Upper airway shape. Is it important in the pathogenesis of obstructive sleep apnea?

American Journal of Respiratory and Critical Care Medicine

Volumn 153, Issue 3, 1996, Pages 894-898

  Leiter, J C ^a  

^a DARTMOUTH MEDICAL SCHOOL   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; BRONCHOSPASM; HUMAN; MUSCLE CONTRACTION; PATHOGENESIS; PRIORITY JOURNAL; SLEEP APNEA SYNDROME; UPPER RESPIRATORY TRACT;

EID: 0030001917     PISSN: 1073449X     EISSN: None     Source Type: Journal    
DOI: 10.1164/ajrccm.153.3.8630569     Document Type: Article

References (38)

1. Remmers, J.E. 1984. Obstructive sleep apnea. A common disorder exacerbated by alcohol. Am. Rev. Respir. Dis. 130:153-155.
2. Isono, A., and J. E. Remmers. 1994. Anatomy and physiology of upper airway obstruction. In M. H. Kryger, T. Roth, and W. C. Dement, editors. Principles and Practice of Sleep Medicine. W. B. Saunders, Philadelphia. 642-656.
3. Shepard, J. W., Jr., M. Garrison, and W. Vas. 1990. Upper airway distensibility and collapsibility in patients with obstructive sleep apnea. Chest 98:84-91.
4. Rivlin, J., V. Hoffstein, J. Kalbfleisch, W. McNicholas, N. Zamel, and A. C. Bryan. 1984. Upper airway morphology in patients with idiopathic obstructive sleep apnea. Am. Rev. Respir. Dis. 129:355-360.
5. Suratt, P. M., P. Dee, R. L. Atkinson, P. Armstrong, and S. C. Wilhoit. 1983. Fluoroscopic and computed tomographic features of the pharyngeal airway in obstructive sleep apnea. Am. Rev. Respir. Dis. 127:487-492.
6. Wasicko, M. J., J. C. Leiter, J. S. Erlichman, R. J. Strobel, and D. Bartlett, Jr. 1991. Nasal and pharyngeal resistance following topical mucosal vasoconstriction in normal humans. Am. Rev. Respir. Dis. 144:1048-1052.
7. Launois, S. H., T. R. Feroah, W. N. Campbell, F. G. Ipsa, D. Morrison, W. A. Whitelaw, S. Isono, and J. E. Remmers. 1993. Site of pharyngeal narrowing predicts outcome of surgery for obstructive sleep apnea. Am. Rev. Respir. Dis. 147:182-189.
8. Stauffer, J. L., C. W. Zwillich, R. J. Cadieux, E. O. Bixler, A. Kales, L. A. Varano, and D. P. White. 1987. Pharyngeal size and resistance in obstructive sleep apnea. Am. Rev. Respir. Dis. 136:623-627.
9. Tammelin, B. R., A. F. Wilson, B. d. B. Borowiecki, and J. F. Sassin. 1983. Flow-volume curves reflect pharyngeal airway abnormalities in sleep apnea syndrome. Am. Rev. Respir. Dis. 128:712-715.
10. Wheatley, J. R., D. J. Tangel, W. S. Mezzanotte, and D. P. White. 1993. The influence of sleep on the response to negative airway pressure of the tensor palatini muscle and the retropalatal airway. J. Appl. Physiol. 75:2117-2124.
11. White, D. P., and R. D. Ballard. 1990. Pharyngeal muscle activity and upper airway resistance in obstructive apnea patients versus controls. In F. G. Ipsa, P. M. Suratt, and J. E. Remmers, editors. Sleep and Respiration. Wiley-Liss, New York. 243-251.
12. Gleeson, K., C. W. Zwillich, T. W. Bendrick, and D. P. White. 1986. Effect of inspiratory nasal loading on pharyngeal resistance. J. Appl. Physiol. 60:1882-1886.
13. Mezzanotte, W. S., D. J. Tangel, and D. P. White. 1991. Waking genioglossal electromyogram in sleep apnea patients versus normal controls (a neuromuscular compensatory mechanism). J. Clin. Invest. 89:1571-1579.
14. Suratt, P. M., R. F. McTier, and S. C. Wilhoit. 1988. Upper airway muscle activation is augmented in patients with obstructive sleep apnea compared with that in normal subjects. Am. Rev. Respir. Dis. 137:889-894.
15. Haponik, E. F., P. L. Smith, M. E. Bohlman, R. P. Allen, S. M. Goldman, and E. R. Bleecker. 1983. Computerized tomography in obstructive sleep apnea. Am. Rev. Respir. Dis. 127:221-226.
16. Hudgel, D.W., and C. Hendricks. 1988. Palate and hypopharynx: sites of inspiratory narrowing of the upper airway during sleep. Am. Rev. Respir. Dis. 138:1542-1547.
17. Wasicko, M. J., J. S. Erlichman, and J. C. Leiter. 1993. Control of segmental upper airway resistance in patients with obstructive sleep apnea. J. Appl. Physiol. 74:2694-2703.
18. Rodenstein, D. O., G. Dooms, Y. Thomas, G. Liistro, D. C. Stanescu, C. Culée, and G. Aubert-Tulkens. 1990. Pharyngeal shape and dimensions in healthy subjects, snorers, and patients with obstructive sleep apnoea. Thorax 45:722-727.
19. Leiter, J. C. 1992. Analysis of pharyngeal resistance and genioglossal EMG activity using a model of orifice flow. J. Appl. Physiol. 73: 576-583.
20. Schwab, R. J., W. B. Gefter, E. A. Hoffman, K. B. Gupta, and A. I. Pack. 1993. Dynamic upper airway imaging during awake respiration in normal subjects and patients with sleep disordered breathing. Am. Rev. Respir. Dis. 148:1385-1400.
21. Hairston, L. E., and E. K. Sauerland. 1981. Electromyography of the human pharynx: discharge patterns of the superior pharyngeal constrictor during respiration. Electromyogr. Clin. Neurophysiol. 21:299-306.
22. Guilleminault, C., M. W. Hill, F. B. Simmons, and W. C. Dement. 1978. Obstructive sleep apnea: electromyographic and fiberoptic studies. Exp. Neurol. 62:48-67.
23. Horner, R. L., R. H. Mohiaddin, D. G. Lowell, S. A. Shea, E. D. Burman, D. B. Longmore, and A. Guz. 1989. Sites and sizes of fat deposits around the pharynx in obese patients with obstructive sleep apnea and weight matched controls. Eur. Respir. J. 2:513-622.
24. Schwab, R. J., K. B. Gupta, W. B. Gefter, L. J. Metzger, E. A. Hoffman, and A. I. Pack. 1995. Upper airway and soft tissue anatomy in normals and patients with sleep-disordered breathing. Am. J. Respir. Crit. Care Med. 152:1673-1689.
25. Schwab, R. J., W. B. Gefter, A. I. Pack, and E. A. Hoffman. 1993. Dynamic imaging of the upper airway during respiration in normal subjects. J. Appl. Physiol. 74:1504-1514.
26. Kuna, S. T., D. G. Bedi, and C. Ryckman. 1988. Effect of nasal airway positive pressure on upper airway size and configuration. Am. Rev. Respir. Dis. 138:969-975.
27. Weitzman, E. D., C. P. Pollak, B. Borowiecki, B. Burack, R. Shprintzen, and S. Rakoff. 1978. The hypersomnia-sleep apnea syndrome: site and mechanism of upper airway obstruction. In C. Guilleminault and W. C. Dement, editors. Sleep Apnea Syndromes. Alan R. Liss, Inc., New York. 235-248.
28. Sher, A. E., M. J. Thorpy, R. J. Shprintzen, A. J. Spielman, B. Burack, and P. A. McGregor. 1985. Predictive value of Müller maneuver in selection of patients for uvulopalatopharyngoplasty. Laryngoscope 95:1483-1487.
29. Zucconi, M., L. Ferini-Strambi, S. Palazzi, C. Orena, S. Zonata, and S. Smirne. 1992. Habitual snoring with and without obstructive sleep apnoea: the importance of cephalometric variables. Thorax 47:157-161.
30. Brown, I. G., T. D. Bradley, E. A. Phillipson, N. Zamel, and V. Hoffstein. 1985. Pharyngeal compliance in snoring subjects with and without obstructive sleep apnea. Am. Rev. Respir. Dis. 132:211-215.
31. Sullivan, C. E., M. Berthon-Jones, F. G. Ipsa, and L. Eves. 1981. Reversal of obstructive sleep apnoea by continuous positive airway pressure applied through the nares. Lancet i:862-865.
32. Engleman, H. M., and N. J. Douglas. 1993. CPAP compliance. Sleep 16:S114.
33. Kribbs, N. B., S. Redline, P. L. Smith, A. R. Schwartz, N. M. Schubert, L. R. Kline, L. Delisser, J. N. Henry, A. I. Pack, and D. F. Dinges. 1991. Objective monitoring of nasal CPAP usage patterns in OSAS patients. Sleep 20:270.
34. Riley, R. W., N. B. Powell, and C. Guilleminault. 1993. Obstructive sleep apnea syndrome: a surgical protocol for dynamic airway reconstruction. J. Oral Maxillofac. Surg. 51:742-747.
35. Katsantonis, G. P., C. S. Maas, and J. K. Walsh. 1989. The predictive efficacy of the Müller manuever in uvulopalatopharyngoplasty. Laryngoscope 99:677-680.
36. Wittig, R., S. Fujita, J. Fortier, F. Zorick, G. Potts, and T. Roth. 1988. Results of uvulopalatopharyngoplasty (UPPP) in patients with both oropharyngeal and hypopharyngeal collapse on Mueller maneuver. Sleep Res. 17:269.
37. Gislason, T., C.-E. Lindholm, M. Almqvist, E. Birring, G. Boman, G. Eriksson, S. G. Larsson, and H. Svanholm. 1988. Uvulopalatopharyngoplasty in sleep apnea syndrome. Arch. Otolarynogol. Head Neck Surg. 114:45-51.
38. Riley, R. W., N. B. Powell, and C. Guilleminault. 1989. Inferior mandibular osteotomy and hyoid myotomy suspension for obstructive sleep apnea: a review of 55 patients. J. Oral Maxillofac. Surg. 47:159-164.