scholarly journals Nasendoscopic Observation of Upper Airway during Treatment of Obstructive Sleep Apnea with Nasal Bilevel Continuous Positive Airway Pressure.

1994 ◽  
Vol 87 (5) ◽  
pp. 679-687
Author(s):  
Tatsuya SADAOKA ◽  
Noriya KAKITSUBA ◽  
Yuki FUJIWARA ◽  
Ibuki HAYASHI ◽  
Hiroaki TAKAHASHI ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Upper Airway ◽  
Obstructive Sleep

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.

scholarly journals Perioperative Management of Obstructive Sleep Apnea With Nasal Continuous Positive Airway Pressure

2008 ◽  
Vol 55 (4) ◽  
pp. 121-123 ◽  
Author(s):  
Hirofumi Arisaka ◽  
Shigeki Sakuraba ◽  
Reiko Kobayashi ◽  
Homare Kitahama ◽  
Naofumi Nishida ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Sleep Apnea Syndrome ◽  
Upper Airway ◽  
Perioperative Period ◽  
Obstructive Sleep ◽  
Analgesic Agents

Abstract The high risks associated with general anesthesia in obstructive sleep apnea syndrome (OSAS) patients have been reported. Many authors have suggested that the intraoperative administration of opioids and sedatives should be limited or avoided because these drugs selectively impair muscle activity in the upper airway. We report the case of an OSAS patient who was managed with nasal continuous positive airway pressure (NCPAP) and treated safely in spite of the use of conventional anesthetic and analgesic agents typically used for patients without OSAS. She had little pain during the perioperative period. It is suggested that NCPAP is an effective treatment for not only preventing airway obstructive apnea but for allowing the administration of anesthetic and analgesic drugs without major complications.

scholarly journals Predictors of oronasal breathing among obstructive sleep apnea patients and controls

2019 ◽  
Vol 127 (6) ◽  
pp. 1579-1585 ◽  
Author(s):  
Juliana A. Nascimento ◽  
Pedro R. Genta ◽  
Paulo H.S. Fernandes ◽  
Lucia P. Barroso ◽  
Tômas S. Carvalho ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Upper Airway ◽  
Anthropometric Measurements ◽  
Anthropometric Measures ◽  
Nasal Symptoms ◽  
Obstructive Sleep

Oronasal breathing may adversely impact obstructive sleep apnea (OSA) patients either by increasing upper airway collapsibility or by influencing continuous positive airway pressure (CPAP) treatment outcomes. Predicting a preferential breathing route would be helpful to guide CPAP interface prescription. We hypothesized that anthropometric measurements but not self-reported oronasal breathing are predictors of objectively measured oronasal breathing. Seventeen OSA patients and nine healthy subjects underwent overnight polysomnography with an oronasal mask with two sealed compartments attached to independent pneumotacographs. Subjects answered questionnaires about nasal symptoms and perceived breathing route. Oronasal breathing was more common ( P = <0.001) among OSA patients than controls while awake (62 ± 44 vs. 5 ± 6%) and during sleep (59 ± 39 vs. 25 ± 21%, respectively). Oronasal breathing was associated with OSA severity ( P = 0.009), age ( P = 0.005), body mass index ( P = 0.044), and neck circumference ( P = 0.004). There was no agreement between objective measurement and self-reported breathing route among OSA patients while awake (κ = −0.12) and asleep (κ = −0.02). The breathing route remained unchanged after 92% of obstructive apneas. These results suggest that oronasal breathing is more common among OSA patients than controls during both wakefulness and sleep and is associated with OSA severity and anthropometric measures. Self-reporting is not a reliable predictor of oronasal breathing and should not be considered an indication for oronasal CPAP. NEW & NOTEWORTHY Continuous positive airway pressure (CPAP) interface choice for obstructive sleep apnea (OSA) patients is often guided by nasal symptoms and self-reported breathing route. We showed that oronasal breathing can be predicted by anthropometric measurements and OSA severity but not by self-reported oronasal breathing. Self-reported breathing and nasal symptoms should not be considered for CPAP interface choice.

Sign in / Sign up

Export Citation Format

Share Document