Upper Airway Resistance Syndrome: a Combined ENT and Dental Approach

Author(s):  
Kenny P. Pang ◽  
Edward B. Pang
SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A155-A156
Author(s):  
Luciana Godoy ◽  
Letícia Soster ◽  
Clarissa Bueno ◽  
Sonia Togeiro ◽  
Dalva Poyares ◽  
...  

Abstract Introduction Upper Airway Resistance Syndrome (UARS) is suspected in individuals with excessive daytime sleepiness, fatigue, and sleep fragmentation associated with increased respiratory effort. UARS can negatively impact daytime function. Conventional polysomnography parameters do not demonstrate significant abnormalities in UARS patients but increase in RERAs and arousal index. Cyclic alternating pattern (CAP) is a periodic electroencephalogram activity of non-REM sleep that expresses a condition of sleep instability. The objective of the study was to compare CAP components between UARS patients and health individuals. Methods Fifteen subjects with UARS and 15 age- and sex- matched controls had their sleep study blinded analyzed. UARS criteria were the presence of sleepiness (Epworth Sleepiness Scale – ESS - ≥ 10) and/or fatigue (Modified Fatigue Impact Scale ≥ 38) associated with an apnea/hypopnea index (AHI) ≤ 5 and a respiratory disturbance index (RDI) > 5 events/hour of sleep, and/or flow limitation in more than 30% of total sleep time. Control group criteria were AHI < 5 events/hour, RDI ≤ 5 events/hour and < 30% of TST with flow limitation and ESS < 10, without sleep, clinical, neurological, or psychiatric disorder. CAP electroencephalogram of both groups was analyzed. Results We found higher CAP rate (p = 0.05) and CAP index in N1 stage (p < 0.001) and in N3 stage (p < 0.001) in UARS patients compared to control group. Considering only CAP phase A1 analysis, UARS patients presented higher CAP rate (p = 0.05) and CAP index in N1 stage (p < 0.001) as well as CAP index in N3 stage (p < 0.001) compared to control group. Considering only CAP phase A2 analysis, UARS patients also presented higher number of CAP in N1 stage (p = 0.05). There was no significant difference for CAP phase A3 between groups. Conclusion Although UARS is associated with high arousal index, we found increase in CAP phase A1 and A2, which do not include necessarily AASM arousals, suggesting not only sleep fragmentation but also sleep instability. Support (if any) Associação Fundo de Incentivo à Pesquisa (AFIP) and Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP).


CHEST Journal ◽  
2008 ◽  
Vol 134 (4) ◽  
pp. 52S
Author(s):  
Anita A. Shah ◽  
Christopher J. Lettieri ◽  
David A. Kristo ◽  
Sean M. MacDermott ◽  
Teotimo Andrada ◽  
...  

Author(s):  
Maria Pia Villa ◽  
Melania Evangelisti ◽  
Athanasios G. Kaditis

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