[Study on pharyngeal wall floppiness of patients with obstructive sleep apnea-hypopnea syndrome attributable to non-structural factors].

Objective: Acoustic pharyngealmetry technology is utilized to evaluate the change and clinical significance of obstructive sleep apnea-hypopnea syndrome (OSAHS) patients caused by non-upper airway structural factor and normal individuals' PWF(pharyngeal wall floppiness). Methods: Acoustic pharyngealmetry instrument of Ecconvision was utilized to examine 102 OSAHS patients and 50 normal individuals, separately recorded their volume of pharyngeal cavity in sit or supine position, calculated PWF in sit or supine position, and SPSS 12.0 of tware was used to analyze data. Results: PWF was 0.14±0.09 in sit position and PWF was 0.21±0.10, (t=5.96, t=9.63, P<0.001)in supine position of OSAHS group, which were all significantly higher than those of control group. PWFs in supine position of OSAHS group and control group were evidently higher than PWF(t=-11.91, P<0.001; t=-2.32, P=0.025) in sit position. ΔPWF(PWF_supine-PWF_sit)was 0.063±0.054 in OSAHS group which was significantly greater than in control(F=41.173, P<0.01). PWF in sit position and supine position were all positively related with age(r=0.714, r=0.735, P<0.001)while irrelevant with BMI(P>0.05). Conclusions: PWF can be utilized to be an index to reflect the physiological feature of upper airway. PWF can more precisely reflect upper airway collapsibility of OSAHS patients on the condition of PWF in supine position. Pharyngeal wall floppiness quantified as a high PWF index is a non-structure vital factor of OSAHS patients and plays a role of guiding us to make personal treatment plans for OSAHS patients.

[A preliminary clinical classification study in REM related obstructive sleep apnea].

Objective:The aim of this study is to introduce a method in classifying the REM related OSA (RrOSA) and the potential clinical significance. Method:Two hundred and fifty patients (male: 219) with OSAS diagnosed by polysomnographywere recruited in the study. The RrOSAS was defined as the ratio of AHIs in REM and non REM sleep (R) greater than one. In RrOSAS group, patients were divided into RrOSAS Ⅰa (R>2, NREM_AHI<15), RrOSAS Ⅰb (R>2, NREM_AHI>15), and RrOSAS II (2>R>1) three subtypes. Parameters of PSG, ESS, BMI and neck circufernces were obtained for further analysis. In RrOSA Ⅰa group, the efficiencies of CPAP and AutoPAP were investigated. Result:①There was a significant difference in gender between RrOSA and NRrOSA groups (P<0.05); ②There was no significant differences in ESS and BMI among the three subtypes of RrOSA (P>0.05); ③There was no significant difference in REM_AHI and REM_ODI between RrOSA and NRrOSA groups. Conclusion:The new method for the RrOSA classification helps better understanding the development of OSAS and might be useful in planning the CPAP treatment. RrOSA may be a special type of OSA, which may develop into other types as the condition develops.