Upper airway obstruction during sleep in children

Felman, Alvin H.; Loughlin, Gerald M.; Leftridge, C A; Cassisi, Nicholas J.

doi:10.2214/ajr.133.2.213

Cited by 48 publications

(11 citation statements)

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“…However, when OSAS is associated with more complex medical conditions, such as craniofacial anomalies or after upper airway surgery, fluoroscopy is commonly used to detect the level of airway obstruction (22,23). The limitations of fluoroscopy are both radiation exposure and that one obtains only a plane lateral image.…”

Section: Discussionmentioning

confidence: 99%

Changes in Upper Airway Size during Tidal Breathing in Children with Obstructive Sleep Apnea Syndrome

Arens

Sin

McDonough

et al. 2005

Am J Respir Crit Care Med

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We performed respiratory-gated magnetic resonance imaging to evaluate airway dynamics during tidal breathing in 10 children with obstructive sleep apnea syndrome (OSAS; age, 4.3 Ϯ 2.3 years) and 10 matched control subjects (age, 5.0 Ϯ 2.0 years). We hypothesized that respiratory cycle fluctuations in upper airway cross-sectional area would be larger in children with OSAS. Methods: Studies were performed under sedation. Respiratory gating was performed automatically at 10, 30, 50, 70, and 90% of inspiratory and expiratory volume. Airway cross-sectional area was measured at four ascending oropharyngeal levels at each increment of the respiratory cycle. Results: We noted the following in subjects with OSAS compared with control subjects: (1 ) a smaller upper airway cross-sectional area, particularly during inspiration; (2 ) airway narrowing occurred during inspiration without evidence of complete airway collapse; (3 ) airway dilatation occurred during expiration, particularly early in the phase; and (4 ) magnitude of cross-sectional areas fluctuations during tidal breathing noted in OSAS at levels 1 through 4 were 317, 422, 785, and 922%, compared with 19, 15 17, and 24% in control subjects (p Ͻ 0.001, p Ͻ 0.005, p Ͻ 0.001, and p Ͻ 0.001, respectively). Conclusions: Fluctuations in airway area during tidal breathing are significantly greater in subjects with OSAS compared with control subjects. Resistive pressure loading is a probable explanation, although increased airway compliance may be a contributing factor.

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Section: Discussionmentioning

confidence: 99%

Changes in Upper Airway Size during Tidal Breathing in Children with Obstructive Sleep Apnea Syndrome

Arens

Sin

McDonough

et al. 2005

Am J Respir Crit Care Med

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“…In some children who have obstructive sleep apnea with underlying causes other than enlarged adenoid and palatine tonsils, evaluation with dynamic sleep fluoroscopy (14)(15)(16)(17)(18) or MR imaging (19)(20)(21)(22)(23)27,28) has been shown to yield information that affects management decisions (14). Such underlying causes of obstructive sleep ap- nea include craniofacial anomalies, congenital syndromes (particularly Down syndrome and achondroplasia), mucopolysaccharidosis, and history of airway surgery (14 -16).…”

Section: Discussionmentioning

confidence: 99%

Upper Airway Motion Depicted at Cine MR Imaging Performed during Sleep: Comparison between Young Patients with and Those without Obstructive Sleep Apnea

et al. 2003

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“…Cinefluoroscopic findings show that the tongue and hypopharyngeal soft tissues are closing up during an apneic episode, obliterat ing the air space [3,4]. The obstruction of air flow are confirmed by polysomnographic re cordings, showing fiat tracings from the nasal and oral thermistors, despite continuous de flections from thoracic strain gauges [5,6].…”

Section: Presentation Of Sleep Apneasmentioning

confidence: 99%

Mechanisms of Obstructive Sleep Apneas in Infants

et al. 1994

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During sleep, infants with obstructive sleep apneas are characterised by snoring, laborious breathing, and profuse sweating. During wakefulness, they may have breath-holding spells, and during feeding, difficult breathing and swallowing coordination. Abnormal weight, difficult growth, and recurring ear infections may also develop. During sleep apneas, cinefiuoroscopy shows approximation of tongue and hypopharyngeal tissues, with an obliteration of the air space. The obstructed breaths occur mainly in REM, and light NREM sleep, associated with total short sleep time, and frequent arousals. Preterm infants, and term neonates are more prone to obstructive apneas than older healthy infants. Apneas are more frequently seen in boys and in case of excess in body weight. Obstructive apneas are frequently associated with upper airway anatomic abnormalities: malformations, soft tissue infiltration, and neurologic lesions impairing muscle contractions. Alterations of the autonomic nervous control may induce airways obstructions. Contributing factors include mucopolysaccharide storage disease, hypothyroidism, or Down’s syndrome. Superimposed factors may occur, such as nasal obstruction, secretions in the airways, or tissue edema. Pressure- and chemo-sensitive reflexes may also favor obstruction. Environmental factors also contribute to the development of sleep apneas: body position, neck flexion, sleep deprivation, or the effects of sedative drugs.

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Upper airway obstruction during sleep in children

Cited by 48 publications

References 0 publications

Changes in Upper Airway Size during Tidal Breathing in Children with Obstructive Sleep Apnea Syndrome

Changes in Upper Airway Size during Tidal Breathing in Children with Obstructive Sleep Apnea Syndrome

Upper Airway Motion Depicted at Cine MR Imaging Performed during Sleep: Comparison between Young Patients with and Those without Obstructive Sleep Apnea

Mechanisms of Obstructive Sleep Apneas in Infants

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