Journal of Nursing Theory and Practice

[Obstructive sleep apnea syndrome: how we screen and diagnose?]


FEBRUARY 28, 2017

Journal of Nursing Theory and Practice - 2017;30(01)

[The obstructive sleep apnea syndrome (OSAS) is known to cause obstructive apneas and hypopneas mostly with desaturations and/or arousals caused by repetitive collapse of the upper airway system during sleep. The disorder negatively affects sleep efficacy and daytime neurocognitive functions as well as increases cardiovascular risks. The typical clinical presentation is excessive daytime sleepiness and loud snoring interrupted by brief pauses of breathing. Its prevalence is 2-4% in the general population. It may be a causative factor in some disorders such as therapy resistant hypertension, nocturnal cardiac arrhythmias, stroke, cognitive decline or depression. Significance of the disorder is highlighted by the fact that its risk must be evaluated by the family doctors during the examination of medical suitability for driving licence in Hungary. ]


  1. SomnoCenter Szeged, Alvásdiagnosztikai és Terápiás Központ
  2. Semmelweis Egyetem, Általános Orvostudományi Kar, Családorvosi Tanszék
  3. Magyar Honvédség Egészségügyi Központ Alvásdiagnosztikai és Terápiás Centrum



Further articles in this publication

Journal of Nursing Theory and Practice

[Zsuzsanna Kossuth, the first head nurse in all of Hungary was born 200 years ago]


Journal of Nursing Theory and Practice

[Investigation of nurses eating habits]


[The aim of the study: was to assess the characteristics of diet among nurses in relation to socio-demographic and workplace related factors. Methods: The survey was conducted in 2015 through a self-constructed online questionnaire. Data were analyzed with SPSS 22.0 using chi square, Mann-Whitney and Kruskal-Wallis tests. Results: Sixty percent of the 548 involved nurses are overweight. Monthly overtime correlates negatively with the number of daily meals (p=0.003) with having hot meals (p=0.022) and with the opinion about dietary habits (p=0.001). Calm meals are typical for 30%, eating vegetables, fruits and whole grain bakery products for 20% and only 24.3% drinks two litres per day. Having children has beneficial effects on dietary habits. Conclusions: It can be concluded that the majority of the nurses included are overweight and they have dissatisfactory diet. The reasons for these might be rooted in the characteristics of the job and the Hungarian eating habits.]

Journal of Nursing Theory and Practice

[The opinion of parents with premature babies about information regarding homecoming and psychological support]


Journal of Nursing Theory and Practice

[Community nurses’ challenges and occupational health hazards associated with home health care]

HIRDI Henriett Éva, LUKÁCS Miklós, BURCSEK Tóthné Ildikó, BALOGH Zoltán

[The aim of the study was to assess the occupational health hazards associated with the delivery of home health care among nurses in family practices. Methods: The cross-sectional survey was conducted between 20 January 2016 and 15 April among nurses working in general, child and family practices, selected using a random, sampling method (N=983). The data gathering took place using a web-based, anonymous, self-completion questionnaire. The authors analysed the gathered data with Microsoft Excel 2013 software, employing a descriptive statistical methods. Results: 99,59% of nurses were female with an average of 27,34 years experience. Nurses reported the following frequently health risks at their client’s homes: 71,4% handling sharp devices or equipment, 54,9% contact with human body fluids, 29,51% smoking in home, 13,7% patient handling without slings or handling devices, 8,9% agressive pets, 7,5% neighborhood violence/crime. Conclusions: Results demonstrated an increased biological health risk among nurses. Based on the results, the authors stress the importance of developing and conducting training programs concerning occupational health hazard issues for nurses working in family practices. ]

Journal of Nursing Theory and Practice

[Advantages of the bevel down puncture technique]

SOMOSI László, KISS Szilvia, LADÁNYI Erzsébet

[The arterio-venous fistula is also called the dialysis patient’s lifeline. The name lifeline stands for the essential connection between the body and the dialysis machine. Keeping it in good condition is very important, because fistulas play a keyrole in the successful dialysis treatment. Fistula care is indispensable both from the nurse and patient side. The dialysis team is responsible for the fistula puncture and care. We introduced the bevel down puncture technique in November of 2011 for better arterio-venous shunt care. Our dialysis nurses were trained on the correct position of the fistula needle. We emphasised the benefits and long-term effects. We use this technique for all patients, except for the first fistula puncture. The bevel down puncture technique reduces the patient’s fear of fistula puncture as it causes less pain. After removal of the needle, the bleeding time decreased from the approximate 6-7 minutes to less than 5 minutes and bleeding volume is also decreased. It also reduces the size of the scab and the aneurysm formation. In our dialysis unit we have had good experiences with the bevel down puncturing technique, as it kept our patients’ fistulas in good condition, this may prolong vascular accesses lifetime.]

All articles in the issue

Related contents

Clinical Neuroscience

Positive airway pressure normalizes glucose metabolism in obstructive sleep apnea independent of diabetes and obesity

KABELOĞLU Vasfiye, SENEL Benbir Gulçin, KARADENIZ Derya

The relationship among obstructive sleep apnea syndrome (OSAS), type 2 diabetes mellitus (DM2) and obesity is very complex and multi-directional. Obesity and increased visceral fat are important perpetuating factors for DM2 in patients with OSAS. On the other hand, OSAS itself leads to obesity by causing both leptin and insulin resistance as a consequence of activation of the sympathetic nervous system. Risk for developing DM2 further increases in patients with OSAS and obesity. Data regarding effects of positive airway pressure (PAP) therapy, gold standard treatment for OSAS, on glycemic control were inconsistent due to variability in duration of and adherence to PAP therapy. In our cohort study we investigated effects of PAP treatment on glucose metabolism in normal-weighted non-diabetic OSAS patients, in obese non-diabetic OSAS patients, and in OSAS patients with DM2. We prospectively analyzed 67 patients diagnosed with OSAS and documented to be effectively treated with PAP therapy for three months. Apnea-hypopnea index was highest in the diabetic group, being significantly higher than in the normal-weighted group (p=0.021). Mean HOMA values were significantly higher in obese (p=0.002) and diabetic group (p=0.001) than normal-weighted group; the differences were still significant after PAP therapy. HbA1c levels were significantly higher in diabetic group compared to those in normal-weighted (p=0.012) and obese (p=0.001) groups. After PAP treatment, decrease in HbA1c levels were significant in normal-weighted (p=0.008), obese (p=0.034), and diabetic (p=0.011) groups. There was no correlation with the change in HbA1c levels and age (p=0.212), BMI (p=0.322), AHI (p=0.098) or oxygen levels (p=0.122). Our study showed that treatment of OSAS by PAP therapy offers beneficial effect on glucose metabolism, not only in diabetic patients, but also in obese and normal-weighted OSAS patients. Although data regarding overall effects of PAP therapy on glycemic control present contradictory results in the literature, it should be emphasized that duration and adherence to PAP therapy were main determinants for beneficial outcome of treatment.

Clinical Neuroscience

[Effect of two month positive airway pressure therapy on the structure of sleep, cognitive function and anxiety]


[Obstructive sleep apnea is a common disorder, characterized by repeated episodes of upper airway obstruction during sleep, resulting intermittent hypoxia and disruption of the normal sleep pattern, which caused cognitive dysfunction in these patients. Nasal continuous positive airway pressure is the treatment of choice for this disorder. The aim of the study is to evaluate the effect of short-term positive airway pressure on sleep pattern (polisomnographic measures), cognitive function and anxiety. Twenty four newly diagnosed and previously untreated patients with obstructive sleep apnea were evaluated a battery of neuropsychological tests before and after 2 and a half months of the treatment. We focused on working memory, short and long-term episodic memory, executive functions, anxiety and subjective sleepiness. Our results showed that the two and half month of treatment improved the respiration during sleep, sleep pattern and the subjective sleepiness. We found improvement in short- and long-term verbal memory, and complex working memory. Despite of treatment we did not find improvement in visuospatial learning. These results reveal that 2 and a half months of positive airway pressure treatment restored not only the normal respiration during sleep and normal sleep pattern, but also the cognitive functions. Our study suggests that cognitive dysfunction is at least partial reversible in obstructive sleep apnea patients after positive airway pressure treatment.]

Hungarian Radiology

[Az emlődaganatok radiológiai vizsgálatának újdonságai Onco Update, 2007]


[Experiences about the breast diagnostic methods are accumulating year-to-year, rapidly. Therefore the current examination algorithm is changing continuously. New diagnostic and therapeutic modalities are entering into the daily practice. Some of them became obsolete, so far their application is becoming a faulty decision. Some other methods become obligatory steps in the diagnostics. These are the reasons why the up-to-date knowledge of the literature is mandatory. Systematic review of the most recent articles of the last two years (January 2005-December 2006) of breast radiological diagnostics and the actual place of the imaging and interventional methods are presented. The following topics are summarized: breast cancer screening with conventional and digital mammography, computer assisted diagnostics (CAD), high risk patients' screening, US, MRI, MSCT, PET/CT, diagnostic interventions, differential diagnostics, percutaneous tumour ablation, therapy-related questions in the diagnostic work up.]

Hypertension and nephrology

[The importance of recognition and proper treatment of hypertension and the maintenance of adherence in hypertension care]

NEMCSIK János, PÁLL Dénes, JÁRAI Zoltán

[Hypertension is the leading cause of death and disability-adjusted life years. In the United States hypertension accounts for more cardiovascular (CV) deaths than any other modifiable CV disease risk factor and was second only to cigarette smoking as a preventable cause of death for any reason. In our country the situation is similar. In Hungary the number of subjects with hypertension is approximately 3.5 million and this high prevalence contributes markedly to the poor Hungarian CV morbidity and mortality figures. The recognition of hypertension, the initiation of drug therapy and the long-term follow- up of the patients is mainly the task of primary care. Besides that it inheres high responsibility, this is also a grateful commitment, as hypertension in most of the cases can be treated properly with lifestyle-changes and medications leading to a marked decrease of CV complications, especially stroke. In our review article we would like to focus on the high prevalence of hypertension worldwide as well as in our country, the exact implementation of screening, the risk reduction potential of the proper treatment and the importance of the long-term maintenance of treatment adherence.]

Lege Artis Medicinae

[Long-term CPAP compliance among Sleep Apnea Patients at the Sleep Laboratory of the Hungarian Defense Forces Medical Center ]


[Obstructive sleep apnea syndrome (OSAS) is the most common sleep disorder, with a prevalence of 2-4% in the overall popula­tion. It is a risk factor for cardiovascular diseases and its daytime symptoms significantly impair the patients’ quality of life and increase the risk of work and road accidents. Its first-line treatment is the CPAP device (Continuous Positive Airway Pres­sure) the effectiveness of which is significantly determined by the compliance of the patient. Although the issue of compliance in such treatment is a very important factor, long-term studies including a large number of patients have not been published yet, and there are no known data about it in Hungary. OBJECTIVE - Examining the long-term compliance of CPAP among OSAS patients in a sleep laboratory in Hungary. METHOD - 3403 OSAS patients were selected for our study between January 1, 2007, and September 30, 2017. The diagnosis and titration of effective CPAP pressure were determined by polysomnography. Patients were controlled after 2 months of therapy and then every 6 and 12 months. During the care, their compliance value was determined by data downloaded from their device's memory card. RESULTS - The mean age (± SD) of patients was 59.0 (± 10.5) years, most of them were male, 2676 (78.6%), their average body mass index (BMI) was 32.6 (± 5.25) kg/m2, their average Epworth Sleepiness Scale score was 11.4 (± 5.0), their average Apnea-Hypopnoe index was 51.0 (± 19.5) events/hour. The average usage time of the CPAP device was 5.0 (± 1.9) hours. 72.3% of the patients used the device for over 4 hours and 27.7% used it for less than 4 hours. 34.7% of the patients used the device for more than 6 hours. The Epworth Sleepiness Score showed a significant and dose-dependent improvement over CPAP treatment, with a greater improvement among patients who used the machine for longer hours. The highest score improvement was achieved by users who used CPAP between 6-7 hours, averaging 7.3 (± 3.2) points (p <0.001). CONCLUSIONS - Our present study shows that high average compliance can be achie­ved among well-adjusted and well-maintained patients. ]