title: Chronic Influences of Obstructive Sleep Apnea on Cerebral Venous Flow.
abstract: OBJECTIVE
  Evidence reveals a pathophysiologic link between sleep apnea syndrome and cerebrovascular diseases. It is known that obstructive sleep apnea (OSA) may cause serial hemodynamic changes and structural abnormalities in the cerebral and cardiac arterial systems, but its effect on the cerebral venous system has remained unclear. The purpose of this study was to compare internal jugular vein hemodynamics between patients with OSA and healthy individuals.
  
  
  METHODS
  Patients with OSA and age-, body mass index-, and sex-matched healthy control participants were recruited for a jugular venous duplex study and neurologic examination. The luminal area of the internal jugular vein, jugular venous flow volume, time-averaged mean velocity, and presence of jugular venous reflux were recorded. These flow characteristics were obtained at different respiratory statuses, and we analyzed the differences between patients and controls.
  
  
  RESULTS
  In the OSA group, there was an increasing flow volume in total internal jugular veins at rest. The frequency of venous reflux in patients compared with controls was significantly decreased (26.7% versus 53.3%, respectively; P < .05). The internal jugular vein drainage dominance was greater on the left side in the OSA group (right versus left: 48.8% versus 51.2%), whereas it was greater on the right side in the control group (right versus left: 61.7% versus 38.3%).
  
  
  CONCLUSIONS
  Our data showed peculiar internal jugular vein hemodynamics at baseline and different respiratory statuses in patients with OSA. These characteristics imply that cerebral venous drainage conditions might be involved in the pathophysiologic mechanisms of OSA syndrome.
authors.affiliation: Departments of Neurology (H.-Y.C., M.H., P.C.) and Chest (C.-S.L.), Show Chwan Memorial Hospital, Lukang, Taiwan; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan (H.-Y.C., H.-H.H.); and Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan (H.-H.H.).
authors.forename: Hsin-Yi
authors.initials: HY
authors.lastname: Chi
authors.affiliation: Departments of Neurology (H.-Y.C., M.H., P.C.) and Chest (C.-S.L.), Show Chwan Memorial Hospital, Lukang, Taiwan; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan (H.-Y.C., H.-H.H.); and Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan (H.-H.H.).
authors.forename: Chang-Sheng
authors.initials: CS
authors.lastname: Lin
authors.affiliation: Departments of Neurology (H.-Y.C., M.H., P.C.) and Chest (C.-S.L.), Show Chwan Memorial Hospital, Lukang, Taiwan; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan (H.-Y.C., H.-H.H.); and Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan (H.-H.H.).
authors.forename: Min-hsien
authors.initials: MH
authors.lastname: Hsu
authors.affiliation: Departments of Neurology (H.-Y.C., M.H., P.C.) and Chest (C.-S.L.), Show Chwan Memorial Hospital, Lukang, Taiwan; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan (H.-Y.C., H.-H.H.); and Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan (H.-H.H.).
authors.forename: Po-chi
authors.initials: PC
authors.lastname: Chan
authors.affiliation: Departments of Neurology (H.-Y.C., M.H., P.C.) and Chest (C.-S.L.), Show Chwan Memorial Hospital, Lukang, Taiwan; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan (H.-Y.C., H.-H.H.); and Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan (H.-H.H.). hhhu@vghtpe.gov.tw.
authors.forename: Han-Hwa
authors.initials: HH
authors.lastname: Hu
mesh_terms: D001783:Blood Flow Velocity; D002550:Cerebral Veins / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002560:Cerebrovascular Circulation; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007601:Jugular Veins / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D020181:Sleep Apnea, Obstructive / Q000000981:diagnostic imaging / Q000503:physiopathology*; D018616:Ultrasonography, Doppler, Duplex / Q000379:methods
keywords: cerebral sonography; cerebral venous flow; neurosonology; obstructive sleep apnea