Neurostimulation for Obstructive Sleep Apnea: Investigations

1993 ◽  
Vol 72 (1) ◽  
pp. 52-57 ◽  
Author(s):  
David W. Fairbanks ◽  
David N.F. Fairbanks
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Apnea Syndrome ◽  
Upper Airway ◽  
Future Research ◽  
Obstructive Sleep ◽  
Airway Obstructions ◽  
Anesthetized Dogs ◽  
Upper Airway Muscles ◽  
Accessory Muscles

Neurostimulation of the upper airway muscles (accessory muscles of respiration) was accomplished in anesthetized dogs and sleeping humans by electrical stimulation of the hypoglossal nerves. Such stimulations relieved partial airway obstructions in dogs. They also aborted (shortened) obstructive sleep apnea events in humans who suffer with obstructive sleep apnea syndrome. In one subject, stimulations delivered in advance of apneic events (by automatic cycling) prevented apneas. Neurostimulation for obstructive sleep apnea may be an important concept for future research and development.

Arousal and ventilatory responses during sleep in children with obstructive sleep apnea

1998 ◽  
Vol 84 (6) ◽  
pp. 1926-1936 ◽  
Author(s):  
Carole L. Marcus ◽  
Janita Lutz ◽  
John L. Carroll ◽  
Owen Bamford
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Apnea Syndrome ◽  
Upper Airway ◽  
Respiratory Drive ◽  
Ventilatory Control ◽  
Arousal Threshold ◽  
Ventilatory Responses ◽  
Obstructive Sleep ◽  
Upper Airway Muscles

Abnormal central regulation of upper airway muscles may contribute to the pathophysiology of the childhood obstructive sleep apnea syndrome (OSAS). We hypothesized that this was secondary to global abnormalities of ventilatory control during sleep. We therefore compared the response to chemical stimuli during sleep between prepubertal children with OSAS and controls. Patients with OSAS aroused at a higher[Formula: see text] (58 ± 2 vs. 60 ± 5 Torr, P < 0.05); those with the highest apnea index had the highest arousal threshold ( r = 0.52, P < 0.05). The hypercapnic arousal threshold decreased after treatment. For all subjects, hypoxia was a poor stimulus to arousal, whereas hypercapnia and, particularly, hypoxic hypercapnia were potent stimuli to arousal. Hypercapnia resulted in decreased airway obstruction in OSAS. Ventilatory responses were similar between patients with OSAS and controls; however, the sample size was small. We conclude that children with OSAS have slightly blunted arousal responses to hypercapnia. However, the overall ventilatory and arousal responses are normal in children with OSAS, indicating that a global deficit in respiratory drive is not a major factor in the etiology of childhood OSAS. Nevertheless, subtle abnormalities in ventilatory control may exist.

Obstructive Sleep Apnea: Epidemiology, Causes, and Consequences

2020 ◽  
Author(s):  
Diane C Lim ◽  
Richard J Schwab
Keyword(s):  
Risk Factors ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Cushing Syndrome ◽  
Upper Airway ◽  
Fat Distribution ◽  
Epidemiologic Studies ◽  
Obstructive Sleep ◽  
Upper Airway Muscles ◽  
Underlying Diseases

As part one of the three chapters on sleep-disordered breathing, this chapter reviews obstructive sleep apnea (OSA) epidemiology, causes, and consequences. When comparing OSA prevalence between 1988 to 1994 and 2007 to 2010, we observe that OSA is rapidly on the rise, paralleling increasing rates in obesity. Global epidemiologic studies indicate that there are differences specific to ethnicity with Asians presenting with OSA at a lower body mass index than Caucasians. We have learned that structural and physiologic factors increase the risk of OSA and both can be influenced by genetics. Structural risk factors include craniofacial bony restriction, changes in fat distribution, and the size of the upper airway muscles. Physiologic risk factors include airway collapsibility, loop gain, pharyngeal muscle responsiveness, and arousal threshold. The consequences of OSA include daytime sleepiness and exacerbation of many underlying diseases. OSA has been associated with cardiovascular diseases including hypertension, coronary heart disease, stroke, atrial fibrillation, and other cardiac arrhythmias; pulmonary hypertension; metabolic disorders such as type 2 diabetes, hypothyroidism, acromegaly, Cushing syndrome, and polycystic ovarian syndrome; mild cognitive impairment or dementia; and cancer. This review contains 4 figures, 1 table and 48 references. Key Words: cardiac consequences, craniofacial bony restriction, epidemiology, fat distribution, metabolic disease, neurodegeneration, obesity, obstructive sleep apnea

scholarly journals Upper Airway Collapsibility During REM Sleep in Children with the Obstructive Sleep Apnea Syndrome

SLEEP ◽  
2009 ◽  
Vol 32 (9) ◽  
pp. 1173-1181 ◽  
Author(s):  
Jingtao Huang ◽  
Laurie R. Karamessinis ◽  
Michelle E. Pepe ◽  
Stephen M. Glinka ◽  
John M. Samuel ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Rem Sleep ◽  
Sleep Apnea Syndrome ◽  
Upper Airway ◽  
Obstructive Sleep ◽  
Airway Collapsibility ◽  
Apnea Syndrome ◽  
Upper Airway Collapsibility

scholarly journals Measurement of pharyngeal segments in Obstructive Sleep Apnea

2018 ◽  
Vol 21 (1) ◽  
pp. 64
Author(s):  
Marcos Marques Rodrigues ◽  
Lucas Borin Moura ◽  
Ariane De Souza Oliveira ◽  
Marisa Aparecida Cabrini Gabrielli ◽  
Valfrido Antonio Pereira Filho ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Cone Beam Ct ◽  
Sleep Apnea Syndrome ◽  
Upper Airway ◽  
Cone Beam ◽  
Obstructive Sleep ◽  
Intimate Relation ◽  
The Mean ◽  
Cephalometric Measurements

<p><strong>Objective</strong>: Obstructive Sleep Apnea (OSA) occurs by recurrent collapse of the upper airway during sleep. It results in complete (apnea) or partial (hypopnea) reduction of airflow and has intimate relation with the upper airway anatomy. Cephalometric analysis has been used to quantify airway dimensions. The aim of this study is evaluate the correlation between the anteroposterior dimension of the upper airway and the severity of obstructive sleep apnea. <strong>Material and Methods</strong>: A retrospective analysis was performed reviewing polysomnographic data (AHI) and anteroposterior cephalometric measurements of pharynx subregions: nasopharynx, oropharynx, hypopharynx. <strong>Results</strong>: The sample consisted of 30 patients. The mean body mass index was 29.60 kg/m<sup>2</sup> and the average age was 46.8 years. Nine patients presented severe OSA, seven had moderate OSA , seven had mild OSA, and seven were healthy.  The Pearson's correlation index between the anteroposterior dimension of the nasopharynx, oropharynx and hypopharynx and AHI was respectively -0.128 (p=0.517), -0.272 (p=0.162) and -0.129 (p=0.513).<strong> Conclusion: </strong>The correlation between anteroposterior linear dimension of the airway and OSA severity, assessed by AHI, was not positive. As an isolated parameter it did not correlate to the severity of the obstrucive sleep apnea syndrome and should be evaluated in conjunction with other factors.</p><p><strong> </strong></p><p><strong>Keywords</strong></p><p>Upper Airway; Obstructive sleep apnea; Cone beam CT.</p>

scholarly journals Interrelationship Between Obstructive Sleep Apnea Syndrome and Severe Asthma: From Endo-Phenotype to Clinical Aspects

2021 ◽  
Vol 8 ◽  
Author(s):  
Beatrice Ragnoli ◽  
Patrizia Pochetti ◽  
Alberto Raie ◽  
Mario Malerba
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Severe Asthma ◽  
Daytime Sleepiness ◽  
Sleep Apnea Syndrome ◽  
Future Research ◽  
Clinical Aspects ◽  
Poor Sleep ◽  
Sleep Related Breathing Disorders ◽  
Obstructive Sleep

Sleep-related breathing disorders (SBDs) are characterized by abnormal respiration during sleep. Obstructive sleep apnea (OSA), a common SBD increasingly recognized by physicians, is characterized by recurrent episodes of partial or complete closure of the upper airway resulting in disturbed breathing during sleep. OSA syndrome (OSAS) is associated with decreased patients' quality of life (QoL) and the presence of significant comorbidities, such as daytime sleepiness. Similarly to what seen for OSAS, the prevalence of asthma has been steadily rising in recent years. Interestingly, severe asthma (SA) patients are also affected by poor sleep quality—often attributed to nocturnal worsening of their asthma—and increased daytime sleepiness and snoring compared to the general population. The fact that such symptoms are also found in OSAS, and that these two conditions share common risk factors, such as obesity, rhinitis, and gastroesophageal reflux, has led many to postulate an association between these two conditions. Specifically, it has been proposed a bidirectional correlation between SA and OSAS, with a mutual negative effect in term of disease severity. According to this model, OSAS not only acts as an independent risk factor of asthma exacerbations, but its co-existence can also worsen asthma symptoms, and the same is true for asthma with respect to OSAS. In this comprehensive review, we summarize past and present studies on the interrelationship between OSAS and SA, from endo-phenotype to clinical aspects, highlighting possible implications for clinical practice and future research directions.

scholarly journals Upper Airway Sensory Function in Children with Obstructive Sleep Apnea Syndrome

SLEEP ◽  
2010 ◽  
Vol 33 (7) ◽  
pp. 968-972 ◽  
Author(s):  
Ignacio E. Tapia ◽  
Preetam Bandla ◽  
Joel Traylor ◽  
Laurie Karamessinis ◽  
Jingtao Huang ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Upper Airway ◽  
Sensory Function ◽  
Obstructive Sleep ◽  
Apnea Syndrome
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