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Query: UMLS:C0037315 (sleep apnea)
 8,000 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Prediction formulae for sleep-disordered breathing can be useful for excluding a diagnosis, establishing an a priori probability of having a positive test, and for prioritizing patient testing. In general, prediction models have high sensitivity but low specificity. In a study analyzing the performance of four previously described prediction models, sensitivities ranged from 76% to 96%, specificities ranged from 13% to 54%, while positive predictive values ranged between 69% and 77%. The models were useful in identifying patients with a respiratory disturbance index of > or = 20 so that these patients could undergo alternative diagnostic testing strategies. The Berlin Questionnaire was tested in primary care settings and was able to identify high-risk patients fairly accurately. A regression neural network performed well with a sensitivity of 99%, a specificity of 80%, a positive predictive value of 88%, and a negative predictive value of 98%. In obese snorers, a regression model utilizing daytime arterial O2 saturation and specific respiratory conductance was effective for excluding obstructive sleep apnea (OSA). In congestive heart failure patients, risk factors for central sleep apnea include male gender, atrial fibrillation, age >60 years, and wake time PaCO2 <38 mm Hg. In children, risk factors for sleep apnea include obesity, African-American race, sinus problems, and persistent wheezing. There are also racial anthropomorphic differences in OSA patients, with whites having a tendency towards brachycephaly facial types (reduced anterior-posterior cranial dimension) and African-Americans having a tendency toward leptoproscopic facial types (longer facial height and decreased facial width). Further refinement of prediction formulae will improve diagnostic accuracy.
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PMID:Prediction formulae for sleep-disordered breathing. 1170 12

The domestic dog may be the most morphologically diverse terrestrial mammalian species known to man; pedigree dogs are artificially selected for extreme aesthetics dictated by formal Breed Standards, and breed-related disorders linked to conformation are ubiquitous and diverse. Brachycephaly--foreshortening of the facial skeleton--is a discrete mutation that has been selected for in many popular dog breeds e.g. the Bulldog, Pug, and French Bulldog. A chronic, debilitating respiratory syndrome, whereby soft tissue blocks the airways, predominantly affects dogs with this conformation, and thus is labelled Brachycephalic Obstructive Airway Syndrome (BOAS). Despite the name of the syndrome, scientific evidence quantitatively linking brachycephaly with BOAS is lacking, but it could aid efforts to select for healthier conformations. Here we show, in (1) an exploratory study of 700 dogs of diverse breeds and conformations, and (2) a confirmatory study of 154 brachycephalic dogs, that BOAS risk increases sharply in a non-linear manner as relative muzzle length shortens. BOAS only occurred in dogs whose muzzles comprised less than half their cranial lengths. Thicker neck girths also increased BOAS risk in both populations: a risk factor for human sleep apnoea and not previously realised in dogs; and obesity was found to further increase BOAS risk. This study provides evidence that breeding for brachycephaly leads to an increased risk of BOAS in dogs, with risk increasing as the morphology becomes more exaggerated. As such, dog breeders and buyers should be aware of this risk when selecting dogs, and breeding organisations should actively discourage exaggeration of this high-risk conformation in breed standards and the show ring.
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PMID:Impact of Facial Conformation on Canine Health: Brachycephalic Obstructive Airway Syndrome. 2650 77

Brachycephaly has several potential deleterious effects, including malocclusion, sleep apnea, and abnormal posture. Nevertheless, the research regarding helmet therapy as a treatment strategy for brachycephaly is limited. Herein, we aimed to analyze the factors influencing the effects of helmet therapy in infants with brachycephaly. We retrospectively reviewed the records of 207 infants aged 3-14 months with a cranial index (CI) >90% who received helmet therapy between May 2016 and October 2019 and complied with the treatment protocol well. We used a multiple regression analysis to determine which factors affected the duration of therapy and a Jonckheere-Terpstra test to establish differences in the duration of helmet therapy according to age and severity. We identified brachycephaly severity (p < 0.001), asymmetry (p < 0.001), and age (p < 0.001) as factors affecting the duration of therapy. Helmet therapy might be effective for infants with moderate to severe brachycephaly, assuming good protocol compliance. In addition, younger treatment initiation age and less severe and less asymmetric brachycephaly significantly shorten the treatment duration.
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PMID:Outcome Analysis of the Effects of Helmet Therapy in Infants with Brachycephaly. 3232 69