1992 Fiscal Year Final Research Report Summary
Pulmovascular Abnormalities in Patients with Upper Airway Obstruction
| Project/Area Number |
03670811
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| Research Category |
Grant-in-Aid for General Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Research Field |
Otorhinolaryngology
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| Research Institution | The University of Tokushima School of Medicine |
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Principal Investigator |
ISHIDA Tatsuya The University of Tokushima School of Medicine,Otolaryngology,Assistant Professor, 医学部, 助教授 (70148419)
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| Co-Investigator(Kenkyū-buntansha) |
ISHITANI Yasuo The University of Tokushima School of Medicine,Otolaryngology,Lecturer, 医学部附属病院, 講師 (00159724)
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| Project Period (FY) |
1991 – 1992
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| Keywords | Upper airway obstruction / Sleep apnea / Mesopharyngeal pressure amplitude / Fingertip blood flow / Blood pressure / Transcutaneous SaO_2 / Polysomnography / Nasal continuous positive airway pressure |
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| Research Abstract |
1.Polysomnographic examination in patients suffering from sleep apnea and snoring Polysomnographic recordings during spontaneous nocturnal sleep were made in 16 patients(age rage,3 to 60 years).Seven of 16 cases were diagnosed as sleep apnea syndrome(SAS).Four cases in this group showed an obstructive type of SAS,and 3 cases exhibited a mixed type.Fifteen of 16 patients showed an irregular transient decrease in fingertip blood flow during the non-apneic period and a regular decrease about 3 seconds after ventilatory resumption during the apneic period.The remaining patient showed an unstable blood flow continuously.How a transient decrease in fingertip blood flow relates to ventilation during sleep is unclear.This transient decrease was referred to as a 'dip phenomenon of blood flow(DBF)'.The frequency of DBF in an hour was defined as the DBF index,and a statistical analysis of DBF index was performed. (1)The DBF index in the SAS group was found to be higher than that in the non-SAS gr
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oup.The difference was considered statistically significant.SAS patients had more frequent episodes of DBF compared to non-SAS subjects.It was suggested that DBF may be correlated with upper airway obstruction. (2)Significant increase in the DBF index was detected with decreasing SaO_2(p<0.05), while no relation was found between the DBF index and mesopharyngeal pressure amplitude. The results demonstrated that peripheral blood flow is affected by pulmonary dysfunction in patients with upper airway obstruction.
2.Nasal continuous positive airway pressure(Nasal CPAP)therapy in a patient with upper airway obstruction A 42-year-old male who complained of snoring and sleep apnea was studied on polysomnographic examination.The data demonstrated that the upper airway was severely obstructed at the base of the tongue and cardiovascular diturbances were also associated. Nasal CPAP therapy was performed and the symptoms disappeared.Sleep apnea and fluctuation of blood pressure were releaved at 5cmH_2O of the nasal CPAP value.Oxygen desaturaion abolished at 6cmH_2O.Upper airway obstruction and change of fingertip blood flow were removed at 7cmH_2O.The results demonstrated that there may be slight variation in improvement of pulmonary and cardiovascular parameters on nasal CPAP therapy. Less
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