Fakülteler / Faculties
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Item The Effect of Adding Gender Item to Berlin Questionnaire in Determining Obstructive Sleep Apnea in Sleep Clinics(2015) Yuceege, Melike; Firat, Hikmet; Sever, Ozlem; Demir, Ahmet; Ardic, Sadik; 25593603BACKGROUND AND AIM: We aimed to validate the Turkish version of Berlin Questionnaire (BQ) and developped a BQ-gender (BQ-G) form by adding gender component. We aimed to compare the two forms in defining patients with moderate to severe obstructive sleep apnea (OSA) in sleep clinics. METHODS: Four hundred and eighty five consecutive patients, refered to our sleep clinic for snoring, witnessed apnea and/or excessive daytime sleepiness were enrolled to the study. All patients underwent in-laboratory polysomnography (PSG). Patients with sleep efficiency less than 40% and total sleep time less than 4 hours, chronic anxiolitic/sedative drug usage, respiratory tract infection within past two weeks were excluded from the study. All the patients fulfilled BQ. The test and retest for BQ were applied in 15-day interval in 30 patients. RESULTS: Totally 433 patients were enrolled to the study (285 male, 148 female). The mean age of the patients was 47,5 +/- 10.5 (21-79). 180 patients (41.6%) had apnea-hypopnea index (AHI) <= 15, while 253 patients (58,4%) had AHI > 15. The. value was 48-94 and the the truth value was 69-94% for the test-retest procedure. Sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and area under the curve AUC were 84.2%, 31.7%, 48.7%, 63.4%, and 0.579 in order for BQ and 79.9 %, 51.7%, 63.2%, 69.6%, and 0.652 for BQ-G. CONCLUSION: The results showed that BQ-G is relatively better than BQ in determining moderate to severe OSA in sleep clinics where most of the patients are sleep apneic but both of the tests were found to have insufficient validities in defining moderate to severe OSA in sleep clinics.Item Serum YKL-40/chitinase 3-Like Protein 1 Level Is an Independent Predictor of Atherosclerosis Development in Patients with Obstructive Sleep Apnea Syndrome(2015) Bakirci, Eftal Murat; Unver, Edhem; Degirmenci, Husnu; Kivanc, Tulay; Gunay, Murat; Hamur, Hikmet; Buyuklu, Mutlu; Ceyhun, Gokhan; Topal, Ergun; Coban, Taha Abdulkadir; 26142786Objective: The inflammatory process plays an important role in the development of cardiovascular complications in patients with obstructive sleep apnea syndrome (OSAS). YKL-40/chitinase 3-like protein 1 is a novel biomarker of systemic inflammation. This study aimed to investigate whether carotid intima-media thickness (CIMT), a useful marker for early atherosclerosis, is associated with serum YKL-40/chitinase 3-like protein 1 levels in patients with normotensive and nondiabetic OSAS. Methods: The study included 40 OSAS patients and 40 agesex- and body mass index-matched healthy controls. Serum YKL-40 levels were detected by enzyme-linked immunosorbent assay. CIMT was measured by B-mode ultrasound. Results: The patients with OSAS had significantly increased CIMT and higher YKL-40 and high sensitivity C-reactive protein (hsCRP) levels than those of the controls. CIMT was strongly correlated with serum YKL-40 levels (r=0.694, p<0.001), hsCRP (r=0.622, p<0.001), age (r=0.525, p=0.001), and weakly correlated with apnea-hypopnea index (AHI) (r=0.365, p=0.021) and the percentage of recording time spent (PRTS) of oxygen saturation <90% (r=0.488, p=0.001). Moreover, it was detected that serum YKL-40 levels were strongly correlated with AHI (r=0.617, p<0.001), and weakly correlated with SaO 2 <90% of PRTS (r=0.394, p=0.012) and hsCRP (r=0.486, p=0.001). In multiple regression analyses, age and serum levels of YKL-40 and hsCRP were found to be independent predictors of CIMT. Conclusion: In patients with OSAS, CIMT was increased. This increase was associated with serum YKL-40 level. Increased serum level of YKL-40 may be an early predictor of atherosclerosis development in patients with OSAS.Item Detection of Hypopnea Using Respiratory Signals(2019) Oktan, Aynur Didem; Aksahin, Mehmet FeyziHypopnea is a respiratory disorder that affects people's sleep quality and reduces their standard of living. Detection and treatment of sleep disorders are costly. It requires time and effort. Because patients have to spend their time with special systems in which their physiological signals are recorded and specialist personnel in their sleep laboratories. Polysomnograms should be analyzed by medical doctors every night. Reliable sleep stage scoring is done manually by experts. This means that each morning, a specialist visually analyzes the 960 period of an eight-hour polysomnogram to create a hypnogram. This requires a long time. In this study, a method for automatic detection of hypopnea by eliminating the effect of the doctor is proposed. In this method, epoxes were scored by using air flow, thorax and abdominal amplitude information obtained from the person. A training data was created using hypopnea and normal epochs and grading was performed using the determined attributes. Quadratic Support Vector Machines (SVM) gave the highest accuracy when determining the presence of hypopnea. The linear DVM method was trained in 90.6% accuracy and the system was then tested. It was found that hioped epochs can be detected with 90% sensitivity.Item Sleep Apnea Detection Using Blood Pressure Signal(2018) Aksahin, Mehmet Feyzi; Oltu, Burcu; Karaca, Busra KubraSleep apnea is a common respiratory disease. Apnea affects sleep quality, reduces people's life standards, and it can result in death at advanced stage. Therefore the ability to detect the apnea quickly and accurately is important for the treatment of this disease. Apnea is diagnosed by specialists however this is a long and exhausting process. Accordingly, a decision support system that automatically diagnoses apnea has been developed to facilitate this process and make it more objective. The developed decision support system in this study is based on patient's blood pressure signals instead of traditional Polysomnography (PSG) records, which requires various physiological signals measured from the patients. In the examined blood pressure signals, the change that results from each heart beat was determined and heart rate variability (HRV) was calculated based on these changes. At the same time, maximum and minimum amplitude values were found for each change period and amplitude variability vector was created. The features for each epoch were determined using the generated amplitude variability vector and HRV data. Presence of apnea in each epoch is classified with determined features and with the use of "Quadratic SVM" classifier. The Quadratic SVM classifier was trained with 87.5% accuracy and then the system is tested. As a result 75.4% sensitivity and 75% positive predictive values were obtained.Item Classification of Sleep Apnea by Photoplethysmography Signal(2018) Aksahin, Mehmet Feyzi; Karaca, Busra Kubra; Oltu, BurcuSleep apnea is a very common respiratory disorder in the community that includes a range from upper airway obstruction to respiratory abnormalities and the absence of a breathing effort, which can lower people's standard of living and even cause death. Therefore, the sleep apnea needs to be diagnosed in a practical way and with high accuracy. The diagnosis of apnea is made by recording the physiological parameters of the patient with polysomnography (PSG) method and by examination of these parameters by specialist physicians, but it is a tedious and time consuming process. In order to simplify the apnea diagnosis process, phospletismography (PPG) signals are used instead of PSG records. PPG signals are suitable for diagnosis of apnea because they reflect changes in respiration. In the proposed study, a decision support system was developed to automatically diagnose apnea and to make apnea diagnosis easier and more objective using PPG signals. In the decision support system, the peaks of the PPG signal were determined and the heart rate variability (HRV) vector was generated depending on the time difference between these peaks. The mean and standard deviation values of the generated vector are determined as features for each epoch. The presence of the apnea at each epoch is classified using "Subspace K Nearest Neighbor (Subspace KNN)" and specified features. The "Subspace KNN" classifier was trained with 85% accuracy and then system was tested. As a result, sensitivity, accuracy and specificity rates were calculated as 91%, 95% and 90% respectively.Item Lingual Tonsil Hypertrophy in Patients With Allergic Rhinitis(2019) Coban, Kubra; Koycu, Alper; Aydin, Erdinc; 0000-0003-1290-3509; 31522521Background Lingual tonsils, part of the Waldeyers' Ring, are located in base of the tongue. They are commonly observed in childhood, due to increased immunological activity. Several factors such as laryngopharyngeal reflux, younger age, smoking, and obesity are associated with hypertrophy of lingual tonsils (LTH) in adulthood. However, the relation between allergic rhinitis and LTH is not clearly highlightened in the literature so far. Objective To investigate the role of allergic rhinitis in the development of LTH. Methods Adult patients who were diagnosed with allergic rhinitis were included in the study group. The control group consisted of age- and sex-match healthy volunteers. Complete otorhinolaryngology examination including fiberoptic endoscopic evaluation was performed to both groups. Blood samples were obtained for total immunglobulin E levels, and skin prick tests were performed to both groups. Patients with allergy complaints and positive skin prick tests were included in the study group, while healthy volunteers with negative skin prick tests were enrolled in the control group. The grading for LTH was achieved by a physician who was blind to the study. Results The incidence of LTH was significantly higher in the study group when compared to the control group (P = .001). Similarly, the incidence of grade 3 LTH was significantly higher in the study group compared to the controls (P = .002). Conclusion According to our results, LTH is more frequently observed in patients with allergic rhinitis. Grade 3 representing larger LTH is more commonly seen in patients with allergic rhinitis.