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Editorials |

Inflammation and Obstructive Sleep Apnea Syndrome : How Many Ways Do I Look at Thee?

Umur Hatipoğlu, MD; Israel Rubinstein, MD, FCCP
Author and Funding Information

Affiliations: Chicago, IL
 ,  Dr. Hatipoğlu is Clinical Assistant Professor of Medicine, Section of Respiratory and Critical Care Medicine, Department of Medicine, University of Illinois at Chicago; Dr. Rubinstein is Professor of Medicine, Section of Respiratory and Critical Care Medicine, Department of Medicine, University of Illinois at Chicago and VA Chicago Health Care System.

Correspondence to: Israel Rubinstein, MD, FCCP, Department of Medicine (M/C 719), University of Illinois at Chicago, 840 South Wood St, Room 173, Chicago, IL 60616-7323; e-mail:IRubinst@uic.edu



Chest. 2004;126(1):1-2. doi:10.1378/chest.126.1.1
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Extract

Obstructive sleep apnea syndrome (OSAS) is characterized by repeated episodes of upper airway occlusion during sleep that are associated with excessive daytime sleepiness and abnormalities in cardiopulmonary and metabolic function. Anatomic narrowing of the airway, increased collapsibility of upper airway tissue, abnormal upper airway reflexes, and pharyngeal inspiratory muscle dysfunction contribute to the occurrence of airway occlusion.

Studies have implicated local and systemic inflammation in the pathophysiology of this seemingly all-mechanical problem. Histologic analysis of tissues obtained from patients undergoing uvulopalatopharyngoplasty for obstructive sleep apnea reveals marked subepithelial edema,1 excessive plasma cell infiltration,2 and reduction in surface area of connective tissue papillae that provide anchorage for epithelium.3 In the nasal lavage fluid of patients with obstructive sleep apnea, polymorphonuclear leukocytes and concentrations of bradykinin and vasoactive intestinal peptide are increased.45 These inflammatory changes are postulated to occur, in part, due to snoring that evokes vibration frequencies associated with soft-tissue damage.6 In addition to local inflammation, evidence of systemic inflammation is present in patients with OSAS.

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