The Effect of Upper Airway Structural Changes on Central Chemosensitivity in Obstructive Sleep Apnea-Hypopnea

We examined the efficiency of upper airway structural changes in uvulopalatopharyngoplasty and/or tonsillectomy on central chemosensitivity, and whether the outcome of such surgeries can be predicted by the central chemosensitivity in obstructive sleep apnea-hypopnea syndrome (OSAHS) patients. In 11 patients with OSAHS group, the average of the hypercapnic ventilatory response (HCVR) slope was 1.93 ± 0.20 L/min/mm Hg preoperatively and 1.78 ± 0.22 L/min/mm Hg postoperatively. The average of the mouth occlusion pressure at 0.1 second after the onset of inspiration (P_0.1) slope was 0.47 ± 0.06 cm H₂O/mm Hg and 0.44 ± 0.08 cm H₂O/mm Hg, before and after surgery, respectively. There were no significant differences before and after treatment, although OSAHS was improved by these surgeries. In control group with 5 patients, the HCVR slope and P_0.1 slope also showed no significant difference before and after the procedure. When we divided the 11 OSAHS patients into 7 responders (apnea-hypopnea index < 20 events/h and > 50% reduction) and 4 poor responders, there was a significant difference between the average HCVR slope of responders (1.59 ± 0.21 L/min/mm Hg) and that of poor responders (2.52 ± 0.20 L/min/mm Hg). We saw no significant difference in physiologic (age, body mass index, one-piece tonsil weight), blood gas values, cephalometric, spirometric, or sleep parameters.

KEYWORDS

Obstructive sleep apnea-hypopnea syndrome - central chemosensitivity - hypercapnic ventilatory response - uvulopalatopharyngoplasty

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