ObjectiveTo systematically review the prevalence of obstructive sleep apnea syndrome (OSAS) in China. MethodsPubMed, EMbase, The Cochrane Library, CBM, CNKI, WanFang Data, and VIP databases were electronically searched to collect cross-sectional studies of the prevalence of OSAS in China from inception to October 30th, 2020. Two reviewers independently screened literature, extracted data and evaluated the risk of bias of included studies. Meta-analysis was then performed using Stata 16.0 software. ResultsA total of 27 studies were included, with a total sample size of 97 746 cases and 10 853 confirmed OSAS patients. Meta-analysis results showed that the prevalence of OSAS in China was 11% (95%CI 5% to 17%), of which females was 12% (95%CI 5% to 19%) and males was 12% (95%CI 5% to 20%). OSAS cases grouped by regions were as follows: Central China 4% (95%CI 2.7% to 4.5%), South China 5% (95%CI 2.7% to 6.7%), North China 7% (95%CI 4.6% to 9.3%), Northeast China 22% (95%CI 17.7% to 61.2%), Southwest China 4% (95%CI 3.2% to 5%), Northwest China 16% (95%CI 14.5% to 17.7%), and East China 17% (95%CI 2.8% to 30.6%). OSAS patients grouped by ages were as follows: 4% (95%CI 3% to 5%) for ≤14 years old, 5% (95%CI 2% to 7%) for 15-44 years old, 13% (95%CI 6% to 20%) for 45-59 years old, 16% (95%CI 6% to 25%) for 60-74 years old, 13% (95%CI 4% to 23%) for 75-89 years old, and 11% (95%CI 2% to 21%) for ≥ 90 years old. A subgroup analysis based on the year of publication found that the prevalence of OSAS fluctuated between 6% and 9% from 2005 to 2020, and the prevalence was the highest from 2000 to 2005 accouted with 21% (95%CI 0.8% to 40.5%). ConclusionsThe prevalence of OSAS in China is relatively high, and there are differences in the prevalence among individuals of different ages and regions. The 60-year-old groups in addition to the Northeast and East China regions have a high incidence. The prevalence of OSAS is substantially consistent between males and females. Due to the limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusions.
Objective To investigate the levels of IL-6 and TNF-α in children with obstructive sleep apnea syndrome (OSAS) and to determine their clinical significance. Methods One hundred children with OSAS in our department from August 2005 to February 2006, and 40 healthy children were enrolled in the study. The serum levels of IL-6 and TNF-α were measured. Results Serum levels of IL-6 and TNF-α were significantly higher in patients with OSAS than those in the control group (Plt;0.05). Both IL-6 and TNF-α were not correlated with AHI. Conclusion It is concluded that OSAS is a chronic inflammatory process. A close correlation was observed between high levels of IL-6 and TNF-α and OSAS. High levels of IL-6 and TNF-α account for the risk factors in the development of cardiovascular diseases in children with OSAS.
Sleep disorder is related to many comorbidities, such as diabetes, obesity, cardiovascular diseases, and hypertension. Because of its increasing prevalence rate, it has become a global problem that seriously threatens people’s health. Various forms of sleep disorder can cause increased insulin resistance and/or decreased sensitivity, thus affecting the occurrence, development and prognosis of diabetes. However, sleep health has not been paid attention to in recent years. Therefore, this article summarizes the findings of the correlation between sleep disorder and diabetes mellitus in recent years, by elaborating the relationship between various types of sleep disorder (including sleep apnea syndrome) and diabetes mellitus, as well as their mechanisms and intervention measures, in order to enhance the attention of clinical workers to sleep health, and to provide basis for reducing the risk of diabetes.
OBJECTIVE: To study the effects of jaw advancement in treating micromandibular deformity associated with obstructive sleep apnea syndrome (OSAS) by ramus osteotomy and genioplasty. METHODS: From April 1998 to February 2002, 12 patients with micromandibular deformity associated with OSAS (aged 14-36 years, 7 females and 5 males) were treated. Invert "L" shape ramus osteotomy and inverted replantation of posterior segment of ramus were performed to reconstruct the TMJ with the jaw advancement and genioplasty at the same time in 7 cases; mandibular angle osteotomy, bone grafts and genioplasty in 3 cases; and the jaw advancement by ramus sagittal osteotomy and genioplasty in 2 cases of the first branchial arch syndrome. RESULTS: The follow-up period was 6 months to 4 years. All the patients gained good appearance and had the distance of opening movement over 3.0 cm. Micromandible and facial asymmetries were corrected satisfactorily. The ratio of SaO2 was ascended from 82%-92% (preoperation) to 97%-99% (postoperation). OSAS was relieved. CONCLUSION: The jaw advancement by ramus osteotomy and genioplasty for treating micromandibular deformity associated with OSAS can correct the maxillofacial deformities and enlarge the upper airway space to relieve OSAS. This method has achieved satisfactory result.
ObjectiveTo systematically review the association between obstructive sleep apnea syndrome and levels of thyroid hormone.MethodsWe electronically searched databases including PubMed, The Cochrane Library (Issue 6, 2016), Web of Science, VIP, CNKI, WanFang Data, CBM and the relevant conference abstracts and unpublished literatures from inception to June, 2016 to collect the case-control studies about the levels of thyroid hormones with OSAS. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed by RevMan 5.2 software.ResultsA total of 8 RCTs involving 1 519 patients were included. The results of meta-analysis showed that: there were no significant differences of levels of FT3 between OSAS group and control group (mild: SMD=–0.01, 95%CI –0.21 to 0.20, P=0.93; moderate: SMD=0.15, 95%CI –0.34 to 0.64, P=0.55; severe: SMD=0.12, 95%CI –0.32 to 1.25, P=0.08). There were significant differences of levels of FT4 between mild and moderate OSAS groups with control group (mild: SMD=–0.49, 95%CI –0.74 to –0.25, P<0.000 1; moderate: SMD=–0.86, 95%CI –1.69 to –0.02, P=0.04), but no significant difference in severe group (SMD=–1.06, 95%CI –2.16 to 0.03, P=0.06). There were no significant differences of levels of TSH between OSAS group and control group (mild: SMD=–0.03, 95%CI –0.13 to 0.20, P=0.69; moderate: SMD=–0.09, 95%CI –0.27 to –0.10, P=0.35; severe: SMD=–0.02, 95%CI –0.26 to –0.22, P=0.88).ConclusionsThe current evidence shows that, OSAS is associated with lower levels of FT4. Due to the limited quality and quantity of included studies, the above results are needed to validate by more studies.
阻塞性睡眠呼吸暂停综合征（OSAS）是在睡眠过程中上气道完全或部分狭窄导致患者反复呼吸暂停或低通气，出现鼾声、低氧血症及睡眠中反复微觉醒引起日间疲乏、嗜睡等症状的一组症候群。高血压是以体循环动脉压升高为主要特点的临床综合征，是最常见的心血管疾病，也是现代社会最主要的流行病之一。近十几年来，越来越多的研究证实OSAS与高血压的形成与发展独立相关，是非常重要的致高血压发生的危险因素[1-4]。 动脉压持续升高可导致心、脑、肾和血管等损害，并可引起全身代谢异常，严重危害人类的健康。但同时高血压又是可以防治的疾病，有效控制血压可明显地降低心脑血管疾病的死亡率。然而临床上难治性高血压的发生比例逐渐增加，原因之一在于部分由OSAS引起的继发性高血压被误诊为原发性高血压，从而使这些患者未得到根本性的病因治疗[5，6]。因此，如何预防和减少OSAS引起的高血压成为现代医学关注的焦点。本文将从流行病学、发病机制、临床意义及治疗几个方面论述OSAS与高血压之间的相关性。
Objective To evaluate the subjective outcomes of sleepiness behavior and mood status applying continuous positive airway pressure（CPAP） in adults of elderly and middle-aged with obstructive sleep apnea syndrome（OSAS）. Methods Nine randomized controlled trails comparing nocturnal CPAP with inactive control appliances in adults with OSAS with the use of computerized search in related medical databases（MEDLINE，EMBASE，CBMdisk，etc） were included.The quality of literature was reviewed，and all data were extracted by two reviewers independently.Meta analysis was conducted used RevMan 4.2 software.Results 9 RCT involving 665 patients of elderly and middle-aged met the inclusion criteria.Meta analysis indicated that the score of Epworth sleepiness scale（ESS） and general health questionnaire-28（GHQ-28） declined significantly after CPAP treatment on effectiveness with WMD（random） －2.94，95 %CI －4.68 to －1.20，or WMD（fixed） －2.26，95 %CI －3.79 to －0.72，Plt;0.01.Nevertheless，hospital anxiety and depression scale（HADS） was not significantly different between CPAP and control with WMD（random） －0.89，95%CI －1.98 to 0.20，Pgt;0.05.Conclusion Current clinical evidence suggested that CPAP was effective in improving day-time subjective outcomes of sleepiness behavior and general mental health status in OSAS patients of elderly and middle-aged，although evidence of improving emotion disorder of anxiety and depression was not confirmed.
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.