Error message

EDS Server Issue
Item request has been placed! ×
Item request cannot be made. ×
loading  Processing Request

Threshold of the upper airway cross-section for hypopnea onset during sleep and its identification under waking condition.

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
  • Additional Information
    • Source:
      Publisher: BioMed Central Ltd Country of Publication: England NLM ID: 101090633 Publication Model: Electronic Cited Medium: Internet ISSN: 1465-993X (Electronic) Linking ISSN: 14659921 NLM ISO Abbreviation: Respir. Res. Subsets: MEDLINE
    • Publication Information:
      Publication: 2001- : London : BioMed Central Ltd.
      Original Publication: London : Current Science Ltd., c2000-
    • Subject Terms:
    • Abstract:
      Background: There is currently no method that can predict whether or under what condition hypopnea, even obstructive sleep apnea (OSA), will occur during sleep for individuals based on credible parameters measured under waking condition. We propose a threshold concept based on the narrowest cross-sectional area of the upper airway (CSA-UA) and aim to prove our hypothesis on the threshold of the area for hypopnea onset (TAHO), which can be used as an indicator of hypopnea onset during sleep and measured while awake.
      Methods: We performed magnetic resonance imaging for 20 OSA patients to observe CSA-UA changes during fluid accumulation in the neck caused by elevating their legs, and identified TAHO by capturing the sudden enlargement in CSA-UA. Correlation analyses between TAHO and the body mass index (BMI), and between the reduction in CSA-UA and the increase in the neck circumference (NC) with fluid accumulation were performed. Logistic regression analysis was performed for identifying OSA patients based on the behaviors of their CSA-UA changes during leg raising. Shape changes of airway cross-section were also investigated.
      Results: Four CSA-UA change patterns after fluid redistribution were identified. Six patients had similar CSA-UA variation behaviors observed in healthy subjects. From the other three change patterns involving 14 patients, a threshold value of CSA-UA 0.63 ± 0.21 cm 2 was identified for normal breathing. Data showed a positive correlation between TAHO and BMI (r = 0.681, p = 0.0007), and a negative correlation between the reduction in CSA-UA and the increase in NC (r = - 0.513, p = 0.051) with fluid accumulation. A sigmoid function for the probability of being a OSA patient p = 1/[1 + exp. (4.836 + 3.850 t-8.4 h)] was obtained to effectively separate OSA patients from normal subjects. The upper airway narrowing occurred in anteroposterior, lateral, or both directions, suggesting different tendencies of upper airway collapse in patients. Three types of shape changes in the cross-section of the upper airway, which had different effects on airway resistance, were measured.
      Conclusions: Our findings prove TAHO hypothesis. The threshold measured while awake for normal breathing can be used clinically as the indicator of hypopnea onset during sleep, and therefore to identify OSA patients under waking condition and design effective personalized treatments for OSA patients. Both shape and size changes in the cross-section of the upper airway affect airway resistance significantly. Shape change in the cross-section of the upper airway can provide key clinical information on the collapse patterns of the upper airway for individuals.
    • References:
      J Appl Physiol (1985). 2005 Sep;99(3):1138-48. (PMID: 15831800)
      Heart. 2015 Aug;101(16):1288-92. (PMID: 25897039)
      Eur Respir J. 2007 Aug;30(2):345-53. (PMID: 17459896)
      J Clin Invest. 1992 May;89(5):1571-9. (PMID: 1569196)
      Am J Respir Crit Care Med. 1996 Jun;153(6 Pt 1):1880-7. (PMID: 8665050)
      J Appl Physiol (1985). 1997 Apr;82(4):1319-26. (PMID: 9104871)
      J Appl Physiol (1985). 2018 Feb 1;124(2):421-429. (PMID: 29191983)
      Sleep Med. 2015 Nov;16(11):1419-1426. (PMID: 26498246)
      Eur Respir J. 2001 Jan;17(1):79-86. (PMID: 11307760)
      Laryngoscope. 2007 Apr;117(4):648-53. (PMID: 17415135)
      Chest. 2005 Sep;128(3):1324-30. (PMID: 16162725)
      J Physiol. 1999 Nov 1;520 Pt 3:897-908. (PMID: 10545152)
      Sleep Breath. 2002 Jun;6(2):49-54. (PMID: 12075479)
      Med Phys. 2017 Apr;44(4):1402-1407. (PMID: 28195345)
      Eur Ann Otorhinolaryngol Head Neck Dis. 2017 Oct;134(5):303-308. (PMID: 28291635)
      Sleep. 2016 Mar 01;39(3):511-21. (PMID: 26612386)
      Am J Respir Crit Care Med. 1998 Oct;158(4):1259-70. (PMID: 9769290)
      Sci China Life Sci. 2019 Feb;62(2):235-243. (PMID: 30215214)
      Am J Respir Crit Care Med. 1995 Nov;152(5 Pt 1):1673-89. (PMID: 7582313)
      Sleep Breath. 2013 Sep;17(3):967-73. (PMID: 23161476)
      Am J Respir Crit Care Med. 2002 Nov 15;166(10):1388-95. (PMID: 12421747)
      Am J Respir Crit Care Med. 2018 Dec 1;198(11):1435-1443. (PMID: 30040909)
      Sleep Med. 2017 Aug;36:10-17. (PMID: 28735905)
      J Physiol. 2003 Aug 1;550(Pt 3):899-910. (PMID: 12807995)
    • Grant Information:
      2012BAI05B03 National Science and Technology Pillar Program of China; 31670959 and 81171422 National Natural Science Foundation of China; KZ201210025022 Key Projects in Science and Technology Program of Beijing Municipal Education Commission, China
    • Contributed Indexing:
      Keywords: Hypopnea onset; Obstructive sleep apnea; Shape change of airway; Threshold of airway caliber
    • Publication Date:
      Date Created: 20191213 Date Completed: 20200601 Latest Revision: 20200601
    • Publication Date:
      20200716
    • Accession Number:
      PMC6907221
    • Accession Number:
      10.1186/s12931-019-1250-4
    • Accession Number:
      31829169
  • Citations
    • ABNT:
      LIN, H. et al. Threshold of the upper airway cross-section for hypopnea onset during sleep and its identification under waking condition. Respiratory research, [s. l.], v. 20, n. 1, p. 280, 2019. DOI 10.1186/s12931-019-1250-4. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=mdc&AN=31829169. Acesso em: 5 ago. 2020.
    • AMA:
      Lin H, Wang C, Zhang H, et al. Threshold of the upper airway cross-section for hypopnea onset during sleep and its identification under waking condition. Respiratory research. 2019;20(1):280. doi:10.1186/s12931-019-1250-4.
    • AMA11:
      Lin H, Wang C, Zhang H, et al. Threshold of the upper airway cross-section for hypopnea onset during sleep and its identification under waking condition. Respiratory research. 2019;20(1):280. doi:10.1186/s12931-019-1250-4
    • APA:
      Lin, H., Wang, C., Zhang, H., Xiong, H., Li, Z., Huang, X., Ji, C., Xian, J., & Huang, Y. (2019). Threshold of the upper airway cross-section for hypopnea onset during sleep and its identification under waking condition. Respiratory Research, 20(1), 280. https://doi.org/10.1186/s12931-019-1250-4
    • Chicago/Turabian: Author-Date:
      Lin, Hongyi, Cunting Wang, Han Zhang, Huahui Xiong, Zheng Li, Xiaoqing Huang, Changjin Ji, Junfang Xian, and Yaqi Huang. 2019. “Threshold of the Upper Airway Cross-Section for Hypopnea Onset during Sleep and Its Identification under Waking Condition.” Respiratory Research 20 (1): 280. doi:10.1186/s12931-019-1250-4.
    • Harvard:
      Lin, H. et al. (2019) ‘Threshold of the upper airway cross-section for hypopnea onset during sleep and its identification under waking condition’, Respiratory research, 20(1), p. 280. doi: 10.1186/s12931-019-1250-4.
    • Harvard: Australian:
      Lin, H, Wang, C, Zhang, H, Xiong, H, Li, Z, Huang, X, Ji, C, Xian, J & Huang, Y 2019, ‘Threshold of the upper airway cross-section for hypopnea onset during sleep and its identification under waking condition’, Respiratory research, vol. 20, no. 1, p. 280, viewed 5 August 2020, .
    • MLA:
      Lin, Hongyi, et al. “Threshold of the Upper Airway Cross-Section for Hypopnea Onset during Sleep and Its Identification under Waking Condition.” Respiratory Research, vol. 20, no. 1, Dec. 2019, p. 280. EBSCOhost, doi:10.1186/s12931-019-1250-4.
    • Chicago/Turabian: Humanities:
      Lin, Hongyi, Cunting Wang, Han Zhang, Huahui Xiong, Zheng Li, Xiaoqing Huang, Changjin Ji, Junfang Xian, and Yaqi Huang. “Threshold of the Upper Airway Cross-Section for Hypopnea Onset during Sleep and Its Identification under Waking Condition.” Respiratory Research 20, no. 1 (December 11, 2019): 280. doi:10.1186/s12931-019-1250-4.
    • Vancouver/ICMJE:
      Lin H, Wang C, Zhang H, Xiong H, Li Z, Huang X, et al. Threshold of the upper airway cross-section for hypopnea onset during sleep and its identification under waking condition. Respiratory research [Internet]. 2019 Dec 11 [cited 2020 Aug 5];20(1):280. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=mdc&AN=31829169