OBJECTIVE: To discuss the main influence factors of sound pressure level parameters in patients with simple snoring (SS) and obstructive sleep apnea hypopnea syndrom (OSAHS). METHOD: Eighty-four cases with snoring disease underwent polysomnography and simultaneously snoring sound pressure level recording. The correlations between AHI, age, BMI, abdomen circumference, neck circumference, the lowest oxygen saturation total apnea time and sound pressure level parameters: equivalent continuous sound level(LAeq)and maximum sound pressure level(L10) were analyzed. RESULT: LAeq was significantly correlated to AHI (P= 0. 000) and BMI (P= 0. 007), and the odd ratios of AHI and BMI were 5. 74,2. 09 respectively, but it was unrelated to age, abdomen circumference, neck circumference, the lowest oxygen saturation and total apnea time. A significantly association also existed between L10 and AHI(P=0. 000), BMI(P=0. 032), and the odd ratios were 4. 11 and 2. 33 respectively. Other factors had nothing to do with L10. CONCLUSION The main factors which affect the snoring sound pressure level parameters LAeq and L10 are AHI and BMI.
Humans ; Polysomnography ; Pressure ; Sleep Apnea, Obstructive ; physiopathology ; Snoring ; physiopathology ; Sound

OBJECTIVE: To realize the characteristics of clinical symptoms and PSG in elderly patients with obstructive sleep apnea hypopnea syndrome (OSAHS). METHOD: The clinical presentations, epworth sleepiness scale (ESS) and polysomnography findings were compared between elderly patients with OSAHS and middle age patients with OSAHS. RESULT: There were no significantly differences in clinical presentations including snoring, apnea and daytime sleepiness complaint between the elderly and middle aged patients with OSAHS, but the incidences of complications such as hypertension and other cardiovascular diseases was significantly higher in elderly patients than those in the middle aged patients (P<0.01). The sleep architecture disturbance was significantly worse in elderly OSAHS patients compared with the middle age patients. The percentages of non-rapid eye movement (NREM) stage I sleep were significantly increased, the rapid eye movement (REM) sleep were significantly decreased in elderly OSAHS patients than those in middle aged group (P<0.01 or P<0.05), but the percentages of awake, NREM stage II sleep and NREM stage II-IV sleep had no significantly difference in the two groups. The apnea hypopnea index (AHI), apnea index (AI), hypopnea index (HI), snoring index, ESS and body mass index (BMI) were significantly decreased, the lowest oxygen saturation (LSO2) and micro-arousal index were significantly increased in elderly OSAHS patients than those in middle aged group (P<0.01 or P<0.05). CONCLUSION The elderly OSAHS patients are less sever than the middle age, but the elderly patients have worse sleep architecture disturbance and more complications such as hypertension and other cardiovascular diseases.
Aged ; Humans ; Middle Aged ; Polysomnography ; Sleep ; Sleep Apnea, Obstructive ; diagnosis ; physiopathology ; Sleep Stages ; Sleep, REM

OBJECTIVE: To study the clinical value of polysomnography (PSG) and ApneaGraph (AG200) in the diagnosis evaluation of obstructive sleep apnea hypopnea syndrome (OSAHS). METHOD: From January to December in 2012, 67 OSAHS patients diagnosed by PSG were examined by AG200. The apnea hypopnea index (AHI), hypopnea index (HI), apnea index (AI), the lowest oxygen saturation (LSaO2) was were detected and the results were analyzed statistically. RESULT: Significant differences were observed in AI, AHI, LSaO2 between AG200 and PSG (P < 0.05, respectively). No statistically significant difference was found in HI. The differences in HI between AG200 and PSG were not significant (P > 0.05). AHI, HI and LSaO2 was were significantly correlated between AG200 and PSG (r = 0.870, 0.743, 0.374, 0.716, P < 0.01). CONCLUSION AG200 could not replace PSG but could identify the level of upper airway obstruction.
Female ; Humans ; Male ; Polysomnography ; methods ; Sleep Apnea, Obstructive ; diagnosis ; physiopathology

Obstructive sleep apnea (OSA), which is the most common sleep-related breathing disorder, is characterized as frequent upper airway collapse and obstruction. It is a treatable disorder but if left untreated is associated with complications in several organ systems. The health risk to OSA patients shows a strong association with acute cardiovascular events, and with chronic conditions. To the central nervous system, OSA causes behavioral and neuropsychologic deficits including daytime sleepiness, depression, impaired memory, mood disorders, cognition deficiencies, language comprehension and expression deficiencies, all of which are compatible with impaired hippocampal function. Furthermore, there exists a significant correlation between disease severity and cognitive deficits in OSA. Children with severe OSA have significantly lower intelligence quotient (IQ) and executive control functions compared to normal children matched for age, gender and ethnicity. This corroborates the findings of several pediatric studies of cognition in childhood OSA, where deficits are reported in general intelligence and some measures of executive function. In studies of OSA, it is difficult to differentiate the effects of its two main pathologic traits, intermittent hypoxia (IH) and sleep fragmentation. Many OSA studies, utilize IH as the only exposure factor in OSA studies. These approaches simplify research process and attain most of the academic goals. IH, continuous hypoxia and intermittent continuous hypoxia can all result in decreases in arterial O2. There are striking differences to them in the response of physiological systems. There are multiple studies showing that IH treatment in a rodent model of OSA can impair performance of standard water maze tests associated with deficits in spatial learning and memory which most likely are hippocampal-dependent. Cellular damage to the hippocampal cornuammonis 1 (CA1) region likely contributes to neuropsychological impairment among OSA patients, since neural circuits in the hippocampus are important in learning and memory. In this article, studies of hippocampal impairments from IH are reviewed for elucidating the mechanisms and relationships between hippocampal impairments and IH of OSA.
Hippocampus ; physiopathology ; Humans ; Hypoxia ; etiology ; physiopathology ; Sleep Apnea, Obstructive ; etiology ; physiopathology

OBJECTIVE: to investigate the origin characters of snore in simple snorers and provide the basis for its treatment. METHOD: Thirty-two simple snorers diagnosed by polysomnography were induced to sleep by propofol and dexmedetomidine, then we observed the vibration sites, pattern and concomitant collapse of soft tissue in pharyngeal cavity by nasendoscopy. RESULT: Thirteen cases showed palatal fluttering only, and 1 case showed vibration of epiglottis only. Six cases showed palatal fluttering with vibration of epiglottis, and 2 cases showed palatal fluttering with vibration of epiglottis and tongue base. Five cases showed palatal fluttering with vibration of pharyngeal lateral wall, and 5 cases showed palatal fluttering with vibration of lateral wall, epiglottis and tongue base together. Palate and pharyngeal lateral wall vibrated strongly and always collapsed with vibrating, but epiglottis and tongue base usually vibrated slightly and seldom collapsed. CONCLUSION The palatal fluttering is the main source of snoring sounds for most simple snorers, then followed by vibration of palatal and pharyngeal lateral wall together. The site of collapse in pharyngeal cavity is consistent with the main site of vibration.
Endoscopy ; Epiglottis ; physiopathology ; Humans ; Palate ; physiopathology ; Pharynx ; physiopathology ; Polysomnography ; Propofol ; Sleep ; Sleep Apnea, Obstructive ; Snoring ; diagnosis ; Tongue ; physiopathology

Recent clinical trials have shown that electrical stimulation has beneficial effects in obstructive sleep apnea syndrome (OSAS). The purpose of this study was to evaluate the efficacy of electrical stimulation therapy for OSAS with a meta-analysis. The meta-analysis of all relative studies was performed through searching international literature, including PUBMED, CNKI, and EMBASE databases. This literature analysis compared all patients undergoing electrical stimulation therapy with respect to the respiratory disturbance index (RDI) and changes in sleep structure. Six studies were selected involving a total of 91 patients. The meta-analysis indicated that electrical stimulation therapy reduced RDI, longest apnea time, and improved the minimum SaO2. Based on the evidence found, electrical stimulation may be a potential therapy for OSAS, warranting further clinical trials.
Electric Stimulation Therapy ; methods ; Humans ; Respiratory Mechanics ; physiology ; Sleep ; physiology ; Sleep Apnea, Obstructive ; physiopathology ; therapy

OBJECTIVE: To build up a steady and credible animal model on obstructive sleep apnea-hypopnea syndrome (OSAHS) with New Zealand rabbit. METHOD: Ten New Zealand rabbit were divided into two groups (A and B, 5 for each). Group A was treated by injecting Dimethiconum from exterior. Group B was blank. EEG, snoring and oxygen-saturation were recorded by PSG after operation. Examination was repeated two weeks later and one month later. CT was done in the operation and two weeks later. Animals were sacrificed three months later and the Dimethiconum in the body was used for examination with light microscopy. RESULT: Group A showed apnea or hypopnea and decreasing SaO2 after operation. The changes in group A were more obvious at two weeks and one month. CONCLUSION A steady and credible animal model of OSAHS has been built. The model provides a tool to study the pathogenesy and pathophysiology of OSAHS.
Animals ; Apnea ; chemically induced ; physiopathology ; Disease Models, Animal ; Oxygen ; metabolism ; Rabbits ; Sleep Apnea, Obstructive ; chemically induced ; physiopathology ; Snoring ; physiopathology

OBJECTIVETo evaluate the feasibility of pulse transit time (PTT) arousals as an index of sleep fragmentation in patients with obstructive sleep apnea hypopnea syndrome (OSAHS).

METHODSIndividuals referred for evaluation of possible OSAHS underwent overnight polysomnography (PSG). Three conventional indices of sleep fragmentation [electroencephalography (EEG) arousals, apnea/hypopnea index (AHI) , oxygen desaturation index (ODI)] , PTT arousals, and Epworth sleepiness scale (ESS) were compared.

RESULTSPTT arousals were positively correlated with EEG arousals (r = 0.746, P < 0.001), AHI (r = 0.786, P < 0.001), and ODI (r = 0.665, P < 0.001) , respectively. But, both PTT arousals and EEG arousals had no correlation with ESS (r = 0.432, P = 0.201; r = 0.196, P = 0.591, respectively).

CONCLUSIONPTT arousals are correlated well with other standard measures estimating severity of OSAHS and potentially a non-invasive marker with which to measure the sleep fragmentation in patients with OSAHS.

Adult ; Arousal ; physiology ; Autonomic Nervous System ; physiopathology ; Electrocardiography ; Electroencephalography ; Humans ; Middle Aged ; Pulse ; Sleep Apnea Syndromes ; physiopathology ; Sleep Apnea, Obstructive ; physiopathology ; Sleep Stages ; physiology

Enuresis ; diagnosis ; pathology ; physiopathology ; Female ; Humans ; Middle Aged ; Polysomnography ; Sleep Apnea, Obstructive ; diagnosis ; pathology ; physiopathology

BACKGROUNDIt is believed that defects in upper airway neuromuscular control play a role in sleep apnea pathogenesis. Currently, there is no simple and non-invasive method for evaluating neuromuscular activity for the purpose of screening in patients with obstructive sleep apnea. This study was designed to assess the validity of chin surface electromyography of routine polysomnography in evaluating the neuromuscular activity of obstructive sleep apnea subjects and probe the neuromuscular contribution in the pathogenesis of the condition.

METHODSThe chin surface electromyography of routine polysomnography during normal breathing and obstructive apnea were quantified in 36 male patients with obstructive sleep apnea. The change of chin surface electromyography from normal breathing to obstructive apnea was expressed as the percent compensated electromyography value, where the percent compensated electromyography value = (normal breath surface electromyography - apnea surface electromyography)/normal breath surface electromyography, and the percent compensated electromyography values among subjects were compared. The relationship between sleep apnea related parameters and the percent compensated electromyography value was examined.

RESULTSThe percent compensated electromyography value of the subjects varied from 1% to 90% and had a significant positive correlation with apnea hypopnea index (R(2) = 0.382, P < 0.001).

CONCLUSIONSRecording and analyzing chin surface electromyography by routine polysomnography is a valid way of screening the neuromuscular activity in patients with obstructive sleep apnea. The neuromuscular contribution is different among subjects with obstructive sleep apnea.

Adult ; Chin ; physiopathology ; Electromyography ; methods ; Humans ; Male ; Middle Aged ; Polysomnography ; methods ; Sleep Apnea, Obstructive ; pathology ; physiopathology