The effect of body position on airway patency in obstructive sleep apnea: CT imaging analysis

Kim, Woo Young; Hong, Seung No; Yang, Seung Koo; Nam, Kuk Jin; Lim, Kang Hyeon; Hwang, Sun Jin; Seo, Min Young; Lee, Seung Hoon

doi:10.1007/s11325-019-01863-x

Cited by 17 publications

(8 citation statements)

References 24 publications

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“…Further study is needed with the DISE results. Third, although body position has been found to have a definite effect on upper airway collapsibility 7,27,28 , this study has a limitation that the effect of body position was not taken into account. This is because PM was measured during natural whole-night sleep and includes all body positions such as supine, right lateral, left lateral and prone, whereas DISF was evaluated only in the supine position during drug-induced sleep.…”

Section: Discussionmentioning

confidence: 96%

Correlation between short-time and whole-night obstruction level tests for patients with obstructive sleep apnea

Kim

Ahn

Choi

et al. 2021

Sci Rep

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Identification of obstructive level is crucial for successful surgical outcomes in patients with obstructive sleep apnea (OSA). Unfortunately, most of the dynamic airway evaluations are performed for a short duration under drug-induced sleep; therefore, it is uncertain whether they represent airway events that occur during a whole night of sleep. This study was aimed to evaluate the correlation between obstructive levels that were identified by a short-time and a whole-night test in patients with OSA. Total 101 patients with OSA underwent drug-induced sleep fluoroscopy (DISF) and pressure manometry (PM). For DISF, the obstructive pattern was classified into one of three groups: soft palate, tongue-based, and a combined obstruction. PM was used to measure the proportion of retroglossal events out of total whole-night obstructive events in each patient. The mean age of the patients was 43.8 years. The obstructive pattern was identified as soft palate in 56 patients, combined in 38 patients, and tongue-based in 7 patients following DISF. Results from PM showed that the mean percentage of retroglossal obstructive events was 31.2 ± 30.7%. The average proportion of retroglossal obstructive events that were identified by PM in patients with soft palate, combined, and tongue-based obstruction was 27.2%, 32.1%, and 59.0%, respectively (p = 0.033). There are limitations of evaluating obstructive events that occur during a whole night with short-time tests. Surgeons should be aware the possibility of disagreement in the obstructive level between short-time and whole-night tests.

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Section: Discussionmentioning

confidence: 96%

Correlation between short-time and whole-night obstruction level tests for patients with obstructive sleep apnea

Kim

Ahn

Choi

et al. 2021

Sci Rep

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“…However, the correlation between ODI and AHI was found to be null when evaluated as a function of the positional component (r=0.02, R 2 =0.56, and r=0.11, R 2 =1.16). Although the mechanism of the positional component is not completely elucidated as a confounding factor for the diagnosis of OSA, its influence can be explained by the increase in the retropalatal space when making a shift from a supine to nonsupine position (32).…”

Section: ' Discussionmentioning

confidence: 99%

Diagnostic accuracy of oximetry for obstructive sleep apnea: a study on older adults in a home setting

Rosa

Peres

Júnior

et al. 2021

Clinics

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Owing to the fact that obstructive sleep apnea (OSA) is an underreported disease, the strategy used for the diagnosis of OSA has been extensively dissected to devise a simplified process that can be accessed by the public health services. Polysomnography (PSG) type I, the gold standard for the diagnosis of OSA, is expensive and difficult to access by low-income populations. In this study, we aimed to verify the accuracy of the oxyhemoglobin desaturation index (ODI) in comparison to the apnea-hypopnea index (AHI) using a portable monitor. METHODS: We evaluated 94 type III PSG home test results of 65 elderly patients (69.21±6.94 years old), along with information, such as the body mass index (BMI) and sex, using data obtained from a clinical trial database. RESULTS: A significant linear positive correlation (r=0.93, po0.05) was observed between ODI and AHI, without any interference from sex, BMI, and positional component. The sensitivity of ODI compared to that of AHI increased with an increase in the severity of OSA, while the specificity of ODI in comparison to that of AHI was high for all degrees of severity. The accuracy of ODI was 80.7% for distinguishing between patients with mild and moderate apnea and 84.4% for distinguishing between patients with moderate and severe apnea. CONCLUSION: The ODI values obtained in uncontrolled conditions exhibited high sensitivity for identifying severe apnea compared to the AHI values, and correctly identified the severity of OSA in more than 80% of the cases. Thus, oximetry is promising strategy for diagnosing OSA.

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“…3 Computed tomography (CT) scanning and magnetic resonance imaging (MRI) provide better information in assessing the objective absolute value, but they are not widely available and are associated with high costs. 4,5 Each of the above procedures has its unique advantages and disadvantages, but they are all time-consuming and patient-compliancable. Precisely identifying the sites of upper airway obstruction can potentially help to tailor surgical treatments, and a simpler, more objective, predictive, and even quantitative method is needed to improve surgical outcomes.…”

Section: Introductionmentioning

confidence: 99%

<p>Quantitative Morphometric Measurements of the Oropharynx in Obstructive Sleep Apnea Syndrome Using a Laser Depth Measurement Module</p>

Kuo

Lin

Chuang

et al. 2020

NSS

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Introduction Current diagnostic routines in obstructive sleep apnea syndrome (OSAS), including drug-induced sleep endoscopy (DISE), provide qualitative data. Quantitative morphometric measurements of oropharyngeal structures remain challenging. This study aims to introduce a special linear laser projection device that can facilitate computer-assisted digitalized analysis and provide important quantitative information for OSAS prediction. Materials and Methods We used a single-wavelength green three-linear laser to provide the scaling reference, with one at an angle of 8.5 degrees with the other two which were parallel. The oropharyngeal images were divided into two groups: the non-OSAS and OSAS group, after polysomnography. A minimum of three evaluations were carried out to determine the maximum cross-sectional area of the oropharyngeal inlet (CSAOI) and the retropalatal depth. Results A total of 132 subjects were enrolled in this study, with 76 subjects in the non-OSAS group and 56 cases in the OSAS group. In the non-OSAS group, the CSAOI was significantly larger in males than in females. There was a trend toward deeper retropalatal region in men than in women (14.25 vs 11.76 mm). Correlation analysis revealed that retropalatal depth is significantly related to body height and the CSAOI. The body weight and BMI of patients with OSAS were significantly higher than those of participants without OSAS. The retropalatal depth and CSAOI were significantly decreased in OSAS patients as compared to those without OSAS. Our new parameter, the oropharyngeal index, showed the most outstanding discrimination by ROC analysis to predict OSAS. Conclusion Our innovative module can provide reference parameters, which make it possible to directly estimate the objective absolute values of relevant oropharyngeal structures. Our non-invasive approach can be used for outpatient screening, since it allows the identification of potential OSAS patients who should be referred for polysomnography, as many patients do not require DISE early in their evaluation.

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The effect of body position on airway patency in obstructive sleep apnea: CT imaging analysis

Cited by 17 publications

References 24 publications

Correlation between short-time and whole-night obstruction level tests for patients with obstructive sleep apnea

Correlation between short-time and whole-night obstruction level tests for patients with obstructive sleep apnea

Diagnostic accuracy of oximetry for obstructive sleep apnea: a study on older adults in a home setting

<p>Quantitative Morphometric Measurements of the Oropharynx in Obstructive Sleep Apnea Syndrome Using a Laser Depth Measurement Module</p>

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