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Adaptation to Hypoxia in Sleep Apnea Patients: Multifaceted Mechanisms

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Pulmonary Health and Disorders

Part of the book series: Advances in Experimental Medicine and Biology ((NR,volume 1150))

Abstract

Obstructive sleep apnea syndrome (OSA) is a form of sleep disordered breathing. The key phenomena are multiple repetitive pauses or restriction of airflow in the airway, defined as apnea and hypopnea. This study was based on a retrospective analysis of the results of polysomnographic (PSG) recordings of 230 adult patients (62 women and 168 men), being evaluated for OSA. The mean age, body mass index (BMI), apnea-hypopnea index (AHI), and pulse oximetry (SO2 nadir) of all patients were 50.4 ± 12.7 years, 30.4 ± 5.4 kg/m2, 33.6 ± 26.6 1/h, and 80.7 ± 12.1%, respectively. Statistical analysis was performed taking into account the moment of obstructive apnea occurrence and duration, sleep stage, and the SaO2 nadir associated with these events. We found a lengthening of apneic episodes with progressing of sleep-time, which depended on the sleep-time. There was rather a fast increase in apnea duration in the first quartile of sleep-time. In the later sleep phases, the dynamics of the increase were four-fold weaker. The lengthening of apnea duration was dependent on the severity of AHI, but was hardly related to the sleep stage or arterial desaturation. In conclusion, the results revealed two time scales of a lengthening of apneic episodes as a function of sleep-time in OSA patients. Sympathetic activation and spleen reflex may be involved in the observed phenomenon. Although the exact mechanisms of increasing duration of apneic episodes with the passage of sleep remain elusive, we believe these mechanisms are liable to be multifaceted.

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Acknowledgments

We are grateful to Dr. Piotr Walerian, a representative of Grass Technologies Co, for help in transferring the PSG data to MATLAB.

Competing Interests

The authors declare the lack of competing interests in relation to this article.

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Authors and Affiliations

  1. Laboratory of Center for Preclinical Research, Department of Experimental and Clinical Physiology, First Faculty of Medicine, Warsaw Medical University, Warsaw, Poland

    Maciej Śmietanowski, Agnieszka Cudnoch-Jędrzejewska & Maryla Śmietanowska

  2. Department of Dietetics and Food Evaluation, Institute of Health, University of Natural Sciences and Humanities, Siedlce, Poland

    Jarosław Wysocki

  3. Department and Clinic of Otolaryngology, Warsaw Medical University, Warsaw, Poland

    Jarosław Wysocki, Jarosław Balcerzak & Kazimierz Niemczyk

Authors
  1. Maciej Śmietanowski
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  2. Jarosław Wysocki
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  3. Jarosław Balcerzak
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  4. Agnieszka Cudnoch-Jędrzejewska
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  5. Maryla Śmietanowska
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  6. Kazimierz Niemczyk
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Corresponding author

Correspondence to Maryla Śmietanowska .

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Editors and Affiliations

  1. Opole Medical School, Opole, Poland

    Mieczyslaw Pokorski

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Śmietanowski, M., Wysocki, J., Balcerzak, J., Cudnoch-Jędrzejewska, A., Śmietanowska, M., Niemczyk, K. (2018). Adaptation to Hypoxia in Sleep Apnea Patients: Multifaceted Mechanisms. In: Pokorski, M. (eds) Pulmonary Health and Disorders. Advances in Experimental Medicine and Biology(), vol 1150. Springer, Cham. https://doi.org/10.1007/5584_2018_268

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