The Effect of Upper Airway Structural Changes on Central Chemosensitivity in Obstructive Sleep Apnea-Hypopnea

Abstract

We examined the efficiency of upper airway structural changes in uvulopalatopharyngoplasty and/or tonsillectomy on central chemosensitivity, and whether the outcome of such surgeries can be predicted by the central chemosensitivity in obstructive sleep apnea-hypopnea syndrome (OSAHS) patients. In 11 patients with OSAHS group, the average of the hypercapnic ventilatory response (HCVR) slope was 1.93 +/- 0.20 L/min/mm Hg preoperatively and 1.78 +/- 0.22 L/min/mm Hg postoperatively. The average of the mouth occlusion pressure at 0.1 second after the onset of inspiration (P (0.1)) slope was 0.47 +/- 0.06 cm H (2)O/mm Hg and 0.44 +/- 0.08 cm H (2)O/mm Hg, before and after surgery, respectively. There were no significant differences before and after treatment, although OSAHS was improved by these surgeries. In control group with 5 patients, the HCVR slope and P (0.1) slope also showed no significant difference before and after the procedure. When we divided the 11 OSAHS patients into 7 responders (apnea-hypopnea index < 20 events/h and > 50% reduction) and 4 poor responders, there was a significant difference between the average HCVR slope of responders (1.59 +/- 0.21 L/min/mm Hg) and that of poor responders (2.52 +/- 0.20 L/min/mm Hg). We saw no significant difference in physiologic (age, body mass index, one-piece tonsil weight), blood gas values, cephalometric, spirometric, or sleep parameters.

Tonsillectomy for adult obstructive sleep apnea: A systematic review and meta-analysis

“…The searches yielded 2,318 studies: 47 were potentially relevant and were downloaded. References revealed two additional potentially relevant studies .…”

“…References revealed two additional potentially relevant studies . Studies were excluded for the following reasons: only posttonsillectomy data was available, no polysomnography or quantitative sleepiness data, the patient(s) underwent a tonsillectomy alone; however, the studies only reported data for the entire group which included additional surgeries, the patient(s) underwent another procedure simultaneously, or the articles were review articles with no new data . Seventeen studies met criteria.…”

Avaliação da eficácia de aparelho intraoral no tratamento da apneia obstrutiva do sono em hospital de ensino

“…Ressalta -se que pacientes com SAOS normalmente apresentam fatores de risco para obesidade, resistência à insulina e hiperlipidemia (Suzuki, Ogawa 2004, Thomas, Chavoya 2003.…”

Η Επίδραση Της Θεραπείας Με CPAP Στην Ικανότητα Για Άσκηση Σε Ασθενείς Με Αποφρακτικού Τύπου Άπνοια/Υπόπνοια Κατά Τον Ύπνο

“…Οι κινητικοί νευρώνες για τους ανώτερους αεραγωγούς φαίνεται να έχουν υψηλότερο ουδό διοξειδίου του άνθρακα από τους νευρώνες για τους θωρακικούς μύες. Αυτό σημαίνει ότι κατά την αναπνοή οι ανώτεροι αεραγωγοί ενεργοποιούνται πιο πριν από τους θωρακικούς μύες29 .Με την έλευση του ύπνου η δραστηριότητα των φαρυγγικών μυών μειώνεται και η αντίσταση φάρυγγα αυξάνεται λόγω της μείωσης της διαμέτρου του φαρυγγικού αυλού. Η φασική δραστηριότητα διατηρείται και η αύξηση της αντίστασης αποδίδεται στην απώλεια της τονικής δραστηριότητας.…”