Unsupervised Approach for the Identification of the Predominant Site of Upper Airway Collapse in Obstructive Sleep Apnoea Patients Using Snore Signals

2021 ◽  
Author(s):  
Arun Sebastian ◽  
Peter A. Cistulli ◽  
Gary Cohen ◽  
Philip de Chazal
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Upper Airway ◽  
Sleep Apnoea ◽  
Airway Collapse ◽  
Upper Airway Collapse ◽  
Obstructive Sleep ◽  
Unsupervised Approach

scholarly journals A systematic review of anaesthetic agents used in Drug Induced Sedation Endoscopy (DISE) and a description of a new DISE technique

2021 ◽  
Author(s):  
Oliver Sanders ◽  
Bhik Kotecha ◽  
Vik Veer
Keyword(s):  
Meta Analysis ◽  
Upper Airway ◽  
Sleep Apnoea ◽  
Limited Information ◽  
Drug Induced ◽  
Anaesthetic Agents ◽  
Industry Standard ◽  
Airway Collapse ◽  
Upper Airway Collapse ◽  
Obstructive Sleep

AbstractObjectivesDrug induced sleep endoscopy (DISE) is a standardly used investigation for surgical planning in obstructive sleep apnoea management once conservative treatments have proven inadequate. There are a variety of anaesthetic agents used to obtain sedation necessary for DISE. These agents may have different effect on the upper airway and other parameters important in the diagnosis of the site of collapse during sleep. We aimed to review the commonly agents and evaluate the significance of their impact on the the diagnosis.MethodsA search was conducted through PubMed looking for studies on commonly used anaesthetic agents and their effect on the upper airway and cardiopulmonary parameters. Results: Of the 109 studies yielded by the search, 19 were deemed relevant to the review and met all inclusion criteria. The agents reviewed were: propofol, dexmedetomidine, remifentanil, isoflurane, sevoflurane, midazolam and topical lidocaine. A meta-analysis was not conducted due to the limited number of relevant studies and the heterogeneity of outcomes measured. All agents examined gave some element of airway collapse and impact on cardiopulmonary measures. Most of these effects were shown to be dose-dependent. Of the agents considered dexmedetomidine and propofol gave the most consistently reliable and physiologically safe representations of upper airway collapse seen in OSA patients.ConclusionThere is limited information and no industry standard for the sedative regimen used for DISE. Of the agents reviewed those that caused least cardiopulmonary instability, respiratory depression and exaggerated upper airway collapse were deemed the most appropriate for DISE. The agent that best meet these criteria is dexmedetomidine followed by propofol.

scholarly journals Effect of radiofrequency vs other surgeries in the management of obstructive sleep apnoea

2019 ◽  
Vol 5 (4) ◽  
pp. 893
Author(s):  
Atul M. Bage ◽  
Lakshman Bhaskar Muthuvel ◽  
Pradheep Kalatharan
Keyword(s):  
Upper Airway ◽  
Cost Effective ◽  
Sleep Apnoea ◽  
Age Group ◽  
Voice Change ◽  
Radiofrequency Surgery ◽  
Airway Collapse ◽  
Upper Airway Collapse ◽  
Post Operative Pain ◽  
Obstructive Sleep

<p class="abstract"><strong>Background:</strong> Snoring is an important social problem seen in both men and women. Snoring occurs as a result of soft tissue vibration caused by a partial upper airway collapse during sleep. The aim of the study was to analyse the morbidity and efficacy of radiofrequency thermal ablation of upper airway in patients suffering from OSA.</p><p class="abstract"><strong>Methods:</strong> In the Department of ENT, Pondicherry, 40 patients between the age group of 20 to 60 years who were diagnosed to have OSA were operated according to the site of obstruction including RFVTR. Various parameters including ESS, partner scores, post-op pain, bleeding, pharyngeal dryness voice change were measured accordingly on the 1st day, 45th day, 90th day and 180th day postoperatively for the efficacy of treatment and also for assessing the morbidity of treatment provided.  </p><p class="abstract"><strong>Results:</strong> There is a statistically significant reduction in ESS scores and partner scores between pre-operative period and post operatively on the 45th day, 90th day and 180th day. Post-operative pain assessment also showed that patients who underwent RFVTR had lesser pain when compared to other surgeries like zetaplasty, LAUP, etc.</p><p class="abstract"><strong>Conclusions:</strong> Radiofrequency surgery should be considered as the treatment of choice for mild OSA and hypopneic snorers. The important advantage of these procedures is technically simple and minimally invasive. RFTA of the soft palate leaves the mucosa intact contrary to LAUP, hence the pain comparably less. Relatively cost effective when compared to LASER and Coblator.</p>

Volume-pressure properties of the upper airway in normal subjects and patients with obstructive sleep apnoea

Respirology ◽  
1999 ◽  
Vol 4 (1) ◽  
pp. 69-75 ◽  
Author(s):  
Denan Wu ◽  
Wataru Hida ◽  
Yoshihiro Kikuchi ◽  
Shinichi Okabe ◽  
Hajime Kurosawa ◽  
...  
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Upper Airway ◽  
Normal Subjects ◽  
Sleep Apnoea ◽  
Obstructive Sleep

scholarly journals Much Ado about Sleep: Current Concepts on Mechanisms and Predisposition to Pediatric Obstructive Sleep Apnea

Children ◽  
2021 ◽  
Vol 8 (11) ◽  
pp. 1032
Author(s):  
Ashley L. Saint-Fleur ◽  
Alexa Christophides ◽  
Prabhavathi Gummalla ◽  
Catherine Kier
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Upper Airway ◽  
Biomechanical Properties ◽  
Primary Role ◽  
Airway Narrowing ◽  
Airway Collapse ◽  
Upper Airway Collapse ◽  
Obstructive Sleep ◽  
Review Current

Obstructive Sleep Apnea (OSA) is a form of sleep-disordered breathing characterized by upper airway collapse during sleep resulting in recurring arousals and desaturations. However, many aspects of this syndrome in children remain unclear. Understanding underlying pathogenic mechanisms of OSA is critical for the development of therapeutic strategies. In this article, we review current concepts surrounding the mechanism, pathogenesis, and predisposing factors of pediatric OSA. Specifically, we discuss the biomechanical properties of the upper airway that contribute to its primary role in OSA pathogenesis and examine the anatomical and neuromuscular factors that predispose to upper airway narrowing and collapsibility.

scholarly journals P019 Obstructive sleep apnoea endotypes in people with multiple sclerosis

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A27-A28
Author(s):  
S Carter ◽  
H Hensen ◽  
A Krishnan ◽  
A Chiang ◽  
J Carberry ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Obstructive Sleep Apnoea ◽  
Group Analysis ◽  
Respiratory Control ◽  
Upper Airway ◽  
Sleep Apnoea ◽  
Loop Gain ◽  
Male Predominance ◽  
Arousal Threshold ◽  
Obstructive Sleep

Abstract Purpose Obstructive sleep apnoea (OSA) is common in people with multiple sclerosis (MS) despite a lack of typical risk factors for OSA in people with MS such as obesity and male predominance. Therefore, underlying factors other than sex and obesity may be particularly important in the pathogenesis of OSA in people with MS. Thus, the primary aim of this study was to determine the relative contributions of OSA endotypes in people with MS and compare this to matched controls with OSA only. Methods Eleven people with MS and OSA (MS-OSA group) (apnoea-hypopnoea index [AHI]&gt;5events/h) and eleven controls matched for OSA severity, age and sex without MS (OSA group) were studied. Participants underwent a detailed overnight polysomnography with an epiglottic pressure catheter and genioglossus intramuscular electrodes to allow for quantification of pathophysiological contributors to OSA. This included the respiratory arousal threshold, genioglossus muscle responsiveness, respiratory loop gain and upper airway collapsibility. Results Measures of the four primary OSA endotypes were not different between the MS-OSA and OSA groups (e.g. NREM respiratory arousal threshold -27±15 vs. -23±8 cmH2O respectively, p=0.24). Within group analysis indicated higher loop gain in non-obese MS-OSA participants compared to obese MS-OSA participants (0.53±0.11 vs. 0.37±0.11, p=0.04). Conclusions Overall, OSA endotypes are similar between MS-OSA participants and matched OSA controls. However, within the MS-OSA group, non-obese participants have higher loop gain (unstable respiratory control) compared to obese participants. Thus, unstable respiratory control may play an important role in OSA pathogenesis in many people with MS.

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