상기도 폐색이 지속성 비강기도양압술 치료에 미치는 영향 = Influence of Upper Airway Obstruction on Continuous Positive Airway Pressure

다국어 초록 (Multilingual Abstract)

Background and Objectives：Nasal continuous positive airway pressure (CPAP) is a useful and efficient treatment modality, butthe patients compliance depends on several factors such as nasal CPAP level. The aim of this study was to evaluate the relationshipbetween upper airway obstruction and nasal CPAP level in obstructive sleep apnea syndrome (OSAS). Subjects and Method：This retrospective study (from August 1995 through May 2005) included 50 patients suffering from OSAS with a mean apneahypopneaindex of 43.78/hr, and those who underwent overnight polysomnography, laboratory nasal CPAP, and acoustic rhinometry(AR) for the measurement of minimal cross-sectional area (MCA) of the nasal cavity. We compared the nasal CPAP level withthe degree of anatomic upper airway obstruction including tonsil and palate grade, MCA, subjective symptoms, or body mass index(BMI). A single linear regression analysis and one-way analysis of variance (ANOVA) were performed to compare variables.Results：The mean nasal CPAP level was 6.32±2.17 cmH2O. We found a significant correlation between the nasal CPAP leveland BMI (p<0.01) and the degree of palatine tonsil grade (p=0.01). Furthermore, AR measurements correlated with the nasalCPAP level (p=0.025) in patients with BMI<25. The other variables such as subjective symptoms, palate grade, and anatomic nasalobstruction in obese patients (BMI>25) revealed no correlation with the nasal CPAP level. Conclusion：Upper airway obstructionincluding nasal obstruction and tonsillar hypertrophy may increase the nasal CPAP level. Correction of nasal obstructionand tonsillectomy may reduce the nasal CPAP level in nonobese patients. (Korean J Otolaryngol 2006;49:986-90)

참고문헌 (Reference)

1 "The nose and sleep-disorderedbreathing:What we know and what we do not know" 124 : 2309-2323, 2003

2 "The nasal airway and obstructed breathing duringsleep" 32 : 243-262, 1999

3 "Reversible obstructive sleep apneacaused by occupational exposure to guar gum dust" 133 : 935-6, Dis1986

4 "Radiofrequency treatment of turbinate hypertrophy in subjects usingcontinuous positive airway pressure: A randomized, double-blind, placebo-controlled clinical pilot trial" 111 : 1783-1790, 2001

5 "Prevalence ofsleep-disordered breathing in middle-aged Korean men and women" 170 : 1108-1113, 2004

6 "Obstructive sleep apnea syndromes" 88 : 611-630, 2004

7 "Obstructive apneas during sleep in patients with seasonal allergicrhinitis" 126 : 625-8, 1982

8 "Nasalobstruction and sleep-disordered breathing:A study using acousticrhinometry" 19 : 33-39, 2005

9 "Nasalobstruction and compliance to nasal positive airway pressure" 120 : 161-166, 2003

10 "Nasal resistance and continuous positive airway pressure treatmentfor sleep apnea/hypopnea syndrome" 39 : 106-110, 2003

11 "Nasal patencyand the effectiveness of nasal continuous positive air pressure in obstructivesleep apnea" 118 : 643-647, 1998

12 "Nasal breathing and continuous positiveairway pressure (CPAP) in patients with obstructive sleep apnea(OSA)." 7 : 87-94, 2003

13 "Intelligent CPAP systems:Clinical experience" 53 (53): 49-54, 1998

14 "Effect of improved nasal breathing on obstructive sleepapnea" 122 : 71-74, 2000

15 "Disturbed sleep andprolonged apnea during nasal obstruction in normal men" 124 : 158-60, 1981

16 "Continuous versus bilevel positive airway pressure for obstructivesleep apnea" 151 : 443-449, 1995

17 "Continuous positive airway pressure:New generations" 24 : 315-342, 2003

18 "Clinical predictors of obstructive sleep apnea" 109 : 1901-1907, 1999