Patogénesis de la apnea obstructiva del sueño

Patogénesis de la apnea obstructiva del sueño

Publicado 1998-04-01

Abrir | Descargar
PDF FLIP
Número
Vol. 10 Núm. 1 (1998): abril
Sección
Revisión de tema
Cómo citar
Chediak A, Ungo JR. Patogénesis de la apnea obstructiva del sueño.
rev. colomb. neumol. [Internet]. 1998 Apr. 1 [cited 2025 Sep. 12];10(1):28-36. Disponible en: https://doi.org/10.30789/rcneumologia.v10.n1.1998.1220
DOI

https://doi.org/10.30789/rcneumologia.v10.n1.1998.1220
Dimensions
PlumX
Licencia
Creative Commons License

Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-CompartirIgual 4.0.

Ninguna publicación, nacional o extranjera, podrá reproducir ni traducir sus artículos ni sus resúmenes sin previa autorización escrita del editor; sin embargo  los usuarios pueden descargar la información contenida en ella, pero deben darle atribución o reconocimiento de propiedad intelectual, deben usarlo tal como está, sin derivación alguna.

Alejandro Chediak
Universidad de Miami Mount Sinaí
    Jaime R. Ungo
    Universidad de Miami Mount Sinai
      Mostrar biografía de los autores

      Alejandro Chediak,

      Jefe, Centro de Enfermedades del Sueño Profesor Asociado de Medicina Escuela de Medicina de la Universidad de Miami Mount Sinaí Medical Center Miami Beach, Florida

      Jaime R. Ungo,

      Médico Residente, Centro ® Enfermedades del Sueño División de Neumología y Cuidados Intensivos Escuela de Medicina de la Universidad de Miami Mount Sinai Medical Center Miami Beach, Florida.

      La vía aérea superior (VAS) comienza en las fosas nasales y en la entrada de la cavidad oral, terminando en la apertura glótica (Figura Nº 1 ). El sitio de oclusión de la vía aérea en la AOS puede ocurrir en uno o varios lugares entre el paladar blando y la epiglotis. El estrechamiento de la VAS generalmente ocurre en el paladar blando, pero puede variar considerablemente. En algunos pacientes con AOS, la oclusión de la VAS puede ocurrir en más de un sitio y el punto de colapso puede desplazarse caudalmente durante la transición del sueño sin movimientos oculares rápidos (no MOR) a sueño MOR.

      Visitas del artículo 9 | Visitas PDF 1

      Descargas

      Los datos de descarga todavía no están disponibles.
      1. Jung R, Kuhlo W. Neurophysiological studies of abnormal night sleep and the Pickwickian syndrome. Progress in Brain Research 1965; 18: 140-59.
      2. Ti lkian AG, Guilleminault C, Schroeder JS, Lehrman KL, Simmons FB, Dement WC. Sleep-induced apnea syndrome. Prevalence of cardiac arrhythmias and their reversal alter tracheostomy. Am J Med 1977; 63:348-58.
      3. Simmons FB. "How I do it''--head and neck. Tracheotomy in obstructive sleep apnea patients. Laryngoscope 1979; 89:1702-3.
      4. Guilleminault C, Simmons FB, Motta J, Cummiskey J, Rosekind M, Schroeder JS, et al. Obstructive sleep apnea syndrome and tracheostomy. Long-term follow-up experience. Arch lntern Med 1981 ; 141 : 985-8.
      5. Dayal VS, Braig F. Tracheotomy in longterm management of sleep apnea. J Otolaryngol 1981 ; 10: 273-7.
      6. Guilleminault C, Quera Salva MA, Partinen M, Jamieson A. Women and the obstructive sleep apnea syndrome. Chest 1988; 93: 104-9.
      7. Chaban R, Cole P, Hoffstein V. Site of upper airway obstruction in patients with idiopathic obstructive sleep apnea. Laryngoscope 1988; 98:641 -7
      8. Remmers JE, DeGrout WJ, Sauerland EK, Anch AM. Pathogenesis of upper airNay occlusion during sleep. J Appl Physiol 1978; 44:931-8.
      9. Kuna ST, Remmers JE. Neural and anatomic factors relatad to upper airway occlusion during sleep. Med Clin North Am 1985; 69:1221-42.
      10. Sullivan CE , lssa FG. Obstructive sleep apnea. Clin Chest Med 1985; 6: 633-50.
      11. Sullivan CE, lssa FG. Pathophysiological mechanisms in obstructive sleep apnea. Sleep 1980; 3:235-46.
      12. Hudgel DW. Variable site of airway narrowing among obstructive sleep apnea patients. J Appl Physiol 1986;61 :1403-9.
      13. Shepard JW, Thawley SE. Localization of upper airway collapse during sleep in patients with obstructive sleep apnea. Am Rev Respir Dis 1990; 141 :1350-5.
      14. lsono 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; 1: 148-54.
      15. Strohl KP, Chernicack NS, Gothe B. Physiologic basis of therapy for sleep apnea. Am Rev Respir Dis 1986;134: 791-802.
      16. van Lunteren E, Strohl KP. The Muscles of the Upper Airways. In: Widdicombe D, editor. The Upper Airways. Philadelphia: W.B. Saunders, 1986:171-88.
      17. 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: 317-30.
      18. Oliven A, Odeh M, Schnall RP. lmproved Upper Airway Patency Elicited by Electrical Stimulation of the Hypoglossus Nerve. Respiration 1996; 63:213-6.
      19. Edmonds LC, Daniels BK, Stanson AW, Sheedy PF, 3d, Shepard JW, Jr. The effects of transcutaneous electrical stimulation during wakefulness and sleep in patients with obstructive sleep apnea. Am Rev Respir Dis 1992; 4:1030-6.
      20. 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 RespirDis 1993; 1: 190-5.
      21. Douglas NJ, Jan MA, Yildirim N, Warren PM, Drummond GB. Effect of postura and breathing route on genioglossal electromyogram activity in normal subjects and in patients with the sleep apnealhypopnea syndrome. Am Rev Respir Dis 1993; 5:1341-5.
      22. Morikawa S, Safar P, DeCarlo J. lnfluence of the head-jaw position upon upper airway patency. Anesthesia 1981 ; 22: 265-70.
      23. Reed WR, Roberts JL, Thach BT. Factors influencing regional patency and configuration of the human infant upper airway. J Appl Physiol 1985; 58:635-44.
      24. Berger RJ. Tonus of extrinsic laryngeal muscles during sleep and dreaming. Science 1961 ; 134: 840.
      25. Sauerland EK, Orr WC, Hairston LE. EMG patterns of oropharyngeal muscles during respiration in wakefulness and sleep. Electromyogr Clin Neurophysiol 1981;21 : 307-16.
      26. Lopes JM, Tabachnik E, Muller NL, Levison H, Bryan AC. Total airway resistance and respiratory muscle activity during sleep. J Appl Physiol 1983; 54: 773-7.
      27. Mathew OP, Abu-Osba YK, Thach BT. lnfluence of upper airway pressure changas on genioglossus muscle respiratory activity. J Appl Physiol 1982; 52: 438-44.
      28. Mathew OP. Upper airway negative-pressure effects on respiratory activity of upper airway muscles. J Appl Physiol 1984; 56: 500-5.
      29. Kuna ST. lnhibition of inspiratory airway motorneuron activity by phasic volume feedback. J Appl Physiol 1986;60: 1373-9.
      30. Leiter JC, Knuth SL, Bartlett DJ. The effect of sleep deprivation on activity of the genioglossus muscle. Am Rev Respir Dis 1985; 132: 1242-5.
      31. Krol RC, Knuth SL, Bartlett D. Selectiva reduction of genioglossal muscle activity by alcohol in normal human subjects. Am Rev Respir Dis 1984; 129: 247-50.
      32. 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: 810-3.
      33. Browman CP, Sampson MG, Yolles SF, Gujavarty KS, Weiler SJ, Walsleben JA, et al. Obstructive sleep apnea and body weight. Chest 1984; 85: 435-8.
      34. Harman EM, Wynne JW, Block AJ. The effect of weight loss on sleep-disordered breathing and oxygen desaturation in morbidly obesa men. Chesl 1982; 82: 291-4.
      35. Peiser J, Lavie P, Ovnat A, Charuzi l. Sleep apnea syndrome in the morbidly obesa as an indication for weight norreduction surgery. Ann Surg 1984; 199:112-5
      36. Charuzi L, Lavie P, Peiser J, Pelad R. Bariatric surgery in morbidly obesa sleep-apnea patients: short-and long-term follow-up. Am J Clin Nutr 1992; 2 Suppl 594S-6.S.
      37. Schwartz AR, Gold AR, Schubert N, Stryzak A, Wise RA, Permutt S, et al. Effect of weight loss on upper airway collapsibility in obstructive sleep apnea. Am Rev Respir Dis 1991; 144: 494-8.
      38. Shelton KE, Woodson H, Gay S, Suratt PM. Pharyngeal fat in obstructive sleep apnea. Am Rev Respir Dis 1993;2: 462-6.
      39. Shelton KE, Gay SB, Hollowell DE, Woodson H, Suratt PM. Mandible enclosure of upper airway and weight in obstructive sleep apnea. Am Rev Respi r Dis 1993; 1:195-200.
      40. Schwab RJ, Gupta KB, GefterWB, Metzger LJ, Hoffman EA, Pack Al. Upper Airway and Soft Tissue Anatomy in Normal Subjects and Patients with Sleep-Disordered Breathing. Am J Respir Crit Care Med 1995; 152:1673-89
      41. Horner RL, Mohiaddin RH, Lowell DG, Shea SA, Burman ED, Longmore DB, et al. Sitas and sizes of fat deposits around the pharynx in obesa patients with obs tructive sleep apnoea and weight matched control s. Eur Respir J 1989; 2: 613-22.
      42. Rubinstein 1, Hoffstein V, Bradley TD. Lung volume-relatad changas in the pharyngeal area of obesa females with and without obstructive sleep apnoea. Eur Respir J 1989; 2:344-51
      43. Shepard JW, Pevernagie DA, Stanson AW, Daniels BK, Sheedy PF. Effects of changas in central venous pressure on upper airway size in patients with obstructive sleep apnea. Am J Respir Crit Care Med 1996; 153: 62. 250-4
      44. Sullivan CE, lssa FG, Berthon-Jones M, Saunders NA. Pathophysiology of sleep apnea. In: Saunders NA, Sullivan CE, editors. Sleep and Breathing. NewYork: Marcel Dekker, 1984: 299-364
      45. lssa FG, Sullivan CE. Upper airway closing pressures in obstructive sleep apnea. J Appl Physiol 1984; 57:520-7.
      46. Brown IG, BradleyTD, Phillipson EA, Zamel N, Hoffstein V. Pharyngeal compliance in snoring subjects with and without obstructive sleep apnea. Am Rev Respir Dis with 1985; 132: 211-5.
      47. 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; 129:355-360
      48. Browman CP, Mitler MM. Hypersomnia and the perception of sleep-wake states: sorne preliminary findings. Percept Mot Skills 1988; 66: 463-70.
      49. Smith PL, Wise RA, Gold AR, Schwartz AR, Permutt S. Upper airway pressure-flow relationships in obstructive sleep apnea. J Appl Physiol 1988; 64: 789-95.
      50. Wilms D, Popovich J, Conway W, Fujita S, Zorick F. Anatomic abnormalities in obstructive sleep apnea. Ann Otol Rhinol Laryngol 1982; 91:595-6.
      51. Colmenero C, Esteban R, Albarino AR, Colmenero B. Sleep apnoea syndrome associated with maxilofacial abnormalities. J Laryngol Otol 1991 ; 105: 94-100.
      52. Tammelin BR, Wilson AF, Borowiecki BB, Sassin JF. Flow-volume curves reflect pharyngeal airway abnomalities in sleep apnea syndrome. Am Rev Respir Dis 1983; 128: 712-5.
      53. Haponik EF, Smith PL, Kaplan J, X. Flow-volume curves and sleep-disordered breathing: therapeutic implications. Thorax 1983; 38: 609-15
      54. Haponik EF, X, Allen RP, Smith PL, Kaplan J. Abnormal inspiratory flow-volume curves in patients with sleep-disordered breathing. Am Rev Respir Dis 1981; 124:571-4.
      55. Shepard JW, Burger CD. Nasal and oral flow-volume loops in normal subjects and patients with obstructive sleep apnea. Am Rev Respir Dis 1990; 142: 1288-93.
      56. Shore ET, Millman RP. Abnormalities in the flow-volume loop in obstructive sleep apnoea sitting and supina. Thorax 1984; 39: 775-9.
      57. Kayaleh RA, Dutt A, Khan A, Wilson AF. Tidal breath flow-volume curves in obstructive sleep apnea. Am Rev Respir Dis 1992; 145:1372-7.
      58. Schwab RJ, Gefter WB, Hoffman EA, Gupta KB, Pack Al. Dynamic upper airway imaging during awake respiration in normal subjects and patients with sleep disordered breathing. Am Rev Respir Dis 1993; 5: 1385-400
      59. Mezzanotte WS, Tangel DJ, White DP. Waking genioglossal electromyogram in sleep apnea patients versus normal controls (a neuromuscular compensatory mechanism). J Clin lnvest 1992; 5:1571-9.
      60. Riley R, Guilleminault C, Herran J, Powell N. Cephalometric analyses and flow-volume loops in obstructive sleep apnea patients. Sleep 1983; 6: 303-11
      61. Suratt PM, Dee P, Atkinson RL, Armstrong P, Wilhoit SC. Fluoroscopic and computad tomographic features of the pharyngeal airway in obstructive sleep apnea Am Rev Respir Dis 1983; 127:487-92
      62. Haponik EF, Smith PL, Bohlman ME, Allen RP, Goldman SM, X. Computerized tomography in obstructive sleep apnea. Correlation of airway size with physiology during sleep and wakefulness. Am Rev Respir Dis 1983; 127:221-6
      63. Osebold JW, Owens SL, Zee YC, Dotson WM, LaBarre DD. lmmunologic alterations in the lungs of mice following ozona exposure: changas in immunoglobulin levels and antibody-containing cells. Arch Environ Health 1979; 34: 258-65.
      64. Sharp JT, Druz WS, Kondragunta VR. Diaphragmatic responses to body position changas in obesa patients with obstructive sleep apnea. Am Rev Respir Dis 1986 133: 32-7.
      65. Stauffer JL, Zwillich CW, Cadieux RJ, Bixler EO, Kales A, Varano LA, et al. Pharyngeal size and resistance in obstructive sleep apnea. Am Rev Respir Dis 1987; 136 623-7.
      66. Anch AM, Remmers JE, Bunce H. Supraglottic airway resistance in normal subjects and patients with occlusive sleep apnea. J Appl Physiol 1982; 53: 1158-63.
      67. Hudgel DW, Martín RJ, Johnson B, Hill P. Mechanics of the respiratory system and breathing pattern during sleep in normal humans. J Appl Physiol 1984; 56: 133-7.
      68. White DP, Lombard RM, Cadieux RJ, Zwillich CW. Pharyngeal resistance in normal humans: influence of gender, age, and obesity. J Appl Physiol 1985; 58: 365-71.
      69. Brooks LJ, Strohl KP. Size and mechanical properties of the pharynx in healthy men and women. Am Rev Respir Dis 1992; 146:1394-7.
      70. Popovic RM, White DP. Am J Respir Crit Care Med 1995;152: 725-31.
      71. 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. Sleep Research 1991;302 Abstract.
      72. Cartwright RO, Diaz F, Lloyd S. The effects of sleep postura and sleep stage on apnea frequency. Sleep 1991; 14: 351 -3 .
      73. Takasaki Y, Kamio K, Okamoto M, Ohta Y, Yamabayashi H. Changas in diaphragmatic EMG activity during sleep in space. Am Rev Respir Dis 1993; 612-7.
      74. Skatrud JB, Dempsey JA. Airway resistance and respiratory muscle function in snorers during NREM sleep J Appl Physiol 1985; 59: 328-35
      75. Wasicko MJ, Hutt DA, Parisi RA, Neubauer JA, Mezrich R, Edelman N H. The role of vascular tone in the control of upper airway collapsibility. Am Rev Respir Dis 1990; 141 : 1569-77.
      76. Chediak AD, Herzberg P, Kim H. Does vasomotion modify the static pressure-volume relationship of the upper airway in normal humans? Sleep Research 1996
      77. Wasicko MJ, Leiter JC, Erlichman JS, Strobel RJ, Bartlett D. Nasal and pharyngeal resistance alter topica mucosal vasoconstriction in normal humans. Am Rev Respir Dis 1991 ; 144: 1048-52
      78. 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; 5 Pt 1: 1250-5.
      79. 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; 153:1080-6.
      80. Follenius M, Krieger J, Krauth MO, Sforza F, Bran-denberger G. Obstructive sleep apnea treatment: peripheral and central effects on plasma renin activity and aldosterone. Sleep 1991 ; 3: 211 -7.
      81. Wheatley JR, Tangel DJ, Mezzanotte WS, White DP lnfluence of sleep on alae nasi EMG and nasal resistance in normal men. J Appl Physiol 1993; 75: 626-32
      82. Zwillich CW, Pickett C, Hanson FN, Weil JV. Disturbad sleep and prolongad apneas during nasal obstruction in normal men. Am Rev Respir Dis 1981; 124:158-60.
      83. Lavie P. Gertner R, Zomer J, Podoohin L. Breathing disorders during sleep associated with "microarousals" in patients with allergic rhinitis. Acta Otolaryngol 1981;92: 529-33.
      84. McNicholas WT, Tarlo S, Cole P, Zamel N, Rutherford R, Griffin D, et al. Obstructive apneas during sleep in patients with seasonal allergic rhiniti s. Am Rev Respir Dis 1982; 126: 625-8.
      85. Olsen KD, Kern ES. Nasal influences on snoring and obstructive sleep apnea. Mayo Clin Proc 1990; 65:1095-1105
      Tutoriales

      Autores:

      ¿Cómo enviar un artículo?

      Par evaluador:

      ¿Cómo evaluar un artículo?

      Información

      Historia de la revista

      Palabras clave

      Directorios e indexadores

       

      Patrocinadores

       Nos apoyan + Info Aquí 

       
      Perfil de Google Scholar

      Más leídos en los últimos 30 días

      Sistema OJS 3.4.0.7 - Metabiblioteca |