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Relationship between overnight rostral fluid shift and obstructive sleep apnea in nonobese men
Redolfi S, Yumino D, Ruttanaumpawan P, et al. · American Journal of Respiratory and Critical Care Medicine 179(3):241–246 · 2009
Key finding
Fluid moving from the legs to the neck when lying down narrows the airway — apnea without obesity (Galpin's tipped-glass analogy).
Citation
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Estimation of the global prevalence and burden of obstructive sleep apnoea~936 million adults aged 30–69 have OSA worldwide; ~425 million moderate-to-severe.Estimation of the clinically diagnosed proportion of sleep apnea syndrome in…~82% of men and ~93% of women with moderate-to-severe apnea were undiagnosed — the numbers Galpin quotes.Increased prevalence of sleep-disordered breathing in adultsPrevalence in US adults 30–70: ~26% of men and ~9–17% of women; rising with obesity.STOP questionnaireOrigin of the STOP-Bang screen; ≥3 'yes' answers = high sensitivity for moderate-severe OSA.Defining phenotypic causes of obstructive sleep apneaOSA has anatomical and non-anatomical phenotypes (muscle responsiveness, arousal threshold, loop gain) — the basis of precision treatment.
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