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Objective: To investigate the upper airway (UA) characteristics of patients with obstructive sleep apnea syndrome (OSAS) using computer-assisted fiberoptic pharyngoscopy with Muller's maneuver (CFPMM)., Methods: The pharyngeal cavity were measured and calculated by CFPMM in 30 OSAS patients and 30 controls. The correlation between UA anatomy and polysomnography data was analyzed., Results: CFPMM can measure the cross-section area of UA accurately. All OSAS patients had minimal cross-section areas of pharyngeal apertures below 40 mm(2) during Muller's maneuver and 60% of cases had complete occlusion. Obstruction sites at the velopharynx were observed in all cases and 40% had multiple obstruction sites. Diminished pharyngeal apertures and increased collapsibility were associated with increased rates of apnea and hypopnea index (p < 0.05)., Conclusion: CFPMM is able to evaluate UA's characteristics and help determine the site of obstruction. Complete occlusion of UA during Muller's maneuver is the criterion to determine the obstruction site in OSAS patients., (Copyright (c) 2007 S. Karger AG, Basel.)

Objective: In order to investigate the treatment of obstructive sleep apnea syndrome (OSAS) METHOD: The improved uvulopalatopharyngoplasty (UPPP) operations were performed on 64 cases., Result: The clinical results showed that 70. Thirty-one percent of the operated patients somewhat improved and 29. Seventy percent unimproved., Conclusion: UPPP is one of the effective methods to treat OSAS, especially for OSAS with stricture in pharyngeal cavity. It has less damage, less operative complications and so on.

Objective: To enhance the understanding of obstructive sleep apnea hypopnea syndrome (OSAHS) and lower its misdiagnosis., Methods: 6 misdiagnosed cases were analyzed systemically., Results: OSAHS can be misdiagnosed as primary hypertension, arrhythmia, asthma, acalcerosis and some other diseases. The main causes of misdiagnosis were: the main complaints and the main signs could be one or more of a series of symptoms or signs of OSAHS itself or its complications and the lack of systemic knowledge of OSAHS., Conclusions: The understanding of OSAHS could be enhanced by analyzing misdiagnosis cases.

Objective: To evaluate the difference between the classificatory results of esophagus pressure monitor and thorax and abdomen belt., Methods: From Nov. 2000 to Jan. 2001, 34 patients received polysomnographic examination in Beijing Tongren Hospital. The aero digestive pressure was monitored simultaneously at 4 different points, i.e., the distal part of esophagus, hypopharynx, oropharynx and nasopharynx. Respiratory events were classified based on measurement of thorax and abdomen movements and esophageal pressure, and two classification results were compared., Results: Four patients were excluded from comparing classification results because of apnea hypopnea index < 5, or deformity in face and low sleep efficiency. Other 30 patients, 26 men and 4 women, at age of 45.4 +/- 9.5 (30-66), were enrolled. Classificatory difference was found in 9.7% (1,183 out of 12,238) of the respiratory events between two methods. The largest part of apneas reclassified by esophageal pressure measurement were mixed apneas reclassified as obstructive apnea (600). The difference of respiratory drive restore time measured by two methods was found between mixed reclassified obstructive apneas and mixed apneas confirmed by two methods, P = 0.028. No difference between mixed reclassified obstructive apneas and obstructive apneas confirmed by two methods. Difference of apnea classifications was due to the changes of respiratory drive restore time caused by different sensitivity of respiratory drive measurement. The number of difference was related to sensitivity of thorax and abdominal channel (P = 0.000, r2 = 0.653)., Conclusion: Apneas are easy to be misclassified due to the low sensitivity of thoracic and abdominal channel, and this problem can be solved by using esophageal pressure measurement. All kinds of apneas have anatomic and neuro-muscular factor in common.

Objective: (1) To analyze upper airway resistance syndrome (UARS) patients' polysomnographic characteristics, to lower the misdianosis of UARS. (2) To improve the understanding of UARS., Methods: (1) Select 12 UARS patients diagnosed by PSG and continuous esophageal pressure measurement, the sleep structure, arousal index, apnea hyponea index (AHI) were analyzed, the body mass index (BMI), epworth sleepiness scale (ESS) were calculated. (2) Select 16 simple snoring cases as the control group, obstructive sleep apnea syndrome (OSAS) and UARS were ruled out by PSG and continuous esophageal pressure measurement for this group of cases. (3) Compare the 2 groups' first night PSG indexes (4) Compare the 2 nights PSG indexes of the UARS group, to see the continuous esophageal pressure measurement effects on their sleep., Results: (1) There are no statistical difference of the 2 group's BMI and AHI. (2) Compared with the control group, UARS patients got higher arousal index and ESS score, more sleep stage 1 and stage 2, less sleep stage 3 and stage 4. (3) The 2 nights PSG indexes of UARS patients are not statistically different., Conclusions: (1) Compared with simple snoring cases, the UARS patients have some special characteristics, i.e., higher arousal index, less deep sleep, and higher ESS score, combined with the clinical manifestations, it is possible to screen UARS patients. (2) No evident effects of continuous esophageal pressure measurement on UARS patients sleep.