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Clinical and functional features of obstructive sleep apnea syndrome


Author: Sîrcu Victoria
Degree:doctor of medicine
Speciality: 14.00.05 - Internal Diseases (with specification: Pulmonology, Gastroenterology, Hepatology, Nephrology, Functional Diagnostics and Endoscopy)
Year:2021
Scientific adviser: Alexadru Corlăteanu
doctor, associate professor (docent), Moldova State University
Scientific consultant: Serghei Şandru
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Institution: Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova

Status

The thesis was presented on the 16 December, 2020
Approved by NCAA on the 26 February, 2021

Abstract

Adobe PDF document – 1.27 Mb / in romanian

Thesis

CZU 616.24-008.444 (043.2)

Adobe PDF document 3.60 Mb / in romanian
134 pages

Keywords

obstructive sleep apnea syndrome, polygraphy, OSAS phenotype

Summary

Structure of the thesis: introduction, five chapters, conclusions, reference list of 195 sources, 103 pages of main text, 19 figures, 34 tables. The obtained results are published in 33 scientific papers.

Field of study: internal medicine, pulmonology, somnology.

Aim of the thesis: Evaluation the clinical, functional and paraclinical features of obstructive sleep apnea syndrome, as well as developing an algorithm for diagnosing and assessment OSAS patients, adjusted to local possibilities for diagnosis and patient assessment.

Objectives of the thesis: Evaluation the clinical and functional parameters depending on the severity of obstructive sleep apnea syndrome and assessment of factors that can predict the severity of OSAS; determination of the pecularities of obstructive sleep apnea syndrome depending on age, sex and position of the body in the time of sleep; assessment of the practical value of the STOP, STOP-Bang questionnaires, NoSAS score, Epworth Sleepiness Scale (ESS) for obstructive sleep apnea syndrome identification; analysis link between severity of obstructive sleep apnea syndrome and comorbidities.

Scientific novelty and originality: The factors that can predict the severity of obstructive sleep apnea syndrome were investigated and analyzed based on a complex study. Was assessed the practical application, sensibility and specificity of the STOP, STOP-Bang questionnaires, NoSAS score, Epworth Sleepiness Scale (ESS) for obstructive sleep apnea syndrome identification The interaction between severity of obstructive sleep apnea syndrome and comorbidities was analyzed. The features of obstructive sleep apnea syndrome depending on age, sex and position of the body in the time of sleep were determined as well. Three new phenotypes of OSAS based on clinical and functional variables have been determined through cluster analysis, with a major impact on the evaluation and treatment of OSAS.

The solved scientific problem was creation of scientific basis for the clinical and paraclinical evaluation of OSAS, which led to the elaboration of OSAS complex evaluation algorithm based on assessing of multiple clinical and functional variables and comorbidities. This made more accurate stratification of OSAS patients possible. The data obtained in the study are the basis for measures to improve and optimize the assessment of patients with OSAS. Theoretical significance: Clinical and functional examinations on OSAS patients have enabled the evolution particularities of this disease to be identified. The STOP-Bang score demonstrated best performance in OSAS risk assessment, while the use of STOP or NoSAS leads to underestimation of risk. Practical significance: Based on the data obtained, an algorithm for diagnosis and patient conduct with OSAS and the implementation of diagnostic methods has been developed. Methodical recommendations can be proposed for use in departments of therapy, pneumology, family medicine centers and in the teaching process of training the medical staff.

Implementation of scientific results: The methodical recommendations are used in the ICU of Institute of Emergency Medicine, for didactic training of new medical personnel at the Pulmonology and Allergology Department, State University of Medicine and Pharmacy “Nicolae Testemitanu”. The national clinical protocol ,,Obstructive sleep apnea syndrome” has been developed.