scholarly journals Simulating Airway Collapse in Obstructive Sleep Apnea Using Fluid-Structure Interaction Methodologies

2018 ◽  
Author(s):  
Trung Bao Le ◽  
Guilherme J. M. Garcia
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Airflow Limitation ◽  
Intraluminal Pressure ◽  
Pharyngeal Airway ◽  
Obstructive Sleep ◽  
Prevalent Disease ◽  
Adults And Children ◽  
Partially Occluded ◽  
Anatomical Geometry

Obstructive Sleep Apnea (OSA) is a prevalent disease among adults and children (Macey, Woo, Kumar, Cross, & Harper, 2010). Patients with OSA have recurrent episodes of airflow limitation during sleep, which lead to daytime sleepiness and several comorbidities, including cardiovascular diseases (Durán, Esnaola, Rubio, & Iztueta, 2001). During the episode of OSA, the airway is partially occluded (hypopnoeas) or totally blocked (apneas). Since the velopharynx is the narrowest segment of the pharyngeal airway, the local air velocity increases significantly leading to the large decrease in the intraluminal pressure. The relationship between the distribution of the minimum pressure and the anatomical geometry of the airway is thus very important. Hence, understanding the mechanical interaction between the soft palate and air flow is important in investigating OSA pathology.

scholarly journals Altered K-complex morphology during sustained inspiratory airflow limitation is associated with next-day lapses in vigilance in obstructive sleep apnea

SLEEP ◽  
2021 ◽  
Author(s):  
Ankit Parekh ◽  
Korey Kam ◽  
Anna E Mullins ◽  
Bresne Castillo ◽  
Asem Berkalieva ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Spectral Characteristics ◽  
Sleep Time ◽  
Airflow Limitation ◽  
Apnea Hypopnea Index ◽  
Complex Morphology ◽  
Obstructive Sleep ◽  
Inspiratory Airflow Limitation ◽  
Psychomotor Vigilance

Abstract Study Objectives Determine if changes in K-complexes associated with sustained inspiratory airflow limitation (SIFL) during N2 sleep are associated with next-day vigilance and objective sleepiness. Methods Data from thirty subjects with moderate-to-severe obstructive sleep apnea who completed three in-lab polysomnograms: diagnostic, on therapeutic continuous positive airway pressure (CPAP), and on suboptimal CPAP (4 cmH2O below optimal titrated CPAP level) were analyzed. Four 20-min psychomotor vigilance tests (PVT) were performed after each PSG, every 2 h. Changes in the proportion of spontaneous K-complexes and spectral characteristics surrounding K-complexes were evaluated for K-complexes associated with both delta (∆SWAK), alpha (∆αK) frequencies. Results Suboptimal CPAP induced SIFL (14.7 (20.9) vs 2.9 (9.2); %total sleep time, p < 0.001) with a small increase in apnea–hypopnea index (AHI3A: 6.5 (7.7) vs 1.9 (2.3); p < 0.01) versus optimal CPAP. K-complex density (num./min of stage N2) was higher on suboptimal CPAP (0.97 ± 0.7 vs 0.65±0.5, #/min, mean ± SD, p < 0.01) above and beyond the effect of age, sex, AHI3A, and duration of SIFL. A decrease in ∆SWAK with suboptimal CPAP was associated with increased PVT lapses and explained 17% of additional variance in PVT lapses. Within-night during suboptimal CPAP K-complexes appeared to alternate between promoting sleep and as arousal surrogates. Electroencephalographic changes were not associated with objective sleepiness. Conclusions Sustained inspiratory airflow limitation is associated with altered K-complex morphology including the increased occurrence of K-complexes with bursts of alpha as arousal surrogates. These findings suggest that sustained inspiratory flow limitation may be associated with nonvisible sleep fragmentation and contribute to increased lapses in vigilance.

Reliability of Holter Oximetry for Home Sleep Apnea Testing

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P83-P84 ◽  
Author(s):  
Jordan C Stern ◽  
Conor Heneghan ◽  
Redmond Shouldice
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Apnea Hypopnea Index ◽  
Patients Âgés ◽  
Home Testing ◽  
Obstructive Sleep ◽  
Adults And Children ◽  
Home Sleep Apnea Testing ◽  
A Prospective Study ◽  
At Home

Objective To test the reliability of the Holter Oximeter for home testing of obstructive sleep apnea. Previous reports have shown a 96% correlation with simultaneous polysomnography and Holter Oximetry in the sleep laboratory. This study was designed to measure reliability of data obtained at home, as well as to obtain information from patients regarding comfort of the device. Methods A prospective study of 120 consecutive patients (ages 5 to 85) presenting to an otolaryngology practice during a 4-month period with complaints of snoring or sleep apnea symptoms. Device: The Holter Oximeter produces an apnea hypopnea index (AHI) based on an automated processing method of a continuous electrocardiogram and pulse oximeter. The reliability of the test was determined by the number of tests completed without interruption due to patient discomfort, electrode or device failure. Results There was 97% data recovery from the home testing device. Data failure was due to faulty memory cards in the device or surface electrode failure. All patients tolerated wearing the device at home, and there were no voluntary interruptions of the tests by patients. On a discomfort scale of 0 to 10 (0: no discomfort and 10: maximal discomfort), the average discomfort score was 2. Conclusions Holter Oximetry represents a new, easy to use, and reliable device for the home diagnosis of obstructive sleep apnea. It can also be used to measure outcomes for the surgical and non-surgical treatment of obstructive sleep apnea in adults and children.

Identification and treatment of obstructive sleep apnea in adults and children with epilepsy: a prospective pilot study

2003 ◽  
Vol 4 (6) ◽  
pp. 509-515 ◽  
Author(s):  
Beth A. Malow ◽  
Kevin J. Weatherwax ◽  
Ronald D. Chervin ◽  
Timothy F. Hoban ◽  
Mary L. Marzec ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Pilot Study ◽  
Prospective Pilot Study ◽  
Obstructive Sleep ◽  
Adults And Children

Induction of airway collapse with subatmospheric pressure in awake patients with sleep apnea

1984 ◽  
Vol 57 (1) ◽  
pp. 140-146 ◽  
Author(s):  
P. M. Suratt ◽  
S. C. Wilhoit ◽  
K. Cooper
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Airway Obstruction ◽  
Supine Position ◽  
Face Mask ◽  
Subatmospheric Pressure ◽  
Pharyngeal Airway ◽  
Airway Collapse ◽  
Obstructive Sleep ◽  
Obese Control

To determine whether the pharyngeal airway is abnormal in awake patients with obstructive sleep apnea (OSA), we measured the ability of the pharyngeal airway to resist collapse from subatmospheric pressure applied to the nose in awake subjects, 12 with OSA and 12 controls. Subatmospheric pressure was applied to subjects placed in the supine position through a tightly fitting face mask. We measured airflow at the mask as well as mask, pharyngeal, and esophageal pressures. Ten patients developed airway obstruction when subatmospheric pressures between 17 and 40 cmH2O were applied. Obstruction did not occur in two patients with the least OSA. Obstruction did not occur in 10 controls; one obese control subject developed partial airway obstruction when -52 cmH2O was applied as did another with -41 cmH2O. We conclude that patients with significant OSA have an abnormal airway while they are awake andthat application of subatmospheric pressure may be a useful screening test to detect OSA.

scholarly journals Upper airway collapsibility measured using a simple wakefulness test closely relates to the pharyngeal critical closing pressure during sleep in obstructive sleep apnea

SLEEP ◽  
2019 ◽  
Vol 42 (7) ◽  
Author(s):  
Amal M Osman ◽  
Jayne C Carberry ◽  
Peter G R Burke ◽  
Barbara Toson ◽  
Ronald R Grunstein ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Airway Pressure ◽  
Pressure Sensors ◽  
Upper Airway ◽  
Apnea Hypopnea Index ◽  
Pharyngeal Airway ◽  
Obstructive Sleep ◽  
Airway Collapsibility ◽  
Upper Airway Collapsibility

AbstractStudy ObjectivesA collapsible or crowded pharyngeal airway is the main cause of obstructive sleep apnea (OSA). However, quantification of airway collapsibility during sleep (Pcrit) is not clinically feasible. The primary aim of this study was to compare upper airway collapsibility using a simple wakefulness test with Pcrit during sleep.MethodsParticipants with OSA were instrumented with a nasal mask, pneumotachograph and two pressure sensors, one at the choanae (PCHO), the other just above the epiglottis (PEPI). Approximately 60 brief (250 ms) pulses of negative airway pressure (~ –12 cmH2O at the mask) were delivered in early inspiration during wakefulness to measure the upper airway collapsibility index (UACI). Transient reductions in the continuous positive airway pressure (CPAP) holding pressure were then performed during sleep to determine Pcrit. In a subset of participants, the optimal number of replicate trials required to calculate the UACI was assessed.ResultsThe UACI (39 ± 24 mean ± SD; range = 0%–87%) and Pcrit (–0.11 ± 2.5; range: –4 to +5 cmH2O) were quantified in 34 middle-aged people (9 female) with varying OSA severity (apnea–hypopnea index range = 5–92 events/h). The UACI at a mask pressure of approximately –12 cmH2O positively correlated with Pcrit (r = 0.8; p < 0.001) and could be quantified reliably with as few as 10 replicate trials. The UACI performed well at discriminating individuals with subatmospheric Pcrit values [receiver operating characteristic curve analysis area under the curve = 0.9 (0.8–1), p < 0.001].ConclusionsThese findings indicate that a simple wakefulness test may be useful to estimate the extent of upper airway anatomical impairment during sleep in people with OSA to direct targeted non-CPAP therapies for OSA.

scholarly journals Severity of obstructive sleep apnea (OSA) in 382 Han and Uyghur patients with sleep disorders

2018 ◽  
Vol 01 (02) ◽  
pp. 163-169
Author(s):  
Aman Gul ◽  
Nassirhadjy Memtily ◽  
Aikeranmu Aihemaiti ◽  
Amir Abdukadir ◽  
Palidan Wushuer
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Race And Ethnicity ◽  
Impact Factors ◽  
Apnea Hypopnea Index ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
Adults And Children ◽  
Respiratory Disturbance ◽  
Distinctive Difference

Objective: Race and ethnicity may impact the prevalence and severity of Obstructive Sleep Apnea (OSA) in adults and children. In this study, we aim to investigate the ethnologic influence on OSA severity between Han and Uyghur OSA patients in Xinjiang, China.Methods: We enrolled total of 382 (205 Han and 177 Uyghur) patients diagnosed with OSA with apnea/hypopnea index (AHI) or respiratory disturbance index (RDI) [Formula: see text] 5. During admission, the severity of OSA was evaluated by polysomnography (PSG).Results: From demographic characteristics of enrolled patients, we found that there was no significant difference in sex, age, BMI, and neck circumference between two study populations. Uyghur OSA patients had longer sleep latency, longer REM sleep and N3 stage, but shorter N1 phase than Han OSA patients. AHI and apnea RDI level, but not hypopnea RDI, were evidently higher in Han patients compared with Uyghur patients. There was no distinctive difference between two ethnic populations in average and minimum peripheral capillary oxygen saturation (SaO2) level.Conclusion: Better understanding of impact factors encompassing ethnicity may help improve OSA diagnosis accuracy, management and treatment for patients in Xinjiang.

scholarly journals FIBRO-OPTIC STUDY OF PHARYNGEAL AIRWAY DURING SLEEP IN PATIENTS WITH HYPERSOMNIA OBSTRUCTIVE SLEEP-APNEA SYNDROME

1978 ◽  
Vol 88 (8) ◽  
pp. 1310???1313 ◽  
Author(s):  
BERNARD BOROWIECKI ◽  
CHARLES P. POLLAK ◽  
ELLIOT D. WEITZMAN ◽  
SAUL RAKOFF ◽  
JOSEPH IMPERATO
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Pharyngeal Airway ◽  
Obstructive Sleep ◽  
Apnea Syndrome

SYNCHRONOUS VIDEO RECORDING OF THE PHARYNGEAL AIRWAY AND POLYSOMNOGRAPH IN PATIENTS WITH OBSTRUCTIVE SLEEP APNEA

1982 ◽  
Vol 92 (3) ◽  
pp. 246???250 ◽  
Author(s):  
THOMAS E. ROJEWSKI ◽  
DAVID E. SCHULLER ◽  
HELMUT S. SCHMIDT ◽  
ROBERT W. CLARK ◽  
ROBERT E. POTTS
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Video Recording ◽  
Pharyngeal Airway ◽  
Obstructive Sleep
Sign in / Sign up

Export Citation Format

Share Document