A method for measuring and modeling the physiological traits causing obstructive sleep apnea
A method for measuring and modeling the physiological traits causing obstructive sleep apnea
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DOI：
10.1152/japplphysiol.00972.2010
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发表时间：
2011-06-01
影响因子：
3.3
通讯作者：
White, David P.
中科院分区：
文献类型：
--
作者：
Wellman, Andrew;Eckert, Danny J.;White, David P.
目前还没有一种临床可用的技术来测量导致阻塞性睡眠呼吸暂停（OSA）的生理特征。因此，通常很难确定为什么一个人患有OSA或各种特征在多大程度上有助于OSA的发展。在这项研究中，我们提出了一种非侵入性的方法来测量引起OSA的四个重要生理特征：1）咽部解剖结构/可吸收性，2）呼吸控制系统增益（环路增益），3）上气道响应呼吸驱动增加而扩张/扩张的能力，以及4）唤醒阈值。这些变量是使用一个单一的动作，其中持续气道正压通气（CPAP）是从一个最佳的下降到各种次最佳的压力为3至5分钟的时间间隔在睡眠期间测量。每个个体的一组特征被输入到OSA的生理模型中，该模型以图形方式说明了每个特征在该个体中的相对重要性。结果从14名受试者（10与OSA）进行了描述。重复性测量，从不同的夜晚也提出了四个主题。测量结果和模型说明了OSA发病机制的多因素性质，以及在一些个体中，一种或另一种性状的微小调整（这可能是用非CPAP药物实现的）如何可能治疗OSA。这项技术可以想象地用于临床，以确定病人的生理和指导治疗的基础上的特点。
There is not a clinically available technique for measuring the physiological traits causing obstructive sleep apnea (OSA). Therefore, it is often difficult to determine why an individual has OSA or to what extent the various traits contribute to the development of OSA. In this study, we present a noninvasive method for measuring four important physiological traits causing OSA: 1) pharyngeal anatomy/collapsibility, 2) ventilatory control system gain (loop gain), 3) the ability of the upper airway to dilate/stiffen in response to an increase in ventilatory drive, and 4) arousal threshold. These variables are measured using a single maneuver in which continuous positive airway pressure (CPAP) is dropped from an optimum to various suboptimum pressures for 3- to 5-min intervals during sleep. Each individual's set of traits is entered into a physiological model of OSA that graphically illustrates the relative importance of each trait in that individual. Results from 14 subjects (10 with OSA) are described. Repeatability measurements from separate nights are also presented for four subjects. The measurements and model illustrate the multifactorial nature of OSA pathogenesis and how, in some individuals, small adjustments of one or another trait (which might be achievable with non-CPAP agents) could potentially treat OSA. This technique could conceivably be used clinically to define a patient's physiology and guide therapy based on the traits.