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Feng HY, Zhang PP, Wang XW. Presbyphagia: Dysphagia in the elderly. World J Clin Cases 2023; 11:2363-2373. [PMID: 37123321 PMCID: PMC10131003 DOI: 10.12998/wjcc.v11.i11.2363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/08/2023] [Accepted: 03/22/2023] [Indexed: 04/06/2023] Open
Abstract
Dysphagia has been classified as a “geriatric syndrome” and can lead to serious complications that result in a tremendous burden on population health and healthcare resources worldwide. A characteristic age-related change in swallowing is defined as “presbyphagia.” Medical imaging has shown some changes that seriously affect the safety and efficacy of swallowing. However, there is a general lack of awareness of the effects of aging on swallowing function and a belief that these changes are part of normal aging. Our review provides an overview of presbyphagia, which has been a neglected health problem for a long time. Attention and awareness of dysphagia in the elderly population should be strengthened, and targeted intervention measures should be actively implemented.
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Affiliation(s)
- Hai-Yang Feng
- School of Rehabilitation Medicine, Weifang Medical University, Weifang 261021, Shandong Province, China
| | - Ping-Ping Zhang
- School of Rehabilitation Medicine, Weifang Medical University, Weifang 261021, Shandong Province, China
| | - Xiao-Wen Wang
- School of Rehabilitation Medicine, Weifang Medical University, Weifang 261021, Shandong Province, China
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Osorio RS, Martínez-García MÁ, Rapoport DM. Sleep apnoea in the elderly: a great challenge for the future. Eur Respir J 2021; 59:13993003.01649-2021. [PMID: 34561285 DOI: 10.1183/13993003.01649-2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 08/25/2021] [Indexed: 11/05/2022]
Abstract
Due in part to overall improvements in health, the population of elderly individuals is increasing rapidly. Similarly, obstructive sleep apnoea (OSA) is both gaining increased recognition and also increasing due to the worldwide obesity epidemic. The overlap of OSA and aging is large, but there is strong plausibility for causation in both directions: OSA is associated with pathological processes that may accelerate aging and aging related processes; aging may cause physical and neurological changes that predispose to obstructive (and central) apnoea. In addition, the common symptoms (e.g. excessive daytime somnolence, defects in memory and cognition), possible physiological consequences of OSA (e.g. accelerated cardiovascular and cerebrovascular atherosclerosis), and changes in metabolic and inflammatory markers overlap with the symptoms and associated conditions seen in aging. There is also the possibility of synergy in the effects of these symptoms and conditions on quality of life, as well as a need to separate treatable consequences of OSA from age-related complaints. Taken together, the above make it essential to review the interaction of OSA and aging, both proven and suspected. The present review examines some aspects of what is known and points to the need for further investigation of the relationships, given the large number of potentially affected subjects.
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Affiliation(s)
- Ricardo S Osorio
- Department of Psychiatry, New York University (NYU) Grossman School of Medicine, New York, New York, USA.,Clinical Research Division, Nathan Kline Institute (NKI), Orangeburg, New York, USA
| | - Miguel Ángel Martínez-García
- Respirology Department, University and Politechnic la Fe Hospital, Valencia, Valencian Community, Spain .,CIBERES de Enfermedades Respiratorias, Madrid, Spain
| | - David M Rapoport
- Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Lee YJG, Lee YJ, Jeong DU. Differential Effects of Obesity on Obstructive Sleep Apnea Syndrome according to Age. Psychiatry Investig 2017; 14:656-661. [PMID: 29042891 PMCID: PMC5639134 DOI: 10.4306/pi.2017.14.5.656] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 11/19/2016] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE To evaluate the effect of obesity on obstructive sleep apnea syndrome (OSAS) by age in relation to anthropometric measurements. METHODS The medical records of 1,110 participants diagnosed with OSAS were analyzed according to age. All participants underwent nocturnal polysomnography and had their body mass index, waist circumference, neck circumference (NC), and waist-to-hip ratio measured. RESULTS According to the multiple linear regression analysis model for the natural logarithm of the apnea-hypopnea index treating all four anthropometric measurements and gender as covariates, the final stepwise model accounted for an increasing percentage of the variability in the severity of OSAS as a function of age: 7.0, 9.1, 14.5, and 25.6% for those aged <30, 30-39, 40-49, and 50-59 yrs, respectively. It accounted for a decreased percentage among those 60-69 (20.3%) and 70 yrs or older (3.9%). The correlation between NC and the severity of OSAS linearly increased as a function of age for those aged 30-59 yrs, peaked among those in their 60s, and dramatically decreased thereafter. CONCLUSION Middle-aged patients with OSAS were more likely to be obese, as measured by anthropometric measurements, than were younger or older OSAS patients. In particular, the predictive value of NC was significantly lower for younger and older OSAS patients.
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Affiliation(s)
- Yu-Jin G. Lee
- Department of Psychiatry, Seoul Metropolitan Eunpyeong Hospital, Seoul, Republic of Korea
| | - Yu Jin Lee
- Department of Psychiatry, Seoul Metropolitan Eunpyeong Hospital, Seoul, Republic of Korea
| | - Do-Un Jeong
- Department of Psychiatry and Center for Sleep and Chronobiology, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea
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Dietsch AM, Solomon NP, Sharkey LA, Duffy JR, Strand EA, Clark HM. Perceptual and instrumental assessments of orofacial muscle tone in dysarthric and normal speakers. ACTA ACUST UNITED AC 2015; 51:1127-42. [PMID: 25437151 DOI: 10.1682/jrrd.2013.07.0167] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Revised: 04/21/2014] [Indexed: 11/05/2022]
Abstract
Clinical assessment of orofacial muscle tone is of interest for differential diagnosis of the dysarthrias, but standardized procedures and normative data are lacking. In this study, perceptual ratings of tone were compared with instrumental measures of tissue stiffness for facial, lingual, and masticatory muscles in 70 individuals with dysarthria. Perceptual and instrumental tone data were discordant and failed to discriminate between five dysarthria types. These results raised concerns about the validity of Myoton-3 stiffness measures in the orofacial muscles. Therefore, a second study evaluated contracted and relaxed orofacial muscles in 10 neurotypical adults. Results for the cheek, masseter, and lateral tongue surface followed predictions, with significantly higher tissue stiffness during contraction. In contradiction, stiffness measures from the superior surface of the tongue were lower during contraction. Superior-to-inferior tongue thickness was notably increased during contraction. A third study revealed that tissue thickness up to ~10 mm significantly affected Myoton-3 measures. Altered tissue thickness due to neuromuscular conditions like spasticity and atrophy may have undermined the detection of group differences in the original sample of dysarthric speakers. These experiments underscore the challenges of assessing orofacial muscle tone and identify considerations for quantification of tone-related differences across dysarthria groups in future studies.
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Pelteret JPV, Reddy BD. Development of a computational biomechanical model of the human upper-airway soft-tissues toward simulating obstructive sleep apnea. Clin Anat 2013; 27:182-200. [PMID: 24515574 DOI: 10.1002/ca.22313] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Revised: 07/27/2013] [Accepted: 07/27/2013] [Indexed: 11/11/2022]
Abstract
Numerous challenges are faced in investigations aimed at developing a better understanding of the pathophysiology of obstructive sleep apnea (OSA). The anatomy of the tongue and other upper-airway tissues, and the ability to model their behavior, are central to such investigations. We present details of the construction and development of a soft-tissue model of the human upper airway, with the ultimate goal of simulating obstructive sleep apnea. The steps taken to produce a representative anatomical geometry, of which the associated muscle histology is also captured, are documented. An overview of the mathematical models used to describe tissue behavior, both at a macro- and microscopic level, is given. A neurological model, which mimics the proprioceptive capabilities of the body, is described as it is applies to control of the active dynamics of the tongue. A simplified scenario, which allows for the manipulation of several environmental influences, is presented. It is demonstrated that the response of the genioglossus is qualitatively similar to that determined through experimental techniques. Furthermore, insights into the stress distribution developed within the tongue are discussed. It is shown that changes in almost any aspect of the breathing or physiological conditions invoke a significant change in the response of the airway dilators. The results of this study provide further evidence of the importance of modeling and simulation techniques as an aid in understanding the complex behavior of the human body.
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Affiliation(s)
- Jean-Paul V Pelteret
- Centre for Research in Computational and Applied Mechanics, University of Cape Town, Cape Town, Western Cape, South Africa
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Kumar V, Chhabra S, Kakkar V, Malik VS. Establishment of Pharyngeal Dimensions in Population of Haryana Using Cephalometric Radiographs. J ANAT SOC INDIA 2012. [DOI: 10.1016/s0003-2778(12)80028-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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7
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Tagaya M, Nakata S, Yasuma F, Noda A, Hamajima N, Katayama N, Otake H, Teranishi M, Nakashima T. Morphological features of elderly patients with obstructive sleep apnoea syndrome: a prospective controlled, comparative cohort study. Clin Otolaryngol 2011; 36:139-46. [DOI: 10.1111/j.1749-4486.2011.02296.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Veldi M, Ani R, Vaher H, Eller T, Hion T, Aluoja A, Vasar V. Obstructive sleep apnea syndrome (OSAS): Pathophysiology in Estonians. PATHOPHYSIOLOGY 2010; 17:219-23. [DOI: 10.1016/j.pathophys.2010.01.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2009] [Accepted: 01/04/2010] [Indexed: 10/19/2022] Open
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Ng AK, Koh TS. Analysis and modeling of snore source flow with its preliminary application to synthetic snore generation. IEEE Trans Biomed Eng 2010; 57:552-60. [PMID: 19846367 DOI: 10.1109/tbme.2009.2034139] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
With the emerging use of snore properties for clinical purposes, there is a need to understand the characteristics of snore source flow (SF)-the acoustic source in snore production. This paper attempts to analyze and model both SF and its derivative (SFD), along with its preliminary application to the generation of synthetic snores. SFs and SFDs were extracted from natural snores via an iterative adaptive inverse filtering approach, and subsequently parameterized into various time- and amplitude-based parameters to quantify the oscillatory maneuvers of snore excitation source (ES). The SF and SFD waveforms were also, respectively, modeled using the first and second derivatives of the Gaussian probability density function. Subjective and objective measures, including paired comparison score and sum-of-squared error, were assessed to appraise the performance of SFD model in producing natural-sounding snores. Results consistently show that: 1) the shapes of SF pulse are different among snores and can be associated with the dynamic biomechanical properties (e.g., compliance and elasticity) of ES; 2) changes to the SF or SFD pulse shape can affect the snore properties, both acoustically and perceptually; and 3) the proposed SFD model can generate close-to-natural sounding snores. Further research in this area can potentially yield valuable benefits to snore-oriented applications.
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Affiliation(s)
- Andrew Keong Ng
- School of Electrical and Electronic Engineering, Nanyang Technological University, Singapore.
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Muñoz JA, Marcoux M, Picandet V, Theoret CL, Perron MF, Lepage OM. Histological and biomechanical effects of palatal sclerotherapy in the horse using sodium tetradecyl sulfate. Vet J 2008; 183:316-21. [PMID: 19109041 DOI: 10.1016/j.tvjl.2008.11.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2008] [Revised: 10/27/2008] [Accepted: 11/02/2008] [Indexed: 11/15/2022]
Abstract
Palatal sclerotherapy using sodium tetradecyl sulfate has been suggested as a treatment for dorsal displacement of the soft palate in young Standardbred horses. The present study evaluated histological and biomechanical changes in the equine soft palate following trans-endoscopic treatment with a low dose of this compound. Two horses were euthanased and examined at 2 weeks and at 1, 2, 4 and 6 months post-sclerotherapy, while two further horses served as untreated controls. The technique was easily performed in all cases without major complications. On histological examination there was no evidence of palatal necrosis, inflammation or fibrosis in any of the treated or control animals. There was no variation in the density of palatal connective tissue between individuals, and on biomechanical assessment no significant difference in the stiffness of the palatal tissue was found between treated and control horses at any time. The lower dose of sodium tetradecyl sulfate used in this study relative to previous reports, might explain the absence of tissue alterations. This method of sclerotherapy did not alter the morphology or biomechanical properties of normal equine soft palates.
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Fricke BL, Abbott MB, Donnelly LF, Dardzinski BJ, Poe SA, Kalra M, Amin RS, Cotton RT. Upper airway volume segmentation analysis using cine MRI findings in children with tracheostomy tubes. Korean J Radiol 2007; 8:506-11. [PMID: 18071281 PMCID: PMC2627453 DOI: 10.3348/kjr.2007.8.6.506] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2007] [Accepted: 02/27/2007] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE The purpose of this study is to evaluate the airway dynamics of the upper airway as depicted on cine MRI in children with tracheotomy tubes during two states of airflow through the upper airway. MATERIALS AND METHODS Sagittal fast gradient echo cine MR images of the supra-glottic airway were obtained with a 1.5T MRI scanner on seven children with tracheotomy tubes. Two sets of images were obtained with either the tubes capped or uncapped. The findings of the cine MRI were retrospectively reviewed. Volume segmentation of the cine images to compare the airway volume change over time (mean volume, standard deviation, normalized range, and coefficient of variance) was performed for the capped and uncapped tubes in both the nasopharynx and hypopharynx (Signed Rank Test). RESULTS Graphical representation of the airway volume over time demonstrates a qualitative increased fluctuation in patients with the tracheotomy tube capped as compared to uncapped in both the nasopharyngeal and hypopharyngeal regions of interest. In the nasopharynx, the mean airway volume (capped 2.72 mL, uncapped 2.09 mL, p = 0.0313), the airway volume standard deviation (capped 0.42 mL, uncapped 0.20 mL, p = 0.0156), and the airway volume range (capped 2.10 mL, uncapped 1.09 mL, p = 0.0156) were significantly larger in the capped group of patients. In the hypopharynx, the airway volume standard deviation (capped 1.54 mL, uncapped 0.67 mL, p = 0.0156), and the airway volume range (capped 6.44 mL, uncapped 2.93 mL, p = 0.0156) were significantly larger in the capped tubes. The coefficient of variance (capped 0.37, uncapped 0.26, p = 0.0469) and the normalized range (capped 1.52, uncapped 1.09, p = 0.0313) were significantly larger in the capped tubes. CONCLUSION There is a statistically significant change in airway dynamics in children with tracheotomy tubes when breathing via the airway as compared to breathing via the tracheotomy tube.
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Affiliation(s)
- Bradley L. Fricke
- Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati OH 45229-3039, USA
- Current Location: Department of Radiology, Emory University School of Medicine, Atlanta GA 30322, USA
| | - M. Bret Abbott
- Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati OH 45229-3039, USA
- Current Location: Department of Radiology, University of Arizona College of Medicine, Tucson AZ 85724-5067, USA
| | - Lane F. Donnelly
- Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati OH 45229-3039, USA
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati OH 45229-3039, USA
- University of Cincinnati, College of Medicine, Cincinnati, OH 45267, USA
| | - Bernard J. Dardzinski
- Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati OH 45229-3039, USA
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati OH 45229-3039, USA
- University of Cincinnati, College of Medicine, Cincinnati, OH 45267, USA
| | - Stacy A. Poe
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati OH 45229-3039, USA
| | - Maninder Kalra
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati OH 45229-3039, USA
- University of Cincinnati, College of Medicine, Cincinnati, OH 45267, USA
- Department of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati OH 45229-3039, USA
| | - Raouf S. Amin
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati OH 45229-3039, USA
- University of Cincinnati, College of Medicine, Cincinnati, OH 45267, USA
- Department of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati OH 45229-3039, USA
| | - Robin T. Cotton
- Department of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati OH 45229-3039, USA
- Department of Otolaryngology, Cincinnati Children's Hospital Medical Center, Cincinnati OH 45229-3039, USA
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Abstract
Sleep apnea is highly prevalent in subjects after age 60, and affects older men and women similarly. Central apneas are often observed in addition to obstructive and mixed events. Pathogenesis of obstructive and central events during sleep in the elderly can be attributed to an amplification of well-established causes of sleep-disordered breathing (SDB) in younger adults. As in middle-aged adults, sleep-related complaints, cardiovascular diseases, depression and traffic accidents should prompt an evaluation by a sleep specialist. However, secondary enuresis and nocturia, cognitive impairment, ophthalmic conditions and repeated falls may be the main complaint in elderly subjects. Sleep studies in the elderly should systematically include reliable means to detect central apneas and periodic leg movements. Untreated SDB in the elderly appears to have a lesser impact on mortality than in middle-aged adults. However, the typical morbidity associated with the disorder in younger adults is observed in the elderly. Elderly symptomatic SDB patients tolerate CPAP no differently than younger patients and should be effectively treated. In conclusion, whether sleep apnea in the elderly represents a specific entity or the same disease as in younger subjects, with some distinctive features, is still unclear. Further research, in particular focusing on the impact of age on SDB outcomes, is needed.
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Affiliation(s)
- Sandrine H Launois
- HP2 Laboratory INSERM ERI EA 3745, Université Joseph Fourier, and Sleep Laboratory, Centre Hospitalo-Universitaire, Grenoble, France.
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Abbott MB, Donnelly LF, Dardzinski BJ, Poe SA, Chini BA, Amin RS. Obstructive Sleep Apnea: MR Imaging Volume Segmentation Analysis. Radiology 2004; 232:889-95. [PMID: 15333801 DOI: 10.1148/radiol.2323031581] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To retrospectively determine airway wall motion with volume segmentation of transverse cine magnetic resonance (MR) images in children with obstructive sleep apnea (OSA). MATERIALS AND METHODS Transverse fast gradient-echo cine MR images of the hypopharynx were obtained at 1.5 T in 31 children with OSA (eight girls, 23 boys; mean age, 11.3 years) and 21 children free of airway symptoms who underwent MR imaging for other clinical indications (11 girls, 10 boys; mean age, 3.5 years). Volume segmentation with a k-means clustering algorithm was applied to transverse cine MR images to quantify airway volumes at each time. Airway wall motion for each child was described with standard deviation and range. Coefficient of variance and normalized range, which are independent of airway size, were used to compare groups (Kruskal-Wallis test). RESULTS Plots of airway volume over time demonstrated large fluctuations during respiration in children with OSA and minimal fluctuations in controls; findings were consistent with airway distention and airway collapse in OSA. Average airway transverse volume was larger in the group with OSA than in the control group (OSA group, 2.52 mL; control group, 0.936 mL; P <.001). Mean standard deviation (OSA group, 0.840 mL; control group, 0.17 mL; P <.001) and mean range of airway cross section (OSA group, 3.552 mL; control group, 0.864 mL; P <.001) were larger in the group with OSA. Coefficient of variance (OSA group, 0.32; control group, 0.17; P <.001) and normalized range (OSA group, 1.42; control group, 0.96; P <.001) indicate statistically significant difference in airway dynamics in children with OSA. CONCLUSION Volume segmentation of transverse cine MR images of the hypopharynx aids in quantification of increased airway wall motion in children with OSA. Transverse MR imaging demonstrates both airway distention and collapse in children with OSA.
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Affiliation(s)
- M Bret Abbott
- Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229-3090, USA
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Unal M, Oztürk L, Kanik A. The role of oxygen saturation measurement and body mass index in distinguishing between non-apnoeic snorers and patients with obstructive sleep apnoea syndrome. CLINICAL OTOLARYNGOLOGY AND ALLIED SCIENCES 2002; 27:344-6. [PMID: 12383294 DOI: 10.1046/j.1365-2273.2002.00592.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The aim of this study was to examine the role of oxygen saturation (SaO2) measurement in identifying apnoeic snorers from non-apnoeic snorers and in the assessment of the severity of obstructive sleep apnoea. Ninety-two patients with clinically suspected obstructive sleep apnoea syndrome (OSAS) were assessed, using overnight polysomnography. The patients were classified as follows: 14 patients were non-apnoeic snorers, 27 patients had mild OSAS, 31 patients had moderate OSAS and 20 patients had severe OSAS. Minimum SaO2 level, mean SaO2, time below 85% of SaO2, the ratio between the time SaO2 and total sleep time and body mass index (BMI) were assessed retrospectively. There was a statistically significant difference between the non-apnoeic group and OSAS patients in Min SaO2 (P = 0.03). Patients who had Min SaO2 above 85% could be evaluated as non-apnoeic snorers; however, SaO2 and BMI were not found to be useful in the assessment of the severity of OSAS.
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Affiliation(s)
- M Unal
- University of Mersin, School of Medicine, Department of Otorhinolaryngology, Mersin, Turkey.
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Pandi-Perumal SR, Seils LK, Kayumov L, Ralph MR, Lowe A, Moller H, Swaab DF. Senescence, sleep, and circadian rhythms. Ageing Res Rev 2002; 1:559-604. [PMID: 12067601 DOI: 10.1016/s1568-1637(02)00014-4] [Citation(s) in RCA: 105] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The goal of this review article is to summarize our knowledge and understanding of the overlapping (interdisciplinary) areas of senescence, sleep, and circadian rhythms. Our overview comprehensively (and visually wherever possible), emphasizes the organizational, dynamic, and plastic nature of both sleep and circadian timing system (CTS) during senescent processes in animals and in humans. In this review, we focus on the studies that deal with sleep and circadian rhythms in aged animals and how these studies have closely correlated to and advanced our understanding of similar processes in ageing humans. Our comprehensive summary of various aspects of the existing research on animal and human ageing, both normal and pathological, presented in this review underscores the invaluable advantage of close collaboration between clinicians and basic research scientists and the future challenges inherent in this collaboration. First, our review addresses the common age-related changes that occur in sleep and temporal organization of both animals and humans. Second, we examine the specific modifications that often accompany sleep and CTS during aging. Third, we discuss the clinical epidemiology of sleep dysfunctions during ageing and their current clinical management, both pharmacological and non-pharmacological. Finally, we predict the possible future promises for complementary and alternative medicine (CAM) that pave the way to the emergence of a "Holistic Sleep Medicine" approach to the treatment of sleep disorders in the ageing population. Further studies will provide additional valuable insights into the understanding of both sleep and circadian rhythms during senescence.
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Affiliation(s)
- S R Pandi-Perumal
- Department of Physiology, UCLA School of Medicine, Los Angeles, CA 90095, USA.
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