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    Impact of rem-related obstructive sleep apnea therapy on anxiety, depression and daytime sleepiness
    (Bayrakol Medical Publisher, 2022) Geckil, Aysegul Altintop; Ermis, Hilal
    Aim: Obstructive Sleep Apnea (OSA) is characterized by repetitive episodes of complete or partial upper airway obstruction during sleep. Patients who slept at least 30 minutes in REM sleep, total apnea-hypopnea index (AHI)>5 and REM AHI/NREM AHI>2 are defined as REM-related OSA. We investigated the efficacy of treatment on anxiety, depression and daytime sleepiness in REM-related OSA. Material and Methods: A total of 110 patients with REM-related OSA participated in the study. Patients were divided into two groups; the treatment group consisted of patients who received treatment (n:38) and the non-treatment group who refused to receive treatments (n:72). Of the 38 patients treated, 33 had mild disease and 5 had moderate disease. Sixty-seven of the 72 patients who did not receive treatment had mild disease and 5 had moderate disease. Both groups completed the HADS (Hospital Anxiety-Depression Scale), ESS (Epworth Sleepiness Scale) questionnaires. SPSS was used for data analysis. Results were expressed as mean and standard deviation. T-test and chi-square tests were performed to compare cases. A p-value <0.05 was considered statistically significant. Results: There was no statistically significant difference between the groups, in terms of age, gender, height, weight, and body mass index (BMI). No statistically significant difference was found between the two groups in terms of polysomnography parameters AHI, REM AHI, arousal index, periodic leg movement (PLM) index, sleep latency, REM latency, minimum oxygen saturation (SPO2), and cumulative percentage of time spent at saturation below 90%. HADS- Anxiety, HADS- Depression and ESS scores were significantly higher in the non-treatment group in comparison to the treatment group (p=0.011, p=0.016, p=0.005, respectively). Discussion: The results of our study showed that treatment has positive effects on anxiety, depression and daytime sleepiness, which are indicative of the quality of life in patients with REM-related OSA.
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    The relationship between anxiety, depression, daytime sleepiness in the REM-related mild OSAS and the NREM-related mild OSAS
    (Geckil, Aysegul Altintop, 2020) Ermis, Hilal; Altintop Geckil, Aysegul
    Introduction: Obstructive sleep apnea syndrome (OSAS) is a common form of sleep-related respiratory disease characterized by recurrent blockages in the upper airway. Rapid eye movement (REM)-related OSAS is a condition in which apneas and hypopneas are more common during REM sleep. We investigated whether there was any difference between REM-related mild OSAS group and NREM-related mild OSAS group in terms of anxiety, depression, and daytime sleepiness. Methods: A total of 166 patients with mild OSAS (72 patients with REM-related and 94 NREM-related OSAS) participated in the study. Hospital Anxiety-Depression Scale (HADS) and Epworth Sleepiness Scale (ESS) questionnaires were completed by both groups. Results: Anxiety and depression scores were significantly higher in patients with REM-related OSAS in comparison to the NREM-related OSAS group (p = 0.01, p = 0.02 respectively). There was no statistically significant difference between the two groups in terms of ESS scores (p = 0.60). Conclusion: The results of our study suggest that patients with REM-related OSAS have higher rates of depression and anxiety compared to non-REM-related OSAS patients and this may adversely affect quality of life. It may be possible to prevent psychiatric complications, such as depression and anxiety, by administering treatments that reduce REM sleep duration and intensity in patients with REM-related OSAS.
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    Tuberculous Lymphadenitis in Abdominal and Pelvic Lymph Nodes
    (Aves, 2005) Ermis, Hilal; Gokirmak, Munire; Kafkasli, Ayse; Bozdag, Zehra; Baysal, Tamer
    Tuberculous lymphadenitis presents with painless enlargement commonly in cervical and to a lesser degree in supraclavicular and axillary lymph nodes. Patients are usually asymptomatic and the disease is diagnosed during physical examination or radiological imaging performed for another reason. Sixty-years old woman presenting with urinary incontinance and vaginal cuff prolapsus was operated. Intraoperatively, multiple conglomerated lymphadenopathies were observed in abdominal and pelvic region. Examination of biopsy specimens obtained from these lymph nodes revealed tuberculous lymphadenitis. When the patient was questioned again, it was learned that she had obscure abdominal pain and anorexia previously. PPD test revealed an induration of 50x35 mm. After two months of antituberculous therapy, a slight regression was observed in the size of lymph nodes at abdominal CT. Altough this case was diagnosed coincidentally, it shows that abdominal tuberculous lymphadenitis must also be kept in mind in differential diagnosis, in patients presenting with obscure abdominal symptoms or in whom imaging techniques revealed enlargment of abdominal lymph nodes.