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.

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

1993 ◽  
Vol 74 (6) ◽  
pp. 2694-2703 ◽  
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.

scholarly journals Orthodontic Management of Adult Sleep Apnea: Clinical Case Reports

2021 ◽  
Author(s):  
Lahcen Ousehal ◽  
Soukaina Sahim ◽  
Hajar Bouzid ◽  
Hakima Aghoutan ◽  
Asmaa El Mabrak ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Case Reports ◽  
Upper Airway ◽  
Public Health Problem ◽  
Airway Collapse ◽  
Upper Airway Collapse ◽  
Obstructive Sleep ◽  
Potential Risks ◽  
Osa Treatment

Obstructive sleep apnea (OSA) is a serious public health problem that has important impacts on the quality and life expectancy of affected individuals. It is characterized by repetitive upper airway collapse during sleep. OSA requires a multidisciplinary plan of treatment. There is increasing interest in the role of the orthodontist both in screening for adult obstructive sleep apnea and its management. Dental appliances and orthognathic surgery are two strategies that are currently used in the treatment of sleep apnea. This chapter focuses on the orthodontic management of sleep apnea in adults through three clinical cases with varying degrees of severity of sleep apnea. It provides a background on OSA treatment approaches and discusses the potential risks and benefits of each.

scholarly journals Hubungan obstructive sleep apnea dengan penyakit sistem kardiovaskuler

2011 ◽  
Vol 41 (1) ◽  
pp. 37
Author(s):  
Arie Cahyono ◽  
Bambang Hermani ◽  
Endang Mangunkusumo ◽  
Riski Satria Perdana
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Upper Airway ◽  
Cardiovascular Complication ◽  
Medical Complication ◽  
Cardiovascular Disorders ◽  
Airway Collapse ◽  
Upper Airway Collapse ◽  
Obstructive Sleep ◽  
Keywords Obstructive Sleep Apnea

Background: Obstructive sleep apnea (OSA) is a disease characterized by periodic upper airway collapse during sleep, which could result in either apnea, hypopnea or both. OSA is very often  undetected but it is strongly associated with variety of medical complication, among others cardiovascular diseases.Purpose: To inform ENT specialists about the pathogenesis and pathophysiology of OSA and its complications. Literature review: Recent data from several studies has documented the association between OSA and cardiovascular disorders such as hypertension, heart failure, arrhytmia and atherosclerosis. The undetectable cardiovascular complication that lead by OSA could make the management of cardiovascular  disorders uneffective. Conclusion: A good understanding can help physicians to diagnose, manage and  prevent cardiovascular complication that caused by OSA. Keywords: obstructive sleep apnea, apnea, hipopnea, cardiovascular disease   Abstrak :  Latar belakang: Obstructive sleep apnea (OSA) adalah suatu penyakit yang ditandai dengan peristiwa kolapsnya saluran napas bagian atas secara periodik pada saat tidur yang mengakibatkan apnea, hipopnea atau keduanya. Gejala klinis OSA sering tidak terdeteksi, namun diduga dapat meningkatkan risiko berbagai macam komplikasi medis antara lain kelainan kardiovaskuler. Tujuan: Agar para ahli THT dapat mengerti mengenai patogenesis dan patofisiologi OSA dan komplikasinya. Tinjauan pustaka: Beberapa penelitian telah menyatakan tentang adanya hubungan antara OSA dengan penyakit kardiovaskuler seperti hipertensi, gagal jantung, aritmia dan arteriosklerosis. Patofisiologi OSA pada komplikasi kardiovaskuler yang sulit dideteksi dapat menyebabkan penatalaksanaan penyakit kardiovaskuler menjadi kurang efektif. Kesimpulan:Pemahaman yang baik dapat membantu menegakkan diagnosis dan melakukan tatalaksana yang tepat untuk mencegah komplikasi kardiovaskuler yang berhubungan dengan OSA.Kata kunci: obstructive sleep apnea, apnea, hipopnea, penyakit kardiovaskuler

scholarly journals Cervical Sympathetic Neurofibroma Masquerading as Obstructive Sleep Apnea Syndrome

2011 ◽  
Vol 1 (2) ◽  
pp. 84-87
Author(s):  
M Gopinath ◽  
VV Ramachandran ◽  
Rohini Jose
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Apnea Syndrome ◽  
Upper Airway ◽  
Neuromuscular Control ◽  
Transcervical Approach ◽  
Airway Collapse ◽  
Upper Airway Collapse ◽  
Obstructive Sleep ◽  
Cervical Sympathetic

ABSTRACT Obstructive sleep apnea is a chronic condition characterized by frequent episodes of upper airway collapse during sleep. Collapsibility can be increased by underlying anatomic alterations and/or disturbances in upper airway, neuromuscular control, or both, which play key roles in the pathogenesis of obstructive sleep apnea. Neurofibromas of the parapharyngeal space are the second most commonly encountered primary tumor of the nerve sheath origin. A parapharyngeal neurofibroma of the cervical sympathetic chain, presenting as obstructive sleep apnea with all the features mimicking that condition is reported here for its rarity in modern clinical practice. A transcervical approach was adopted to excise the tumor in toto, following which patient was completely relieved of the symptoms, especially those of respiratory distress and features of OSAS.

scholarly journals Cardiovascular morbidities of obstructive sleep apnea and the role of circulating extracellular vesicles

2019 ◽  
Vol 13 ◽  
pp. 175346661989522
Author(s):  
Abdelnaby Khalyfa ◽  
Anabel L. Castro-Grattoni ◽  
David Gozal
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Extracellular Vesicles ◽  
Upper Airway ◽  
Cvd Risk ◽  
Diagnostic Assays ◽  
Airway Collapse ◽  
Upper Airway Collapse ◽  
Obstructive Sleep ◽  
Osa Treatment

Obstructive sleep apnea (OSA) is characterized by recurrent upper airway collapse during sleep resulting in impaired blood gas exchange, namely intermittent hypoxia (IH) and hypercapnia, fragmented sleep (SF), increased oxidative stress and systemic inflammation. Among a myriad of potential associated morbidities, OSA has been particularly implicated as mechanistically contributing to the prevalence and severity of cardiovascular diseases (CVD). However, the benefits of continuous positive airway pressure (CPAP), which is generally employed in OSA treatment, to either prevent or improve CVD outcomes remain unconvincing, suggesting that the pathophysiological mechanisms underlying the incremental CVD risk associated with OSA are not clearly understood. One of the challenges in development of non-invasive diagnostic assays is the ability to identify clinically and mechanistically relevant biomarkers. Circulating extracellular vesicles (EVs) and their cargos reflect underlying changes in cellular homeostasis and can provide insights into how cells and systems cope with physiological perturbations by virtue of the identity and abundance of miRNAs, mRNAs, proteins, and lipids that are packaged in the EVs under normal as well as diseased states, such as OSA. EVs can not only provide unique insights into coordinated cellular responses at the organ or systemic level, but can also serve as reporters of the effects of OSA in CVD, either by their properties enabling regeneration and repair of injured vascular cells or by damaging them. Here, we highlight recent progress in the pathological CVD consequences of OSA, and explore the putative roles of EVs in OSA-associated CVD, along with emerging diagnostic and therapeutic opportunities. The reviews of this paper are available via the supplemental material section.

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