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Frequency and significance of increased upper airway resistance during sleep
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Rees, Karen, Kingshott, Ruth N., Wraith, Peter K. and Douglas, Neil J. (2000) Frequency and significance of increased upper airway resistance during sleep. American Journal of Respiratory and Critical Care Medicine, 162 (4). pp. 1210-1214. doi:10.1164/ajrccm.162.4.9908052 ISSN 1073-449X.
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Official URL: http://dx.doi.org/10.1164/ajrccm.162.4.9908052
Abstract
Previous studies have shown that episodes of inspiratory flow limitation can be clinically important. We have challenged the hypothesis that patients with the “upper airway resistance syndrome” have more episodes of inspiratory flow limitation, associated with greater swings in pleural pressure and more arousals from sleep than normal subjects. We thus studied eight symptomatic patients with UARS (ESS > 10, AHI < 15) and eight matched asymptomatic subjects. All had overnight polysomnography with recording of pleural pressure and airflow derived from nasal pressure. Events scored visually using nasal pressure were termed flow limitation events and those using both signals “resistive events.” The patients with UARS had no more episodes of flow limitation or resistive events than the controls. However, pleural pressure swings at resistive event termination were significantly more negative in the patient group ( − 15 [IQR 9–19]; − 11 [8–12] cm H2O; p = 0.02) and the number of cortical arousals associated with resistive events was higher in the patients (median, 10 [5–15]; 3 [1–9]/h slept; p = 0.02). This study confirms that patients with UARS have periods of increased upper airway resistance associated with significant sleep fragmentation. However, resistive events are also common in normal subjects, although these are associated with less negative pleural pressure swings and fewer arousals. Thus, the clinical significance of resistive events needs to be interpreted with caution.
Item Type: | Journal Article | ||||
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Statistics and Epidemiology Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Journal or Publication Title: | American Journal of Respiratory and Critical Care Medicine | ||||
ISSN: | 1073-449X | ||||
Official Date: | 2000 | ||||
Dates: |
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Volume: | 162 | ||||
Number: | 4 | ||||
Page Range: | pp. 1210-1214 | ||||
DOI: | 10.1164/ajrccm.162.4.9908052 | ||||
Status: | Peer Reviewed | ||||
Publication Status: | Published | ||||
Access rights to Published version: | Restricted or Subscription Access |
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