"[Opioids] decrease hypercapnia but increase hypoxic ventilatory response, decrease the arousal index
, decrease upper-airway muscle tone, and decrease and also act on chest and abdominal wall compliance."
Demographic (age, gender, and BMI) and polysomnographic (AHI severity, inclusion in either old or new definitions of REM-related OSA, ESS, arousal index
, saturation below 90%, and saturation nadir) details of the included sample are shown in Table 1.
The reported parameters included sleep efficiency, wake after sleep onset (WASO), sleep latency, REM latency, rapid-eye movement (REM) sleep, nonREM (NREM) sleep (stages 1-3), snoring sounds, apnea-hypopnea index (AHI), arousal index
, spontaneous arousals, respiratory effort-related arousals (RERA), leg movement arousals, periodic leg movements in sleep (PLMS), PLMS in REM and NREM, oxygen saturation (Sp[O.sub.2]), and CT90.
Other measures of the disease activity include the degree of hypoxemia and the arousal index
. For some, the presence of the clinical sequelae of apnea is considered when evaluating the clinical severity of OSA.
Significant differences were found for AHI (F = 388.368, P< 0.001), minimal pulse oxygen saturation (F = 91.902, P< 0.001), and arousal index
(F = 31.014, P< 0.001) among four groups; no significant differences were found for CRAE (F = 0.460, P = 0.599) and CRVE (F = 0.404, P = 0.586) among groups; there were significant differences for AVR between Group I and Group IV (63.6 [+ or -] 5.1% vs.
PSG baseline segment revealed significant sleep fragmentation with increased awakenings and arousals (arousal index
Spontaneous arousals also accounted for total arousal index
(ArI), and if one occurred, stimulus was not presented until 45 seconds after the subject fell back to sleep.
Body mass index (BMI), AHI severity, and mean oxygen saturation, lowest oxygen saturation and arousal index
scores acquired during PSG were significantly correlated with OSDI scores, TBUT and Schirmer test values (p<0.001) (Table 3).
Various surrogate measures of arousals such as actigraphy have been shown to improve the arousal index
and possibly the agreement between OSAS diagnosis and PSG.5,6 Any improvement may only be slight and not clinically important, as reported by Masa et al.7 in case of a type 3 device.
4) TAI (Total Arousal Index
) with oxygen drop/AHI (Apnoea Hypopnoea Index) and OA are high in Group 1 patients.
was defined as the number of awakenings per hour.
A drop in the blood pressure at this time, it is suggested, will provide further protection against these adverse cardiovascular events.18-19 Most studies found in favor of a monobloc appliance (75% of maximum mandibular advancement) over treatment periods from 2 weeks to 3 months, a reduction in AHI and arousal index
and improving oxygen saturation.