Pathogenesis of obstructive sleep apnea: Insights from upper airway imaging studies

2013-03-01

INTRODUCTION Obstructive sleep apnea (OSA) is a major public health problem. While the clinical features of OSA are well recognized, the understanding of its pathogenesis remains incomplete. It is clear, however, that upper airway anatomy is important in the pathogenesis of OSA. This chapter will focus on the anatomical basis for the pathogenesis of OSA, with an emphasis on the structures surrounding the upper airway.

Single Slice vs. Volumetric MR Assessment of Visceral Adipose Tissue: Reliability and Validity Among the Overweight and Obese

Obesity · 2012-03-07 · 75 citations

Visceral adipose tissue (VAT) is associated with abnormal cardiovascular and metabolic profiles. Total VAT volume of the abdominal compartment by magnetic resonance imaging (MRI) is the gold-standard measurement for VAT but is costly and time consuming. Prior studies suggest VAT area on a single slice MR image may serve as a surrogate for total VAT volume but it is unknown if this relationship is maintained in overweight and obese men and women. Untreated sleep apnea subjects enrolled into the Icelandic Sleep Apnea Cohort (ISAC) underwent abdominal MRI. VAT area and subcutaneous adipose tissue (SAT) area at the L2-L3 and L4-L5 interspaces and total VAT and SAT volumes were determined by manual examination using image analysis software; 539 men and 129 women with mean ages of 54.1 and 58.8 years and mean BMI of 32.2 kg/m(2) and 33.7 kg/m(2), respectively, were studied. Mean total VAT volume was 40% smaller and mean total SAT was 25% larger among females compared with males. The correlation with VAT volume was significantly larger for L2-L3 VAT area (r = 0.96) compared to L4-L5 VAT area (r = 0.83). The difference in correlation coefficients was statistically significant (nonparametric bootstrap P < 0.001 with 95% confidence interval (CI) for the difference from 0.11 to 0.15. VAT area at L2-L3 was also significantly better correlated with VAT volume than traditional anthropometric variables. Linear regression analyses demonstrated that L2-L3 area alone was sufficient for predicting total VAT volume and that the nature of the linear association was maintained across all levels of obesity and in both genders.

Abnormal Chest X-Ray in a Drug Abuser

2011-05-02

A 56-year-old man has been admitted on several prior occasions for left groin abcesses related to injection drug use.

Pathogenesis of obstructive sleep apnea

2011-11-11 · 27 citations

Pathogenesis of obstructive sleep apnea: Insights from upper airway imaging studies

2011-10-27

Chronic Noninvasive Positive -P ressure Ventilation: During Sleep

2008-01-01

Chronic Noninvasive Positive-Pressure Ventilation: Considerations During Sleep

Sleep Medicine Clinics · 2008-11-08 · 3 citations

Portable Monitors in the Diagnosis of Obstructive Sleep Apnea

CHEST Journal · 2007-11-01 · 35 citations

Split-Night Polysomnography

CHEST Journal · 2007-11-01 · 36 citations

Upper airway imaging in obstructive sleep apnea

Current Opinion in Pulmonary Medicine · 2006-10-18 · 28 citations

PURPOSE OF REVIEW: Obstructive sleep apnea continues to be a significant public health problem. A variety of imaging modalities have been used recently to gain insight into the pathogenesis of this disease, as well as to identify therapeutic options. RECENT FINDINGS: Data from more recent imaging studies have highlighted key findings regarding the anatomic sites of collapse and local tissue factors promoting upper airway compromise. The role of genetics, aging, gender and ethnicity in the development of sleep apnea and the identification of predictors for successful treatment outcomes for sleep-disordered breathing are also reviewed. SUMMARY: As our understanding of obstructive sleep apnea evolves, newer imaging techniques and computerized models may be able to further enhance our understanding of the pathogenesis and treatment of this disease.