Sleep-disordered breathing and comorbidities: role of the upper airway and craniofacial skeleton

Lucy Charlotte Brennan,1 Fenella Jane Kirkham,1– 3 Johanna Cristine Gavlak2 1Developmental Neurosciences Section, UCL Great Ormond Street Institute of Child Health, London, UK; 2Department of Child Health, University Hospital Southampton NHS Foundation Trust, Southampton, UK; 3Clinical and...

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Autores principales:	Brennan LC, Kirkham FJ, Gavlak JC
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	obstructive sleep apnoea sickle cell polysomnography desaturation mri airway adenoids Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
Acceso en línea:	https://doaj.org/article/06553f762189429e8a60a2d358fbe273
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spelling	oai:doaj.org-article:06553f762189429e8a60a2d358fbe2732021-12-02T11:38:05ZSleep-disordered breathing and comorbidities: role of the upper airway and craniofacial skeleton1179-1608https://doaj.org/article/06553f762189429e8a60a2d358fbe2732020-11-01T00:00:00Zhttps://www.dovepress.com/sleep-disordered-breathing-and-comorbidities-role-of-the-upper-airway--peer-reviewed-article-NSShttps://doaj.org/toc/1179-1608Lucy Charlotte Brennan,1 Fenella Jane Kirkham,1– 3 Johanna Cristine Gavlak2 1Developmental Neurosciences Section, UCL Great Ormond Street Institute of Child Health, London, UK; 2Department of Child Health, University Hospital Southampton NHS Foundation Trust, Southampton, UK; 3Clinical and Experimental Sciences, University of Southampton, Southampton, UKCorrespondence: Fenella Jane KirkhamDevelopmental Neurosciences Section, UCL Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UKTel +44 207 905 4114Email Fenella.Kirkham@ucl.ac.ukAbstract: Obstructive sleep-disordered breathing (SDB), which includes primary snoring through to obstructive sleep apnea syndrome (OSAS), may cause compromise of respiratory gas exchange during sleep, related to transient upper airway narrowing disrupting ventilation, and causing oxyhemoglobin desaturation and poor sleep quality. SDB is common in chronic disorders and has significant implications for health. With prevalence rates globally increasing, this condition is causing a substantial burden on health care costs. Certain populations, including people with sickle cell disease (SCD), exhibit a greater prevalence of OSAS. A review of the literature provides the available normal polysomnography and oximetry data for reference and documents the structural upper airway differences between those with and without OSAS, as well as between ethnicities and disease states. There may be differences in craniofacial development due to atypical growth trajectories or extramedullary hematopoiesis in anemias such as SCD. Studies involving MRI of the upper airway illustrated that OSAS populations tend to have a greater amount of lymphoid tissue, smaller airways, and smaller lower facial skeletons from measurements of the mandible and linear mental spine to clivus. Understanding the potential relationship between these anatomical landmarks and OSAS could help to stratify treatments, guiding choice towards those which most effectively resolve the obstruction. OSAS is relatively common in SCD populations, with hypoxia as a key manifestation, and sequelae including increased risk of stroke. Combatting any structural defects with appropriate interventions could reduce hypoxic exposure and consequently reduce the risk of comorbidities in those with SDB, warranting early treatment interventions.Keywords: obstructive sleep apnea, sickle cell, polysomnography, desaturation, MRI, airway, adenoidsBrennan LCKirkham FJGavlak JCDove Medical Pressarticleobstructive sleep apnoeasickle cellpolysomnographydesaturationmriairwayadenoidsPsychiatryRC435-571Neurophysiology and neuropsychologyQP351-495ENNature and Science of Sleep, Vol Volume 12, Pp 907-936 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	obstructive sleep apnoea sickle cell polysomnography desaturation mri airway adenoids Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
spellingShingle	obstructive sleep apnoea sickle cell polysomnography desaturation mri airway adenoids Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495 Brennan LC Kirkham FJ Gavlak JC Sleep-disordered breathing and comorbidities: role of the upper airway and craniofacial skeleton
description	Lucy Charlotte Brennan,1 Fenella Jane Kirkham,1– 3 Johanna Cristine Gavlak2 1Developmental Neurosciences Section, UCL Great Ormond Street Institute of Child Health, London, UK; 2Department of Child Health, University Hospital Southampton NHS Foundation Trust, Southampton, UK; 3Clinical and Experimental Sciences, University of Southampton, Southampton, UKCorrespondence: Fenella Jane KirkhamDevelopmental Neurosciences Section, UCL Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UKTel +44 207 905 4114Email Fenella.Kirkham@ucl.ac.ukAbstract: Obstructive sleep-disordered breathing (SDB), which includes primary snoring through to obstructive sleep apnea syndrome (OSAS), may cause compromise of respiratory gas exchange during sleep, related to transient upper airway narrowing disrupting ventilation, and causing oxyhemoglobin desaturation and poor sleep quality. SDB is common in chronic disorders and has significant implications for health. With prevalence rates globally increasing, this condition is causing a substantial burden on health care costs. Certain populations, including people with sickle cell disease (SCD), exhibit a greater prevalence of OSAS. A review of the literature provides the available normal polysomnography and oximetry data for reference and documents the structural upper airway differences between those with and without OSAS, as well as between ethnicities and disease states. There may be differences in craniofacial development due to atypical growth trajectories or extramedullary hematopoiesis in anemias such as SCD. Studies involving MRI of the upper airway illustrated that OSAS populations tend to have a greater amount of lymphoid tissue, smaller airways, and smaller lower facial skeletons from measurements of the mandible and linear mental spine to clivus. Understanding the potential relationship between these anatomical landmarks and OSAS could help to stratify treatments, guiding choice towards those which most effectively resolve the obstruction. OSAS is relatively common in SCD populations, with hypoxia as a key manifestation, and sequelae including increased risk of stroke. Combatting any structural defects with appropriate interventions could reduce hypoxic exposure and consequently reduce the risk of comorbidities in those with SDB, warranting early treatment interventions.Keywords: obstructive sleep apnea, sickle cell, polysomnography, desaturation, MRI, airway, adenoids
format	article
author	Brennan LC Kirkham FJ Gavlak JC
author_facet	Brennan LC Kirkham FJ Gavlak JC
author_sort	Brennan LC
title	Sleep-disordered breathing and comorbidities: role of the upper airway and craniofacial skeleton
title_short	Sleep-disordered breathing and comorbidities: role of the upper airway and craniofacial skeleton
title_full	Sleep-disordered breathing and comorbidities: role of the upper airway and craniofacial skeleton
title_fullStr	Sleep-disordered breathing and comorbidities: role of the upper airway and craniofacial skeleton
title_full_unstemmed	Sleep-disordered breathing and comorbidities: role of the upper airway and craniofacial skeleton
title_sort	sleep-disordered breathing and comorbidities: role of the upper airway and craniofacial skeleton
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/06553f762189429e8a60a2d358fbe273
work_keys_str_mv	AT brennanlc sleepdisorderedbreathingandcomorbiditiesroleoftheupperairwayandcraniofacialskeleton AT kirkhamfj sleepdisorderedbreathingandcomorbiditiesroleoftheupperairwayandcraniofacialskeleton AT gavlakjc sleepdisorderedbreathingandcomorbiditiesroleoftheupperairwayandcraniofacialskeleton
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Sleep-disordered breathing and comorbidities: role of the upper airway and craniofacial skeleton

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