scholarly journals Site of Airway Narrowing in Obstructive Sleep Apnea. The Difference between Good Responders and Poor Responders to Uvulopalatopharyngoplasty.

1996 ◽  
Vol 89 (10) ◽  
pp. 1271-1281 ◽  
Author(s):  
Hiroyuki TADA
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Poor Responders ◽  
Airway Narrowing ◽  
Obstructive Sleep ◽  
The Difference

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 0692 Difference In Improvement Of ESS Score After CPAP Use In Patients From Different Workforces

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A264-A264
Author(s):  
T R Mehta ◽  
P Gurung ◽  
L Digala ◽  
Y Nene ◽  
P C Bollu
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
White Collar ◽  
Blue Collar ◽  
University Of Missouri ◽  
Initial Analysis ◽  
Cardiovascular Comorbidities ◽  
Institutional Review ◽  
Obstructive Sleep ◽  
The Difference

Abstract Introduction Obstructive sleep apnea (OSA) is characterized by recurrent occurrences of apnea and hypopnea throughout the night during sleep. Reported to prevail in 23.4% women and 49.7% men aged 40 years or older, OSA is considered to be the most preventable cause of excessive daytime sleepiness. Methods After obtaining approval from the institutional review board (IRB) for this retrospective study, a total of 825 patient records from a prospective registry of obstructive sleep apnea from our sleep lab affiliated with the University of Missouri Hospital were searched for variables including but not limited to age, race, gender, occupation, medications any sleep-related comorbidities, psychiatric comorbidities, cardiovascular comorbidities, pre CPAP ESS score and post CPAP ESS score. The mean improvement score of ESS in both these populations was compared and possible causes for the difference in these groups were analyzed. Results Initial analysis from 22 patients belonging to the white-collar and 22 patients belonging to the blue-collar workforce with a mean age of 49.27 (±14.28) years and a mean BMI of 37.60 (±9.41) showed a mean improvement of -1.27 and 0.63 respectively with no significance statistically. Statistical analysis will be performed after gathering data from a larger sample size. Conclusion Although insignificant, the blue-collar workforce showed more improvement than the white-collar workforce in the initial analysis. Support No support, financial or otherwise was used for this study.

Obstructive Sleep Apnea in Acromegaly and the Effect of Treatment: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 105 (3) ◽  
pp. e23-e31 ◽  
Author(s):  
Matteo Parolin ◽  
Francesca Dassie ◽  
Luigi Alessio ◽  
Alexandra Wennberg ◽  
Marco Rossato ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Meta Analysis ◽  
Upper Airway ◽  
Apnea Hypopnea Index ◽  
Cross Sectional ◽  
Obstructive Sleep ◽  
Before And After ◽  
The Difference

Abstract Background Obstructive sleep apnea (OSA) is a common disorder characterized by upper airway collapse requiring nocturnal ventilatory assistance. Multiple studies have investigated the relationship between acromegaly and OSA, reporting discordant results. Aim To conduct a meta-analysis on the risk for OSA in acromegaly, and in particular to assess the role of disease activity and the effect of treatments. Methods and Study Selection A search through literature databases retrieved 21 articles for a total of 24 studies (n = 734). Selected outcomes were OSA prevalence and apnea-hypopnea index (AHI) in studies comparing acromegalic patients with active (ACT) vs inactive (INACT) disease and pretreatment and posttreatment measures. Factors used for moderator and meta-regression analysis included the percentage of patients with severe OSA, patient sex, age, body mass index, levels of insulin-like growth factor 1, disease duration and follow-up, and therapy. Results OSA prevalence was similar in patients with acromegaly who had ACT and INACT disease (ES = −0.16; 95% CI, −0.47 to 0.15; number of studies [k] = 10; P = 0.32). In addition, AHI was similar in ACT and INACT acromegaly patients (ES = −0.03; 95% CI, −0.49 to 0.43; k = 6; P = 0.89). When AHI was compared before and after treatment in patients with acromegaly (median follow-up of 6 months), a significant improvement was observed after treatment (ES = −0.36; 95% CI, −0.49 to −0.23; k = 10; P < 0.0001). In moderator analysis, the percentage of patients with severe OSA in the populations significantly influenced the difference in OSA prevalence (P = 0.038) and AHI (P = 0.04) in ACT vs INACT patients. Conclusion Prevalence of OSA and AHI is similar in ACT and INACT patients in cross-sectional studies. However, when AHI was measured longitudinally before and after treatment, a significant improvement was observed after treatment.

Digital fluoroscopy before and after laser uvulopalatopharyngoplasty in obstructive sleep apnea

1997 ◽  
Vol 38 (2) ◽  
pp. 214-221 ◽  
Author(s):  
Y. Tsushima ◽  
J. Antila ◽  
E. Laurikainen ◽  
E. Svedström ◽  
O. Polo ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Upper Airway ◽  
Poor Responders ◽  
Dynamic Changes ◽  
Digital Fluoroscopy ◽  
Obstructive Sleep ◽  
Before And After ◽  
Cephalometric Measurements ◽  
Normal Controls

Purpose: to study the changes in pharyngeal behavior after laser uvulopalatopharyngoplasty (LUPPP). Material and Methods: the dynamic changes in the upper airway size were evaluated with digital fluoroscopy in 24 patients with obstructive sleep apnea (OSA) before and after LUPPP and in 16 normal controls, while they were awake and breathing normally. Cephalometric measurements were also made. the patients were classified into the categories of good and poor responders by means of a static-charge-sensitive bed. Results: Following LUPPP, collapsibility at the velopharyngeal level was within the normal range in 15 of 17 good responders, but only in 2 of 7 poor responders (p=0.0086). the minimum airway size at the same level showed a similar trend. in 3 of 7 poor responders the hyoid bone was positioned more caudally than in the good responders (p=0.017). Conclusion: Digital fluoroscopy provides information on the change in upper airway behavior after LUPPP.

scholarly journals The Impact of Obstructive Sleep Apnea on Clinical, Perioperative, and Cost Outcomes in Patients Who Underwent Posterior Cervical Discectomy and Fusion: A Single Center Retrospective Analysis from 2008 to 2016

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Alejandro Carrasquilla ◽  
Dominic A Nistal ◽  
John M Caridi
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Upper Airway ◽  
Regression Analyses ◽  
Cervical Discectomy ◽  
Prolonged Intubation ◽  
Airway Narrowing ◽  
Icu Admission ◽  
Obstructive Sleep ◽  
The Impact

Abstract INTRODUCTION Obstructive sleep apnea (OSA) is a chronic condition that results from upper airway narrowing during sleep, with an increasing prevalence estimated to be around 9% to 24%. The combination of an unstable, recently fused or immobile cervical spine and OSA may reasonably lead to special considerations, although this topic has not been well studied. METHODS We retrospectively obtained 1191 posterior cervical discectomy and fusion (PCDF) cases, of which 93 subjects (7.81%) had a history of OSA and 1098 subjects (92.19%) did not. The primary outcome selected was prolonged intubation. Secondary outcomes included intensive care unit (ICU) admission, overall complications, extended hospitalization, nonhome discharge, readmission within 30 and 90 d, emergency room visit within 30 and 90 d, and higher total costs. Univariate and multivariate logistic regression analyses were conducted to assess OSA-affected clinical and perioperative outcome measures. RESULTS Compared to the control cohort, the OSA cohort had more subjects with body mass index (BMI) >30 (P < .0001) and ASA status >2 (P < .0001). After controlling for age, sex, obesity, and ASA status, multivariate regression analyses revealed no difference in the odds of a prolonged intubation (P = .4092). However, a difference was noted in the odds of ICU admission (P = .0038), extended hospitalization (P = .0223), and nonhome discharge (P = .0218). Variables predictive of higher direct cost included a higher ASA status (<0.0001), higher Elixhauser Comorbidities Index (ECI) score (P = .004), and more segments involved in the procedure (P < .0001). Conversely, our models suggested that the 2 cohorts did not differ significantly in the odds of increased complications, readmission at 30 and 90 d, and ER visit at 30 or 90 d. CONCLUSION This study is the largest retrospective review, to our knowledge, of patients who have undergone PCDF with a specific focus on OSA. The results from this study suggest that OSA status is an important determinant of primary and secondary clinical outcomes following posterior cervical fusion procedures.

scholarly journals Abnormal Cytokine Profile in Patients with Obstructive Sleep Apnea-Hypopnea Syndrome and Erectile Dysfunction

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Izolde Bouloukaki ◽  
Vaios Papadimitriou ◽  
Frank Sofras ◽  
Charalampos Mermigkis ◽  
Violeta Moniaki ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Erectile Dysfunction ◽  
Sleep Apnea ◽  
Endothelial Dysfunction ◽  
Statistical Significance ◽  
High Sensitivity ◽  
Reactive Protein ◽  
Obstructive Sleep ◽  
The Difference ◽  
Hypopnea Syndrome

Patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) show a high prevalence of erectile dysfunction (ED). Although the underlying pathogenesis is still unknown, endothelial dysfunction, induced by inflammatory cytokines, chemokines, and adhesion molecules, has been proposed as a possible mechanism. The aim of this study was to assess whether OSAHS is associated with activation of the inflammatory cytokine system in patients with ED compared to the matched OSAHS patients with normal sexual function. Thirty-one patients with severe OSAHS and ED were included. Fifteen patients with severe OSAHS and without ED served as controls. Serum concentrations of high-sensitivity C-reactive protein (hsCRP), tumor necrosis factor-α(TNF-a), interleukin-6 (IL-6), interleukin-8 (IL-8), and adiponectin were measured after the diagnostic polysomnography. We found that hsCRP levels were significantly elevated in OSAHS patients with ED compared to controls. Similarly, TNF-a levels, IL-6, and IL-8 were elevated in OSAHS patients with ED compared to controls. Serum adiponectin levels were lower in OSAHS-ED patients, but the difference did not reach statistical significance. The presence of ED in patients with severe OSAHS is associated with elevated levels of inflammatory markers, underlining a possible involvement of endothelial dysfunction in the pathogenesis of ED.

Importance Of RP And RG Airway Narrowing In Patients With Obstructive Sleep Apnea

2011 ◽  
Author(s):  
Andrew M. Kim ◽  
Nicholas Jackson ◽  
Thorarinn Gislason ◽  
Erna S. Arnardottir ◽  
B Benediktsdottir ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Airway Narrowing ◽  
Obstructive Sleep

scholarly journals Assessment of the Test-Retest Reliability of Level III Polysomnography: Comparison of Results Using Difference of Apnea-Hypopnea Index Score and Severity of Obstructive Sleep Apnea

2021 ◽  
Vol 64 (7) ◽  
pp. 479-485
Author(s):  
Byung-Hyun Han ◽  
Ji Min Yun ◽  
Ick Soo Choi
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Apnea Hypopnea Index ◽  
Retest Reliability ◽  
Subjective Sleep ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
The Difference ◽  
Level I ◽  
Test Retest Reliability

Background and Objectives Although studies of test-retest reliability of the standard polysomnography has been reported numerous times, studies of portable sleep devices have been reported in very few cases to date. The purpose of this study is to investigate the test-retest reliability of level III devices, to examine the characteristics of patients with tendency of underestimation and to determine whether there are factors that can predict when retest is needed. Subjects and Method We enrolled 74 patients for this study from April 2014 to March 2019. Two indicators were used to assess night to night variability. If the difference of apneahypopnea index (AHI) score was less than 10 or there is no difference of severity of obstructive sleep apnea (OSA) between two nights, we decided that the results have a reliability. Results Seventeen out of 57 patients with an AHI difference of less than 10 showed unreliable results based on severity, and 3 out of 17 patients with the AHI difference more than 10 showed reliable results based on severity. Eight out of 74 patients were diagnosed at Night 2 but not at Night 1. In other words, about 11% of the subjects needed retest. Based on the change in severity of OSA, subjective sleep scores showed a statistically significant difference, indicating that the subjective sleep score should be considered when deciding a retest. AHI differed by more than 10 in about 23% of the subjects in this study, falling within “15%- 32%,” which has been reported in the literature on the level I test. Conclusion This suggests that there is no significant difference in reliability between level I and III.

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