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Soft palate sensory neuropathy in the pathogenesis of obstructive sleep apnea
Author(s) -
Sunnergren Ola,
Broström Anders,
Svanborg Eva
Publication year - 2011
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.21371
Subject(s) - obstructive sleep apnea , medicine , soft palate , sensory neuropathy , pathogenesis , apnea , sensory system , sleep (system call) , sleep apnea , anesthesia , neuroscience , surgery , psychology , computer science , operating system
Objectives/ Hypothesis: In general, obstructive sleep apnea (OSA) seems to be a progressive disorder whose pathogenesis is not fully understood. One hypothesis is that long‐standing snoring vibrations cause a local neuropathy in the upper airway, which predisposes to obstructive events during sleep. The aim of this study was to investigate sensory function in the upper airway in a cohort of subjects comprising nonsnorers, snorers, and untreated subjects with OSA, and to correlate data to apnea–hypopnea index (AHI) and duration of snoring. Study Design: Cross‐sectional cohort study. Methods: Subjects were recruited from primary care hypertension clinics. Whole‐night respiratory recordings were performed to determine presence and degree of OSA. Three groups were formed based on AHI and snoring history: 1) nonsnorers (n = 25); 2) snorers, AHI < 10 (n = 32); 3) OSA subjects, AHI ≥ 10 (n = 33). Quantitative cold sensory testing of the soft palate and lip was used to assess neuropathy. Results: There were no significant differences concerning lip sensory function between groups. Nonsnorers showed significantly lower thresholds for cold (i.e., better sensitivity) in the soft palate compared to both other groups ( P < .01). Snorers had lower thresholds than OSA subjects ( P < .05). There were significant correlations ( P < .01) between decreased sensory function and AHI ( r s = .41) and to duration of snoring ( r s = .47). Conclusions: The degree of sensory neuropathy in the upper airway correlates with degree of obstructive sleep disorder. Our results strengthen the hypothesis that snoring vibrations may cause a neuropathy in the upper airway, which contributes to the progression and development of OSA. Laryngoscope, 2011