Prolonged partial upper airway obstruction during sleep - an underdiagnosed phenotype of sleep-disordered breathing.
Obstructive sleep apnea syndrome (OSAS) is a well-recognized disorder conventionally diagnosed with an elevated apnea-hypopnea index. Prolonged partial upper airway obstruction is a common phenotype of sleep-disordered breathing (SDB), which however is still largely underreported. The major reasons for this are that cyclic breathing pattern coupled with arousals and arterial oxyhemoglobin saturation are easy to detect and considered more important than prolonged episodes of increased respiratory effort with increased levels of carbon dioxide in the absence of cycling breathing pattern and repetitive arousals. There is also a growing body of evidence that prolonged partial obstruction is a clinically significant form of SDB, which is associated with symptoms and co-morbidities which may partially differ from those associated with OSAS. Partial upper airway obstruction is most prevalent in women, and it is treatable with the nasal continuous positive pressure device with good adherence to therapy. This review describes the characteristics of prolonged partial upper airway obstruction during sleep in terms of diagnostics, pathophysiology, clinical presentation, and comorbidity to improve recognition of this phenotype and its timely and appropriate treatment.
Division of Medicine, Department of Pulmonary Diseases, Turku University Hospital, Turku, Finland.|Department of Pulmonary Diseases and Clinical Allergology, University of Turku, Turku, Finland.|Sleep Research Centre, Department of Physiology, University of Turku, Turku, Finland; ulla.anttalainen@tyks.fi.
Ulla
U
Anttalainen
Department of Clinical Neurophysiology, Medical Imaging Centre and Hospital Pharmacy, Pirkanmaa Hospital District, Tampere University Hospital, Tampere, Finland.|Department of Medical Physics, Medical Imaging Centre and Hospital Pharmacy, Pirkanmaa Hospital District, Tampere University Hospital, Tampere, Finland.
Mirja
M
Tenhunen
School of Medicine, University of Tampere, Tampere, Finland.
Ville
V
Rimpilä
Unesta Research Center, Tampere, Finland.|Department of Pulmonary Diseases, Tampere University Hospital, Tampere, Finland.
Olli
O
Polo
Department of Clinical Neurophysiology, Satakunta Hospital District, Pori, Finland.
Esa
E
Rauhala
Department of Clinical Neurophysiology, Medical Imaging Centre and Hospital Pharmacy, Pirkanmaa Hospital District, Tampere University Hospital, Tampere, Finland.|School of Medicine, University of Tampere, Tampere, Finland.
Sari-Leena
SL
Himanen
Division of Medicine, Department of Pulmonary Diseases, Turku University Hospital, Turku, Finland.|Department of Pulmonary Diseases and Clinical Allergology, University of Turku, Turku, Finland.|Sleep Research Centre, Department of Physiology, University of Turku, Turku, Finland.
Tarja
T
Saaresranta
UARS; flow limitation; increased respiratory resistance; non-apneic snoring; prolonged partial upper airway obstruction; simple snoring; sleep; sleep apnea