scholarly journals Contribution of male sex, age, and obesity to mechanical instability of the upper airway during sleep

2008 ◽  
Vol 104 (6) ◽  
pp. 1618-1624 ◽  
Author(s):  
Jason P. Kirkness ◽  
Alan R. Schwartz ◽  
Hartmut Schneider ◽  
Naresh M. Punjabi ◽  
Joseph J. Maly ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Body Mass ◽  
Upper Airway ◽  
Obstructive Sleep ◽  
Airway Mechanics ◽  
Male Sex ◽  
The Relationship

Male sex, obesity, and age are risk factors for obstructive sleep apnea, although the mechanisms by which these factors increase sleep apnea susceptibility are not entirely understood. This study examined the interrelationships between sleep apnea risk factors, upper airway mechanics, and sleep apnea susceptibility. In 164 (86 men, 78 women) participants with and without sleep apnea, upper airway pressure-flow relationships were characterized to determine their mechanical properties [pharyngeal critical pressure under hypotonic conditions (passive Pcrit)] during non-rapid eye movement sleep. In multiple linear regression analyses, the effects of body mass index and age on passive Pcrit were determined in each sex. A subset of men and women matched by body mass index, age, and disease severity was used to determine the sex effect on passive Pcrit. The passive Pcrit was 1.9 cmH2O [95% confidence interval (CI): 0.1–3.6 cmH2O] lower in women than men after matching for body mass index, age, and disease severity. The relationship between passive Pcrit and sleep apnea status and severity was examined. Sleep apnea was largely absent in those individuals with a passive Pcrit less than −5 cmH2O and increased markedly in severity when passive Pcrit rose above −5 cmH2O. Passive Pcrit had a predictive power of 0.73 (95% CI: 0.65–0.82) in predicting sleep apnea status. Upper airway mechanics are differentially controlled by sex, obesity, and age, and partly mediate the relationship between these sleep apnea risk factors and obstructive sleep apnea.

scholarly journals Risk factors and fraction of exhaled nitric oxide in obstructive sleep apnea in adults

2020 ◽  
Vol 48 (7) ◽  
pp. 030006052092601
Author(s):  
Xiaokai Feng ◽  
Xiheng Guo ◽  
Junling Lin ◽  
Zhiling Zhao ◽  
Zhaohui Tong
Keyword(s):  
Nitric Oxide ◽  
Risk Factors ◽  
Body Mass Index ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Soft Palate ◽  
Upper Airway ◽  
Transverse Diameter ◽  
Obstructive Sleep ◽  
Male Sex

Objective This study aimed to evaluate the relationship between obstructive sleep apnea (OSA) and the fraction of exhaled nitric oxide (FENO), and to assess the effect of risk factors of airway inflammation on OSA. Methods Medical records of patients in the Respiratory Sleep Center at Chao-Yang Hospital in Beijing between January 2015 and June 2017 were analyzed. All patients were diagnosed with OSA. Data of the medical history, clinical examinations, FENO, and upper airway computed tomographic findings were collected. Logistic regression was used to evaluate risk factors of OSA. Results A total of 181 patients were admitted to the Respiratory Sleep Center during the study and 170 had a diagnosis of OSA and were included in the study. Single factor analysis showed that male sex, age, body mass index, smoking index, alcohol consumption, FENO, soft palate thickness, soft palate length, the narrowest transverse diameter of the upper airway, tonsil size, and nasal sinusitis were risk factors for sleep-disordered breathing and disease severity. Conclusions Male sex, age, body mass index, FENO, the narrowest transverse diameter of the upper airway, and normal tonsil size are associated with OSA and disease severity. The severity of OSA is associated with FENO levels.

scholarly journals Polysomnographic and clinical characteristics of positional obstructive sleep apnea patients

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Seda Beyhan Sagmen ◽  
Sevda Cömert
Keyword(s):  
Body Mass Index ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Body Mass ◽  
Severe Disease ◽  
Upper Airway ◽  
Neck Circumference ◽  
Apnea Hypopnea Index ◽  
Obstructive Sleep ◽  
The Mean

Abstract Background Obstructive sleep apnea is a condition characterized by the complete or partial obstruction of the upper airway during sleep. This study aimed to compare the clinical and polysomnographic characteristics of our obstructive sleep apnea patients according to their positional and non-positional features. Results Two hundred eighty patients were included in the study. One hundred two patients (36.43%) were female, while 178 patients (63.57%) were male. While 88 (31.43%) of these patients were defined as positional patients, 192 (68.57%) were defined as non-positional patients. The mean age of the positional patients (46.78 ± 9.66) was lower than the mean age of the non-positional patients (50.90 ± 10.96) (p 0.001). Similarly, the mean body mass index of the positional patients (29.39 ± 3.80) was lower than the mean body mass index of the non-positional patients (33.30 ± 6.45) (p < 0.001). Neck circumference values of the positional patients (40.36 ± 2.65) were lower compared to the non-positional patients (43.32 ± 2.54) (p < 0.001). Sleep values were compared based on the presence of positional sleep apnea. In the positional patients, sleep duration, sleep efficiency (percentage), duration of stage N3, minimum, and mean saturation values were found to be higher compared to the non-positional patients, while nightlong apnea hypopnea index, apnea index, percentage of sleep time with oxygen saturation below 90%, oxygen desaturation index, mean heart rate, and periodic limb movement index values were found to be lower (p < 0.05). The rate of severe sleep apnea (7.95%) in the positional patients was lower than the non-positional patients (53.65%) (p < 0.001). Conclusion In the light of these data, positional OSA is a very important condition presented in 31.43% of OSA patients and it was determined that these patients were younger, had less body mass index, and shorter neck circumference. The rate of severe disease was found to be lower in positional OSA patients

Upper Airway Stimulation in Patients With Obstructive Sleep Apnea and an Elevated Body Mass Index: A Multi-institutional Review

2018 ◽  
Vol 128 (10) ◽  
pp. 2425-2428 ◽  
Author(s):  
Colin Huntley ◽  
Armin Steffen ◽  
Karl Doghramji ◽  
Benedikt Hofauer ◽  
Clemens Heiser ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Body Mass ◽  
Upper Airway ◽  
Upper Airway Stimulation ◽  
Elevated Body Mass Index ◽  
Institutional Review ◽  
Obstructive Sleep

scholarly journals Body Mass Index Reduction and Selected Cardiometabolic Risk Factors in Obstructive Sleep Apnea: Meta-Analysis

2021 ◽  
Vol 10 (7) ◽  
pp. 1485
Author(s):  
Marta Stelmach-Mardas ◽  
Beata Brajer-Luftmann ◽  
Marta Kuśnierczak ◽  
Halina Batura-Gabryel ◽  
Tomasz Piorunek ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Body Mass ◽  
Meta Analysis ◽  
Apnea Hypopnea Index ◽  
Metabolic Risk ◽  
Index Reduction ◽  
Obstructive Sleep

Although clinical studies have been carried out on the effects of weight reduction in sleep apnea patients, no direct link has been shown between weight reduction and changes in cardio-metabolic risk factors. We aimed to analyze changes in the apnea–hypopnea index and selected cardio-metabolic parameters (total cholesterol, triglycerides, glucose, insulin, blood pressure) in relation to the reduction in body mass index in obstructive sleep apnea patients. Medline, Web of Science and Cochrane databases were searched to combine results from individual studies in a single meta-analysis. We identified 333 relevant articles, from which 30 papers were assigned for full-text review, and finally 10 (seven randomized controlled trials and three nonrandomized studies) were included for data analysis. One unit of body mass index reduction was found to significantly influence changes in the apnea–hypopnea index (−2.83/h; 95% CI: −4.24, −1.41), total cholesterol (−0.12 mmol/L; 95% CI: −0.22, −0.01), triglycerides (−0.24 mmol/L; 95% CI: −0.46, −0.02), fasting insulin (−7.3 pmol/L; 95% CI: −11.5, −3.1), systolic (−1.86 mmHg; 95% CI: −3.57, −0.15) and diastolic blood pressure (−2.07 mmHg; 95% CI: −3.79, −0.35). Practical application of lifestyle modification resulting in the reduction of one unit of body mass index gives meaningful changes in selected cardio-metabolic risk factors in obstructive sleep apnea patients.

Glottic and cervical tracheal narrowing in patients with obstructive sleep apnea

1989 ◽  
Vol 67 (6) ◽  
pp. 2427-2431 ◽  
Author(s):  
I. Rubinstein ◽  
T. D. Bradley ◽  
N. Zamel ◽  
V. Hoffstein
Keyword(s):  
Body Mass Index ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Body Mass ◽  
Upper Airway ◽  
The Body ◽  
Apnea Hypopnea Index ◽  
Structural Abnormality ◽  
Pathophysiological Mechanism ◽  
Obstructive Sleep

There are several studies showing that patients with idiopathic obstructive sleep apnea (OSA) have a narrow and collapsible pharynx that may predispose them to repeated upper airway occlusions during sleep. We hypothesized that this structural abnormality may also extend to the glottic and tracheal region. Consequently, we measured pharyngeal (Aph), glottic (Agl), cervical tracheal (Atr1), midtracheal (Atr2), and distal (Atr3) tracheal areas during tidal breathing in 66 patients with OSA (16 nonobese and 50 obese) and 8 nonapneic controls. We found that Aph, Agl, and Atr1, but not Atr2 or Atr3, were significantly smaller in the OSA group than in the control group. Obese patients with OSA had the smallest upper airway area, although the nonapneic controls had the largest areas. Multiple linear regression analysis revealed that the pharyngeal area, cervical tracheal area, and body mass index were all independent determinants of the apnea-hypopnea index, accounting for 31% of the variability in apnea-hypopnea index. Aph, Agl, and Atr showed significant correlation with the body mass index. We conclude that sleep-disordered breathing is associated with diffuse upper airway narrowing and that obesity contributes to this narrowing. Furthermore, we speculate that a common pathophysiological mechanism may be responsible for this reduction in upper airway area extending from the pharynx to the proximal trachea.

scholarly journals THE EFFECT OF BODY MASS INDEX ON THE UPPER AIRWAY OF SEVERE OBSTRUCTIVE SLEEP APNEA PATIENTS.

Sleep Science ◽  
2015 ◽  
Vol 8 (4) ◽  
pp. 249
Author(s):  
Nina Teixeira Fonseca ◽  
Luis Vicente Franco Oliveira ◽  
Jessica Julioti Urbano ◽  
Salvatore Romano ◽  
Giuseppe Insalaco
Keyword(s):  
Body Mass Index ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Body Mass ◽  
Upper Airway ◽  
Severe Obstructive Sleep Apnea ◽  
Obstructive Sleep

scholarly journals The Relationship Between Enlistment Body Mass Index and the Development of Obstructive Sleep Apnea in the U.S. Military

2016 ◽  
Vol 181 (8) ◽  
pp. 913-919 ◽  
Author(s):  
Richard S. Langton ◽  
Joan Neyra ◽  
John W. Downs ◽  
David W. Niebuhr
Keyword(s):  
Body Mass Index ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Body Mass ◽  
Obstructive Sleep ◽  
The Relationship ◽  
The U.S

Abstract 3560: Obstructive Sleep Apnea Exacerbates Endothelial Dysfunction In Patients With Metabolic Syndrome

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Masahiro Akishita ◽  
Yumiko Ohike ◽  
Masayoshi Hashimoto ◽  
Katsuya Iijima ◽  
Masato Eto ◽  
...  
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Body Mass Index ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Endothelial Dysfunction ◽  
Body Mass ◽  
Hdl Cholesterol ◽  
Control Group ◽  
Obstructive Sleep

Background: Both obstructive sleep apnea (OSA) and metabolic syndrome (MS) are well known as the risk factor of cardiovascular diseases, and are prevalent among obese patients. However, whether OSA deteriorates endothelial dysfunction in MS patients has not been determined. We therefore examined flow-mediated vasodilation (FMD) in MS patients with or without OSA. Methods: We enrolled 49 overweight patients (body mass index ≥25, aged 35–69 years) and categorized into the 3 groups; patients with MS but not OSA (MS group, n=21), Group 2: patients with both MS and OSA (MS+OSA group, n=14), Group 3: patients with no risk factors but overweight (control group, n=14). MS was defined using the IDF criteria and OSA using polysomnography. FMD was measured using ultrasound as the percent change of the brachial artery diameter. Results: Compared with the control group, MS group showed significantly lower %FMD (6.8±2.4 [mean±SD] vs 5.0±2.7, p<0.001) and HDL cholesterol, and higher triglycerides and hemoglobin A1c. Although there were no significant differences in classical risk factors between MS group and MS+OSA group, %FMD was significantly lower in MS+OSA group than in MS group (3.0±1.3 vs 5.0±2.7, p<0.001). On multiple regression analysis, OSA was significantly related to %FMD, independent of age, body mass index, blood pressure, LDL cholesterol, HDL cholesterol, triglycerides, fasting plasma glucose, and smoking (β=−0.328, p=0.02). Conclusion: OSA exacerbates endothelial dysfunction in patients with MS, possibly leading to the increased risk of cardiovascular disease.

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