Sleep magnetic resonance imaging with electroencephalogram in obstructive sleep apnea syndrome

Kavcic, Pavel; Koren, Aleš; Koritnik, Blaž; Fajdiga, Igor; Grošelj, Leja Dolenc

doi:10.1002/lary.25085

Cited by 24 publications

(26 citation statements)

References 30 publications

(44 reference statements)

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“…Previous sleep MRI studies have demonstrated retropalatal and retroglossal airway collapse in subjects with OSA [6]. In this study, we found that retropalatal airway collapse is common in all OSA subjects, which is [6][7][8][9]15]. We did not, however, find any isolated retroglossal airway collapse in subjects with severe OSA as described in previous imaging studies [7,9].…”

Section: Discussioncontrasting

confidence: 51%

“…In this study, we found that retropalatal airway collapse is common in all OSA subjects, which is [6][7][8][9]15]. We did not, however, find any isolated retroglossal airway collapse in subjects with severe OSA as described in previous imaging studies [7,9]. All of our severe OSA subjects showed retroglossal or retropalatal airway collapse in combination with lateral pharyngeal wall collapse.…”

Section: Discussioncontrasting

confidence: 50%

“…Without EEG in our MRI scanners, we do not have information about the patients' sleep staging. It has been suggested that patients who could fall asleep in the scanner remain mostly in stages I and II [7]. Finally, an increase in number of subjects would allow multivariate analyses examining other anatomic or physiologic contributors to lateral pharyngeal wall collapse.…”

Section: Discussionmentioning

confidence: 99%

“…To date, sleep MRI studies have focused on observations using sagittal views of the UA, which only allows for the identification of retropalatal and retroglossal airway collapse in an anterior to posterior direction [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

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Dynamic upper airway collapse observed from sleep MRI: BMI-matched severe and mild OSA patients

Huon

Liu

Shih

et al. 2016

Eur Arch Otorhinolaryngol

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Dynamic magnetic resonance imaging (MRI) allows real-time characterization of upper airway collapse in sleeping subjects with obstructive sleep apnea (OSA). The aim of our study was to use sleep MRI to compare differences in upper airway collapse sites between BMI-matched subjects with mild OSA and severe OSA. This is a prospective, nested case-control study using dynamic sleep MRI to compare 15 severe OSA subjects (AHI >40) and 15 mild OSA (AHI <10) subjects, who were matched for BMI. Upper airway imaging was performed on sleeping subjects in a 3.0 T MRI scanner. Sleep MRI movies were used by blinded reviewers to identify retropalatal (RP), retroglossal (RG), and lateral pharyngeal wall (LPW) airway collapse. Mean AHI in the severe OSA group was 70.3 ± 23 events/h, and in the mild group was 7.8 ± 1 events/h (p < 0.001). All mild and severe OSA subjects demonstrated retropalatal airway collapse. Eighty percent in the mild group showed single-level RP collapse (p < 0.001). All subjects in the severe group showed multi-level collapse: RP + LPW (n = 9), RP + RG + LPW (n = 6). All severe OSA subjects showed LPW collapse, as compared with three subjects in the mild group (p < 0.001). LPW collapse was positively associated with AHI in simple regression analysis (β = 51.8, p < 0.001). In conclusion, severe OSA patients present with more lateral pharyngeal wall collapse as compared to BMI-matched mild OSA patients.

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Section: Discussioncontrasting

confidence: 51%

Section: Discussioncontrasting

confidence: 50%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Dynamic upper airway collapse observed from sleep MRI: BMI-matched severe and mild OSA patients

Huon

Liu

Shih

et al. 2016

Eur Arch Otorhinolaryngol

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“…Electroencephalograms are recorded synchronously with MRI to objectively determine sleep and wakefulness [79]. Respiration, heart rate, and oxygen saturation signals are simultaneously recorded to infer central or obstructive apneic events [49].…”

Section: Synchronized Acquisitionmentioning

confidence: 99%

Fast upper airway magnetic resonance imaging for assessment of speech production and sleep apnea

Kim

2018

Precis Future Med

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The human upper airway is involved in various functions, including speech, swallowing, and respiration. Magnetic resonance imaging (MRI) can visualize the motion of the upper airway and has been used in scientific studies to understand the dynamics of vocal tract shaping during speech and for assessment of upper airway abnormalities related to obstructive sleep apnea and swallowing disorders. Acceleration technologies in MRI are crucial in improving spatiotemporal resolution or spatial coverage. Recent trends in technical aspects of upper airway MRI are to develop state-of-the-art image acquisition methods for improved dynamic imaging of the upper airway and develop automatic image analysis methods for efficient and accurate quantification of upper airway parameters of interest. This review covers the fast upper airway magnetic resonance (MR) acquisition and reconstruction, MR experimental issues, image analysis techniques, and applications, mainly with respect to studies of speech production and sleep apnea.

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Transverse Maxillary Deficiency Predicts Increased Upper Airway Collapsibility during Drug‐Induced Sleep Endoscopy

Thuler

Seay

Woo

et al. 2023

Otolaryngol.--head neck surg.

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Objective. To examine the relationship between craniofacial skeletal anatomy and objective measures of pharyngeal collapse obtained during drug-induced sleep endoscopy. We hypothesized that transverse maxillary deficiency and an increased pharyngeal length will be associated with higher levels of pharyngeal collapsibility.Study Design. Cross-sectional analysis in a prospective cohort.Setting. University Hospital.Methods. A cross-sectional analysis was conducted in a cohort of consecutive patients from the positive airway pressure (PAP) alternatives clinic who underwent computed tomography (CT) analysis and drug-induced sleep endoscopy for characterization of upper airway collapsibility. PAP titration was used to determine pharyngeal critical pressure (P CRIT ) and pharyngeal opening pressure (PhOP). CT metrics included: Transverse maxillary dimensions (interpremolar and intermolar distances) and pharyngeal length (posterior nasal spine to hyoid distance).Results. The cohort (n = 103) of severe obstructive sleep apnea (Apnea and Hipopnea Index 32.1 ± 21.3 events/h) was predominantly male (71.8%), Caucasian (81.6%), middleaged (54.4 ± 14.3 years), and obese (body mass index [BMI] = 30.0 ± 4.9 kg/m 2 ). Reduced transverse maxillary dimensions were associated with higher P CRIT (intermolar distance: β [95% confidence interval, CI] = −.25 [−0.14, −0.36] cmH 2 O/mm; p = .03) and PhOP (Interpremolar distance: β = −.25 [−0.14, −0.36] cmH 2 O/ mm; p = .02). Longer pharyngeal length was also associated with higher P CRIT (β = .11 [0.08, 0.14] cmH 2 O/mm, p = .04) and PhOP (β [95% CI] = .06 [0.03, 0.09] cmH 2 O/mm, p = .04). These associations persisted after adjustments for sex, age, height, and BMI. Conclusion.Our results further the concept that skeletal restriction in the transverse dimension and hyoid descent are associated with elevations in pharyngeal collapsibility during sleep, suggesting a role of transverse deficiency in the pathogenesis of airway obstruction.

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Sleep magnetic resonance imaging with electroencephalogram in obstructive sleep apnea syndrome

Abstract: 2b.

Cited by 24 publications

References 30 publications

Dynamic upper airway collapse observed from sleep MRI: BMI-matched severe and mild OSA patients

Dynamic upper airway collapse observed from sleep MRI: BMI-matched severe and mild OSA patients

Fast upper airway magnetic resonance imaging for assessment of speech production and sleep apnea

Transverse Maxillary Deficiency Predicts Increased Upper Airway Collapsibility during Drug‐Induced Sleep Endoscopy

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