Airway Mechanics and Ventilation in Response to  Resistive Loading during Sleep

Pillar, Giora; Malhotra, Atul; Fogel, Robert; Beauregard, Josée; Schnall, Robert P.; White, David P.

doi:10.1164/ajrccm.162.5.2003131

Cited by 177 publications

(114 citation statements)

References 23 publications

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“…The comparison of genotypes with gender was done because of a higher prevalence of OSAS in males, as shown in the literature. 1,6,9,19 There was no correlation between the AHI (obtained during polysomnography) and the genotypes of both polymorphisms in index cases, which again concurs with the literature. 8,9 This condition may suggest that other mechanisms besides 5-HTR2A gene polymorphisms may be involved in the pathophysiology of OSAS.…”

Section: Resultssupporting

confidence: 90%

Polymorphisms in the 5-HTR2A gene related to obstructive sleep apnea syndrome

Piatto

Carvalho

Marchi

et al. 2011

Braz. j. otorhinolaryngol. (Impr.)

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Obstructive sleep apnea syndrome (OSAS) is one of the most complex disorders of sleep; it involves several genetic factors that contribute to the phenotype. Serotonin (5-HT) regulates a variety of visceral and physiological functions, including sleep. Gene 5-HTR2A polymorphisms may change the transcription of several receptors in the serotoninergic system, thereby contributing to OSAS. Aim To investigate the prevalence of T102C and -1438G/A polymorphisms in the 5-HTR2A gene of patients with and without OSAS. Material and Method A molecular study of 100 index-cases and 100 controls of both genders. DNA was extracted from blood leukocytes samples and the regions that enclose both polymorphisms were amplified with PCR-RFLP. Study design A cross-sectional case study. Results There was a significant prevalence of males in index cases compared to controls (p<0.0001). No significant genotypic differences between cases and controls were found in T102C polymorphisms ( p =1.000). There were significant differences between the AA genotype of -1438G/A polymorphisms and patients with OSAS (OR:2.3; CI95%:1.20-4.38, p =0.01). Conclusion Serotonergic mechanisms may be related to OSAS. There were no differences in the prevalence of T102C polymorphisms in patients with OSAS and the control group. There is evidence of an association between the -1438G/A polymorphism and OSAS.

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Section: Resultssupporting

confidence: 90%

Polymorphisms in the 5-HTR2A gene related to obstructive sleep apnea syndrome

Piatto

Carvalho

Marchi

et al. 2011

Braz. j. otorhinolaryngol. (Impr.)

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“…More recently, methods have been developed for quantifying active neuromuscular responses in sleeping subjects, and a defect in these active responses has been demonstrated in patients with sleep apnea compared with normal subjects. This defect in neuromuscular control was independent of age, obesity, and sex (86), and may be caused by sleep-related reductions in dilator activity during sleep compared with wakefulness (87,88) or by a loss of compensatory responses during sleep (87)(88)(89)(90)(91)(92)(93)(94)(95)(96)(97)(98)(99). Thus, current evidence indicates that sleep apnea is associated with fundamental disturbances in upper airway mechanical (68,100,101) and neuromuscular control (80,(102)(103)(104)(105)(106)) (see Figure 1, left), and suggests that a combined defect is required to produce sleep apnea (86).…”

Section: Obesity and Upper Airway Neuromechanical Control Modeling Upmentioning

confidence: 89%

“…Its effect is suggested by studies demonstrating improvements in critical pressure and sleep apnea after weight loss (25,116). Central adiposity may lead to disturbances in neuromuscular control because men have a greater severity of sleep apnea in clinical and community-based cohorts than do women (1), and even lean men demonstrate subtle defects in upper airway neuromuscular responses to mechanical loads compared with lean women (87,(117)(118)(119)(120). These findings are consistent with the notion that central obesity is associated with a marked blunting of upper airway neuromuscular responses (Figure 1), although the mechanisms linking regional adiposity and neural responses have not been delineated.…”

Section: Neuromuscular Effects Of Obesitymentioning

confidence: 99%

Obesity and Obstructive Sleep Apnea: Pathogenic Mechanisms and Therapeutic Approaches

Schwartz

Patil²,

Laffan

et al. 2008

Proceedings of the American Thoracic Society

584

395

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Obstructive sleep apnea is a common disorder whose prevalence is linked to an epidemic of obesity in Western society. Sleep apnea is due to recurrent episodes of upper airway obstruction during sleep that are caused by elevations in upper airway collapsibility during sleep. Collapsibility can be increased by underlying anatomic alterations and/or disturbances in upper airway neuromuscular control, both of which play key roles in the pathogenesis of obstructive sleep apnea. Obesity and particularly central adiposity are potent risk factors for sleep apnea. They can increase pharyngeal collapsibility through mechanical effects on pharyngeal soft tissues and lung volume, and through central nervous system-acting signaling proteins (adipokines) that may affect airway neuromuscular control. Specific molecular signaling pathways encode differences in the distribution and metabolic activity of adipose tissue. These differences can produce alterations in the mechanical and neural control of upper airway collapsibility, which determine sleep apnea susceptibility. Although weight loss reduces upper airway collapsibility during sleep, it is not known whether its effects are mediated primarily by improvement in upper airway mechanical properties or neuromuscular control. A variety of behavioral, pharmacologic, and surgical approaches to weight loss may be of benefit to patients with sleep apnea, through distinct effects on the mass and activity of regional adipose stores. Examining responses to specific weight loss strategies will provide critical insight into mechanisms linking obesity and sleep apnea, and will help to elucidate the humoral and molecular predictors of weight loss responses.

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“…[1][2][3][4][5][6][7] Inspiratory breathing sounds can vary significantly across sleep and between subjects; in some cases the sounds may be soft (sound intensity < 40 dB), but in others it can be loud. [8][9][10][11][12][13][14][15][16] Intense breathing sounds are commonly referred to as snoring.…”

Section: Introductionmentioning

confidence: 99%

Breathing and Snoring Sound Characteristics during Sleep in Adults

Levartovsky

Dafna

Zigel

et al. 2016

Journal of Clinical Sleep Medicine

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Study Objectives: Sound level meter is the gold standard approach for snoring evaluation. Using this approach, it was established that snoring intensity (in dB) is higher for men and is associated with increased apnea-hypopnea index (AHI). In this study, we performed a systematic analysis of breathing and snoring sound characteristics using an algorithm designed to detect and analyze breathing and snoring sounds. The effect of sex, sleep stages, and AHI on snoring characteristics was explored. Methods: We consecutively recruited 121 subjects referred for diagnosis of obstructive sleep apnea. A whole night audio signal was recorded using noncontact ambient microphone during polysomnography. A large number (> 290,000) of breathing and snoring (> 50 dB) events were analyzed. Breathing sound events were detected using a signal-processing algorithm that discriminates between breathing and nonbreathing (noise events) sounds. Results: Snoring index (events/h, SI) was 23% higher for men (p = 0.04), and in both sexes SI gradually declined by 50% across sleep time (p < 0.01) independent of AHI. SI was higher in slow wave sleep (p < 0.03) compared to S2 and rapid eye movement sleep; men have higher SI in all sleep stages than women (p < 0.05). Snoring intensity was similar in both genders in all sleep stages and independent of AHI. For both sexes, no correlation was found between AHI and snoring intensity (r = 0.1, p = 0.291).Conclusions: This audio analysis approach enables systematic detection and analysis of breathing and snoring sounds from a full night recording. Snoring intensity is similar in both sexes and was not affected by AHI.

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Airway Mechanics and Ventilation in Response to Resistive Loading during Sleep

Cited by 177 publications

References 23 publications

Polymorphisms in the 5-HTR2A gene related to obstructive sleep apnea syndrome

Polymorphisms in the 5-HTR2A gene related to obstructive sleep apnea syndrome

Obesity and Obstructive Sleep Apnea: Pathogenic Mechanisms and Therapeutic Approaches

Breathing and Snoring Sound Characteristics during Sleep in Adults

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