International Journal of Environmental Research and Public Health

Editorial

3 pages, 272 KiB

Open AccessEditorial

Obstructive Sleep Apnea Syndrome: From Symptoms to Treatment

by Giannicola Iannella, Giuseppe Magliulo, Antonio Greco, Marco de Vincentiis, Massimo Ralli, Antonino Maniaci, Annalisa Pace and Claudio Vicini

Int. J. Environ. Res. Public Health 2022, 19(4), 2459; https://doi.org/10.3390/ijerph19042459 - 21 Feb 2022

Cited by 18 | Viewed by 3886

Abstract

Obstructive sleep apnea (OSA) syndrome is a respiratory sleep disorder characterized by partial or complete recurrent episodes of upper airway collapse that occur during the night. The OSA manifests with a reduction (hypopnea) or complete cessation (apnea) of airflow in the upper airways, [...] Read more.

Obstructive sleep apnea (OSA) syndrome is a respiratory sleep disorder characterized by partial or complete recurrent episodes of upper airway collapse that occur during the night. The OSA manifests with a reduction (hypopnea) or complete cessation (apnea) of airflow in the upper airways, associated with breathing effort. OSA is a frequent and often underestimated pathology affecting between 2 and 5% of the middle-aged population. Typical nocturnal symptoms are the persistent snoring and awakenings with dyspnea sensation. On the other hand, diurnal symptoms could be sleepiness, headaches, asthenia, neurological disorders, and impaired personal relationships. Surgery of the velo-pharyngeal region had a huge evolution going from ablative techniques (UP3 and LAUP) to remodeling techniques of the pharyngeal lateral walls. Full article

(This article belongs to the Special Issue Obstructive Sleep Apnea Syndrome: From Symptoms to Treatment)

Research

Jump to: Editorial, Review

12 pages, 1997 KiB

Open AccessArticle

The Use of Middle Latency Auditory Evoked Potentials (MLAEP) as Methodology for Evaluating Sedation Level in Propofol-Drug Induced Sleep Endoscopy (DISE) Procedure

by Michele Arigliani, Domenico M. Toraldo, Enrico Ciavolino, Caterina Lattante, Luana Conte, Serena Arima, Caterina Arigliani, Antonio Palumbo and Michele De Benedetto

Int. J. Environ. Res. Public Health 2021, 18(4), 2070; https://doi.org/10.3390/ijerph18042070 - 20 Feb 2021

Cited by 3 | Viewed by 2968

Abstract

To analyze the middle latency auditory evoked potential index (MLAEPi), compared to the standard bispectral index (BIS), as a method for evaluating the sedation level in drug-induced sleep endoscopy (DISE). In this controlled clinical study on a sample of 99 obstructive sleep apnea [...] Read more.

To analyze the middle latency auditory evoked potential index (MLAEPi), compared to the standard bispectral index (BIS), as a method for evaluating the sedation level in drug-induced sleep endoscopy (DISE). In this controlled clinical study on a sample of 99 obstructive sleep apnea (OSA) or snoring patients, we compared the MLAEPi with the BIS after propofol infusion during the standard DISE technique in order to define the MLAEPi values within the observational window of the procedure. The DISE procedure was divided into eight steps, and we collected both MLAEPi and BIS data values from the same patient in every step. The MLAEPi showed a faster response than the BIS after propofol infusion during DISE. Therefore, the clinical use of the MLAEPi in evaluating the sedation level seems to be a good alternative to the current technological standards. Full article

(This article belongs to the Special Issue Obstructive Sleep Apnea Syndrome: From Symptoms to Treatment)

► Show Figures

Graphical abstract

9 pages, 444 KiB

Open AccessArticle

Endothelin-1 and LOX-1 as Markers of Endothelial Dysfunction in Obstructive Sleep Apnea Patients

by Monika Kosacka and Anna Brzecka

Int. J. Environ. Res. Public Health 2021, 18(3), 1319; https://doi.org/10.3390/ijerph18031319 - 1 Feb 2021

Cited by 16 | Viewed by 2683

Abstract

Introduction: The search of biochemical markers of endothelial dysfunction: lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1)—involved in atherosclerotic plaques formation—and endothelin-1 (ET-1)—potent vasoconstrictor-might help in detecting obstructive sleep apnea (OSA) patients at high risk of cardiovascular diseases. Material and Methods: In 71 OSA patients [...] Read more.

Introduction: The search of biochemical markers of endothelial dysfunction: lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1)—involved in atherosclerotic plaques formation—and endothelin-1 (ET-1)—potent vasoconstrictor-might help in detecting obstructive sleep apnea (OSA) patients at high risk of cardiovascular diseases. Material and Methods: In 71 OSA patients (apnoea/hypopnoea index, AHI 28.2 ± 17.9/hour) and in 21 healthy controls the serum levels of LOX-1 and ET-1 were measured. Results: There were increased levels of ET-1 (1.58 ± 0.65 vs. 1.09 ± 0.38 pg/mL; p < 0.001) but not of LOX-1 in OSA patients as compared with healthy controls. In the patients’ group ET-1 levels negatively correlated with serum LDL levels. LOX-1 levels positively correlated with fasting glucose levels and were higher in the patients with than without diabetes. Neither ET-1 nor LOX-1 correlated with OSA severity. In mild OSA patients, there was a negative correlation between LOX-1 and mean arterial oxygen saturation during sleep. In severe OSA patients, there was a positive correlation between LOX-1 levels and uric acid. Conclusion: There is endothelial dysfunction in OSA patients as indicated by increased serum levels of ET-1 and possibly endothelial dysfunction in diabetic OSA patients as indicated by increased serum levels of LOX-1 and its correlation with fasting glucose levels. Full article

(This article belongs to the Special Issue Obstructive Sleep Apnea Syndrome: From Symptoms to Treatment)

► Show Figures

Figure 1

14 pages, 2027 KiB

Open AccessArticle

The Association between Temporomandibular Disorder and Sleep Apnea—A Nationwide Population-Based Cohort Study

by Ju-Hui Wu, Kun-Tsung Lee, Chia-Yu Kuo, Chih-Hung Cheng, Jih-Yu Chiu, Jen-Yu Hung, Chung-Yao Hsu and Ming-Ju Tsai

Int. J. Environ. Res. Public Health 2020, 17(17), 6311; https://doi.org/10.3390/ijerph17176311 - 30 Aug 2020

Cited by 19 | Viewed by 3376

Abstract

An increased incidence of temporomandibular disorders (TMD) among patients with sleep apnea (SA) has been reported. However, the association between TMD and SA has not been demonstrated in a large-scale study. This population-based cohort study with the Taiwan National Health Insurance (NHI) Research [...] Read more.

An increased incidence of temporomandibular disorders (TMD) among patients with sleep apnea (SA) has been reported. However, the association between TMD and SA has not been demonstrated in a large-scale study. This population-based cohort study with the Taiwan National Health Insurance (NHI) Research Database aimed to understand the association between SA and TMD. We identified adult patients with suspected SA (identified with diagnostic codes) and excluded those diagnosed with TMD prior to SA. Patients with SA diagnosis after polysomnography were also identified as probable SA patients. The index dates were the dates of their initial SA diagnosis. Ten control subjects were matched, by age and sex, to each SA patient, and were assigned the same index dates as the SA patients. In total, 10,408 suspected SA patients (including 4105 probable SA patients) matched to 104,080 control subjects (including 41,050 subjects matched to the probable SA patients) in this study. The TMD incidence rate was significantly higher in the SA patients than in the control subjects (2.8 vs. 1.0 per thousand-patient-year in probable SA patients vs. the corresponding control subjects, with an adjusted incidence rate ratio [95% confidence interval] = 2.5 [2.3–2.7], p < 0.0001). SA patients significantly showed a higher cumulative incidence of TMD than the corresponding control subjects (p < 0.0001). Multivariable Cox regression analysis revealed SA as an independent risk factor for the development of TMD (adjusted hazard ratio = 2.5 [1.7–3.7], p < 0.0001). In summary, this study confirmed an increased TMD incidence in the SA patients. While treating TMD patients, dentists should pay careful attention to the potential underlying SA. Full article

(This article belongs to the Special Issue Obstructive Sleep Apnea Syndrome: From Symptoms to Treatment)

► Show Figures

Figure 1

11 pages, 330 KiB

Open AccessArticle

Comparison of Findings between Clinical Examinations and Drug-Induced Sleep Endoscopy in Patients with Obstructive Sleep Apnea Syndrome

by Huan-Yu Lin, Yi-Chih Lin, Ying-Shuo Hsu, Liang-Chun Shih, Tyler Nelson, Wen-Dien Chang and Yung-An Tsou

Int. J. Environ. Res. Public Health 2020, 17(17), 6041; https://doi.org/10.3390/ijerph17176041 - 19 Aug 2020

Cited by 13 | Viewed by 2810

Abstract

The Velum, Oropharynx, Tongue base and Epiglottis (VOTE) classification on drug-induced sleep endoscopy (DISE) is used widely for obstructive sleep apnea (OSA) syndrome, though research into comparative physical examinations with VOTE on DISE is still limited. The aim of this study was to [...] Read more.

The Velum, Oropharynx, Tongue base and Epiglottis (VOTE) classification on drug-induced sleep endoscopy (DISE) is used widely for obstructive sleep apnea (OSA) syndrome, though research into comparative physical examinations with VOTE on DISE is still limited. The aim of this study was to evaluate the relationship between the findings of physical examinations and DISE in patients with OSA. Fifty-five patients with OSA were enrolled in this retrospective study. All of the patients received clinical explorations including a Brodsky classification, a modified Mallampati score (MMS), a modified Friedman’s staging system, and a Muller’s test. Drug-induced sleep endoscopy was further evaluated in the operating room. There were significant relationships between Brodsky classification, modified Friedman’s staging system, Muller’s test and oropharynx collapse during DISE (p < 0.05). Brodsky classification, MMS, modified Friedman’s staging system and retropalatal lateral-to-lateral (L–L) collapse of Muller’s test were significantly correlated with VOTE count (p < 0.05). The concordance between VOTE under DISE and Brodsky classification or modified Friedman’s staging system was moderate. In contrast, the concordance between VOTE under DISE and MMS or Muller’s test was slight. The study revealed that Brodsky classification and Friedman staging had a significant relationship with DISE on the velum and oropharynx, but the level of tongue base is uncertain between DISE and MMS. Correlation of awake evaluation of tongue base is still not correlated to the DISE findings. Pre-treatment evaluation of DISE is still warranted. Full article

(This article belongs to the Special Issue Obstructive Sleep Apnea Syndrome: From Symptoms to Treatment)

13 pages, 759 KiB

Open AccessArticle

Interactions among Obstructive Sleep Apnea Syndrome Severity, Sex, and Obesity on Circulatory Inflammatory Biomarkers in Patients with Suspected Obstructive Sleep Apnea Syndrome: A Retrospective, Cross-Sectional Study

by Ming-Feng Wu, Yu-Hsuan Chen, Hui-Chen Chen and Wei-Chang Huang

Int. J. Environ. Res. Public Health 2020, 17(13), 4701; https://doi.org/10.3390/ijerph17134701 - 30 Jun 2020

Cited by 21 | Viewed by 3106

Abstract

The interaction among obstructive sleep apnea syndrome (OSAS) severity, sex, and obesity on cardiovascular risk as determined by serum levels of C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) remains unclear. Therefore, this study aimed to analyze individual associations between these [...] Read more.

The interaction among obstructive sleep apnea syndrome (OSAS) severity, sex, and obesity on cardiovascular risk as determined by serum levels of C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) remains unclear. Therefore, this study aimed to analyze individual associations between these three OSAS characteristics and three cardiovascular biomarkers and to determine whether the relationship was affected by other features in patients with suspected OSAS. For all participants (n = 100), OSAS severity and sex had an interaction effect on IL-6 level (p = 0.030). Specifically, the male patients (p = 0.005) with severe OSAS had higher IL-6 levels than those with normal to moderate OSAS, but this relationship was not significant in the female patients (p = 0.438). Moreover, in patients with normal to moderate OSAS (p = 0.004), but not in those with severe OSAS (p = 0.824), the female patients had higher IL-6 levels than the male patients. Both CRP (p = 0.001) and IL-6 (p = 0.000) levels were higher in the obese group than in the non-obese group independently of OSAS severity and sex. The three features had no effects on TNF-α level individually and interactively. Our findings suggest that circulatory inflammatory markers should be comprehensively evaluated in this population and that treatment and preventive therapies should be modified accordingly. Full article

(This article belongs to the Special Issue Obstructive Sleep Apnea Syndrome: From Symptoms to Treatment)

► Show Figures

Figure 1

11 pages, 1653 KiB

Open AccessArticle

A New Technological Advancement of the Drug-Induced Sleep Endoscopy (DISE) Procedure: The “All in One Glance” Strategy

by Michele Arigliani, Domenico M. Toraldo, Filippo Montevecchi, Luana Conte, Lorenzo Galasso, Filippo De Rosa, Caterina Lattante, Enrico Ciavolino, Caterina Arigliani, Antonio Palumbo, Michele De Benedetto and Claudio Vicini

Int. J. Environ. Res. Public Health 2020, 17(12), 4261; https://doi.org/10.3390/ijerph17124261 - 15 Jun 2020

Cited by 8 | Viewed by 4251

Abstract

To illustrate a new technological advance in the standard drug-induced sleep endoscopy (DISE) model, a new machine was used, the Experimental 5 Video Stream System (5VsEs), which is capable of simultaneously visualizing all the decisional parameters on a single monitor, and recording and [...] Read more.

To illustrate a new technological advance in the standard drug-induced sleep endoscopy (DISE) model, a new machine was used, the Experimental 5 Video Stream System (5VsEs), which is capable of simultaneously visualizing all the decisional parameters on a single monitor, and recording and storing them in a single uneditable video. The DISE procedure was performed on 48 obstructive sleep apnea (OSA) or snoring patients. The parameters simultaneously recorded on a single monitor are (1) the pharmacokinetics and pharmacodynamics of propofol (through the target controlled infusion (TCI) pump monitor), (2) the endoscopic upper airway view, (3) the polygraphic pattern, and (4) the level of sedation (through the bispectral index (BIS) value). In parallel to the BIS recording, the middle latency auditory evoked potential (MLAEP) was also recorded and provided. Recorded videos from the 5VsEs machine were re-evaluated six months later by the same clinician and a second clinician to evaluate the concordance of the therapeutic indications between the two. After the six-month period, the same operator confirmed all their clinical decisions for 45 out of 48 videos. Three videos were no longer evaluable for technical reasons, so were excluded from further analysis. The comparison between the two operators showed a complete adherence in 98% of cases. The 5VsEs machine provides a multiparametric evaluation setting, defined as an “all in one glance” strategy, which allows a faster and more effective interpretation of all the simultaneous parameters during the DISE procedure, improving the diagnostic accuracy, and providing a more accurate post-analysis, as well as legal and research advantages. Full article

(This article belongs to the Special Issue Obstructive Sleep Apnea Syndrome: From Symptoms to Treatment)

► Show Figures

Figure 1

9 pages, 941 KiB

Open AccessArticle

Acquired Nasopharyngeal Stenosis Correction Using a Modified Palatal Flaps Technique in Obstructive Sleep Apnea (OSA) Patients

by Giovanni Cammaroto, Luigi Marco Stringa, Luca Cerritelli, Giulia Bianchi, Giuseppe Meccariello, Riccardo Gobbi, Giannicola Iannella, Giuseppe Magliulo, Henry Zhang, Ahmed Yassin Baghat, Francesco Galletti, Stefano Pelucchi, Francesco Stomeo, Muawya Bani Younes, Mohamed AlAjmi, Andrea De Vito and Claudio Vicini

Int. J. Environ. Res. Public Health 2020, 17(6), 2048; https://doi.org/10.3390/ijerph17062048 - 19 Mar 2020

Cited by 7 | Viewed by 3665

Abstract

Background: Acquired nasopharyngeal stenosis is a rare and heterogeneous pathological condition that has different causes, generally resulting as a complication of a pharyngeal surgery, especially in patients affected by obstructive sleep apnea (OSA). Different approaches have been proposed for the treatment of [...] Read more.

Background: Acquired nasopharyngeal stenosis is a rare and heterogeneous pathological condition that has different causes, generally resulting as a complication of a pharyngeal surgery, especially in patients affected by obstructive sleep apnea (OSA). Different approaches have been proposed for the treatment of nasopharyngeal stenosis but a unique and standardized management has not yet been presented. The aim of our paper is to evaluate the efficacy of our surgical technique, describing its steps and results with the aim to consider it as a possible solution for the treatment of this condition. Methods: This is a retrospective cohort study. Eight patients (mean age 27.25 years old (yo), range 8–67 yo; Male/Female ratio 4/4; mean body mass index (BMI) 26.1) affected by OSA (mean apnea hypopnea index (AHI) before OSA surgery was 22.1) and acquired nasopharyngeal stenosis as a consequence of different pharyngeal surgeries were treated with our modified approach in the Department of Otolaryngology, Morgagni Pierantoni Hospital, Forlì, Italy. Resolution of stenosis and complication rate were the main outcome measures. Results: Complete resolution of the stenosis was achieved in all cases and no complications were recorded at three weeks, six months, and 2 years follow-up. Conclusions: Our technique appears to be a promising method for the management of nasopharyngeal stenosis in OSA patients. However, further studies comparing different techniques and reporting on larger series and longer follow up time are needed to prove the efficacy of the proposed technique. Full article

(This article belongs to the Special Issue Obstructive Sleep Apnea Syndrome: From Symptoms to Treatment)

► Show Figures

Figure 1

11 pages, 871 KiB

Open AccessArticle

Long-Term Subjective Outcomes of Barbed Reposition Pharyngoplasty for Obstructive Sleep Apnea Syndrome Treatment

by Giannicola Iannella, Bianca Vallicelli, Giuseppe Magliulo, Giovanni Cammaroto, Giuseppe Meccariello, Andrea De Vito, Antonio Greco, Stefano Pelucchi, Rossella Sgarzani, Ruggero Massimo Corso, Gloria Napoli, Giulia Bianchi, Salvatore Cocuzza, Antonino Maniaci and Claudio Vicini

Int. J. Environ. Res. Public Health 2020, 17(5), 1542; https://doi.org/10.3390/ijerph17051542 - 27 Feb 2020

Cited by 38 | Viewed by 4469

Abstract

Background: The purpose of this study was to evaluate long-term subjective outcomes of barbed reposition pharyngoplasty for obstructive sleep apnea syndrome (OSAS) treatment using a specific questionnaire, the Palate Postoperative Problem Score (PPOPS). Methods: 140 patients who underwent barbed reposition pharyngoplasty [...] Read more.

Background: The purpose of this study was to evaluate long-term subjective outcomes of barbed reposition pharyngoplasty for obstructive sleep apnea syndrome (OSAS) treatment using a specific questionnaire, the Palate Postoperative Problem Score (PPOPS). Methods: 140 patients who underwent barbed reposition pharyngoplasty (BRP) surgery in the Morgagni Pierantoni Hospital of Forlì, Italy were enrolled in the study. Postoperative outcomes were evaluated in a short- and long-term follow-up using the PPOPS questionnaire. The average period of follow-up was 26 months. All patients received the PPOPS questionnaire by telephone in a period between April and August 2019. Results: 51% of patients complained of swallowing problems after surgery. In 91% of cases, the problem cleared up spontaneously. At the time of the interview, only 9% of patients had a residual swallowing difficult. At the time of PPOPS evaluation, rhinolalia was observed in 8% of patients, whereas nose regurgitation was present in 2% of patients. In 20% of patients, the foreign body sensation was present during follow-up. The value of apnea–hypopnea index (AHI) reduced from the preoperative value of 31.5 to the postoperative value of 11.4. Conclusions: BRP surgery proved to be an effective technique, appreciated by the majority of patients. Use of the PPOPS questionnaire has demonstrated that the BRP technique seems to ensure efficacy and lower morbidity, with few complications after surgery. Full article

(This article belongs to the Special Issue Obstructive Sleep Apnea Syndrome: From Symptoms to Treatment)

► Show Figures

Figure 1

Review

Jump to: Editorial, Research

12 pages, 609 KiB

Open AccessReview

The Role of Myofunctional Therapy in Treating Sleep-Disordered Breathing: A State-of-the-Art Review

by Marina Carrasco-Llatas, Carlos O’Connor-Reina and Christian Calvo-Henríquez

Int. J. Environ. Res. Public Health 2021, 18(14), 7291; https://doi.org/10.3390/ijerph18147291 - 8 Jul 2021

Cited by 19 | Viewed by 7954

Abstract

Myofunctional therapy (MFT) may have a role in improving muscle tone and alleviating upper airway collapse in sleep-disordered breathing. The purposes of this state-of-the-art review are to first review systematically the current literature on the effectiveness of MFT in treating sleep-disordered breathing and [...] Read more.

Myofunctional therapy (MFT) may have a role in improving muscle tone and alleviating upper airway collapse in sleep-disordered breathing. The purposes of this state-of-the-art review are to first review systematically the current literature on the effectiveness of MFT in treating sleep-disordered breathing and then to provide an overview of the current understanding of patient selection, side effects, type and duration of exercises, guidance of exercise performance, evaluation of results, and how best to promote adherence. PubMed (Medline), the Cochrane Library, and the EMBASE, Scopus and SciELO databases were checked for relevant studies by three authors, and a total of 23 studies were included. This review focuses only on adults with sleep-disordered breathing. The available evidence shows a positive effect of MFT in reducing sleep apnoea, as measured using polysomnography and clinical variables (including snoring). There is no evidence of the utility of MFT for treating upper airway resistance syndrome, the duration of the effects of MFT, or regarding which MFT protocol is best. Despite these knowledge gaps, the available evidence suggests that MFT is a safe treatment modality. Full article

(This article belongs to the Special Issue Obstructive Sleep Apnea Syndrome: From Symptoms to Treatment)

► Show Figures

Figure 1

24 pages, 3623 KiB

Open AccessReview

The Hypoglossal Nerve Stimulation as a Novel Therapy for Treating Obstructive Sleep Apnea—A Literature Review

by Saif Mashaqi, Salma Imran Patel, Daniel Combs, Lauren Estep, Sonia Helmick, Joan Machamer and Sairam Parthasarathy

Int. J. Environ. Res. Public Health 2021, 18(4), 1642; https://doi.org/10.3390/ijerph18041642 - 9 Feb 2021

Cited by 44 | Viewed by 13208

Abstract

Obstructive sleep apnea (OSA) is a common sleep disorder that affects all age groups and is associated with many co-morbid diseases (especially cardiovascular diseases). Continuous positive airway pressure (CPAP) is the gold standard for treating OSA. However, adherence to PAP therapy has been [...] Read more.

Obstructive sleep apnea (OSA) is a common sleep disorder that affects all age groups and is associated with many co-morbid diseases (especially cardiovascular diseases). Continuous positive airway pressure (CPAP) is the gold standard for treating OSA. However, adherence to PAP therapy has been a major challenge with an estimated adherence between 20% and 80%. Mandibular advancement devices (MAD) are a good alternative option if used in the appropriate patient. MAD are most effective in mild and moderate OSA but not severe OSA. Surgical options are invasive, not appropriate for severe OSA, and associated with pain and long healing time. Hypoglossal nerve stimulation (HGNS), or upper airway stimulation (UAS), is a novel therapy in treating moderate and severe degrees of OSA in patients who cannot tolerate CPAP therapy. We reviewed the MEDLINE (PubMed) database. The search process yielded 303 articles; 31 met the inclusion and exclusion criteria and were included. We concluded that hypoglossal nerve stimulation is a very effective and novel alternative therapy for moderate and severe OSA in patients who cannot tolerate CPAP therapy. Adherence to HGNS is superior to CPAP. However, more developments are needed to ensure the highest safety profile. Full article

(This article belongs to the Special Issue Obstructive Sleep Apnea Syndrome: From Symptoms to Treatment)

► Show Figures

Figure 1

15 pages, 2265 KiB

Open AccessReview

Qualitative Phenotyping of Obstructive Sleep Apnea and Its Clinical Usefulness for the Sleep Specialist

by Marcello Bosi, Andrea De Vito, Danny Eckert, Joerg Steier, Bhik Kotecha, Claudio Vicini and Venerino Poletti

Int. J. Environ. Res. Public Health 2020, 17(6), 2058; https://doi.org/10.3390/ijerph17062058 - 20 Mar 2020

Cited by 22 | Viewed by 5693

Abstract

Introduction: The anatomical collapsibility of the upper airway, neuromuscular tone and function, sleep–wake and ventilatory control instability, and the arousal threshold all interact and contribute to certain pathophysiologic features that characterize different types of obstructive sleep apnea (OSA). A model of qualitative phenotypizationallowsus [...] Read more.

Introduction: The anatomical collapsibility of the upper airway, neuromuscular tone and function, sleep–wake and ventilatory control instability, and the arousal threshold all interact and contribute to certain pathophysiologic features that characterize different types of obstructive sleep apnea (OSA). A model of qualitative phenotypizationallowsus to characterize the different pathophysiological traits in OSA patients.Methods: A narrative review was performed, to analyze the available literature evidence, with the purpose of generating a model of qualitative phenotypization to characterize pathophysiological traits in patients with OSA.Results: 96 out of 3829 abstracts were selected for full-text review. Qualitative phenotyping model of OSA:Data concerning the OSA qualitative pathophysiological traits’ measurement can be deducted by means of clinical PSG, grade of OSA severity, and therapeutic level of Continuous Positive Airway Pressure (CPAP) and are reported in the text. This approach would allow qualitative phenotyping with widely accessible methodology in a routine clinical scenario and is of particular interest for the sleep specialist, surgical treatment decision-making, and customized OSA multimodality treatment. Full article

(This article belongs to the Special Issue Obstructive Sleep Apnea Syndrome: From Symptoms to Treatment)

► Show Figures

Figure 1

Journal Menu

Journal Browser

Obstructive Sleep Apnea Syndrome: From Symptoms to Treatment

Share This Special Issue

Special Issue Editors

Special Issue Information

Keywords

Benefits of Publishing in a Special Issue

Published Papers (12 papers)

Editorial

Research

Review

Further Information

Guidelines

MDPI Initiatives

Follow MDPI