Inspiratory Effort Sensation to Added Resistive Loading in Patients With Obstructive Sleep Apnea

Tun, Ye; Hida, Wataru; Okabe, Shinichi; Kikuchi, Yoshihiro; Kurosawa, Hájíme; Tabata, Masao; Shirato, Kunio

doi:10.1378/chest.118.5.1332

Cited by 25 publications

(23 citation statements)

References 21 publications

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“…In support of a role of long-term sensory injury in OSA, one study revealed only partial resolution of oropharynx sensation with vibration detection and two-point discrimination after 4 months of CPAP therapy (Kimoff et al, 2001). However, in another study, impaired sensation to loaded breathing was corrected after 2 weeks of CPAP therapy (Tun et al, 2000). In untreated OSA patients breathing responses to respiratory stimuli measured during wakefulness vary.…”

Section: Evidence For Upper Airway Afferent Changesmentioning

confidence: 99%

“…Two-point discrimination and detection of vibration, airflow, and temperature for the upper airway are all altered in OSA patients (see Table 4). The ability to detect and rate the size of inspiratory resistive loads to breathing in patients with OSA is impaired (McNicholas et al, 1984; Tun et al, 2000; c.f. Clerk et al, 1994).…”

Section: Evidence For Upper Airway Afferent Changesmentioning

confidence: 99%

“…Thus, there is the potential for synergistic effects to mediate upper airway remodeling in OSA. Some of the changes in muscle properties and sensory impairments resolve, at least in part, with CPAP treatment (e.g., Carrera et al, 1999; Mayer et al, 1999; Tun et al, 2000; Kimoff et al, 2001; Nguyen et al, 2005; Dziewas et al, 2007). …”

Section: Summary and Potential Role Of Neural Injury In Osamentioning

confidence: 99%

See 2 more Smart Citations

Functional Role of Neural Injury in Obstructive Sleep Apnea

Saboisky¹,

Butler²,

Gandevia³

et al. 2012

Front. Neur.

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The causes of obstructive sleep apnea (OSA) are multifactorial. Neural injury affecting the upper airway muscles due to repetitive exposure to intermittent hypoxia and/or mechanical strain resulting from snoring and recurrent upper airway closure have been proposed to contribute to OSA disease progression. Multiple studies have demonstrated altered sensory and motor function in patients with OSA using a variety of neurophysiological and histological approaches. However, the extent to which the alterations contribute to impairments in upper airway muscle function, and thus OSA disease progression, remains uncertain. This brief review, primarily focused on data in humans, summarizes: (1) the evidence for upper airway sensorimotor injury in OSA and (2) current understanding of how these changes affect upper airway function and their potential to change OSA progression. Some unresolved questions including possible treatment targets are noted.

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Section: Evidence For Upper Airway Afferent Changesmentioning

confidence: 99%

Section: Evidence For Upper Airway Afferent Changesmentioning

confidence: 99%

Section: Summary and Potential Role Of Neural Injury In Osamentioning

confidence: 99%

See 1 more Smart Citation

Functional Role of Neural Injury in Obstructive Sleep Apnea

Saboisky¹,

Butler²,

Gandevia³

et al. 2012

Front. Neur.

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“…However, there are no studies concerning the quality of life in OHS patients. Furthermore, although it has been reported that nasal continuous positive airway pressure (CPAP), which is a major treatment for patients with OSA, improves sleep-disordered breathing, 10 excessive daytime sleepiness, 11,12 cognitive function, 11 mood, 12,13 inspiratory effort sensation, 14 and daily activity [15][16][17] in OSA, little is known about the effect of nasal CPAP on the quality of life in OHS.…”

Section: Protocolmentioning

confidence: 99%

Nasal Continuous Positive Airway Pressure Improves Quality of Life in Obesity Hypoventilation Syndrome

et al. 2003

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We studied the quality of life of obesity hypoventilation syndrome (OHS) by comparing it with age- and body mass index-matched patients without hypoventilation and age-matched obstructive sleep apnea (OSA) patients with body mass index (BMI) under 30, and the efficacy of nasal continuous positive airway pressure (CPAP) therapy for 3 to 6 months on the quality of life in these patients. Prospectively recruited patients from six sleep laboratories in Japan were administered assessments of the general health status by the Short-Form 36 Health Survey (SF-36) and subjective sleepiness by the Epworth Sleepiness Scale (ESS). Compared with matched healthy subjects, OHS and OSA patients not yet treated had worse results on the ESS scores and the SF-36 subscales for physical functioning, role limitations due to physical problems, general health perception, energy/vitality, role limitations due to emotional problems, and social functioning. The ESS scores of OHS patients were worse than those of the OSA groups including the age- and BMI-matched OSA patients. In the SF-36 subscales of OHS patients, only the subscale of social functioning showed worse results compared with that of BMI-matched OSA patients. After 3 to 6 months of treatment, ESS scores and these SF-36 subscales in all three patient groups improved to the normal level. These results suggested that the quality of life of OHS before nasal CPAP was significantly impaired and that nasal CPAP for OHS improved the quality of life associated with the improvement of daytime sleepiness to the level of the other OSA patients.

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“…The recording duration was chosen because it was considered comparable with those of obstructive apnea seen during sleep, which is known to induce sympathetic responses. 13 Furthermore, this duration were selected to reduce unnecessary strains to the raised arm holding the facemask. Particularly, this was to minimize possible motional artifacts that can affect the recorded PPG signals and thereby complicate the acquired results.…”

Section: Experimental Protocolmentioning

confidence: 99%

Photoplethysmographic Assessment of Hemodynamic Variations Using Pulsatile Tissue Blood Volume

2008

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Sympathetic responses to provocative tests have shown to provide an early prognosis of abnormalities in the human autonomic nervous system. Photoplethysmographic signal characteristics have been studied to identify vascular diseases. However, knowledge about the pulse-added arterial volume of the photoplethysmographic waveforms during these clinical investigations is limited. In all, 16 normotensive adults (9 men) were recruited to perform 3 provocative test (2 postural changes and 1 resistive breathing) activities with photoplethysmographic signals being monitored on the upper and lower peripheries using customized devices. In all, 4 parameters derived from the photoplethysmographic waveforms that related to the pulsatile tissue blood volume changes were then assessed. The results obtained showed that amplitude-related parameters during these activities showed significant changes (>9.63%; P < .05). However, comparison of pulse-added arterial volume showed insignificant changes (<5.56%; P > .05) for all test settings. Hence, the findings herein suggest that there is clinical potential in using this aspect of the photoplethysmographic waveform.

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Inspiratory Effort Sensation to Added Resistive Loading in Patients With Obstructive Sleep Apnea

Cited by 25 publications

References 21 publications

Functional Role of Neural Injury in Obstructive Sleep Apnea

Functional Role of Neural Injury in Obstructive Sleep Apnea

Nasal Continuous Positive Airway Pressure Improves Quality of Life in Obesity Hypoventilation Syndrome

Photoplethysmographic Assessment of Hemodynamic Variations Using Pulsatile Tissue Blood Volume

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