Gender Differences in the Expression of Sleep-Disordered Breathing

Mohsenin, Vahid

doi:10.1378/chest.120.5.1442

Cited by 245 publications

(140 citation statements)

References 25 publications

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“…A cross-sectional study cannot prove potential reasons and consequences, but only proposes reasons when other confounding factors are controlled. In the current study, the factors that may alter UA dimension were controlled, including sex [22,27,30], age [22], obesity [6][7][8]22], familial factors [31] and sleep state [32]. However, the nonpregnant group tended to have a higher BMI (p,0.059) than the pregnant group reported prior to pregnancy.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to pre-pregnancy BMI and gestational weight gain, fat deposition that infiltrates pharyngeal muscle tissue or soft tissue deposition in the neck and around UA may cause UA narrowing in pregnancy [4,27]. In a pregnancy study, ear, nose and throat examination revealed nasal mucosal engorgement at 6 months of pregnancy [28].…”

Section: Discussionmentioning

confidence: 99%

“…First, the results reported in this study were obtained during wakefulness. Measurements using this technique, however, correlate well with snoring and disturbed breathing during sleep [5,21,27]. …”

Section: Discussionmentioning

confidence: 99%

“…Thus, the results of acoustic reflection during wakefulness have been shown to predict differences in airway calibre and function during sleep [5,7,21,27].…”

Section: Discussionmentioning

confidence: 99%

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Sleep-disordered breathing and upper airway size in pregnancy and post-partum

Izci

Vennelle

Liston

et al. 2006

European Respiratory Journal

187

118

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Sleep-disordered breathing and snoring are common in pregnancy. The aim of this study was to determine whether pregnancy was associated with upper airway narrowing.One-hundred females in the third trimester of pregnancy were recruited and 50 agreed to be restudied 3 months after delivery. One-hundred nonpregnant females were also recruited. Upper airway dimensions were measured using acoustic reflection.Snoring was less common in nonpregnant (17%) than pregnant females (41%; odds ratio (OR) 3.34; 95% confidence interval (CI) 1.65-6.74) and returned to nonpregnant levels after delivery (18%; OR 0.15; 95% CI 0.06-0.40). Pregnant females had significantly smaller upper airways than nonpregnant females at the oropharyngeal junction when seated (mean difference 0.12; 95% CI 0.008-0.25), and smaller mean pharyngeal areas in the seated (mean difference 0.14; 95% CI 0.001-0.28), supine (mean difference 0.11; 95% CI 0.01-0.22) and lateral postures (mean difference 0.13; 95% CI 0.02-0.24) compared with the nonpregnant females. Pregnant females had smaller mean pharyngeal areas compared with post-partum in the seated (mean difference 0.18; 95% CI 0.02-0.32), supine (mean difference 0.20; 95% CI 0.06-0.35) and lateral postures (mean difference 0.26; 95% CI 0.12-0.39).In conclusion, this study confirmed increased snoring and showed narrower upper airways during the third trimester of pregnancy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Thus, the results of acoustic reflection during wakefulness have been shown to predict differences in airway calibre and function during sleep [5,7,21,27].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Sleep-disordered breathing and upper airway size in pregnancy and post-partum

Izci

Vennelle

Liston

et al. 2006

European Respiratory Journal

187

118

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“…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

574

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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