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. 2012 Jan;2(1):3-8.
doi: 10.4103/2231-0770.94803.

Obstructive sleep apnea-hypopnea syndrome: Etiology and diagnosis

Abdul Ghani Sankri-Tarbichi  1
Affiliations

Obstructive sleep apnea-hypopnea syndrome: Etiology and diagnosis

Abdul Ghani Sankri-Tarbichi. Avicenna J Med. 2012 Jan.

Abstract

Sleep disordered breathing is a common chronic condition in the general population. This review will highlight the prevalence of different types of sleep apnea in general and obstructive type in particular in the United States and Middle East. Despite the extensive research studies on the sleep apnea pathogenesis, the exact mechanism is not well known. Obesity, however, is the leading risk factor to upper airway narrowing and obstruction and main contributor to the escalating prevalence of morbidity worldwide including the Arab countries. Due to the serious consequences of the untreated sleep disordered breathing, this article will emphasize on the importance of early recognition, key clinical manifestations, and how to treat and prevent the disease.

Keywords: Apnea; breathing; sleep.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Schematic illustration for the collapsible segment of upper airway as a Starling Resistor. In this model, flow is determined by the gradient between the upstream segment and critical closing pressure (Pcrit). During inspiration, when upstream pressure (Pus) (i.e., PN: Nasal pressure) is below the Pcrit, the collapsible segment is closed, and no flow occurs. During expiration, when Pus in the supraglottic area (i.e., PSG: Supraglottic pressure) is below the Pcrit, the collapsible segment is closed, and no flow occurs. During hypopnea, inspiratory and expiratory flows are limited, correlating with the gradient between the upstream pressure and Pcrit. Hence, this pressure gradient is important determinant of pharyngeal narrowing. Rus, upstream resistance; Vmax, maximal flow
Figure 2
Figure 2
A diagram to illustrate the potential mechanisms responsible of pharyngeal narrowing during reduced ventilator motor output and how neuromuscular and non-neuromuscular factors influence upper airway patency. The reduced ventilatory drive inhibits thoracic and pharyngeal neuromuscular activity affecting upper airway transmural pressure and/or compliance, respectively. In addition non-neuromuscular factors influence the upper airway patency by increasing surrounding pressure. UA - Upper airway, NC - Neck circumference, ILP - Intra-luminal pharyngeal pressure, ELP - Extra-luminal pharyngeal pressure.
Figure 3
Figure 3
A diagram to illustrate the risk factors for sleep disordered breathing. Abbreviations: SDB - Sleep disordered breathing; CHF - Chronic heart failure; CNS - Central nervous system
See this image and copyright information in PMC

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