Sleep Apnea: Peripheral Action, Central Impact

Sunday, September 29, 2024

3:18 PM – 3:24 PM EDT

Location: MBCC, 238-239

Disclosure(s):

Gustavo Pedrosa Rocha, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Cristina A. Adonis, Md:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Apnea, the cessation of breathing, is a common physiological and pathophysiological phenomenon. Among the different forms of apnea, obstructive sleep apnea (OSA) is clinically the most prominent manifestation and is associated with peripheral airway obstruction. Not only OSA, but also central apneas (CA) have multiple, and partly overlapping mechanisms. In OSA and CA the underlying mechanisms are neither “exclusively peripheral” nor “exclusively central” in origin.
The purpose of the study was to evaluate the effect of successful OSA surgery in the mixed and central apneas.

Methods: Patients treated with retropalatal and/or retrolingual surgery for OSA were retrospectively evaluated for baseline and postoperative polysomnographic results. Inclusion criteria were adults with a presence of at least one mixed or central apnea at the baseline. We defined total success as 50% reduction in AHI and partial success as a 50% reduction in obstructive apneas. The pre and postoperative obstructive, central and mixed apnea parameters were compared.

Results: Of the included 29 patients, 12 patients (41%) had partial success surgery and 11 patients (38%) had a total success surgery. When the surgery had total success, the patients significantly improved mixed apneas (p = 0.047) and central apneas (p = 0.01). When the surgery had partial success, despite the mean number improved, patients didn’t have a statistically significant improvement: mixed apneas (mean 18.3 to 3.5) p = 0.492; central apneas (mean 2.3 to 1.5) p = 0.178.

Conclusions: Within the undeniable limitations of the study our findings corroborate the key concept suggesting that the mechanisms of central and obstructive sleep apnea are tightly intertwined. It seems that an extension of mixed and central apneas should not be regarded as a contraindication for surgery and can possible be an indication.

Presenting Author(s)

Gustavo Pedrosa Rocha, MD

Resident
Hospital Fernando Da Fonseca
Lisboa, Lisboa, Portugal

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

NO

Nuno O'neill Mendes, MD

Hospital Fernando da Fonseca, United States

Disclosure information not submitted.
JC

João Carvalho, MD

Hospital Fernando da Fonseca, United States

Disclosure information not submitted.
Cristina A. Adonis, MD

Obstructive Sleep apnea coordinator
Hospital Fernando Fonseca
Carnaxide, Lisboa, Portugal

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
MM

Marco Menezes, MD

Hospital Fernando da Fonseca, United States

Disclosure information not submitted.
FF

Filipe Freire, MD

MD
Hospital Fernando Fonseca
Amadora, Lisboa, United States

Disclosure information not submitted.