Anatomic Determinants of Sleep-Disordered Breathing Across the Spectrum of Clinical and Nonclinical Male Subjects

Dempsey, Jerome A.; Skatrud, James B.; Jacques, Anthony J.; Ewanowski, Stanley J.; Woodson, B. Tucker; Hanson, Pamela R.; Goodman, Brian

doi:10.1378/chest.122.3.840

Cited by 146 publications

(71 citation statements)

References 23 publications

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“…Consequently, the OSAHS subjects demonstrated higher BMIs, heavier body weights, older ages, and shorter height (Table 1). This ten-Dynamic changes of the tongue in OSAHS during sleep dency coincides with previous reports (Dempsey et al, 2002;Hudgel et al, 2012) that suggest that local soft tissue alterations in OSAHS patients might be partial manifestations of general processes such as obesity and aging.…”

Section: Discussionsupporting

confidence: 90%

“…OSAHS is a multifactorial disorder that is influenced by factors such as obesity (Dempsey et al, 2002), age (Hudgel et al, 2012), and gender (Shepertycky et al, 2005). Craniofacial morphology, including skeletal and soft tissue morphology, is also an important factor that contributes to upper airway collapse during sleep (Takai et al, 2012).…”

Section: Discussionmentioning

confidence: 99%

“…Aside from obesity (Battagel et al, 2000;Dempsey et al, 2002), age (Hudgel et al, 2012), and gender (Shepertycky et al, 2005), craniofacial morphology is reportedly an important factor. Craniofacial morphologic abnormalities can be classified into skeletal anomalies such as small jaw, and soft tissue anomalies, such as enlargement of the soft palate or tongue area, which is related to the body mass index (BMI) (Battagel et al, 2000).…”

Section: Introductionmentioning

confidence: 99%

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Dynamic alterations of the tongue in obstructive sleep apnea-hypopnea syndrome during sleep: analysis using ultrafast MRI

Wang¹,

McDonald²,

Liu³

et al. 2014

Genet. Mol. Res.

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ABSTRACT.Patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) were evaluated using ultrafast magnetic resonance imaging (UMRI) while asleep and awake to analyze tongue changes. The upper airway of 21 OSAHS patients and 20 normal controls were examined during sleep using UMRI. A series of midline sagittal images of the upper airway were obtained to measure dynamic changes in tongue size and the distance from the tongue to the x-axis (an extended line from the anterior nasal spine to posterior nasal spine) and the y-axis (a perpendicular line from the center of the pituitary to the x-axis). The maximum and minimum sagittal Dynamic changes of the tongue in OSAHS during sleep diameters of the tongue were shorter in the OSAHS group than in the control group (P < 0.01) while awake, whereas the difference between the maximum and minimum vertical diameters of the tongue and the upper and central part of tongue between the posterior border and the retropharyngeal wall were greater (P < 0.05). During sleep, the maximum values and differences between the maximum and minimum tongue sizes in the OSAHS group were larger than in the control group (P < 0.05), whereas the minimum values were lower than in the control group (P < 0.01). Tongue size significantly differs between OSAHS patients and normal controls during sleep. The tongue tends to move downward during OSAHS, which may be attributed to increased upper airway resistance.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Dynamic alterations of the tongue in obstructive sleep apnea-hypopnea syndrome during sleep: analysis using ultrafast MRI

Wang¹,

McDonald²,

Liu³

et al. 2014

Genet. Mol. Res.

View full text Add to dashboard Cite

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“…[1][2][3] Moreover, a racial difference may be due to increased prevalence of obesity and hypertension in African Americans, both of which have been associated with increased OSAHS severity. 4,5 The purpose of this study was to determine whether the severity and mortality of sleep apnea were higher in African American patients with OSAHS compared to white individuals. To study this hypothesis, we compared polysomnographic variables of OSAHS in a cohort of African American and white patients diagnosed with OSAHS in an urban clinical sleep center and determined survival of the members of the cohort after approximately 10 years.…”

Section: S C I E N T I F I C I N V E S T I G a T I O N Smentioning

confidence: 99%

The Influence of Race on the Severity of Sleep Disordered Breathing

Pranathiageswaran

Badr

Severson

et al. 2013

Journal of Clinical Sleep Medicine

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Background: Studies have indicated that the prevalence of obstructive sleep apnea-hypopnea syndrome (OSAHS) is similar between white and African American patients, but it is unclear if there are differences in the severity of OSAHS. We hypothesized that in patients with diagnosed OSAHS, African Americans would have higher apnea-hypopnea index (AHI) and higher mortality than white individuals. Methods: We analyzed a prospectively collected database of 512 patients studied between July 1996 through February 1999. Inclusion criteria included age ≥ 18 y, AHI ≥ 5/h, and full-night PSG. Statistical analysis was performed to determine the association between race and AHI while controlling for the effect of confounders and effect modifi ers, which included gender, age, body mass index, and comorbidities.

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“…2001; Dempsey et al. 2002). Our group has also previously shown that older age may exacerbate anatomical risk factors for OSA, and conversely, that a larger pharyngeal caliber is protective against OSA in older age (Carlisle et al.…”

Section: Discussionmentioning

confidence: 99%

Investigation of the link between fluid shift and airway collapsibility as a mechanism for obstructive sleep apnea in congestive heart failure

et al. 2017

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The increased prevalence of obstructive sleep apnea (OSA) in congestive heart failure (CHF) may be associated with rostral fluid shift. We investigated the effect of overnight rostral fluid shift on pharyngeal collapsibility (Pcrit), pharyngeal caliber (APmean), and apnea‐hypopnea index (AHI) in CHF patients. Twenty‐three optimally treated systolic CHF patients were studied. Neck circumference was measured immediately prior to sleep in the evening and immediately after waking in the morning as a marker of rostral fluid shift. Pcrit was measured during sleep, early and late in the night. APmean was measured using acoustic reflection at the same times as neck circumference measurements. 15/23 CHF patients experienced an overnight increase in neck circumference; overall neck circumference significantly increased overnight (mean±SD, evening: 41.7 ± 3.2 cm; morning: 42.3 ± 3.1 cm; P = 0.03). Pcrit increased significantly overnight (early‐night: −3.8 ± 3.3 cmH2O; late‐night: −2.6 ± 3.0 cmH2O; P = 0.03) and APmean decreased (evening: 4.2 ± 1.3 cm2; morning: 3.7 ± 1.3 cm2; P = 0.006). The total AHI correlated with neck circumference (r = 0.4; P = 0.04) and Pcrit (r = 0.5; P = 0.01). APmean correlated with neck circumference (r = −0.47; P = 0.02). There was no significant change in AHI between the first and second half of the night (first‐half: 12.9 ± 12.4/h; second‐half: 13.7 ± 13.3/h; P = 0.6). Overnight rostral fluid shift was associated with increased pharyngeal collapsibility and decreased pharyngeal caliber during sleep in CHF patients. Rostral fluid shift may be an important mechanism of OSA in this patient group.

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Anatomic Determinants of Sleep-Disordered Breathing Across the Spectrum of Clinical and Nonclinical Male Subjects

Cited by 146 publications

References 23 publications

Dynamic alterations of the tongue in obstructive sleep apnea-hypopnea syndrome during sleep: analysis using ultrafast MRI

Dynamic alterations of the tongue in obstructive sleep apnea-hypopnea syndrome during sleep: analysis using ultrafast MRI

The Influence of Race on the Severity of Sleep Disordered Breathing

Investigation of the link between fluid shift and airway collapsibility as a mechanism for obstructive sleep apnea in congestive heart failure

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