title: A method for measuring and modeling the physiological traits causing obstructive sleep apnea.
abstract: There is not a clinically available technique for measuring the physiological traits causing obstructive sleep apnea (OSA). Therefore, it is often difficult to determine why an individual has OSA or to what extent the various traits contribute to the development of OSA. In this study, we present a noninvasive method for measuring four important physiological traits causing OSA: 1) pharyngeal anatomy/collapsibility, 2) ventilatory control system gain (loop gain), 3) the ability of the upper airway to dilate/stiffen in response to an increase in ventilatory drive, and 4) arousal threshold. These variables are measured using a single maneuver in which continuous positive airway pressure (CPAP) is dropped from an optimum to various suboptimum pressures for 3- to 5-min intervals during sleep. Each individual's set of traits is entered into a physiological model of OSA that graphically illustrates the relative importance of each trait in that individual. Results from 14 subjects (10 with OSA) are described. Repeatability measurements from separate nights are also presented for four subjects. The measurements and model illustrate the multifactorial nature of OSA pathogenesis and how, in some individuals, small adjustments of one or another trait (which might be achievable with non-CPAP agents) could potentially treat OSA. This technique could conceivably be used clinically to define a patient's physiology and guide therapy based on the traits.
authors: 221 Longwood Ave., 036 BLI, Boston, MA 02115, USA. awellman@rics.bwh.harvard.edu
authors: Andrew
authors: A
authors: Wellman
authors: Danny J
authors: DJ
authors: Eckert
authors: Amy S
authors: AS
authors: Jordan
authors: Bradley A
authors: BA
authors: Edwards
authors: Chris L
authors: CL
authors: Passaglia
authors: Andrew C
authors: AC
authors: Jackson
authors: Shiva
authors: S
authors: Gautam
authors: Robert L
authors: RL
authors: Owens
authors: Atul
authors: A
authors: Malhotra
authors: David P
authors: DP
authors: White
mesh_terms: D000328:Adult; D000368:Aged; D000403:Airway Resistance; D001143:Arousal; D001696:Biomechanical Phenomena; D016022:Case-Control Studies; D045422:Continuous Positive Airway Pressure; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D009434:Neural Pathways / Q000503:physiopathology; D010614:Pharynx / Q000294:innervation / Q000503:physiopathology*; D017286:Polysomnography; D011312:Pressure; D012123:Pulmonary Ventilation; D012132:Respiratory Muscles / Q000294:innervation / Q000503:physiopathology*; D012307:Risk Factors; D012684:Sensory Thresholds; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D013997:Time Factors; D055815:Young Adult