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Upper Airway Resistance Syndrome

Tarig Ali-Dinar, Jason E Lang
Obesity is a major risk factor for several conditions including atherosclerotic disease, metabolic syndrome, and upper airway dysfunction. However, the purported link between obesity and asthma has remained more difficult to define, in part due to limitations in past epidemiologic studies and the inherent challenge in accurately defining asthma in children. It is possible that obesity leads to asthma only in the presence of a mediating variable such as an obesity-related conditions such as esophageal reflux or insulin resistance...
October 17, 2016: Pediatric Pulmonology
Arikin Abdeyrim, Liang Tang, Arzugl Muhamat, Kelimu Abudeyrim, YongPing Zhang, NanFang Li, Yinchun Wang, Minghua Zhao
BACKGROUND: Inability to maintain upper-airway patency during sleep is a cause of obstructive sleep apnea (OSA) and its sequelae. The associated syndrome (OSAS) is common in obese populations, currently, nocturnal polysomnography is the gold standard for diagnosing this conditions, but the diagnostic procedures are expensive and time-consuming. Therefore, identification of new markers of OSAS would be useful. This study aims to examine the receiver operating characteristics of impulse oscillometry (IOS) parameters for the prediction of OSAS in preobese and obese snoring patients...
2016: BMC Pulmonary Medicine
David M Wootton, Sanghun Sin, Haiyan Luo, Alireza Yazdani, Joseph M McDonough, Mark E Wagshul, Carmen R Isasi, Raanan Arens
Obstructive sleep apnea syndrome (OSAS) is associated with anatomical abnormalities restricting upper airway size and functional factors decreasing pharyngeal dilator activity in sleep. In this study we hypothesized that OSAS is also associated with altered pharyngeal mechanical compliance during wakefulness. Five OSAS and six control obese girls between 14 and 18 years of age were studied. All underwent polysomnography, critical closing pressure (Pcrit) studies, and dynamic MRI of the upper airway during awake tidal breathing...
October 1, 2016: Journal of Applied Physiology
Luciana Balester Mello de Godoy, Gabriela Pontes Luz, Luciana Oliveira Palombini, Luciana Oliveira E Silva, Wilson Hoshino, Thaís Moura Guimarães, Sergio Tufik, Lia Bittencourt, Sonia Maria Togeiro
PURPOSE: To compare sleep quality and sustained attention of patients with Upper Airway Resistance Syndrome (UARS), mild Obstructive Sleep Apnea (OSA) and normal individuals. METHODS: UARS criteria were presence of excessive daytime sleepiness (Epworth Sleepiness Scale-ESS-≥ 10) and/or fatigue (Modified Fatigue Impact Scale-MFIS-≥ 38) associated to Apnea/hypopnea index (AHI) ≤ 5 and Respiratory Disturbance Index (RDI) > 5 events/hour of sleep or more than 30% of total sleep time with flow limitation...
2016: PloS One
Hela Marmouch, Sondes Arfa, Sameh Graja, Tensim Slim, Ines Khochtali
A 52-year-old female with a history of poorly controlled resistant hypertension was admitted to our hospital with severe hypertension. She had a history of fatigue and intermittent episodes of palpitations. Laboratory evaluation was significant for elevated 24-h urinary catecholamine levels (3,5 times the upper normal levels). This case was presenting with a clinical and biochemical picture indistinguishable from that of pheochromocytoma. However, neither computed tomography nor meta-iodo-benzyl-guanidine scintigraphy detected any catecholamine-producing tumor in or outside the adrenal glands...
2016: Pan African Medical Journal
Kyung-Hwa Jeong, Youngsoo Yang, Hye Rang Choi, Jae Hoon Cho, Gee-Tae Kim, Jin Kook Kim
OBJECTIVES: Patients with obstructive sleep apnea syndrome (OSAS) have impaired responses to inspiratory resistive loading during sleep. This may be due, in part, to a change in the upper airway sensation. Therefore, we hypothesized that patients with OSAS have diminished upper airway sensation due to snoring. METHODS: A total of 53 participants were selected based on clinical evaluation and polysomnography. Two-point discrimination was measured with modified calipers in the tongue and soft palate...
September 2016: Clinical and Experimental Otorhinolaryngology
Goutham Mylavarapu, Dhananjay Subramaniam, Raghuvir Jonnagiri, Ephraim J Gutmark, Robert J Fleck, Raouf S Amin, Mohamed Mahmoud, Stacey L Ishman, Sally R Shott
Current treatment options are successful in 40% to 60% of children with persistent obstructive sleep apnea after adenotonsillectomy. Residual obstruction assessments are largely subjective and do not clearly define multilevel obstruction. We endeavor to use computational fluid dynamics to perform virtual surgery and assess airflow changes in patients with Down syndrome and persistent obstructive sleep apnea. Three-dimensional airway models were reconstructed from respiratory-gated computed tomography and magnetic resonance imaging...
July 2016: Otolaryngology—Head and Neck Surgery
Debora Petrungaro Migueis, Luiz Claudio Santos Thuler, Lucas Neves de Andrade Lemes, Chirlene Santos Souza Moreira, Lucia Joffily, Maria Helena de Araujo-Melo
INTRODUCTION: Obstructive sleep apnea syndrome (OSAS) is a common disorder that can lead to cardiovascular morbidity and mortality, as well as to metabolic, neurological, and behavioral consequences. It is currently believed that nasal obstruction compromises the quality of sleep when it results in breathing disorders and fragmentation of sleep. However, recent studies have failed to objectively associate sleep quality and nasal obstruction. OBJECTIVE: The aim of this systematic review is to evaluate the influence of nasal obstruction on OSAS and polysomnographic indices associated with respiratory events...
March 2016: Brazilian Journal of Otorhinolaryngology
Tshering Amdo, Nadia Hasaneen, Morris S Gold, Avram R Gold
OBJECTIVES: We tested the hypothesis that the prevalence of somatic syndromes, anxiety, and insomnia among sleep disordered breathing (SDB) patients is correlated with their levels of somatic arousal, the symptoms of increased sympathetic nervous system tone under conditions of stress. METHODS: We administered the Body Sensation Questionnaire (BSQ; a 17-item questionnaire with increasing levels of somatic arousal scored 17-85) to 152 consecutive upper airway resistance syndrome (UARS) patients and 150 consecutive obstructive sleep apnea/hypopnea (OSA/H) patients...
May 2016: Sleep & Breathing, Schlaf & Atmung
Ignacio E Tapia, Carole L Marcus, Joseph M McDonough, Ji Young Kim, Mary Anne Cornaglia, Rui Xiao, Julian L Allen
STUDY OBJECTIVES: Enlarged tonsils and adenoids, the main cause of obstructive sleep apnea syndrome (OSAS) in children, results in upper airway (UA) loading. This contributes to the imbalance between structural and neuromotor factors ultimately leading to UA collapse during sleep. However, it is unknown whether this UA loading can cause elevated airway resistance (AR) during wakefulness. We hypothesized that children with OSAS have elevated AR compared to controls and that this improves after OSAS treatment...
2016: Sleep
Camila de Castro Corrêa, Giédre Berretin-Felix
The literature presents publications on the treatment of patients with obstructive sleep apnea syndrome (OSAS) by myofunctional therapy, but there are no reports of this approach to patients with upper airway resistance syndrome (UARS). The objective was to verify the effect of myofunctional therapy in a case of UARS in relation to morphological and functional aspects of the stomatognathic system, anthropometric data, and quality of sleep. Patient, aged 61 years, diagnosed with UARS, underwent 12 sessions of myofunctional therapy for 3 months with exercises aimed at the suprahyoid, the tongue, and the soft palate muscles...
November 2015: CoDAS
R Venkat, M Vasanthakumar, D Balakrishnan, P Deenadayalan
BACKGROUND: Reduction of upper airway (UA) dimensions during sleep is contemplated to cause reduced sleep efficiency (SE) but a definitive association is not affirmed. Efficacy of nasopharyngeal appliance (NPA) in management of UA resistance syndrome (UARS) has not been compared with mandibular repositioning splint (MRS). This study intended to assess relation of UA dimensions to SE and effectiveness of NPA. MATERIALS AND METHODS: Research had two phases: Case-control study to determine association between UA and SE; randomized control trial (with independent concurrent trial groups and double-blind design) to analyze treatment outcome with NPA...
September 2015: Indian Journal of Dental Research: Official Publication of Indian Society for Dental Research
Rosanna Vaschetto, Massimo Corradi, Matteo Goldoni, Laura Cancelliere, Simone Pulvirenti, Ugo Fazzini, Fabio Capuzzi, Federico Longhini, Antonio Mutti, Francesco Della Corte, Paolo Navalesi
Recent studies in spontaneously breathing subjects indicate the possibility of obtaining the alveolar fraction of exhaled breath condensate (aEBC). In critically ill mechanically ventilated patients, in whom microbial colonization of the upper airways is constant, collection of aEBC could considerably add to the ability of monitoring alveolar inflammation. We designed this study to test the feasibility of collecting aEBC in mechanically ventilated critically ill patients through a dedicated apparatus, i.e. a CO2 valve combined with a condenser placed in the expiratory limb of the ventilator circuit...
December 2015: Journal of Breath Research
S M'saad, I Yangui, W Feki, N Abid, N Bahloul, F Marouen, A Chakroun, S Kammoun
The upper airway resistance syndrome "UARS" is a poorly defined entity, often described as a moderate variant of the obstructive sleep apnea syndrome. It is associated with respiratory effort-related arousal, absence of obstructive sleep apnea, and absence of significant desaturation. It is a relatively common condition that predominantly affects non-obese young adults, with no predominance in either sex. The degree of upper airway collapsibility during sleep of patients with UARS is intermediate between that of normal subjects and that of patients with mild-to-moderate sleep apnea syndrome...
December 2015: Revue des Maladies Respiratoires
Fernando Jaén-Águila, José Antonio Vargas-Hitos, Juan Diego Mediavilla-García
Obstructive sleep apnea (OSA) syndrome is a prevalent condition characterized by repeated episodes of obstruction of the upper airway, leading to intermittent hypoxemia and important endothelial and anatomical dysfunctions that cause cardiovascular and cerebrovascular disease. The finding of the relationship between OSA and hypertension, especially resistant hypertension (RHT), has increased the interest in therapeutic strategies that affect renal sympathetic activity in these patients. The observational studies published until now demonstrated that renal denervation therapy can reduce the severity of OSA syndrome...
2015: International Journal of Hypertension
Luciana B M de Godoy, Luciana O Palombini, Christian Guilleminault, Dalva Poyares, Sergio Tufik, Sonia M Togeiro
OBJECTIVE: To evaluate the available literature regarding Upper Airway Resistance Syndrome (UARS) treatment. METHODS: Keywords "Upper Airway Resistance Syndrome," "Sleep-related Breathing Disorder treatment," "Obstructive Sleep Apnea treatment" and "flow limitation and sleep" were used in main databases. RESULTS: We found 27 articles describing UARS treatment. Nasal continuous positive airway pressure (CPAP) has been the mainstay therapy prescribed but with limited effectiveness...
January 2015: Sleep Science
Necdet Demir, Arif Sanli, Gokhan Demir, Banu Atalay Erdogan, Huseyin Baki Yilmaz, Mustafa Paksoy
INTRODUCTION: It is known that obesity causes obstructive sleep apnea syndrome by increasing upper airway resistance. Also, obese patients are admitted to the ear, nose, and throat clinic very often because of nasal obstruction complaint. The aim of this study is to identify the change and relation among body mass index (BMI), nasal resistance, reduction in nasal ariflow, nasal anatomy, and patients' subjective complaints. MATERIAL AND METHOD: A total of 67 patients admitted to our clinic between August 2013 and January 2014 were included in the study...
September 2015: Journal of Craniofacial Surgery
Gerard Torres, Manuel Sánchez-de-la-Torre, Ferran Barbé
There is a bidirectional association between OSA and systemic hypertension. The strengths of this relationship appear to be modulated by factors such as age, sex, and somnolence. The 24-h BP circadian pattern also appears to be influenced by OSA. Patients with this syndrome exhibit a high prevalence of nondipping or riser circadian patterns, which are related to clinical and subclinical organ damage in the heart and brain. However, the influence of OSA on nocturnal hypertension development has not yet been clarified...
September 2015: Chest
Seo-Young Lee, Christian Guilleminault, Hsiao-Yean Chiu, Shannon S Sullivan
BACKGROUND: Adenotonsillectomy (T&A) may not completely eliminate sleep-disordered breathing (SDB), and residual SDB can result in progressive worsening of abnormal breathing during sleep. Persistence of mouth breathing post-T&As plays a role in progressive worsening through an increase of upper airway resistance during sleep with secondary impact on orofacial growth. METHODS: Retrospective study on non-overweight and non-syndromic prepubertal children with SDB treated by T&A with pre- and post-surgery clinical and polysomnographic (PSG) evaluations including systematic monitoring of mouth breathing (initial cohort)...
December 2015: Sleep & Breathing, Schlaf & Atmung
Soo-Jung So, Heon-Jeong Lee, Seung-Gul Kang, Chul-Hyun Cho, Ho-Kyoung Yoon, Leen Kim
OBJECTIVE: To investigate the personality characteristics of patients with upper airway resistance syndrome (UARS) and those of patients with obstructive sleep apnea syndrome (OSAS). METHODS: Eighty-eight patients with UARS and 365 patients with OSAS participated. All patients had a diagnostic full-night attended polysomnography (PSG) and completed the Athens Insomnia Scale (AIS), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Symptom Checklist-90-Revision (SCL-90-R) and Eysenck Personality Questionnaire (EPQ)...
April 2015: Psychiatry Investigation
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