Upper airway and soft tissue anatomy in normal subjects and patients with sleep-disordered breathing. Significance of the lateral pharyngeal walls.

Schwab, R; Gupta, Krishanu B.; Gefter, Warren B.; Metzger, Louis J.; Hoffman, Eric A.; Pack, Allan I.

doi:10.1164/ajrccm.152.5.7582313

Cited by 718 publications

(553 citation statements)

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“…These alterations may accrue from adiposity around the pharynx and torso as follows. First, increases in neck circumference and fat deposited around the upper airway (12,72,(107)(108)(109) in obesity might narrow the upper airway. Second, upper airway collapsibility is higher in obese compared with nonobese individuals (25), and does not decrease appropriately when the pharynx is dilated by advancing the mandible anteriorly (110).…”

Section: Mechanical 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

583

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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Section: Mechanical 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

583

395

View full text Add to dashboard Cite

show abstract

“…Schwab 34 proposed that the retropalatal region in patients with OSA was narrowed in the lateral aspect and the contrary, the retropalatal region in nonapneic people was narrowed in the AP dimension 34 . Li et al 20 reported that lateral narrowing of retropalatal region was closely associated with the degree of sleep apnea in their study 20 .…”

Section: Reported That 3dmentioning

confidence: 99%

A comparative CT evaluation of pharyngeal airway changes in class III patients receiving bimaxillary surgery or mandibular setback surgery

Degerliyurt

Ueki

Hashiba

et al. 2008

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, an

116

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Purpose: The purpose of this study was to compare the morphologic changes of the upper airway space in Class III patients underwent mandibuler set back or bimaxillary surgery (maxillary advancement and mandibular setback) by computed tomography at 2 levels: soft palate and base of tongue Materials and Methods:The sample is consisted of 47 patients in 2 groups who had been diagnosed with Class III skeletal deformities and had been treated by mandibular setback or bimaxillary surgery (maxillary advancement and mandibular setback).Anteroposterior, lateral, cross sectional area dimensions of the airway at the level of soft palate and base of tongue was measured pre-and postoperatively on computed tomography images.Results: However, anteroposterior dimensions of the airway decreased in both groups (p<.0001), the reduction was significantly less in cases treated with bimaxillary surgery (p<.05). In mandibular setback surgery group, the cross sectional area of the airway decreased significantly (p<.001) Although, the cross sectional area of the airway decrease in bimaxillary surgery group, the reduction was not statistically significant (p>.05).Conclusions: This study suggested that bimaxillary surgery could prevent narrowing of the upper airway in the correction of Class III deformities rather than mandibular setback surgery .

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“…Az OSAS előfordulási gyakorisága egyebekben szoros összefüggést mutat a dohányzással [7]. A kórkép kialakulásában jelentős szerepet játszanak bizonyos anatómiai eltérések [14]. A hormonális tényezők hatását a kórkép kialakulásának esélyére Reutrakul és mtsai vizsgálták egészséges várandós és nem várandós nő-kön.…”

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Az alvási apnoe szindróma vezető rizikótényezőinek esélyhányadosai

Szabó¹,

Ihász

2017

Orvosi Hetilap

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Bevezetés: Az alvás minősége komoly szerepet játszik az egyén nappali teljesítőképességében és egészségi állapotában, erős hatást gyakorolva ezáltal a társadalomra. Célkitűzés: Jelen vizsgálat a légzészavarok csoportjába tartozó obsruktív alvási apnoe szindróma kialakulásának és súlyosságának valószínűségét méri, a kórkép vezető rizikótényezőinek esélyhányadosain keresztül. Módszer: A vizsgálatban 127 fő vett részt. Az alvásszerkezet vizsgálatához poliszomnográfiás szűrőkészülék adatai kerültek feldolgozásra. A tápláltság mértéke testtömegindexben , a nyakkörfogat adatai cm-ben kerültek rögzítésre. Eredmények: A nem mint rizikótényező vizsgálata alapján elmondható, hogy a férfiak esélyhányadosa a nőkéhez viszonyítva az alvási apnoe szindróma kialakulására több mint háromszoros. A súlyos kórkép kialakulására több mint négyszer esélyesebbek. A vizsgált férfiak csoportjában a rizikótényezők esélyhányadosai közül a nyakkörfogat a legjelentősebb prediktora az obstruktív alvási apnoénak. A női csoport vezető esélyhányadosa a BMI. Következtetések: Az apnoés betegek több mint 50%-a nem számol be nappali aluszékonyságról, ami felhívja a figyelmet a rizikótényezők esélyhányadosainak szelekcióban betöltött szerepére. Orv Hetil. 2017; 158(21): 823-828. Kulcsszavak: obstruktív alvási apnoe, rizikófaktor, esélyhányados The probability of obstructive sleep apnea disorders emergence by odds ratio of main risk factorsIntroduction: The quality of sleep plays a serious role in the individual's daytime performace and state of health, there by it has a strong influence on the society. Aim: The present study measures the probability developing and severity of obstructive sleep apnea syndrome, -which belongs to group of disorders of the respiratory -through odds ratio of leading risk factors. Method: 127 persons were examined in the test. The sleep structure test data were processed by polysomnographic screening device. Results: The nutritional level of body in mass index (BMI), and the neck circumferences data were recorded in cm. On the basis of the examination the gender as a risk factor it can be said that the odds ratio for men compared to women, more than three times higher of emergence of disease. Conclusions: Men's chance of the emergence of serious disease is more than four times higher than women's chance. In the men's test group the most significant predictor of obstructive sleep apnea amongst the risk factors is the circumference according to odds ratio. In women's group the leader odds ratio is BMI. More than 50% of test goup don't report about daytime sleepiness, and this fact draws our attention to the role of risk factors' odds ratio in selection.

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Upper airway and soft tissue anatomy in normal subjects and patients with sleep-disordered breathing. Significance of the lateral pharyngeal walls.

Cited by 718 publications

References 0 publications

Obesity and Obstructive Sleep Apnea: Pathogenic Mechanisms and Therapeutic Approaches

Obesity and Obstructive Sleep Apnea: Pathogenic Mechanisms and Therapeutic Approaches

A comparative CT evaluation of pharyngeal airway changes in class III patients receiving bimaxillary surgery or mandibular setback surgery

Az alvási apnoe szindróma vezető rizikótényezőinek esélyhányadosai

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