Share This Article:

Association of Superior Vena Cava Syndrome with Sleep Apnea: Investigation Using an Impulse Oscillometry System

Abstract Full-Text HTML Download Download as PDF (Size:343KB) PP. 270-275
DOI: 10.4236/ijcm.2012.34053    3,940 Downloads   5,952 Views   Citations

ABSTRACT

Superior vena cava syndrome (SVCS) patients sometimes show signs of obstructive sleep apnea (OSA). However, the mechanism causing hypoxia during sleep in SVCS patients is still uncertain. The aim of this study was to elucidate 1) the changes in central and peripheral respiratory resistance with SVCS, and 2) interpret the mechanism underlying the development of hypoxia during sleep in patients with SVCS related to OSA. Ten SVCS patients related to a neoplasm were recruited for this study. The degree of apnea hypopnea index (AHI) for OSA was evaluated by portable diagnosing device before and after SVCS treatment. We also analyzed the airway resistance and reactance quantitatively in the supine position by Master Screen impulse oscillometry system (MS-IOS?). After SVCS treatment, mean values of AHI were significantly decreased from 30.9 to 16.9 (/hour) (p = 0.001). Central respiratory resistance (R20) also decreased significantly from 0.40 to 0.33 kPa/L/s (p = 0.025) in the supine position. In contrast, peripheral respiratory resistance (R5-R20) and distal capacitive reactance (X5) did not change significantly. It is thought that the exacerbation of OSA due to SVCS is caused by increasing upper airway resistance related to reversible edema of the upper airway mucous or tissue. In contrast, SVCS may not cause peripheral respiratory tract and lung parenchyma edema.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

M. Yokoba, N. Ishii, T. Ichikawa, M. Wada, H. Mitsufuji, M. Kubota, N. Masuda and M. Katagiri, "Association of Superior Vena Cava Syndrome with Sleep Apnea: Investigation Using an Impulse Oscillometry System," International Journal of Clinical Medicine, Vol. 3 No. 4, 2012, pp. 270-275. doi: 10.4236/ijcm.2012.34053.

References

[1] N. R. Barshes, S. Annambhotla, H. F. El Sayed, T. T. Huynh, P. Kougias, A. Dardik and P. H. Lin, “Percutaneous Stenting of Supyerior Vena Cava Syndrome: Treatment Outcome in Patients with Benign and Malignant Etiology,” Vascular, Vol. 15, No. 5, 2007, pp. 314- 321.
[2] C. Lanciego, C. Pangua, J. I. Chacon, J. Velasco, R. C. Boy, A. Viana, S. Cerezo and L. G. Garcia, “Endovascular Stenting as the First Step in the Overall Management of Malignant Superior Vena Cava Syndrome,” American Journal of Roentgenology, Vol. 193, No. 2, 2009, pp. 549-558.
[3] T. Takeda, M. Saitoh and S. Takeda, “Superior Vena Cava Syndrome Caused by an Intravascular Thrombosis Due to Underlying Prostate Carcinoma,” Internal Medicine, Vol. 47, No. 22, 2008, pp. 2007-2009.
[4] S. Arinc, U. Gonlugur, O. Dervan, N. Erdal, F. Ece, M. Ertugrul, D. Derince, O. Oruc and A. Hazar, “Prognostic Factors in Patients with Small Cell Lung Carcinoma,” Medical Oncology, Vol. 27, 2010, pp. 237-241. doi:10.1007/s12032-009-9198-8
[5] N. McArdle and N. J. Douglas, “Effect of Continuous Positive Airway Pressure on Sleep Architecture in the Sleep Apnea-Hypopnea Syndrome—A Randomized Controlled Trial,” American Journal of Respiratory and Critical Care Medicine, Vol. 164, No. 8, 2001, pp. 1459-1463.
[6] B. Fernandez, L. A. Smolley, S. M. Swirsky and M. D. Kaye, “Relief of Sleep Apnea after Intravascular Stenting for Superior Vena Cava Syndrome,” Vascular Medicine, Vol. 22, No. 4, 1999, pp. 33-36.
[7] J. R. Stradling, S. Huddart and A. G. Arnold, “Sleep Apnoea Syndrome Caused by Neuro-fibromatosis and Superior Vena Caval Obstruction,” Thorax, Vol. 36, No. 8, 1981, pp. 634-635.
[8] Y. Us-tundag, Y. Bayraktar and S. Emri, “Superior Vena Cava Thrombosis and Obstructive Sleep Apnea in a Patient with Familial Mediterranean Fever,” American Journal of the Medical Sciences, Vol. 316, No. 1, 1998, pp. 53-55.
[9] J. P. Baguet, M. Nadra, G. Barone-Rochette, O. Ormezzano, H. Pierre and J. L. Pepin, “Early Cardiovascular Abnormalities in Newly Diagnosed Obstructive Sleep Apnea,” Jouanal of Vascular Health and Risk Management, Vol. 5, 2009, pp. 1063-1073. doi:10.2147/VHRM.S8300
[10] N. Botros, J. Concato, V. Mohsenin, B. Selim, K. Doctor, H. K. Yaggi, “Obstructive Sleep Apnea as a Risk Factor for Type 2 Diabetes,” American Journal of Medicine, Vol. 122, No. 12, 2009, pp. 1122-1127.
[11] T. A. Dernaika, G. T. Kinasewitz and M. M. Tawk, “Effects of Nocturnal Continuous Positive Airway Pressure Therapy in Patients with Resistant Hypertension and Obstructive Sleep Apnea,” Journal of Clinical Sleep Medicine, Vol. 5, No. 2, 2009, pp. 103-107.
[12] A. G. Wheaton, G. S. Perry, D. P. Chapman and J. B. Croft, “Sleep Disordered Breathing and Depression among U.S. Adults: National Health and Nutrition Examination Survey, 2005-2008,” Sleep, Vol. 35, No. 4, 2012, pp. 461-467.
[13] M. Colleoni, M. Mandala, G. Peruzzotti, C. Robertson, A. Bredart and A. Goldhirsch, “Depression and Degree of Acceptance of Adjuvant Cytotoxic Drugs,” Lancet, Vol. 356, No. 9238, 2000, pp. 1326-1327.
[14] A. Zager, M. L. Andersen, F. S. Ruiz, I. B. Antunes and S. Tufik, “Effects of Acute and Chronic Sleep Loss on Immune Modulation of Rats,” American Journal of Physiology—Regulatory, Integrative and Comparative Physiology, Vol. 293, No. 1, 2007, pp. R504-509.
[15] H. J. Smith, P. Reinhold and M. D. Goldman, “Forced Oscillation Technique and Impulse Oscillometry,” European Respiratory Monograph, Vol. 31, 2005, pp. 72-105. doi:10.1183/1025448x.00031005
[16] M. D. Goldman, C. Saadeh and D. Ross, “Clinical Applications of Forced Oscillation to Assess Peripheral Airway Function,” Respiratory Physiology & Neurobiology, Vol. 148, No. 1-2, 2005, pp. 179-194.
[17] C. C. Lin, K. M. Wu, C. S. Chou and S. F. Liaw, “Oral Airway Resistance during Wakefulness in Eucapnic and Hypercapnic Sleep Apnea Syndrome,” Respiratory Physiology & Neurobiology, Vol. 139, No. 2, 2004, pp. 215- 224.
[18] J. Cao, C. Que, G. Wang and B. He, “Effect of Posture on Airway Resistance in Obstructive Sleep Apnea-Hypopnea Syndrome by Means of Impulse Oscillation,” Respiration, Vol. 77, No. 1, 2009, pp. 38-43.
[19] E. Oostveen, D. MacLeod, H. Lorino, R. Farre, Z. Hantos, K. Desager and F. Marchal, “The Forced Oscillation Technique in Clinical Practice: Methodology, Recommendations and Future Developments,” European Respiratory Journal, Vol. 22, No. 6, 2003, pp. 1026-1041.
[20] D. G. Spyratos, G. P. Glattki, L. T. Sichletidis and D. Patakas, “Assessment of Respiratory Mechanics by Impulse Oscillometry in Orthopneic Patients with Acute Left Ventricular Failure,” Heart Lung, Vol. 40, No. 2, 2011, pp. 97-104.
[21] H. Yagi, S. Nakata, H. Tsuge, F. Yasuma, A. Noda, M. Morinaga, M. Tagaya and T. Nakashima, “Significance of a Screening Device (Apnomonitor 5) for Sleep Apnea Syndrome,” Auris Nasus Larynx, Vol. 36, No. 2, 2009, pp. 176-180.
[22] M. Amemiya, A. Takise, K. Kaira, K. Endou, T. Horie and M. Inazawa, “Obstructive Sleep Apnea Syndrome in a Patient with Superior Vena Cava Syndrome Caused by Malignant Lymphoma,” The Journal of the Japanese Respiatory Society, Vol. 44, No. 3, 2006, pp. 197-201.
[23] G. Fuyuno, R. Kobayashi, R. Iga, H. Nomori, K. Kodera and S. Morinaga, “Obstructive Sleep Apnea Syndrome Associated with Superior Vena Cava Syndrome,” Nihon Kyobu Shikkan Gakkai Zasshi, Vol. 33, 1995, pp. 322- 326.
[24] M. Ito, J. Tanaka, K. Kubota, H. Sato, M. Takahashi, H. Tanaka, T. Ohdaira, H. Yoshizawa, Y. Muramatsu, M. Satoh, E. Suzuki, M. Arakawa and F. Gejyo, “Obstructive Sleep Apnea Syndrome in a Patient with Superior Vena Cava Syndrome Caused by Lung Cancer,” The Journal of the Japanese Respiatory Society, Vol. 38, No. 6, 2000, pp. 471-475.
[25] A. Ursavas, M. Karadag, B. Burgazlioglu, F. Coskun, E. Ceylan, S. Onart and R. O. Gozu, “Relief from Sleep Apnea after Radiation and Chemotherapy,” Clinical Lung Cancer, Vol. 8, No. 8, 2007, pp. 502-503.
[26] D. W. Hudgel, “Mechanisms of Obstructive Sleep-Apnea,” Chest, Vol. 101, No. 2, 1992, pp. 541-549.
[27] G. E. Anastassov and N. Trieger, “Edema in the Upper Airway in Patients with Obstructive Sleep Apnea Syndrome,” Oral Surgery Oral Medicine Oral Pathology Oral Radiology and Endodontics, Vol. 86, No. 6, 1998, pp. 644-647.
[28] D. A. Hutt, M. J. Wasicko, R. A. Parisi, J. A. Neubauer and N. H. Edelman, “Effects of Vascular Tone on Pharyngeal Size Independent of Skeletal Muscle Activity,” American Review of Respiratory Disease, Vol. 139 (suppl), 1989, p. A374.
[29] R. A. Parisi, M. J. Wasicko, D. A. Hutt, M. Mandel, T. V. Santiago and N. H. Edelman, “Mucosal Vasoconstriction Increases Pharyngeal Size in Normal Subjects,” American Review of Respiratory Disease, Vol. 139 (suppl), 1989, p. A374.
[30] K. L. Chiu, C. M. Ryan, S. Shiota, P. Rutta-naumpawan, M. Arzt, J. S. Haight, C. T. Chan, J. S. Floras, T. D. Bradley, “Fluid Shift by Lower Body Positive Pressure Increases Pharyngeal Resistance in Healthy Subjects,” American Journal of Respiratory and Critical Care Medicine, Vol. 174, No. 12, 2006, pp. 1378-1383.
[31] M. C. Su, K. L. Chiu, P. Ruttanaumpa-wan, S. Shiota, D. Yumino, S. Redolfi, J. S. Haight and T. D. Bradley, “Lower Body Positive Pressure Increases Upper Airway Collapsibility in Healthy Subjects,” Respiratory Physiology & Neurobiology, Vol. 161, No. 3, 2008, pp. 306-312

  
comments powered by Disqus

Copyright © 2018 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.