scholarly journals Airway inflammation in patients affected by obstructive sleep apnea

2016 ◽  
Vol 65 (2) ◽  
Author(s):  
R. Sabato ◽  
P. Guido ◽  
F.G. Salerno ◽  
O. Resta ◽  
A. Spanevello ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Airway Inflammation ◽  
Systemic Inflammation ◽  
Inflammatory Mediators ◽  
Upper Airway ◽  
Airway Hyperreactivity ◽  
Variable Degree ◽  
Airway Occlusion ◽  
Obstructive Sleep

Obstructive sleep apnea (OSA) is characterised by repetitive episodes of upper airway occlusion during sleep. OSA has been shown to be associated with a variable degree of nasal inflammation, uvula mucosal congestion and airway hyperreactivity. The upper airway inflammation, whose clinical importance is uncertain, is characterised by leukocytes infiltration and interstitial oedema. In addition, recent data has shown the presence of neutrophilic inflammation in the lower airways. The current opinion is that airway inflammation is caused by the local, repeated mechanical trauma related to the intermittent airway occlusion typical of the disease. Another potential mechanism involves the intermittent nocturnal hypoxemia that through the phenomenon of the ischemia- reperfusion injury may induce the production of oxygen free radicals and therefore cause local and systemic inflammation. Finally, a state of low-grade systemic inflammation may be related to obesity per se with the pro-inflammatory mediators synthesised in the visceral adipose cells. Several authors stress the role of circulating and local inflammatory mediators, such as proinflammatory cytokines, exhaled nitric oxide, pentane and 8-isoprostane as the determinants of inflammation in OSA.

scholarly journals Continuous positive airway pressure treatment does not normalize the prolonged reflex inhibition to inspiratory loading in obstructive sleep apnea

2016 ◽  
Vol 121 (4) ◽  
pp. 910-916
Author(s):  
Nicholas P. S. Murray ◽  
David K. McKenzie ◽  
Simon C. Gandevia ◽  
Jane E. Butler
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Continuous Positive Airway Pressure ◽  
Airway Obstruction ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Upper Airway ◽  
Cpap Therapy ◽  
Airway Occlusion ◽  
Obstructive Sleep

In obstructive sleep apnea (OSA), the short-latency inhibitory reflex (IR) of inspiratory muscles to airway occlusion is prolonged in proportion to the severity of the OSA. The mechanism underlying the prolongation may relate to chronic inspiratory muscle loading due to upper airway obstruction or sensory changes due to chronic OSA-mediated inflammation. Continuous positive airway pressure (CPAP) therapy prevents upper airway obstruction and reverses inflammation. We therefore tested whether CPAP therapy normalized the IR abnormality in OSA. The IR responses of scalene muscles to brief airway occlusion were measured in 37 adult participants with untreated, mostly severe, OSA, of whom 13 were restudied after the initiation of CPAP therapy (usage >4 h/night). Participants received CPAP treatment as standard clinical care, and the mean CPAP usage between initial and subsequent studies was 6.5 h/night (range 4.1-8.8 h/night) for a mean of 19 mo (range 4–41 mo). The duration of the IR in scalene muscles in response to brief (250 ms) inspiratory loading was confirmed to be prolonged in the participants with OSA. The IR was assessed before and after CPAP therapy. CPAP treatment did not normalize the prolonged duration of the IR to airway occlusion (60 ± 21 ms pretreatment vs. 59 ± 18 ms posttreatment, means ± SD) observed in participants with severe OSA. This suggests that the prolongation of IR reflects alterations in the reflex pathway that may be irreversible, or a specific disease trait.

OBSTRUCTIVE SLEEP APNEA AND ALLERGIC RHINITIS: IMPACT OF TREATING UPPER AIRWAY INFLAMMATION ON SLEEP PARAMETERS

2011 ◽  
Vol 12 ◽  
pp. S10-S11
Author(s):  
Veronique-Isabelle Forest ◽  
Basil Petrof ◽  
Najat Binotham ◽  
Qutayba Hamid ◽  
François Lavigne
Keyword(s):  
Obstructive Sleep Apnea ◽  
Allergic Rhinitis ◽  
Sleep Apnea ◽  
Airway Inflammation ◽  
Upper Airway ◽  
Obstructive Sleep ◽  
Sleep Parameters
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