Pressure Recordings—A Method for Detecting Site of Upper Airway Obstruction in Obstructive Sleep Apnea Syndrome

Tvinnereim, Magne; Miljeteig, Harald

doi:10.3109/00016489209136832

Cited by 24 publications

(21 citation statements)

References 20 publications

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“…This is in agreement with the results of SCATVEDT [13] and TVINNEREIM and MILJETEIG [12] who found multiple sites of UA obstruction in seven out of 20 and one out of seven patients, respectively. Our results, however, contrast with those of many others who found the site of obstruction to be fixed during repeated measurements in a given subject.…”

Section: Discussionsupporting

confidence: 82%

“…UA pressure measurements provide information about UA dynamics in terms of changes in UA pressure before, during and after the appearance of respiratory events. Results from UA pressure measurements have been reported by several authors using different techniques varying from a fluid-filled catheter [5] to movable catheters [6,7], a bias flow catheter [8][9][10] and micropressure sensors [11][12][13][14][15]. Most studies were performed in a limited number of patients (n<20) except those of KATSANTONIS et al [15], SCATVEDT [13] and METES et al [7].…”

mentioning

confidence: 99%

“…The results of these studies, however, are controversial. SCATVEDT [13] and TVINNEREIM and MILJETEIG [12] demonstrated that apnoeas may result from obstruction at variable sites in a given patient. In contrast, the other authors concluded that UA obstruction is located at one particular site in the UA which remains the same during consecutive apnoeas.…”

mentioning

confidence: 99%

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Site of upper airway obstruction in obstructive apnoea and influence of sleep stage

Boudewyns¹,

Heyning²,

Backer³

1997

Eur Respir J

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Twenty eight obstructive sleep apnoea patients underwent UA pressure measurements during polysomnography. Solid-state pressure sensors were located at the nasopharynx, oropharynx, tongue base, hypopharynx and oesophagus and the lower limit of UA obstruction was determined relying on the observed pressure pattern.The site of UA obstruction varied among consecutive apnoeas in all but two patients. The lower limit of UA obstruction was predominantly located at the nasoand oropharynx. Rapid eye movement (REM) sleep was associated with a tendency for obstruction to extend towards lower levels of the UA and nasopharyngeal occlusion was significantly less observed during REM compared to oropharyngeal obstruction.Upper airway obstruction involves more than one specific site of the upper airway in the majority of sleep apnoea patients. Obstruction at lower levels of the upper airway is more likely to be observed during rapid eye movement sleep.

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Section: Discussionsupporting

confidence: 82%

mentioning

confidence: 99%

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Site of upper airway obstruction in obstructive apnoea and influence of sleep stage

Boudewyns¹,

Heyning²,

Backer³

1997

Eur Respir J

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“…In restricted oropharyngeal views it was diYcult to know which transducer was being visualized and which direction the catheter need to be adjusted in order to see the marker. We felt that using diVerent colour transducers would be extremely helpful in obtaining accurate positioning and are aware that this technique was employed in an early study [12].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of ApneaGraph in the diagnosis of sleep-related breathing disorders

Singh

Al-Reefy

Hewitt

et al. 2008

Eur Arch Otorhinolaryngol

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ApneaGraph relies on measuring pressure and airXow simultaneously at diVerent levels in the pharynx identifying the segment of airway obstruction and providing baseline respiratory parameters. This study aims to evaluate ApneaGraph and correlate results with both sleep nasendoscopy and polysomnography. This was a prospective study of 49 patients with snoring and/or obstructive sleep apnoea. Thirty of the these patients underwent a PSG and an ApneaGraph study simultaneously in the Sleep Lab. Nineteen patients attended the day surgery unit and had a sleep nasendoscopy with a 10-min ApneaGraph analysis. Polysomnography was used to validate the ApneaGraph system. There are no signiWcant diVerences (independent t test, P > 0.15) between ApneaGraph compared to Polysomnography based on the apnoea-hypopnoea index, total number of apnoeic events, average oxygen saturations and maximum desaturation. This suggests that the ApneaGraph can be used to assess OSA. Statistically, there is poor correlation between the two groups (Spearman's 0.29). In the cases of discordance, ApneaGraph places greater emphasis on a lower pharyngeal contribution. This unique study analyses the ApneaGraph system in the diagnosis of obstructive sleep apnoea and snoring. It demonstrates the beneWts of this new system and highlights certain limitations in localizing the site and level of pharyngeal obstruction in patients with sleep disorders.

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“…Languin et al [15] demonstated that the changes in the oropharyngeal diameter after UPPP were correlated with the changes in the AHI, signaling the importance of the change in oropharyngeal caliber in determining surgical outcome. Several studies using CT scan or upper airway pressure measurements evaluated the site of airway collapse postoperatively during sleep [17,[19][20][21]. In more than 80%, the collapse of the upper airway remained after UPPP at the level of the oropharynx.…”

Section: Uvulopharyngopalatoplastymentioning

confidence: 99%

Obstructive Sleep Apnea Syndrome and Snoring: What Is the Role of Surgery?

Pelletier¹,

Pellanda²,

Jaques³

2000

Otorhinolaryngol Nova

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This paper evaluates the different surgical treatments used in obstructive sleep apnea syndrome and snoring. This critical analysis is based on an extensive review of the literature and the authors’ experience. In snoring patients, the success rate of surgery focusing on the soft palate does not exceed 50–60%, and the risk of pharyngeal narrowing is high. Therefore, this treatment should be selectively performed. More conservative approaches are now under development. The surgical treatment of the obstructive sleep apnea syndrome is controversial. Surgery of the soft palate is associated with a high rate of complications and, therefore, is restricted to a limited number of cases. The compliance with continuous positive airway pressure is low, especially among young patients. Therefore, maxillofacial surgery has regained interest with two opposite concepts. Some authors favor a step-by-step approach, while others proceed in a one-stage surgery. The latter is more aggressive, but its success rate is superior (90%). Results and indications of hyoid myotomy and suspension associated with genioplasty (phase 1) and maxillomandibular osteotomy and advancement (phase 2) are reviewed in detail.

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Pressure Recordings—A Method for Detecting Site of Upper Airway Obstruction in Obstructive Sleep Apnea Syndrome

Cited by 24 publications

References 20 publications

Site of upper airway obstruction in obstructive apnoea and influence of sleep stage

Site of upper airway obstruction in obstructive apnoea and influence of sleep stage

Evaluation of ApneaGraph in the diagnosis of sleep-related breathing disorders

Obstructive Sleep Apnea Syndrome and Snoring: What Is the Role of Surgery?

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