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Updated: Aug 9, 2026
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Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Obstructive sleep apnoea syndrome: translating science to clinical practice
Walter T McNicholas1, Silke Ryan
1Respiratory Sleep Research Laboratory, St. Vincent's University Hospital, Dublin, Ireland. walter.mcnicholas@ucd.ie
Respirology (Carlton, Vic.)
|March 22, 2006
Summary
Obstructive sleep apnea (OSA) involves upper airway obstruction during sleep. Treatments like nasal CPAP and auto-adjusting CPAP (APAP) help maintain airway patency and reduce cardiovascular risks.
Area of Science:
- Sleep Medicine
- Cardiovascular Physiology
- Respiratory Mechanics
Background:
- Obstructive sleep apnea (OSA) is defined by recurrent upper airway (UA) obstruction during sleep.
- UA collapse occurs when negative inspiratory pressure overcomes dilator muscle function.
- Reduced UA caliber increases resistance, leading to negative pharyngeal pressure and potential occlusion.
Purpose of the Study:
- To explain the mechanisms of upper airway collapse in OSA.
- To discuss the role of positive airway pressure therapies in managing OSA.
- To explore the cardiovascular morbidity associated with OSA and its underlying mechanisms.
Main Methods:
- Review of physiological mechanisms of UA collapse during sleep.
- Discussion of the principles and benefits of nasal continuous positive airway pressure (CPAP) and auto-adjusting CPAP (APAP).
- Examination of the cardiovascular consequences of OSA, including intermittent hypoxia and sympathetic overactivity.
Main Results:
- Increased negative pharyngeal pressure during inspiration contributes to UA occlusion in OSA.
- Nasal CPAP and APAP counteract collapsing forces, allowing UA muscles to rest.
- Cardiovascular morbidity in OSA is linked to intermittent hypoxia, activating pathways like NFkappaB, and sympathetic overactivity.
Conclusions:
- OSA pathophysiology involves a complex interplay of respiratory mechanics and muscle function.
- Positive airway pressure therapies are effective in managing OSA by maintaining UA patency.
- Understanding the mechanisms of OSA-related cardiovascular disease is crucial for effective management and prevention.
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