scholarly journals Length of Individual Apnea Events Is Increased by Supine Position and Modulated by Severity of Obstructive Sleep Apnea

2016 ◽  
Vol 2016 ◽  
pp. 1-13 ◽  
Author(s):  
Timo Leppänen ◽  
Juha Töyräs ◽  
Anu Muraja-Murro ◽  
Salla Kupari ◽  
Pekka Tiihonen ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Supine Position ◽  
Scientific Information ◽  
Clinical Severity ◽  
Individual Event ◽  
Apnea Duration ◽  
Obstructive Sleep ◽  
Polygraphic Recordings ◽  
The Individual

Positional obstructive sleep apnea (OSA) is common among OSA patients. In severe OSA, the obstruction events are longer in supine compared to nonsupine positions. Corresponding scientific information on mild and moderate OSA is lacking. We studied whether individual obstruction and desaturation event severity is increased in supine position in all OSA severity categories and whether the severity of individual events is linked to OSA severity categories. Polygraphic recordings of 2026 patients were retrospectively analyzed. The individual apnea, and hypopnea durations and desaturation event depth, duration, and area of 526 included patients were compared between supine and nonsupine positions in different OSA severity categories. Apnea events were 6.3%, 12.5%, and 11.1% longer (p<0.001) in supine compared to nonsupine position in mild, moderate, and severe OSA categories, respectively. In moderate and severe OSA categories desaturation areas were 5.7% and 25.5% larger (p<0.001) in supine position. In both positions the individual event severity was elevated along increasing OSA severity category (p<0.05). Supine position elevates apnea duration in all and desaturation area in moderate and severe OSA severity categories. This might be more hazardous for supine OSA patients and therefore, estimation of clinical severity of OSA should incorporate also information about individual event characteristics besides AHI.

Supine position related obstructive sleep apnea in adults: Pathogenesis and treatment

2014 ◽  
Vol 18 (1) ◽  
pp. 7-17 ◽  
Author(s):  
Simon A. Joosten ◽  
Denise M. O'Driscoll ◽  
Philip J. Berger ◽  
Garun S. Hamilton
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Supine Position ◽  
Obstructive Sleep

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.

Effect of topical upper airway anesthesia on apnea duration through the night in obstructive sleep apnea

1996 ◽  
Vol 81 (6) ◽  
pp. 2618-2626 ◽  
Author(s):  
S. J. Cala ◽  
P. Sliwinski ◽  
M. G. Cosio ◽  
R. J. Kimoff
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Upper Airway ◽  
Random Order ◽  
Esophageal Pressure ◽  
Apnea Hypopnea Index ◽  
Sensory Receptors ◽  
Apnea Duration ◽  
Obstructive Sleep ◽  
Rate Of Increase

Cala, S. J., P. Sliwinski, M. G. Cosio, and R. J. Kimoff.Effect of topical upper airway anesthesia on apnea duration through the night in obstructive sleep apnea. J. Appl. Physiol. 81(6): 2618–2626, 1996.—It has previously been reported that the duration of obstructive apneas increases from the beginning to the end of the night (M. Charbonneau, J. M. Marin, A. Olha, R. J. Kimoff, R. D. Levy, and M. Cosio. Chest 106: 1695–1701, 1994). The purpose of this study was to test the hypothesis that stimulation of upper airway (UA) sensory receptors during obstructed inspiratory efforts contributes to arousal and apnea termination and that a progressive attenuation of this mechanism through the night contributes to apnea lengthening. We studied seven patients (six men, one woman) with severe obstructive sleep apnea (apnea-hypopnea index = 93 ± 26 events/h) during two consecutive nights of polysomnographic monitoring. On one night (random order), we performed topical UA anesthesia with 0.2% tetracaine and on the control night, sham anesthesia. We measured apnea duration, esophageal pressure (Pes) during apneas, and apneic O2 desaturation. Consistent with previous findings, apnea duration, number of efforts per apnea, and peak Pes at end apnea increased from the beginning to the end of the control nights. UA anesthesia produced a significant increase in apnea duration at the beginning of the night but no change in apnea length at the end of the night. Peak Pes and the rate of increase in Pes during the anesthesia nights were greater than during control nights, but the rate of increase in Pes was similar for the beginning and end of the control and anesthesia nights. These findings suggest that UA sensory receptors play a role in mediating apnea termination at the beginning of the night but that the contribution of these receptors diminishes as the night progresses such that greater inspiratory efforts are required to trigger arousal, leading to apnea prolongation.

Apnea Duration and Hypoxemia During REM Sleep in Patients with Obstructive Sleep Apnea

CHEST Journal ◽  
1985 ◽  
Vol 87 (4) ◽  
pp. 432-436 ◽  
Author(s):  
Larry J. Findley ◽  
Stephen C. Wilhoit ◽  
Paul M. Suratt
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Rem Sleep ◽  
Apnea Duration ◽  
Obstructive Sleep

scholarly journals Eat, Breathe, Sleep With Osteogenesis Imperfecta

2021 ◽  
Author(s):  
Antonella LoMauro ◽  
Vittorio Landoni ◽  
Paolo Fraschini ◽  
Franco Molteni ◽  
Andrea Aliverti ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Lung Function ◽  
Nutritional Status ◽  
Osteogenesis Imperfecta ◽  
Supine Position ◽  
Vicious Circle ◽  
Obstructive Sleep

Abstract Background: Although Osteogenesis Imperfecta (OI) affects the connective tissue causing extremely brittle bones with consequent skeletal deformities, it is important to go beyond bones. Indeed, the quality of life in OI does not only depends on bones status, as OI might affect also other important functions. We have therefore implemented a multidisciplinary study to assess lung function, breathing pattern, sleep quality and nutritional status in 27 adult OI type III and IV patients (median age: 34.6 years; 19 women; 14 type III).Results: According to nocturnal oxygen desaturation, two groups were identified: 13 patients with (OI_OSA, incidence: 48.2%) and 14 without (no_OSA) obstructive sleep apnea. The former was characterized by higher spinal and ribcage deformity, by more restrictive lung function, by paradoxical thoracic breathing in supine position, by rapid and shallow breathing, by higher body mass index, by longer neck and waist circumferences; by higher abdominal volume and by greater percentage of body fat mass, particularly localized in the trunk. The best predictor of OI_OSA was the negative value of the supine ribcage contribution to tidal volume, followed by the ratio between the neck and the waist circumferences with body height and the supine thoraco-abdominal volumes phase shift angle. Conclusions: The pathophysiology of OI ensued a dangerous vicious circle, in which breathing, sleep and nutritional status are tightly linked, and they might all end up in negatively affecting the quality of life. The vicious circle is fed by some intrinsic characteristics of the disease (thoracic, cranial and mandibular deformities) and some bad daily habits of the patients (i.e. physical inactivity and low dietary quality). The former impacts on restricting the respiratory function, the latter makes Olers more prone to experience overweight or obesity. The main consequence is a high incidence of obstructive sleep apnea, which remains an underdiagnosed disorder in individuals with severe OI who are obese, with a neck to height ratio over than 31.6%, and characterized by paradoxical breathing in supine position. A multidisciplinary approach, including evaluations of breathing, sleep and nutrition, is required to better manage the disease and fulfil the maximizing well-being of OI patients.

Supine position and REM dependence in obstructive sleep apnea

HNO ◽  
2016 ◽  
Vol 65 (S1) ◽  
pp. 52-58 ◽  
Author(s):  
A. Steffen ◽  
L. Maibücher ◽  
I. R. König
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Supine Position ◽  
Obstructive Sleep

Lung volumes and mean apnea duration in obstructive sleep apnea

2009 ◽  
Vol 168 (3) ◽  
pp. 303-305 ◽  
Author(s):  
Sabine Zirlik ◽  
Simin Pour Schahin ◽  
Wolfgang Premm ◽  
Eckhart G. Hahn ◽  
Florian S. Fuchs
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Lung Volumes ◽  
Apnea Duration ◽  
Obstructive Sleep

scholarly journals Nocturnal Hypoxemia Rather Than Obstructive Sleep Apnea Is Associated With Decreased Red Blood Cell Deformability and Enhanced Hemolysis in Patients With Sickle Cell Disease

2021 ◽  
Vol 12 ◽  
Author(s):  
Emeric Stauffer ◽  
Solène Poutrel ◽  
Giovanna Cannas ◽  
Alexandra Gauthier ◽  
Romain Fort ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Pulmonary Hypertension ◽  
Sleep Apnea ◽  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Clinical Severity ◽  
Cell Disease ◽  
Nocturnal Hypoxemia ◽  
Obstructive Sleep ◽  
Rbc Deformability

Background: Although obstructive sleep apnea (OSA) could act as a modulator of clinical severity in sickle cell disease (SCD), few studies focused on the associations between the two diseases.Research Question: The aims of this study were: (1) to explore the associations between OSA, nocturnal oxyhemoglobin saturation (SpO2) and the history of several acute/chronic complications, (2) to investigate the impact of OSA and nocturnal SpO2 on several biomarkers (hematological, blood rheological, and coagulation) in patients with SCD.Study Design and Methods: Forty-three homozygous SCD patients underwent a complete polysomnography recording followed by blood sampling.Results: The proportion of patients suffering from nocturnal hypoxemia did not differ between those with and those without OSA. No association between OSA and clinical severity was found. Nocturnal hypoxemia was associated with a higher proportion of patients with hemolytic complications (glomerulopathy, leg ulcer, priapism, or pulmonary hypertension). In addition, nocturnal hypoxemia was accompanied by a decrease in RBC deformability, enhanced hemolysis and more severe anemia.Interpretation: Nocturnal hypoxemia in SCD patients could be responsible for changes in RBC deformability resulting in enhanced hemolysis leading to the development of complications such as leg ulcers, priapism, pulmonary hypertension or glomerulopathy.Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT03753854.

Sign in / Sign up

Export Citation Format

Share Document