Introduction: Fibromyalgia is characterized by pain all over the body, whose diagnosis and treatment are not fully understood. Obstructive sleep apnea syndrome (OSAS) is a disease that causes apnea, hypopnea and oxygen desaturation due to collapse in the upper respiratory tract and is characterized by excessive daytime sleepiness, fatigue and lack of attention. Symptoms and signs of OSAS and fibromyalgia are similar. In our study, we aimed to compare the association of fibromyalgia in female OSAS patients in terms of polysomnography and laboratory parameters. Materials and Methods: We aimed to examine the association of fibromyalgia in patients with female OSAS. A total of 190 female OSAS patients were included in the study. The patients were divided into two groups according to the presence of fibromyalgia: 88 (46.3%) patients in the fibromyalgia group and 102 (53.7%) patients in the control group. Statistical Package for the Social Sciences (SPSS) program was used for the evaluation of demographic data, polysomnography parameters and laboratory tests of the patients, and values with p< 0.05 were considered statistically significant. Results: Mean age of the patients was 52.1 +/- 11.9 years and mean body mass index (BMI) was 35.1 +/- 7.2. There was no difference between age and BMI (p= 0.971, p= 0.716, respectively). Periodic leg movements (PLMS) were higher in the fibromyalgia group (p= 0.02). The desaturation index (CT90) was found to be high in the fibromyalgia group (p= 0.043). The minimum SaO(2 )value was found to be low in the fibromyalgia group (p= 0.022). Sleep latency was found to be higher in the fibromyalgia group (p= 0.031). Hemoglobin and hematocrit values were found to be statistically significantly higher in the fibromyalgia group (p= 0.020, p= 0.027, respectively). Triglyceride level was found to be high in the fibromyalgia group (p= 0.043). Conclusion: We recommend clinical evaluation of female patients with fibromyalgia and we suggest polysomnography, especially in patients with excessive daytime sleepiness. Early diagnosis and treatment of concomitant OSAS will contribute to quality of fibromyalgia patients' life.

Background and Objectives: Apnea hypopnea index is the most important criterion in determining the severity of obstructive sleep apnea (OSA), while the percentage of the total number of times which oxygen saturation is measured below 90% during polysomnography (CT90%) is important in determining the severity of hypoxemia. As hypoxemia increases, inflammation will also increase in OSA. Inflammation in the respiratory tract may affect phonation. We aimed to determine the effects of the degree of OSA and CT90% on phonation. Materials and Methods: The patients were between the ages of 18–60 years and were divided into four groups: normal, mild, moderate, and severe OSA. Patients were asked to say the vowels /α:/ and /i:/ for 5 s for voice recording. Maximum phonation time (MPT) was recorded. Using the Praat voice analysis program, Jitter%, Shimmer%, harmonics-to-noise ratio (HNR), and f0 values were obtained. Results: Seventy-two patients were included. Vowel sound /α:/; there was a significant difference for Jitter%, Shimmer%, and HNR measurements between the 1st and the 4th group (p < 0.001, p < 0.001, and p < 0.001, respectively) and a correlation between CT90% and Shimmer% and HNR values (p < 0.001 and p < 0.021, respectively). Vowel sound /i:/; there was a significant difference in f0 values between the 1st group and 2nd and 4th groups (p < 0.028 and p < 0.015, respectively), and for Jitter%, Shimmer%, and HNR measurements between the 1st and 4th group (p < 0.04, p < 0.000, and p < 0.000, respectively), and a correlation between CT90% and Shimmer% and HNR values (p < 0.016 and p < 0.003, respectively). The difference was significant in MPT between the 1st group and 3rd and 4th groups (p < 0.03 and p < 0.003, respectively). Conclusions: Glottic phonation can be affected, especially in patients whose AHI scores are ≥15. Voice quality can decrease as the degree of OSA increases. The increase in CT90% can be associated with the worsening of voice and can be used as a predictor in the evaluation of voice disorders in the future.

Background and Objectives: Carbonic anhydrase (CA) enzymes are a family of metalloenzymes that contain a zinc ion in their active sites. CA enzymes have been implied in important situations such as CO₂ transport, pH regulation, and oncogenesis. CA-IX is a transmembrane glycoprotein and stimulates the expression of hypoxia-inducible factor-1 (HIF-1) CA-IX. This study aimed to determine serum CA-IX levels in OSA patients in whom intermittent hypoxia is important and to investigate the relationship between serum CA-IX levels and disease severity. Materials and Methods: The study included 88 people who applied to Malatya Turgut Özal University Training and Research Hospital Sleep Disorders Center without a history of respiratory disease, malignancy, and smoking. Patients were divided into three groups: control (AHI < 5, n = 31), mild–moderate OSA (AHI = 5–30, n = 27) and severe OSA (AHI > 30, n = 30). The analysis of the data included in the research was carried out with the SPSS (IBM Statistics 25, NY, USA). The Shapiro–Wilk Test was used to check whether the data included in the study had a normal distribution. Comparisons were made with ANOVA in multivariate groups and the t-test in bivariate groups. ANCOVA was applied to determine the effect of the CA-IX parameter for OSA by controlling the effect of independent variables. The differentiation in CA-IX and OSA groups was analyzed regardless of BMI, age, gender, and laboratory variables. ROC analysis was applied to determine the parameter cut-off point. Sensitivity, specificity, and cut-off were calculated, and the area under the curve (AUC) value was calculated. Results: Serum CA-IX levels were 126.3 ± 24.5 pg/mL in the control group, 184.6 ± 59.1 pg/mL in the mild–moderate OSA group, and 332.0 ± 39.7 pg/mL in the severe OSA group. Serum CA-IX levels were found to be higher in the severe OSA group compared to the mild–moderate OSA group and control group and higher in the mild–moderate OSA group compared to the control group (p < 0.001, p < 0.001, p < 0.001, respectively). In addition, a negative correlation between CA-IX and minimum SaO₂ and mean SaO₂ (r = –0.371, p = 0.004; r = –0.319, p = 0.017, respectively). A positive correlation between CA-IX and desaturation index (CT90) was found (r = 0.369, p = 0.005). A positive correlation was found between CA-IX and CRP (r = 0.340, p = 0.010). When evaluated by ROC curve analysis, the area under the curve (AUC) value was determined as 0.940 (95% CI 0.322–0.557; p < 0.001). When the cut-off value for CA-IX was taken as 254.5 pg/mL, it was found to have 96.7% sensitivity and 94.8% specificity in demonstrating severe OSA. Conclusions: Our study found that serum CA-IX value was higher in OSA patients than in control patients, and this elevation was associated with hypoxemia and inflammation. CA-IX value can be a fast, precise, and useful biomarker to predict OSA.