Pathogenesis of Obstructive Sleep Apnea

Jung R , Kuhlo W. Neurophysiological studies of abnormal night sleep and the Pickwickian syndrome. Progress in Brain Research 1965; 18:140–159.

Tilkian AG , Guilleminault C , Schroeder JS , Lehrman KL , Simmons FB , Dement WC . Sleep-induced apnea syndrome. Prevalence of cardiac arrhythmias and their reversal after tracheostomy. Am J Med 1977;63(3):348–358.

Simmons FB . "How I do it"-head and neck. Tracheotomy in obstructive sleep apnea patients. Laryngoscope 1979; 89(10 Pt 1):1702–1703.

Guilleminault C , Simmons FB , Motta J , Cummiskey J , Rosekind M , Schroeder JS , . Obstructive sleep apnea syndrome and tracheostomy. Long-term follow-up experience. Arch Intern Med 1981;141(8):985–988.

Dayal VS , Braig F. Tracheotomy in longterm management of sleep apnea. J Otolaryngol 1981;10(4):273–277.

Guilleminault C , Quera Salva MA , Partinen M , Jamieson A. Women and the obstructive sleep apnea syndrome. Chest 1988;93(1):104–109.

Chaban R , Cole P , Hoffstein V. Site of upper airway obstruction in patients with idiopathic obstructive sleep apnea. Laryngoscope 1988;98(6 Pt 1):641–647.

Remmers JE , deGroot WJ , Sauerland EK , Anch AM . Pathogenesis of upper airway occlusion during sleep. J Appl Physiol 1978;44(6):931–938.

Kuna ST , Remmers JE . Neural and anatomic factors related to upper airway occlusion during sleep. Med Clin North Am 1985;69(6):1221–1242.

Sullivan CE , Issa FG . Obstructive sleep apnea. Clin Chest Med 1985;6(4):633–650.

Sullivan CE , Issa FG . Pathophysiological mechanisms in obstructive sleep apnea. Sleep 1980;3(3-4):235–246.

Hudgel DW . Variable site of airway narrowing among obstructive sleep apnea patients. J Appl Physiol 1986;61(4):1403–1409.

Shepard JW , Thawley SE . Localization of upper airway collapse during sleep in patients with obstructive sleep apnea. Am Rev Respir Dis 1990;141(5 Pt 1):1350–1355.

Isono S , Morrison DL , Launois SH , Feroah TR , Whitelaw WA , Remmers JE . Static mechanics of the velopharynx of patients with obstructive sleep apnea. J Appl Physiol 1993;75(1):148–154.

Strohl KP , Cherniack NS , Gothe B. Physiologic basis of therapy for sleep apnea. Am Rev Respir Dis 1986;134(4):791–802.

van Lunteren E , Strohl KP . The muscles of the upper airways. In: Widdicombe D , editor. The upper airways. Philadelphia: WB Saunders, 1986:171–188.

Sanna A , Veriter C , Stanescu D. Upper airway obstruction induced by negative-pressure ventilation in awake healthy subjects. J Appl Physiol 1993;75(2):546–552.

Anch AM , Remmers JE , Sauerland EK , deGroot WJ . Oropharyngeal patency during waking and sleep in the Pickwickian syndrome: electromyographic activity of the tensor veli palatini. Electromyogr Clin Neurophysiol 1981;21(2-3):317–330.

Oliven A , Odeh M , Schnall RP . Improved upper airway patency elicited by electrical stimulation of the hypoglossus nerve. Respiration 1996;63(4):213–216.

Edmonds LC , Daniels BK , Stanson AW , Sheedy PF , 3d JW ShepardJr. The effects of transcutaneous electrical stimulation during wakefulness and sleep in patients with obstructive sleep apnea. Am Rev Respir Dis 1992;146(4):1030–1036.

Okabe S , Chonan T , Hida W , Satoh M , Kikuchi Y , Takishima T. Role of chemical drive in recruiting upper airway and inspiratory intercostal muscles in patients with obstructive sleep apnea. Am Rev Respir Dis 1993;147(1):190–195.

Douglas NJ , Jan MA , Yildirim N , Warren PM , Drummond GB . Effect of posture and breathing route on genioglossal electromyogram activity in normal subjects and in patients with the sleep apnea/hypopnea syndrome. Am Rev Respir Dis 1993;148(5):1341–1345.

Isono S , Remmers JE . Anatomy and physiology of upper airway obstruction. In: Kryger MH , Roth T , Dement WC , editors. Principles and practice of sleep medicine, 2nd ed. Philadelphia: WB Saunders, 1994:642–656.

Morikawa S , Safar P , DeCarlo J. Influence of the head-jaw position upon upper airway patency. Anesthesia 1981;22:265–270.

Reed WR , Roberts JL , Thach BT . Factors influencing regional patency and configuration of the human infant upper airway. J Appl Physiol 1985; 58(2):635–644.

Berger RJ . Tonus of extrinsic laryngeal muscles during sleep and dreaming. Science 1961;134:840.

Sauerland EK , Orr WC , Hairston LE . EMG patterns of oropharyngeal muscles during respiration in wakefulness and sleep. Electromyogr Clin Neurophysiol 1981;21(2-3):307–316.

Lopes JM , Tabachnik E , Muller NL , Levison H , Bryan AC . Total airway resistance and respiratory muscle activity during sleep. J Appl Physiol 1983;54(3):773–777.

Mathew OP , Abu-Osba YK , Thach BT . Influence of upper airway pressure changes on genioglossus muscle respiratory activity. J Appl Physiol 1982;52(2):438–444.

Mathew OP . Upper airway negative-pressure effects on respiratory activity of upper airway muscles. J Appl Physiol 1984;56(2):500–505.

Kuna ST . Inhibition of inspiratory airway motorneuron activity by phasic volume feedback. J Appl Physiol 1986;60(4):1373–1379.

Larsson H , Carlsson-Nordlander B , Lindblad LE , Norbeck O , Svanborg E. Temperature thresholds in the oropharynx of patients with obstructive sleep apnea syndrome. Am Rev Respir Dis 1992;146:1246–1249.

Leiter JC , Knuth SL , Bartlett DJ . The effect of sleep deprivation on activity of the genioglossus muscle. Am Rev Respir Dis 1985;132(6):1242–1245.

Krol RC , Knuth SL , Bartlett D. Selective reduction of genioglossal muscle activity by alcohol in normal human subjects. Am Rev Respir Dis 1984;129(2):247–250.

Chadwick GA , Crowley PJ , Fitzgerald MX , O'Regan RG , McNicholas WT . Obstructive sleep apnea following topical oropharyngeal anesthesia in loud snorers. Am Rev Respir Dis 1991;143(4 Pt 1):810–813.

Browman CP , Sampson MG , Yolles SF , Gujavarty KS , Weiler SJ , Walsleben JA , . Obstructive sleep apnea and body weight. Chest 1984;85(3):435–438.

Harman EM , Wynne JW , Block AJ . The effect of weight loss on sleep-disordered breathing and oxygen desaturation in morbidly obese men. Chest 1982;82(3):291–294.

Peiser J , Lavie P , Ovnat A , Charuzi I. Sleep apnea syndrome in the morbidly obese as an indication for weight reduction surgery. Ann Surg 1984;199(1):112–115.

Charuzi I , Lavie P , Peiser J , Peled R. Bariatric surgery in morbidly obese sleep-apnea patients: short- and long-term follow-up. Am J Clin Nutr 1992;55(2 Suppl):594S–596S.

Schwartz AR , Gold AR , Schubert N , Stryzak A , Wise RA , Permutt S , . Effect of weight loss on upper airway collapsibility in obstructive sleep apnea. Am Rev Respir Dis 1991;144(3 Pt 1):494–498.

Shelton KE , Woodson H , Gay S , Suratt PM . Pharyngeal fat in obstructive sleep apnea. Am Rev Respir Dis 1993;148(2):462–466.

Shelton KE , Gay SB , Hollowell DE , Woodson H , Suratt PM . Mandible enclosure of upper airway and weight in obstructive sleep apnea. Am Rev Respir Dis 1993;148(1):195–200.

Schwab RJ , Gupta KB , Gefter WB , Metzger LJ , Hoffman EA , Pack AI . Upper airway and soft tissue anatomy in normal subjects and patients with sleep-disordered breathing. Am J Respir Crit Care Med 1995;152(5 Pt 1):1673–1689.

Horner RL , Mohiaddin RH , Lowell DG , Shea SA , Burman ED , Longmore DB , . Sites and sizes of fat deposits around the pharynx in obese patients with obstructive sleep apnoea and weight matched controls. Eur Respir J 1989;2(7):613–622.

Rubinstein I , Hoffstein V , Bradley TD . Lung volume-related changes in the pharyngeal area of obese females with and without obstructive sleep apnoea. Eur Respir J 1989;2(4):344–351.

Shepard JW , Pevernagie DA , Stanson AW , Daniels BK , Sheedy PF . Effects of changes in central venous pressure on upper airway size in patients with obstructive sleep apnea. Am J Respir Crit Care Med 1996;153(1):250–254.

Sullivan CE , Issa FG , Berthon-Jones M , Saunders NA . Pathophysiology of sleep apnea. In: Saunders NA , Sullivan CE , editors. Sleep and breathing. New York: Marcel Dekker, 1984:299–364.

Issa FG , Sullivan CE . Upper airway closing pressures in obstructive sleep apnea. J Appl Physiol 1984;57(2):520–527.

Brown IG , Bradley TD , Phillipson EA , Zamel N , Hoffstein V. Pharyngeal compliance in snoring subjects with and without obstructive sleep apnea. Am Rev Respir Dis 1985;132(2):211–215.

Rivlin J , Hoffstein V , Kalbfleisch J , McNicholas W , Zamel N , Bryan AC . Upper airway morphology in patients with idiopathic obstructive sleep apnea. Am Rev Respir Dis 1984;129(3):355–360.

Hoffstein V , Zamel N , Phillipson EA . Lung volume dependence of pharyngeal cross-sectional area in patients with obstructive sleep apnea. Am Rev Respir Dis 1984;130(2):175–178.

Smith PL , Wise RA , Gold AR , Schwartz AR , Permutt S. Upper airway pressure-flow relationships in obstructive sleep apnea. J Appl Physiol 1988; 64(2):789–795.

Wilms D , Popovich J , Conway W , Fujita S , Zorick F. Anatomic abnormalities in obstructive sleep apnea. Ann Otol Rhinol Laryngol 1982;91(6 Pt 1):595–596.

Colmenero C , Esteban R , Albarino AR , Colmenero B. Sleep apnoea syndrome associated with maxillofacial abnormalities. J Laryngol Otol 1991;105(2):94–100.

Tammelin BR , Wilson AF , Borowiecki BB , Sassin JF . Flow-volume curves reflect pharyngeal airway abnormalities in sleep apnea syndrome. Am Rev Respir Dis 1983;128(4):712–715.

Haponik EF , Smith PL , Kaplan J , Bleecker ER . Flow-volume curves and sleep-disordered breathing: therapeutic implications. Thorax 1983;38(8):609–615.

Haponik EF , Bleecker ER , Allen RP , Smith PL , Kaplan J. Abnormal inspiratory flow-volume curves in patients with sleep-disordered breathing. Am Rev Respir Dis 1981;124(5):571–574.

Shepard JW , Burger CD Jr. Nasal and oral flow-volume loops in normal subjects and patients with obstructive sleep apnea. Am Rev Respir Dis 1990;142(6 Pt 1):1288–1293.

Shore ET , Millman RP . Abnormalities in the flow-volume loop in obstructive sleep apnoea sitting and supine. Thorax 1984;39(10):775–779.

Kayaleh RA , Dutt A , Khan A , Wilson AF . Tidal breath flow-volume curves in obstructive sleep apnea. Am Rev Respir Dis 1992; 145(6):1372–1377.

Schwab RJ , Gefter WB , Hoffman EA , Gupta KB , Pack AI . Dynamic upper airway imaging during awake respiration in normal subjects and patients with sleep disordered breathing. Am Rev Respir Dis 1993;148(5):1385–1400.

Mezzanotte WS , Tangel DJ , White DP . Waking genioglossal electromyogram in sleep apnea patients versus normal controls (a neuromuscular compensatory mechanism). J Clin Invest 1992;89(5):1571–1579.

Riley R , Guilleminault C , Herran J , Powell N. Cephalometric analyses and flow-volume loops in obstructive sleep apnea patients. Sleep 1983;6(4):303–311.

Suratt PM , Dee P , Atkinson RL , Armstrong P , Wilhoit SC . Fluoroscopic and computed tomographic features of the pharyngeal airway in obstructive sleep apnea. Am Rev Respir Dis 1983;127(4):487–492.

Haponik EF , Smith PL , Bohlman ME , Allen RP , Goldman SM , Bleecker ER . Computerized tomography in obstructive sleep apnea. Correlation of airway size with physiology during sleep and wakefulness. Am Rev Respir Dis 1983;127(2):221–226.

Bohlman ME , Haponik EF , Smith PL , Allen RP , Bleecker ER , Goldman SM . CT demonstration of pharyngeal narrowing in adult obstructive sleep apnea. Am J Roentgenol 1983;140(3):543–548.

Bradley TD , Brown IG , Grossman RF , Zamel N , Martinez D , Phillipson EA , . Pharyngeal size in snorers, nonsnorers, and patients with obstructive sleep apnea. N Engl J Med 1986;315(21):1327–1331.

Stauffer JL , Zwillich CW , Cadieux RJ , Bixler EO , Kales A , Varano LA , . Pharyngeal size and resistance in obstructive sleep apnea. Am Rev Respir Dis 1987;136(3):623–627.

Anch AM , Remmers JE , Bunce H. Supraglottic airway resistance in normal subjects and patients with occlusive sleep apnea. J Appl Physiol 1982;53(5):1158–1163.

Hudgel DW , Martin RJ , Johnson B , Hill P. Mechanics of the respiratory system and breathing pattern during sleep in normal humans. J Appl Physiol 1984;56(1):133–137.

White DP , Lombard RM , Cadieux RJ , Zwillich CW . Pharyngeal resistance in normal humans: influence of gender, age, and obesity. J Appl Physiol 1985;58(2):365–371.

Brooks LJ , Strohl KP . Size and mechanical properties of the pharynx in healthy men and women. Am Rev Respir Dis 1992;146(6):1394–1397.

Popovic RM , White DP . Influence of gender on waking genioglossal myogram and upper airway resistance. Am J Respir Crit Care Med 1995;152(2):725–731.

Demirozu MC , Razzetti A , Gazeroglu HB , Diaz T , Kiel M , Chediak AD . Sleep body position influences apnea frequency and duration in obese and nonobese patients with obstructive sleep apnea (abstract). Sleep Research 1991;20A:302.

Cartwright RD , Diaz F , Lloyd S. The effects of sleep posture and sleep stage on apnea frequency. Sleep 1991;14(4):351–353.

Takasaki Y , Kamio K , Okamoto M , Ohta Y , Yamabayashi H. Changes in diaphragmatic EMG activity during sleep in space. Am Rev Respir Dis 1993;148(3):612–617.

Skatrud JB , Dempsey JA . Airway resistance and respiratory muscle function in snorers during NREM sleep. J Appl Physiol 1985; 59(2):328–335.

Wasicko MJ , Hutt DA , Parisi RA , Neubauer JA , Mezrich R , Edelman NH . The role of vascular tone in the control of upper airway collapsibility. Am Rev Respir Dis 1990;141(6):1569–1577.

Chediak AD , Herzberg P , Kim H. Does vasomotion modify the static pressure-volume relationship of the upper airway in normal humans? Sleep Research 1996;25:43.

Wasicko MJ , Leiter JC , Erlichman JS , Strobel RJ , Bartlett D. Nasal and pharyngeal resistance after topical mucosal vasoconstriction in normal humans. Am Rev Respir Dis 1991;144(5):1048–1052.

Georgopoulus D , Giannouli E , Tsara V , Argiropoulou P , Patakas D , Anthonisen NR . Respiratory short-term poststimulus potentiation (after-discharge) in patients with obstructive sleep apnea. Am Rev Respir Dis 1992;146:1250–1255.

Entzian P , Linnemann K , Schlaak M , Zabel P. Obstructive sleep apnea syndrome and circadian rhythms of hormones and cytokines. Am J Respir Crit Care Med 1996;153(3):1080–1086.

Follenius M , Krieger J , Krauth MO , Sforza F , Brandenberger G. Obstructive sleep apnea treatment: peripheral and central effects on plasma renin activity and aldosterone. Sleep 1991;14(3):211–217.

Wheatley JR , Tangel DJ , Mezzanotte WS , White DP . Influence of sleep on alae nasi EMG and nasal resistance in normal men. J Appl Physiol 1993; 75(2):626–632.

Zwillich CW , Pickett C , Hanson FN , Weil JV . Disturbed sleep and prolonged apneas during nasal obstruction in normal men. Am Rev Respir Dis 1981;124(2):158–160.

Lavie P , Gertner R , Zomer J , Podoohin L. Breathing disorders during sleep associated with "microarousals" in patients with allergic rhinitis. Acta Otolaryngol 1981;92(5-6):529–533.

McNicholas WT , Tarlo S , Cole P , Zamel N , Rutherford R , Griffin D , . Obstructive apneas during sleep in patients with seasonal allergic rhinitis. Am Rev Respir Dis 1982;126(4):625–628.

Olsen KD , Kern EB . Nasal influences on snoring and obstructive sleep apnea. Mayo Clin Proc 1990;65(8):1095–1105.