Pathophysiology

Pathophysiology


  It has been hypothesized genioglossal that individuals with OSA have impaired genio glossal function, allowing the prolapse of the tongue against the posterior pharyngeal wall with inspiratory effort during sleep. The situation now appears to be more complicated – evidence suggests that an invagination of the pharyngeal walls and a general hypotonia of the dilating muscles of the upper airway can also be involved in allowing airway occlusion during sleep.

 The nasal airway can also play an important role in total airway occlustion. Nasal obstruction increases resistance to air flow, which in turn results in increased inspiratory effort and greater negative pressure in the pharyngeat airway. This suction increases the likelihood of collapse of the pharyngeal airway. Various factors which predispose to obstructive sleep apnea, the most important being obesity structural abnormalities in the face, skull, or airways that cause some obstruction or collapse in the upper airways and reduce air pressure can produce sleep apnea syndrome. People with micorgnathia, adenoids, retrognathia, enlarged tonsils, tongue enlargement, acromegaly and longer anterior facial height are especially predisposed to obstructive sleep apnea.

Symptoms

Snoring (OSA is unlikely in the absence of habitual snoring)
Apneic pauses (choking, gasping, snoring during the night)
Restless leg syndrome (RLS)
restless sleep and increased body movements
Bruxism (nocturnal tooth grinding)
Nocturnal and daytime enuresis
Sleep position (side and stomach sleepers) or neck hyper extended
Growth failure restriction
Sleep walking or sleep terrors
Obesity Daytime symptoms can include: Mouth breathing, due to adenoidal hypertrophy, and dry mouth
 Chronic nasal congestion ,rhinorrhea
Adenotonsillar hypertrophy
Hyponasal speech ,
Fatigue Excessive daytime sleepiness: difficulty waking or falling asleep at school Mood changes;
 Ireitability,
 Low frustration tolerance,
 Impatience,
Depression anxiety,
Social withdrawal,
A negative sense of well being Acting-out beaviors including aggression and hyperactivity Cognitive impairment and poor school performance Inattention,
Poor concentration, and distractibility ADHD-like symptoms Infraorbital venous congestion

 Continuation in the next articles of this series.

To send a patient to the NPMC "Ukrtelemed", the doctor should call us at + 38-044-537-36-86 and provide the contact phone number of the patient or his relatives. For more information please visit: www.ukrtelemed.com

Adress of "Ukrtelemed": 03151, Kyiv, Narodnogo Opolchennya str, 5, N.D. Strazhesko Cardiology Institute. Strazhesko, сardiac arrythmia department.

tel.: 
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+38-050-410-75-57

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