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Objective To evaluate the efficacy and safety of polysomnography-manual continuous positive airway pressure titration (PSG-CPAP), polysomnography-automatic positive airway pressure titration (PSG-APAP), or automatic positive airway pressure titration (APAP) in patients with moderate or severe simple obstructive sleep apnea syndrome (OSAS). Methods Twenty patients with moderate or severe OSAS sequentially underwent PSG-CPAP, PSG-APAP and APAP titration 3 days apart, and then 3 primary efficacy indicators (titration pressure, remaining respiratory event and state of sleep), and safety indicators (compression injury of face skin, the subjective evaluation on degree of comfort or any complaint during titration) were compared. Results The results of efficacy indicators revealed that all PSG-APAP, APAP and PSG-CPAP were effective. Compared with the optimal pressure of PSG-CPAP titration, PSG-APAP and APAP pressures were 3.05 and 2.55cmH2O higher, respectively, in 90% of occasion (P0.05). There was no statistically significant difference between the optimal pressure of PSG-CPAP and the mean pressures of PSG-APAP and APAP (P>0.05). There was no statistically significant difference between the 3 titration methods on residue apnea/hypopnea index (AHI, P>0.05). The oxygen desaturation index (ODI) decreased significantly after titration treatment (P0.05). Both PSG-CPAP and PSG-APAP titrations showed the same effects in improving ODI. Compared with basic PSG, no obvious improvement was found in sleep efficiency (SE) after PSG-CPAP and PSG-APAP titration (P>0.05), however, the arousal index (ArI) decreased obviously (P0.05). The results of safety indicators showed that no face skin compression injury or severe adverse event related to the titration was found in all the patients during the study. The main complaints of the patients were sleep disturbance, dryness of eyes or mouth, headache, breath holding and abdominal distention. Conclusion Both PSG-APAP and APAP titration are effective in treatment with moderate or severe simple OSAS, the measured mean pressure may be used to define the optimal therapeutic pressure of CPAP.

Objective To investigate the sleep habit, common sleep problems, level of daytime sleepiness, and sleep quality among military pilots during nighttime before flying. Methods Random cluster sampling survey was conducted to complete the questionnaire for 1380 military pilots. Statistical analysis of data from the 1328 participants was conducted. Results The mean nighttime sleep duration of pilots was 6.99h and the mean sleep duration during a 24-h period was 8.10h. Approximately 4.10% of the pilots slept less than 6h in a 24-h period. The incidence of moderate and severe snoring was 22.80%. The incidence of nocturnal awakening and/or early morning awakening and difficulty in initiating sleep ≥3 times/week among the pilots was 7.65% and 5.81%, respectively. Consequently, the incidence of nocturia was 4.03%. The mean score of the Epworth sleepiness scale (ESS) was 5.59±4.40. ESS scores of ≥11 were taken to represent excessive daytime sleepiness, the incidence of which was 14.99%. Further, the incidence of drowsiness during a flight was 14.20%. Among the respondents, 62.53% had changed in their normal sleep schedules and habits during the night before flying. Conclusions Pilots have diverse sleep problems and their normal sleep habits change in the night before flying, which might affect flight safety. Therefore, proper intervention for the sleep problems is recommended in pilots.

To assess the diagnostic value of oxygen saturation combined with airflow (OF) monitoring for diagnosis of obstructive sleep apnea hypopnea syndrome (OSAHS).Sixty-two subjects including suspected OSAHS and non-snorers underwent overnight polysomnography (PSG) and OF monitoring simultaneously in sleep laboratory. The apnea-hypopnea index (AHI), lowest oxygen saturation (LSaO(2)), and oxygen desaturation index (ODI) recorded by OF were compared with those recorded by PSG. The AHI and ODI data that showed skew distribution underwent square root transformation to approximate to normal distribution. Pair t test was used for difference hypothesis test. The agreement between the two measures was analyzed using Bland-Altman plot.Forty-five of the 62 subjects were diagnosed as with OSAHS based on PSG with the mean AHI value of (40 +/- 27) events per hour. The mean AHI values derived from OF (OF-AHI) and PSG (PSG-AHI) according to total sleep time were (28 +/- 26) and (29 +/- 28) times per hour respectively, and those after square root transformation were (4.6 +/- 2.7) and (4.7 +/- 2.7) times per hour respectively (P = 0.08). The mean LSaO(2) derived from OF (OF-LSaO(2)) was (82 +/- 11)%, not significantly different from that derived from PSG (PSG-LSaO(2)) [(82 +/- 10)%, P = 0.65]. The ODI derived from OF (OF-ODI) after square root transformation was (3.0 +/- 2.4) times/h, significantly lower than that derived from PSG (PSG-ODI) after square root transformation [(4.0 +/- 2.9) times/h, P = 0.00]. The Bland-Altman plot revealed a good agreement between the OF-AHI and PSG-AHI in non-OSAHS people and patients with mild OSAHS (P = 0.28), however, the OF-AHI was lower than PSG-AHI (P = 0.00) in the patients with moderate to severe OSAHS. There was no significant difference between OF-LSaO(2) and PSG-LSaO2 (P = 0.65).There is a good agreement between OF and PSG for AHI and LSaO(2). OF can be used to screen patients with suspected OSAHS in high risk population. However, OF tends to underestimate the AHI in moderate to severe OSAHS so additional manual analysis is necessary to confirm the diagnosis.

To investigate and analysis the prevalence and risk factors of snoring and excessive daytime sleepiness among male pilots.1108 subjects were derived from a random sample of pilots. They were asked to answer the questions from a questionnaire concerning their snoring and daytime sleepiness, etc. 1054 questionnaire were available for evaluation.The overall prevalence of snoring among male pilots was 51.04% (538/1054), while moderate and severe snorers accounted for 26.28% (227/1054). The prevalence of snoring among male pilots aged over 30 yr was 63.68% (426/669). The prevalence and severity of snoring increase with age and BMI. Age, overweight and obesity, alcohol ingestion and family history of snoring were associated with the prevalence and severity of snoring. There was significant difference in Epworth sleepiness scale scores among without snoring group and various severity of snoring groups (chi2 = 16.948, P0.05).The prevalence of snoring is high in male pilots. The Epworth sleepiness scale score increase with increasing degree of snoring. Doctors should pay more attention to snoring in male pilot.