OCT-Angiography Comparison between Obstructive Sleep Apnea Children and Normal Subjects in China

Abstract Introduction Previous studies have shown that obese patients with obstructive sleep apnea (OSA) have a significantly greater percentage of fat tissue in soft palate than normal subjects. However, the influence of soft palate fat is not clear in non-obese adults with OSA. This study compared the volume of fat in the soft palate between lean adults with OSA and lean controls. Methods We examined soft palate fat in 21 lean OSA cases and 16 lean controls with body mass index (BMI) <25 kg/m2. All subjects underwent a magnetic resonance imaging (MRI) with three-point Dixon scan. We used volumetric reconstruction algorithms to quantify the amount of soft palate fat, which was compared between apnecis and controls. Analysis reproducibility was quantified using intraclass correlation coefficients (ICC) from repeated analyses of 20 randomly-chosen MRIs. Results Analysis of soft palate fat was highly reproducible, with an ICC (95% confidence interval) of 0.968 (0.923, 0.987). Lean apneics were younger than lean controls (45.3±13.0 vs. 62.1±10.4 years; p<0.0001). No significant differences between apneics and controls were observed in the average BMI (23.4±2.2 vs. 23.5 ± 2.6 kg/m2; p=0.824), the fat pads volume (4198±1728 vs. 3880±1544 mm3; p=0.646), and the proportion of males (61.9% vs. 68.8%; p=0.666). In unadjusted analyses, the lean OSA group showed significantly higher soft palate fat volume than lean controls (7605±2109 vs. 5327±1783 mm3; p=0.003). When adjusting for age, gender and BMI, no differences was observed between groups in soft palate fat volume (p=0.122) and fat pads volume (p=0.702). Conclusion Analysis of soft palate fat volume from Dixon MRI is highly reproducible. Our results indicate no significant difference in deposition of fat at soft palate between lean patients with OSA and lean controls when accounting for age, gender and BMI. Support This study is supported by National Institutes of Health Grant: 2P01HL094307-06A1. LX is supported by Young Elite Scientists Sponsorship Program of China Association for Science and Technology.

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Determinants of heart rate variability in obstructive sleep apnea syndrome during wakefulness and sleep

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.01065.2003 ◽

2005 ◽

Vol 288 (3) ◽

pp. H1103-H1112 ◽

Cited By ~ 38

Author(s):

J. A. Jo ◽

A. Blasi ◽

E. Valladares ◽

R. Juarez ◽

A. Baydur ◽

...

Keyword(s):

Heart Rate ◽

Obstructive Sleep Apnea ◽

Heart Rate Variability ◽

Sleep Apnea ◽

Obstructive Sleep Apnea Syndrome ◽

Sleep Apnea Syndrome ◽

Normal Subjects ◽

Sinus Arrhythmia ◽

Obstructive Sleep ◽

Apnea Syndrome

Heart rate variability (HRV) is mediated by at least three primary mechanisms: 1) vagal feedback from pulmonary stretch receptors (PSR), 2) central medullary coupling between respiratory and cardiovagal neurons (RCC), and 3) arterial baroreflex (ABR)-induced fluctuations. We employed a noninvasive experimental protocol in conjunction with a minimal model to determine how these sources of HRV are altered in obstructive sleep apnea syndrome (OSAS). Respiration, heart rate, and blood pressure were monitored in eight normal subjects and nine untreated OSAS patients in relaxed wakefulness and stage 2 and rapid eye movement sleep. A computer-controlled ventilator delivered inspiratory pressures that varied randomly from breath to breath. Application of the model to the corresponding subject responses allowed the delineation of the three components of HRV. In all states, RCC gain was lower in OSAS patients than in normal subjects ( P < 0.04). ABR gain was also reduced in OSAS patients ( P < 0.03). RCC and ABR gains increased from wakefulness to sleep ( P < 0.04). However, there was no difference in PSR gain between subject groups or across states. The findings of this study suggest that the adverse autonomic effects of OSAS include impairment of baroreflex gain and central respiratory-cardiovascular coupling, but the component of respiratory sinus arrhythmia that is mediated by lung vagal feedback remains intact.

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IDENTIFICATION OF OBSTRUCTIVE SLEEP APNEA USING ARTIFICIAL NEURAL NETWORKS AND WAVELET PACKET DECOMPOSITION OF THE HRV SIGNAL

The Journal of Engineering Research [TJER] ◽

10.24200/tjer.vol17iss1pp24-33 ◽

2020 ◽

Vol 17 (1) ◽

pp. 24

Author(s):

Abdulnasir Hossen ◽

Sarah Qasim

Keyword(s):

Neural Network ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Probabilistic Neural Network ◽

Wavelet Packet ◽

Back Propagation ◽

Normal Subjects ◽

University Hospital ◽

Feedforward Network ◽

Obstructive Sleep

The advancement of telecommunication technologies has provided us with new promising alternatives for remote diagnosis and possible treatment suggestions for patients of diverse health disorders, among which is the ability to identify Obstructive Sleep Apnea (OSA) syndrome by means of Electrocardiograph (ECG) signal analysis. In this paper, the standard spectral bands’ powers and statistical interval-based parameters of the Heart Rate Variability (HRV) signal were considered as a form of features for classifying the Sultan Qaboos University Hospital (SQUH) database for OSA syndrome into 4 different levels. Wavelet packet analysis was applied to obtain and estimate the standard frequency bands of the HRV signal. Further, the single perceptron neural network, the feedforward with back-propagation neural network and the probabilistic neural network have been implemented in the classification task. The classification between normal subjects versus severe OSA patients achieved 95% accuracy with the probabilistic neural network. While the classification between normal subjects versus mild OSA subjects reached accuracy of 95% also. When grouping mild, moderate and severe OSA subjects in one group compared to normal subjects as a second group, the classification with the feedforward network achieved an accuracy of 87.5%. Finally, when classifying subjects directly into one of the four classes (normal or mild or moderate or severe), a 77.5% accuracy was achieved with the feedforward network.

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Control of segmental upper airway resistance in patients with obstructive sleep apnea

Journal of Applied Physiology ◽

10.1152/jappl.1993.74.6.2694 ◽

1993 ◽

Vol 74 (6) ◽

pp. 2694-2703 ◽

Cited By ~ 11

Author(s):

M. J. Wasicko ◽

J. S. Erlichman ◽

J. C. Leiter

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Upper Airway ◽

Normal Subjects ◽

Emg Activity ◽

Electromyographic Activity ◽

Resistive Load ◽

Airway Collapse ◽

Upper Airway Collapse ◽

Obstructive Sleep

We sought to determine if the upper airway response to an added inspiratory resistive load (IRL) during wakefulness could be used to predict the site of upper airway collapse in patients with obstructive sleep apnea (OSA). In 10 awake patients with OSA, we investigated the relationship between resistance in three segments of the upper airway (nasal, nasopharyngeal, and oropharyngeal) and three muscles known to influence these segments (alae nasi, tensor veli palatini, and genioglossus) while the patient breathed with or without a small IRL (2 cmH2O.l–1.s). During IRL, patients with OSA exhibited increased nasopharyngeal resistance and no significant increase in either the genioglossus or tensor veli palatini activities. Neither nasal resistance nor alae nasi EMG activity was affected by IRL. We contrasted this to the response of five normal subjects, in whom we found no change in the resistance of either segment of the airway and no change in the genioglossus EMG but a significant activation of the tensor palatini. In six patients with OSA, we used the waking data to predict the site of upper airway collapse during sleep and we had limited success. The most successful index (correct in 4 of 6 patients) incorporated the greatest relative change in segmental resistance during IRL at the lowest electromyographic activity. We conclude, in patients with OSA, IRL narrows the more collapsible segment of the upper airway, in part due to inadequate activation of upper airway muscles. However, it is difficult to predict the site of upper airway collapse based on the waking measurements where upper airway muscle activity masks the passive airway characteristics.

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Upper Airway Muscle Activation Is Augmented in Patients with Obstructive Sleep Apnea Compared with That in Normal Subjects

American Review of Respiratory Disease ◽

10.1164/ajrccm/137.4.889 ◽

1988 ◽

Vol 137 (4) ◽

pp. 889-894 ◽

Cited By ~ 117

Author(s):

Paul M. Suratt ◽

Robert F. Mctier ◽

Stephen C. Wilhoit

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Muscle Activation ◽

Upper Airway ◽

Normal Subjects ◽

Obstructive Sleep

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Computed Tomography of the Oropharynx in Obstructive Sleep Apnea

Acta Radiologica ◽

10.1177/028418518802900404 ◽

1988 ◽

Vol 29 (4) ◽

pp. 401-405 ◽

Cited By ~ 6

Author(s):

S.-G. Larsson ◽

T. Gislason ◽

C. E. Lindholm

Keyword(s):

Computed Tomography ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Sleep Apnea Syndrome ◽

Normal Subjects ◽

Control Group ◽

Control Groups ◽

Oropharyngeal Airway ◽

Obstructive Sleep ◽

Objective Evidence

Uvulopalatopharyngoplasty (UPPP) is currently the preferred method for treatment of the obstructive sleep apnea syndrome (OSAS). However, only 50 per cent of the patients operated upon are cured by this surgical procedure, and there is a demand for better and more objective selection criteria. Computed tomography (CT) of the oropharynx was obtained in 32 consecutive adult patients with proven OSAS. An additional 15 patients with the same complaints, but without objective evidence of OSAS, were used as a control group, together with 20 normal subjects. The axial widths of the tongue and the genioglossus and hyoglossus muscles were measured by CT. Both the tongue and genioglossus widths were significantly larger in the OSAS patients than in the two control groups (p<0.001). The increased tongue width will cause encroachment of the oropharyngeal airway below the level of the soft palate. Thus, CT can be used to measure the tongue size in order to evaluate its predictive value for the outcome of the UPPP procedure.

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Continuous Wavelet Analysis of the Breathing Sounds of Obstructive Sleep Apnea Patients and Normal Subjects during Wakefulness

Applied Mechanics and Materials ◽

10.4028/www.scientific.net/amm.622.45 ◽

2014 ◽

Vol 622 ◽

pp. 45-50 ◽

Cited By ~ 1

Author(s):

R. Premkumar ◽

Chokkalingam Arun ◽

Ramakrishnan Sai Divya

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Low Cost ◽

Upper Airway ◽

Normal Subjects ◽

Continuous Wavelet ◽

Blood Oxygen ◽

Blood Oxygen Saturation ◽

Non Invasive ◽

Obstructive Sleep

Obstructive sleep apnea (OSA) is the most common type of sleep apnea and is caused by obstruction of the upper airway. Its distinctive feature is occurrence of repetitive pauses in breathing during sleep, due to intermittent relaxing and blocking of the patients airway by the throat muscles. Continuous such actions might narrow down the throat or may completely block it. These actions cause more difference in breathing sounds and are usually associated with a reduction in blood oxygen saturation. The breathing sounds of the patients with and without obstructive sleep apnea were recorded using a non-invasive, low-cost sensor during wakefulness in supine (lying) position and Continuous wavelet 1-D analysis was performed on those signals.

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Velopharyngeal Anatomy in Patients With Obstructive Sleep Apnea Versus Normal Subjects

Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.joms.2013.12.006 ◽

2014 ◽

Vol 72 (7) ◽

pp. 1350-1372 ◽

Cited By ~ 22

Author(s):

Yehuda Finkelstein ◽

Lior Wolf ◽

Ariela Nachmani ◽

Uri Lipowezky ◽

Mordechai Rub ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Normal Subjects ◽

Obstructive Sleep

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Decreased maxillary sinus volume is a potential predictor of obstructive sleep apnea

The Angle Orthodontist ◽

10.2319/080819-520.1 ◽

2020 ◽

Vol 90 (4) ◽

pp. 556-563

Author(s):

Yoon-Ji Kim ◽

Hyung-Kyun Shin ◽

Dong-Yul Lee ◽

Jae-Jun Ryu ◽

Tae Hoon Kim

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Maxillary Sinus ◽

High Body Mass Index ◽

Normal Subjects ◽

University Hospital ◽

Nasal Airway ◽

Maxillary Sinus Volume ◽

Obstructive Sleep ◽

Maxillary Sinuses

ABSTRACT Objectives To investigate the associations between nasal airway volume and the presence and severity of obstructive sleep apnea (OSA) in adults. Materials and Methods The medical records of adult patients who visited the sleep clinic at University Hospital between June 2013 and April 2017 and underwent overnight polysomnography for the diagnosis of obstructive sleep apnea were reviewed retrospectively. Using computed tomography, the volumes of the nasal airways and maxillary sinuses were measured, and associations with the presence and severity of OSA were analyzed while controlling for the effects of possible confounders such as lateral cephalometric variables, maxillary widths, tongue/hyoid position, and soft palate dimensions. Results Comparison between normal subjects and patients with OSA revealed that the latter had decreased ratios of maxillary sinus volume to whole nasal airway volume (P = .029) than normal subjects. OSA severity was greater in those with inferior positions of the hyoid (P = .010), in older patients (P = .011), and in those with high body mass index (P = .001). The volume of the total nasal airway or maxillary sinuses were not associated with OSA severity. Conclusions A decreased ratio of maxillary sinus volume to whole nasal airway volume is associated with adult OSA. However, OSA severity is not associated with either maxillary sinus volume or whole nasal airway volume.

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