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Clinical Investigations: SLEEP |

Comparison of Respiratory Polysomnographic Parameters in Matched Cohorts of Upper Airway Resistance and Obstructive Sleep Apnea Syndrome Patients*

Daniel I. Loube, MD, FCCP; Teotimo F. Andrada, MS
Author and Funding Information

Affiliations: ,  *From the Sleep Disorders Center, Pulmonary and Critical Care Medicine Service, Walter Reed Army Medical Center, Washington, DC.

Affiliations: ,  *From the Sleep Disorders Center, Pulmonary and Critical Care Medicine Service, Walter Reed Army Medical Center, Washington, DC.



Chest. 1999;115(6):1519-1524. doi:10.1378/chest.115.6.1519
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Objective: To compare respiratory nocturnal polysomnography (NPSG) characteristics between matched cohorts of upper airway resistance syndrome (UARS) and obstructive sleep apnea syndrome (OSAS) patients.

Methods: All patients received 13-channel NPSG, including esophageal pressure (Pes) manometry. By definition, OSAS patients had an apnea-hypopnea index (AHI, number of apneas/hypopneas per hour total sleep time) ≥ 15, and UARS patients had an AHI < 5. Respiratory effort-related arousal (RERA) was defined as the absence of apnea/hypopnea with ≥ 10 s duration of progressive negative Pes, culminating in an arousal or microarousal. UARS patients, by definition, had ≥ 15 RERAs per hour. Fifteen consecutively diagnosed UARS patients were matched with OSAS patients on the basis of body mass index (BMI) and gender.

Results: Respiratory disturbance index (sum of the AHI and RERA per hour) was the same for both cohorts: UARS, 36 ± 4; OSAS, 42 ± 6 (p = 0.34). There were no differences between cohorts for mean inspiratory Pes nadirs for each 30-s epoch of sleep compared for each sleep stage over an entire night. For randomly selected breaths from supine stage 2 sleep, the mean inspiratory Pes nadir was the same for the cohorts: UARS, −16.6 ± 2 cm H2O; OSAS, −16.1 ± 3 cm H2O (p = 0.30). Differences between cohorts for each parameter fell within respective 95% confidence intervals.

Conclusion: With the exception of AHI, respiratory NPSG parameters were the same for UARS and OSAS patients when BMI and gender were controlled for.

Abbreviations: AHI = apnea/hypopnea index; BMI = body mass index; CI = confidence interval; NPSG = nocturnal polysomnography; OSAS = obstructive sleep apnea syndrome; Pes = esophageal pressure; RDI = respiratory disturbance index; RERA = respiratory effort-related arousal; UARS = upper airway resistance syndrome

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