***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Objective . Determine the association between obstructive sleep apnea ( OSA ) and auditory dysfunction in older subjects . Study Design . Cross-sectional study . Setting . Hospital volunteer helpers undergoing question naire , morphometry measurement , auditory examinations , and polysomnography between 2008 and 2009 . Subjects and Methods . In total , 224 subjects older than 50 years were r and omly sample d for above evaluation and testing . The effects of OSA on the peripheral auditory function , represented by averaged pure-tone threshold of low frequencies ( PTA-low ) and high frequencies ( PTA-high ) , and central auditory function , shown by pitch pattern sequence ( PPS scores ) , were analyzed . Results . The mean ± SD age was 61.2 ± 6.7 years . OSA was confirmed in 6 of 98 women ( 6.1 % ) and 28 of 126 men ( 22.2 % ) . After adjusting for age , gender , and other variables , OSA did not show a significant positive association with PTA-low or PTA-high for all subjects . Conversely , there was a significant negative association between OSA and PPS scores for all subjects , even after adjusting for age , gender , and other variables . When OSA and central obesity together were taken into account in the multivariate linear regression analysis , OSA still showed significant association with PPS score for all subjects . Conclusion . OSA is independently associated with poorer central auditory function in older subjects Abstract Obstructive sleep apnea ( OSA ) is a common disorder , characterized by cyclic cessation of airflow for 10 seconds or more . There is growing awareness that OSA is related to the development and progression of cardiovascular disease . However , only a few studies have associated OSA directly to major cardiovascular events . The aim of this study was to evaluate the relationship between OSA and cardiovascular morbidity in a well defined population of patients .The electronic data base of the central district of a major health management organization was search ed for all patients diagnosed with OSA in 2002–2010 . For each patient identified , an age- and sex-matched patient was r and omly selected from the members of the same health management organization who did not have OSA . Data on demographics , socioeconomic status , and relevant medical parameters were collected as well . The study population included 2797 patients , average age 58.1 , in which 76.6 % were males . There was a significant correlation between OSA and the presence of ischemic heart disease ( P < 0.001 ) , pulmonary hypertension ( P < 0.001 ) , congestive heart failure ( P < 0.001 ) , cardiomyopathy ( P = 0.003 ) , and arrhythmia ( P < 0.001 ) . OSA was also significantly correlated with low socioeconomic status ( P < 0.001).OSA and cardiovascular disease were strongly correlated . As such , early diagnosis and treatment of OSA may change the course of both diseases . We suggest that sleep disordered breathing should be routinely assessed in patients with cardiovascular problems . An ear – nose – throat evaluation may also be important to rule out anatomic disorders that cause upper airway obstruction Background The Berlin Question naire ( BQ ) is a useful tool to identify the high-risk group for obstructive sleep apnea ( OSA ) in the primary care sites or hospital , but the usefulness of the BQ to identify the high-risk group for OSA in the general population has not been evaluated . The purpose of our study was to develop the Korean version of the BQ ( KBQ ) and evaluate the usefulness of the BQ in identifying patients with OSA in the general population . Methods A total of 1,305 subjects were included in a population -based door-to-door cross-sectional study . For validation of the KBQ , an overnight polysomnography ( PSG ) was performed on 101 subjects who were r and omly selected considering their age , sex , and risk group classification at a controlled sleep laboratory . Results The KBQ showed a relatively good to excellent internal consistency ( Cronbach ’s α correlation 0.64–0.78 ) and test – retest reliability ( intraclass correlation 0.92 ) . The apnea – hypopnea index ( AHI ) was significantly correlated with the scores in each category and the total scores of the KBQ . In addition , high risk grouping based on the KBQ predicted an AHI ≥ 5 with a sensitivity of 0.69 and a specificity of 0.83 . According to the risk categorization based on the KBQ , 26.1 % subjects were in the high-risk group for OSA which was similar to the prevalence of OSA in a previous large epidemiological study using PSG in Korea . Conclusion This is the first study to confirm the usefulness of the BQ as a screening tool for OSA by prioritizing subjects at high risk for OSA in the general population STUDY OBJECTIVES Experimental evidence indicates that alcohol use near bedtime may exacerbate  sleep disordered breathing ( SDB ) . However , scarce research has examined the relation between moderate habitual alcohol use and objective ly assessed SDB , and it is unclear whether patients with SDB , or those at risk for SDB , should be counseled to avoid alcohol regardless of proximity to bedtime . In this population -based epidemiology study , our objective is to measure the association of SDB with usual alcohol consumption habits . METHODS Men ( N = 775 ) and women ( N = 645)--initially r and omly selected from a working population --participating in the Wisconsin Sleep Cohort Study were evaluated for alcohol consumption and SDB . The apnea-hypopnea index ( AHI , events/hour ) was determined by in-laboratory polysomnography . AHI > 5 defined " mild or worse " SDB and AHI > 15 defined " moderate or worse " SDB . Alcohol consumption ( drinks/day ) was assessed by question naire . Potential confounding or interacting variables such as smoking , body mass index , and medication use , were measured by clinical assessment and question naire . RESULTS Relative to men who consumed less alcohol , for each increment of one drink per day , men who consumed more alcohol had 25 % greater odds of mild or worse SDB ( OR = 1.25 , 95 % CI = 1.07 - 1.46 , p = 0.006 ) . Among women , minimal to moderate alcohol consumption was not significantly associated with increased risk of SDB . DISCUSSION In men , increased usual alcohol consumption was associated with increased risk of mild or worse SDB .  Persons with SDB might benefit from generally reduced alcohol consumption and not just avoidance near bedtime OBJECTIVE Obstructive sleep apnea ( OSA ) has been recognized in the Western world as a public health burden , but there has been no community-based study performed to assess the prevalence of the condition in India . The study was performed to assess the prevalence and risk factors of OSA in a semi-urban Indian population . DESIGN A two-stage , cross-sectional , community-based prevalence study . SETTING A semi-urban community in Delhi . DURATION Two years ( 2003 to 2005 ) . PATIENTS AND PARTICIPANTS All citizens residing in the community who were 30 to 60 years of age . Exclusion criteria included those patients with recent myocardial infa rct ion , upper airway surgery , class III/IV congestive heart failure , pregnancy , hypothyroidism on treatment , acromegaly , chronic renal failure , systemic steroid treatment , and hormone replacement therapy . INTERVENTION An  OSA assessment  was performed in 2,400 subjects who were screened in stage 1 of the study by means of a sleep question naire . Subjects were then divided into habitual and nonhabitual snorers . Eighty-three r and omly selected habitual snorers and 80 nonhabitual snorers were invited to participate in stage 2 of the study , which consisted of in-hospital polysomnography studies . OBSERVATIONS AND RESULTS A total of 2,150 subjects returned question naires ( response rate , 90 % ) . Of 550 habitual snorers and 1,596 nonhabitual snorers , 77 habitual snorers and 73 nonhabitual snorers underwent polysomnography . A total of 36 habitual snorers ( 46.75 % ) and 2 nonhabitual snorers ( 2.73 % ) were found to have OSA , giving prevalence rates of 13.74 % and 3.57 % , respectively , for OSA and OSA syndrome ( OSAS ) on extrapolation . Multivariate analysis revealed that male gender , age , obesity ( defined by a high body mass index ) , and waist/hip ratio as significant risk factors for OSAS . CONCLUSIONS This study demonstrated that the risk factors and prevalence for OSA in India are similar to those in the West , which is contrary to the findings of some previous reports , which had a strong inclusion bias Nasal continuous positive airway pressure ( nasal CPAP ) and polysomnography were used to analyze the time course of the effect of bedtime ethanol on resistance of upper airways and on the number of respiratory pauses during sleep . On one night , six asymptomatic nonalcoholic male snorers drank 2 ml/kg of 100 proof vodka mixed in orange juice ( ethanol dose , 0.79 gm/kg , giving a peak blood alcohol level of 71.8 + /- 33.3 mg/dl ) . On a second night they received a placebo ( 1 - 2 drops of vodka floated on top of the orange juice ) . We measured ( a ) the minimum nasal ( CPAP ) required to eliminate snoring , ( b ) the number of hypopneas and apneas during each hour of sleep and ( c ) the arterial oxygen saturation ( SaO2 ) by ear oximetry . On the alcohol night there was a significant increase in the CPAP pressure required to eliminate snoring ( placebo 4.8 + /- 1.7 cm H2O , alcohol 6.2 + /- 1.5 cm H2O ) . The number of respiratory events per hour of sleep ( apnea index ) was 7.5 + /- 2.1 for ethanol nights versus 3.8 + /- 2.7 for placebo nights ( p less than 0.0125 ) . An apnea index of greater than 5 is generally considered abnormal . There was no significant difference in the number of desaturation events ( declines of 4 % or more in the SaO2 ) or in the mean SaO2 , but the minimum SaO2 was significantly lower on the ethanol night ( placebo 89.8 % + /- 1.6 , alcohol 86.8 % + /- 2.7 , p less than 0.05 ) . The effect of this dose of alcohol on airway resistance was most pronounced during the first 2 hr after ingestion BACKGROUND Sleep-disordered breathing is prevalent in the general population and has been linked to chronically elevated blood pressure in cross-sectional epidemiologic studies . We performed a prospect i ve , population -based study of the association between objective ly measured sleep-disordered breathing and hypertension ( defined as a laboratory-measured blood pressure of at least 140/90 mm Hg or the use of antihypertensive medications ) . METHODS We analyzed data on sleep-disordered breathing , blood pressure , habitus , and health history at base line and after four years of follow-up in 709 participants of the Wisconsin Sleep Cohort Study ( and after eight years of follow-up in the case of 184 of these participants ) . Participants were assessed overnight by 18-channel polysomnography for sleep-disordered breathing , as defined by the apnea-hypopnea index ( the number of episodes of apnea and hypopnea per hour of sleep ) . The odds ratios for the presence of hypertension at the four-year follow-up study according to the apnea-hypopnea index at base line were estimated after adjustment for base-line hypertension status , body-mass index , neck and waist circumference , age , sex , and weekly use of alcohol and cigarettes . RESULTS Relative to the reference category of an apnea-hypopnea index of 0 events per hour at base line , the odds ratios for the presence of hypertension at follow-up were 1.42 ( 95 percent confidence interval , 1.13 to 1.78 ) with an apnea-hypopnea index of 0.1 to 4.9 events per hour at base line as compared with none , 2.03 ( 95 percent confidence interval , 1.29 to 3.17 ) with an apnea-hypopnea index of 5.0 to 14.9 events per hour , and 2.89 ( 95 percent confidence interval , 1.46 to 5.64 ) with an apnea-hypopnea index of 15.0 or more events per hour . CONCLUSIONS We found a dose-response association between sleep-disordered breathing at base line and the presence of hypertension four years later that was independent of known confounding factors . The findings suggest that sleep-disordered breathing is likely to be a risk factor for hypertension and consequent cardiovascular morbidity in the general population Apnea during sleep has been associated with both increased pharyngeal resistance and nasal obstruction . Alcohol can worsen obstructive sleep apnea , but its influence on pharyngeal resistance and nasal patency has not been evaluated . Accordingly , we determined the effects of alcohol on pharyngeal and nasal resistances in 11 normal awake subjects on 2 separate days . Baseline pharyngeal resistance prior to placebo and alcohol was not significantly different . After placebo , pharyngeal resistance did not change significantly . However , after alcohol , pharyngeal resistance increased from 1.9 + /- 0.5 ( SEM ) to 
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This estimate 's differences were robust in alcohol consumption and sleep apnoea definitions , study design , and quality but was greater in Low and Middle Income Country locations .
Conclusion These findings suggest that alcohol consumption is associated with a higher risk of sleep apnoea , further supporting evidence that reducing alcohol intake is of potential therapeutic and preventive value in this condition