Document Detail

Obstructive sleep apnoea syndrome: translating science to clinical practice.
MedLine Citation:
PMID:  16548897     Owner:  NLM     Status:  MEDLINE    
OSA syndrome is characterized by recurring episodes of upper airway (UA) obstruction during sleep. The UA is subjected to collapse when the negative airway pressure generated by inspiratory activity of the diaphragm and intercostal muscles exceeds the force produced by the UA dilating muscles. Factors that reduce UA calibre lead to increased UA resistance with the generation of a more negative pharyngeal pressure during inspiration, and thereby predispose to UA occlusion during sleep. As a consequence, UA dilating muscles must contract more forcefully to maintain a patent UA, which may predispose to fatigue. Nasal CPAP counteracts these collapsing forces and is associated with resting of the UA muscles. The more recent development of auto-adjusting CPAP (APAP) is a reflection of the understanding that the pressure required to prevent UA collapse fluctuates throughout the night and results in a lower mean pressure that may be more comfortable for some patients. The predominant morbidity of the OSA syndrome is cardiovascular and there is growing understanding of the basic mechanisms involved. Intermittent hypoxia appears to play a central role by activating transcription factors that predispose to atherogenesis, particularly NFkappaB. Sympathetic overactivity also appears to play an important role but the mechanisms involved are unclear.
Walter T McNicholas; Silke Ryan
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Respirology (Carlton, Vic.)     Volume:  11     ISSN:  1323-7799     ISO Abbreviation:  Respirology     Publication Date:  2006 Mar 
Date Detail:
Created Date:  2006-03-21     Completed Date:  2006-07-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9616368     Medline TA:  Respirology     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  136-44     Citation Subset:  IM    
Respiratory Sleep Research Laboratory, St. Vincent's University Hospital, Dublin, Ireland.
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MeSH Terms
Airway Resistance / physiology
Cardiovascular Diseases / etiology
Continuous Positive Airway Pressure / methods
Risk Factors
Sleep Apnea, Obstructive* / complications,  physiopathology,  therapy

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