotic group. Conclusions: This is the first pilot research to analyze the association between the gut microbiome and atherosclerosis in adult patients with OSA with and without carotid atherosclerosis. Dysbiosis and individual bacteria may contribute to the development of carotid atherosclerosis in patients with OSA. Further investigations are necessary to reveal a more precise background in a larger sample. Full article

(This article belongs to the Special Issue Obstructive Sleep Apnoea Syndrome and Its Management)

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14 pages, 4686 KiB

Open AccessArticle

Ultrasound and Magnetic Resonance Imaging of the Tongue in Obstructive Sleep Apnoea

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Ádám Domonkos Tárnoki

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László Kunos

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Zsófia Jokkel

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László Tamás

Appl. Sci. 2022, 12(19), 9583; https://doi.org/10.3390/app12199583 - 24 Sep 2022

Cited by 2 | Viewed by 2671

Abstract

To examine the geometrical parameters of the tongue in obstructive sleep apnoea (OSA) based on sex, age and BMI parameters and ultrasound (US) and MRI. The presence of OSA and tongue-based obstruction can be predicted using these parameters. Of 100 patients, 64% were [...] Read more.

To examine the geometrical parameters of the tongue in obstructive sleep apnoea (OSA) based on sex, age and BMI parameters and ultrasound (US) and MRI. The presence of OSA and tongue-based obstruction can be predicted using these parameters. Of 100 patients, 64% were diagnosed with OSA according to overnight polysomnography. MRI and US devices were used to measure tongue parameters. The location of the obstruction was identified using drug-induced sleep endoscopy. Statistical analysis was performed using the quadratic discriminant analysis. Men presented higher tongue volumes and axial diameter during Müller’s maneuver (MM) of US and coronal diameter of the MRI. In women, all examined MRI parameters were significantly correlated with apnoea-hypopnea index (AHI). A stronger correlation between BMI and AHI parameters was observed in women than in men. Using our algorithm, which includes tongue parameters and anthropometric values, the presence of OSA could be predicted in 91% with US and 82% with MRI. The detection of tongue-based obstruction was successful in 89% using US and 87% using MRI, whereas tongue-based obstruction was successful in 70% using US. Using MRI and US of the tongue combined with basic anthropometric parameters, the presence of OSA and tongue-based obstruction can be identified with high precision. Full article

(This article belongs to the Special Issue Obstructive Sleep Apnoea Syndrome and Its Management)

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13 pages, 3190 KiB

Open AccessArticle

The Heritability of Upper Airway Dimensions Using MRI Scans in Twins

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Adam Domonkos Tarnoki

Appl. Sci. 2022, 12(15), 7646; https://doi.org/10.3390/app12157646 - 29 Jul 2022

Cited by 1 | Viewed by 1240

Abstract

Introduction: Obstructive sleep apnea (OSA) is a common disorder characterized by the repetitive collapse of the upper airways during sleep, most likely in the oropharyngeal region. Anatomical factors significantly contribute to the disease development; however, the heritability of the upper airway dimensions, which [...] Read more.

Introduction: Obstructive sleep apnea (OSA) is a common disorder characterized by the repetitive collapse of the upper airways during sleep, most likely in the oropharyngeal region. Anatomical factors significantly contribute to the disease development; however, the heritability of the upper airway dimensions, which lead to the collapsibility of the upper airways, is less known. In the current study, we aimed to quantify the impact of heritable and environmental factors on the upper airway dimensions in twins using magnetic resonance imaging (MRI). Methods: We completed head and neck MRI imaging on 110 (66 monozygotic and 44 dizygotic, age median and Q1–Q3: 53 (44–63.75) years) adult twins from the Hungarian Twin Registry. We completed cephalometric, soft tissue and fatty tissue space measurements on T1- and T2-weighted images in sagittal, coronal and axial planes. For the analysis of the genetic and environmental, the determination of the measured parameters was performed with an ACE twin statistical model. Results: We found a strong genetic determination in the anteroposterior diameter of the tongue and the thickness of the submental fatty tissue of the neck. Other parameters of the tongue, soft palate and uvula have shown moderate heritability, while we found strong environmental determination in the thickness of the parapharyngeal fatty tissue, the thickness of the pharyngeal wall, and the smallest diameter of the posterior upper airways. Conclusion: Our twin study can help better understand the genetic and environmental background of anatomical structures involved in the development of sleep apnea. Full article

(This article belongs to the Special Issue Obstructive Sleep Apnoea Syndrome and Its Management)

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12 pages, 1854 KiB

Open AccessArticle

Gut Microbiome in Patients with Obstructive Sleep Apnoea

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Adam Domonkos Tarnoki

Appl. Sci. 2022, 12(4), 2007; https://doi.org/10.3390/app12042007 - 15 Feb 2022

Cited by 7 | Viewed by 2033

Abstract

Background: Obstructive sleep apnoea (OSA) is a risk factor for cardiovascular disease. Alterations in the gut microbiome have been implicated in the development of cardiovascular disease and may potentially link OSA to its cardiovascular consequences. However, only one study to date has investigated [...] Read more.

Background: Obstructive sleep apnoea (OSA) is a risk factor for cardiovascular disease. Alterations in the gut microbiome have been implicated in the development of cardiovascular disease and may potentially link OSA to its cardiovascular consequences. However, only one study to date has investigated gut microbiomes in adult patients with OSA. Methods: 19 patients with OSA and 20 non-OSA controls participated in the study. Following a diagnostic sleep study, blood was collected for metabolic profiling, and the subjects provided a stool sample for microbiome analysis. The gut microbiome was investigated using the 16S ribosomal RNA method. Results: Patients with OSA had a higher relative abundance of the Proteobacteria phylum (p = 0.03), Gammaproteobacteria class (p = 0.01), Lactobacillae family (p = 0.02), Lactobacillus (p = 0.03), and Roseburia genus (p = 0.03), and a lower abundance of the Actinobacteria phylum (p = 0.03). The abundance of Proteobacteria, Gammaproteobacteria, Lactobacillae, and Lactobacillus were related to disease severity and dyslipidaemia (all p < 0.05), whilst the abundance of Proteobacteria and Gammaproteobacteria was also related to hypertension and cardiovascular disease (all p < 0.05). However, following adjustment for relevant confounders only the association between OSA and Actinobacteria remained significant (p = 0.04). Conclusions: Obstructive sleep apnoea is associated with only subtle changes in gut microbiome. Further studies should investigate gut dysbiosis in OSA. Full article

(This article belongs to the Special Issue Obstructive Sleep Apnoea Syndrome and Its Management)

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Review

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21 pages, 1087 KiB

Open AccessReview

Nursing Professionals’ Role in the Comprehensive Management of Obstructive Sleep Apnoea: A Literature Review

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Rabie Adel El Arab

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Manuel Sánchez-de-la-Torre

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Fran Valenzuela-Pascual

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Esther Rubinat-Arnaldo

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Joan Blanco-Blanco

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Francesc Rubí-Carnacea

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Oriol Martinez-Navarro

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Olga Mediano

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Montserrat Gea-Sánchez

Appl. Sci. 2023, 13(6), 3516; https://doi.org/10.3390/app13063516 - 09 Mar 2023

Viewed by 1561

Abstract

Background: obstructive sleep apnoea is a common and burdensome condition, characterised by obstruction of the airway during sleep at the level of the pharynx, which may occur with symptoms or without any symptoms. The most common place for obstructive sleep apnoea management is [...] Read more.

Background: obstructive sleep apnoea is a common and burdensome condition, characterised by obstruction of the airway during sleep at the level of the pharynx, which may occur with symptoms or without any symptoms. The most common place for obstructive sleep apnoea management is in specialised sleep units. Aim: to identify what is known about nurses’ role in comprehensive management of obstructive sleep apnoea, and to determine the effectiveness of nurse-led interventions as well as the cost effectiveness of management of obstructive sleep apnoea in primary care settings. Methods: a scoping review was carried out by searching PubMed/Medline, CINAHL, Scopus, Cochrane Database of Systematic Reviews and ScienceDirect. The study findings were synthesised using a thematic analysis approach. Results: In this review, 12 articles were included, and three key themes emerged, namely the role of nurses in the diagnosis of obstructive sleep apnoea, role of nurses in the follow up and support of obstructive sleep apnoea patients, and role of nurses in the management of obstructive sleep apnoea in primary care and the cost-effectiveness. Conclusion: Nurses can play a critical role in obstructive sleep apnoea. There are many ways in which nurses can contribute, including screening, assessment, diagnosis, promotion of therapy adherence, and following up with patients, including monitoring for any side effects associated with the CPAP machine, such as irritation of the face. Additionally, nurses can provide patient education and coordinate with other health care providers. Nursing interventions such as patient education have been demonstrated to be highly effective in promoting adherence to PAP therapy in both sleep units and primary care settings. Based on the findings of this review, the primary care model is more cost-effective than the sleep unit model in the management of obstructive sleep apnoea patients. The role of nurses in managing Obstructive Sleep Apnoea in both paediatric and adult populations shares similarities, but also includes differences that should be carefully considered and explored. In this review, one article only explored the role of nurses in paediatric OSA care. Thus, there is a need to identify the potential role of nursing in the comprehensive management of paediatric obstructive sleep apnoea, as well as to explore alternative cost-effective approaches that include primary care settings. Full article

(This article belongs to the Special Issue Obstructive Sleep Apnoea Syndrome and Its Management)

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15 pages, 668 KiB

Open AccessReview

Management of Obstructive Sleep Apnea in Hospitalized Patients

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Abdullah Khalid

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Tanvi H. Mukundan

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Raeesa Khalid

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Snigdha Pusalavidyasagar

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Akram Khan

Appl. Sci. 2023, 13(4), 2108; https://doi.org/10.3390/app13042108 - 06 Feb 2023

Viewed by 1801

Abstract

Obstructive sleep apnea (OSA) is highly prevalent in the general population. In addition, patients with comorbid OSA are frequently hospitalized for unrelated conditions. This review focuses on managing patients with comorbid OSA in inpatient and acute care settings for inpatient providers. OSA can [...] Read more.

Obstructive sleep apnea (OSA) is highly prevalent in the general population. In addition, patients with comorbid OSA are frequently hospitalized for unrelated conditions. This review focuses on managing patients with comorbid OSA in inpatient and acute care settings for inpatient providers. OSA can impact the length of stay, the risk of intubation, the transfer to the intensive care unit, and mortality. Screening questionnaires such as STOP-BANG can help with screening hospitalized patients at admission. High-risk patients can also undergo additional screening with overnight pulse oximetry, which can be used to guide management. Options for empiric treatment include supplemental oxygen, continuous positive airway pressure therapy (CPAP), auto adjusting-PAP, bilevel positive airway pressure therapy (BPAP), or high-flow nasal cannula. In addition, discharge referral to a board-certified sleep physician may help improve these patients’ long-term outcomes and decrease readmission risks. Full article

(This article belongs to the Special Issue Obstructive Sleep Apnoea Syndrome and Its Management)

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21 pages, 1165 KiB

Open AccessReview

A Scientometric Review of Obstructive Sleep Apnea and Obesity

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Michelle Jin Yee Neoh

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Appl. Sci. 2023, 13(2), 753; https://doi.org/10.3390/app13020753 - 05 Jan 2023

Cited by 7 | Viewed by 1660

Abstract

Obstructive sleep apnea (OSA) is a common sleep disorder that has a high prevalence in the obese population. Studies have established the relationship between OSA and a multitude of adverse health outcomes including cardiovascular diseases and metabolic diseases, indicating the nature of OSA [...] Read more.

Obstructive sleep apnea (OSA) is a common sleep disorder that has a high prevalence in the obese population. Studies have established the relationship between OSA and a multitude of adverse health outcomes including cardiovascular diseases and metabolic diseases, indicating the nature of OSA as a disorder with high comorbidity and mortality. Thus, OSA is a growing public health concern in the face of rising obesity trends globally. This study conducted a systematic analysis of the scientific literature on OSA from 1977 to 2022 in order to gain a better understanding of major research areas concerning OSA and the connections between these areas. Findings indicate that there are major clusters investigating the relationship between OSA and cardiovascular and metabolic diseases, which are health conditions commonly associated with obesity and have a significant disease burden. The findings from this scientometric analysis also indicate emerging clusters of research into more specific populations such as children with obesity and pregnant women. Full article

(This article belongs to the Special Issue Obstructive Sleep Apnoea Syndrome and Its Management)

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10 pages, 595 KiB

Open AccessReview

Ocular Implications in Patients with Sleep Apnea

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Camelia Margareta Bogdănici

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Daniel Constantin Brănișteanu

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Bogdan Doroftei

Appl. Sci. 2021, 11(21), 10086; https://doi.org/10.3390/app112110086 - 28 Oct 2021

Viewed by 1283

Abstract

Sleep apnea syndrome (SAS) is a condition characterized by recurrent episodes of total or partial collapse of the upper respiratory tract associated with daytime drowsiness that cannot be explained by other factors. SAS is a pathology that can cause ophthalmological damage both directly [...] Read more.

Sleep apnea syndrome (SAS) is a condition characterized by recurrent episodes of total or partial collapse of the upper respiratory tract associated with daytime drowsiness that cannot be explained by other factors. SAS is a pathology that can cause ophthalmological damage both directly through the pathophysiological mechanism characteristic of the disease on the ocular system, and indirectly by promoting the development of other pathologies (cardiovascular, metabolic), which are a risk factor for ocular morbidity in the absence of sleep apnea syndrome. The aim of this paper is to highlight the ocular symptoms determined by sleep apnea syndrome (SAS), by analyzing literature over the past 20 years. Method: A mini-review that collected data from Pub Med Central, ResearchGate, GoogleScholar, DovePress, ScienceDirect, Elsevier, related to the ocular implications given by sleep apnea syndrome, with or without continuous positive airway pressure (CPAP) treatment. The study included articles that identified a number of eye conditions associated with sleep apnea, such as: dry eye syndrome and impaired ocular surface, glaucoma, non-arteritic anterior ischemic optic neuropathy, floppy eyelid syndrome, keratoconus, central serous chorioretinopathy, central vein occlusion, corneal neovascularization, and age-related macular degeneration. Sleep apnea syndrome is a pathology that can cause the onset or worsening of varying degrees of severity eye diseases by its pathophysiological mechanism, with a different impact on the quality of the individual’s life. On one hand, the purpose of this review is to identify studies in literature that associate sleep apnea syndrome with eye alterations; on the other hand, to inform the Romanian medical staff in different fields of the patients’ guidance diagnosed with SAS to an ophthalmology clinic since early and mild symptoms, so that these patients benefit from an ophthalmological approach and monitoring, in an attempt to diagnose and treat eye diseases in time and prevent their worsening. Full article

(This article belongs to the Special Issue Obstructive Sleep Apnoea Syndrome and Its Management)

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Other

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14 pages, 9883 KiB

Open AccessSystematic Review

Diet Therapy of Obstructive Sleep Apnea Syndrome Treated with Positive Airway Pressure: A Systematic Review of Randomized Controlled Trials

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Dominika Guzek

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Dominika Głąbska

Appl. Sci. 2023, 13(8), 5105; https://doi.org/10.3390/app13085105 - 19 Apr 2023

Viewed by 733

Abstract

The positive airway pressure (PAP) is a gold standard in therapy for obstructive sleep apnea (OSA) patients, though weight loss is among the most effective supportive therapeutic methods. The aim of the study is to conduct a systematic review of randomized controlled trials [...] Read more.

The positive airway pressure (PAP) is a gold standard in therapy for obstructive sleep apnea (OSA) patients, though weight loss is among the most effective supportive therapeutic methods. The aim of the study is to conduct a systematic review of randomized controlled trials (RCTs) of diet therapy interventions for OSA patients treated with PAP. The systematic review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42023398374). The 1436 records were screened and five records were included identified as RCTs available within PubMed and Web of Science databases until 1 February 2023. Two researchers independently conducted identification, screening, inclusion, and evaluation of RCTs, using the revised Cochrane risk-of-bias tool for randomized trials. The studies were conducted in groups with patients treated or intended to be treated with CPAP, while patients with moderate-to-severe or severe OSA were included. Within all included studies, an experimental diet was compared with a control group; however, various interventions were applied, including dietary intervention, which was compared with no intervention, and dietary and physical activity intervention, which was only compared with general advice. The applied intervention included various dietary approaches, such as various energy deficits or dietary health-promoting behaviors. The monitored variables included apnea–hypopnea index (AHI), sleep time, sleep efficiency, sleep latency, oxygen desaturation episodes, oxygen saturation, OSA type, Epworth Sleepiness Scale score, Pittsburgh Sleep Quality Index, and quality of life. For the majority of studies, some concerns were defined for the risk of bias; however, for one study the risk was high. Three studies supported the positive influence of diet therapy, one study somewhat supported it and one study did not support it. It may be stated that for excessive body mass individuals, even if PAP is applied, the diet therapy should be included in order to reduce body mass, reduce the symptoms of OSA, and improve the quality of life. This therapeutic option should be applied, even if no effect on OSA is noted, as body mass reduction have multiple positive effects, which may also influence the quality of life. Full article

(This article belongs to the Special Issue Obstructive Sleep Apnoea Syndrome and Its Management)

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