Association between proteomics and obstructive sleep apnea phenotypes in a community‐based cohort of women

Proteomic‐based technologies offer new opportunities to identify proteins that might reflect the cardiometabolic stress caused by different aspects of sleep‐disordered breathing. We aimed to investigate whether severe obstructive sleep apnea and severe obstructive sleep apnea during rapid eye movement sleep are associated with changed levels of inflammatory and cardiac disease‐related proteins in a population‐based cohort of women. In the community‐based “Sleep and Health in Women” (SHE) cohort study, 400 women underwent polysomnography, anthropometric measurements and blood sampling. Two proteomic assays (Olink Proseek^® Inflammation panel and Olink Proseek^® Cardiovascular II panel), each measuring 92 proteins, were analysed in a subsample of 253 women. p‐Values were adjusted for multiple testing, with false discovery rate set at 10%. In unadjusted models, 57 proteins were associated with apnea?hypopnea index, 56 proteins with oxygen desaturation index and 64 proteins with rapid eye movement?apnea?hypopnea index. After adjustment for age, body mass index and plate, there were no significant associations between apnea?hypopnea index or oxygen desaturation index and any of the proteins. Severe obstructive sleep apnea during rapid eye movement sleep (rapid eye movement?apnea?hypopnea index ≥ 30) was associated with decreased levels of two anti‐inflammatory proteins; Sirt2 (q‐value .016) and LAP‐TGF‐β₁ (q‐value .016). There was also a negative association between rapid eye movement?apnea?hypopnea index of ≥ 30 and Axin1 (q‐value .095), a protein thought to facilitate TGF‐β‐signalling. We conclude that severe obstructive sleep apnea during rapid eye movement sleep is associated with low levels of Sirt2, LAP‐TGF‐β₁ and Axin1, anti‐inflammatory proteins involved in metabolic regulation and in the atherosclerotic process. For obstructive sleep apnea based on a whole night, the associations with cardiac and inflammatory proteins are weaker, and explained to a large extent by age and body mass index.     

Low‐grade albuminuria in children with obstructive sleep apnea

Small urinary protein loss (low‐grade albuminuria or microalbuminuria) may reflect altered permeability of the glomerular filtration barrier. In the present study, it was hypothesized that children with obstructive sleep apnea have an increased risk of microalbuminuria compared with control subjects without sleep‐disordered breathing. Albumin‐to‐creatinine ratio was measured in morning spot urine specimens collected from consecutive children with or without snoring who were referred for polysomnography. Three groups were studied: (i) control subjects (no snoring, apnea–hypopnea index < 1 episode h^?1; n = 31); (ii) mild obstructive sleep apnea (snoring, apnea–hypopnea index = 1–5 episodes h^?1; n = 71); and (iii) moderate‐to‐severe obstructive sleep apnea (snoring, apnea–hypopnea index > 5 episodes?h^?1; n = 27). Indications for polysomnography in control subjects included nightmares, somnambulism and morning headaches. An albumin‐to‐creatinine ratio > median value in the control group (1.85 mg of albumin per g of creatinine) was defined as elevated. Logistic regression analysis revealed that children with moderate‐to‐severe obstructive sleep apnea, but not those with mild obstructive sleep apnea, had increased risk of elevated albumin‐to‐creatinine ratio relative to controls (reference) after adjustment for age, gender and presence of obesity: odds ratio 3.8 (95% confidence interval 1.1–12.6); P = 0.04 and 1.5 (0.6–3.7); P > 0.05, respectively. Oxygen desaturation of hemoglobin and respiratory arousal indices were significant predictors of albumin‐to‐creatinine ratio (r = 0.31, P = 0.01; and r = 0.43, P < 0.01, respectively). In conclusion, children with moderate‐to‐severe obstructive sleep apnea are at significantly higher risk of increased low‐grade excretion of albumin in the morning urine as compared with control subjects without obstructive sleep apnea. These findings may reflect altered permeability of the glomerular filtration barrier related to nocturnal hypoxemia and sympathetic activation which are induced by obstructive sleep apnea.     

Autonomic cardiovascular tests in children with obstructive sleep apnea syndrome

Study Objectives:

The aim of our study was to investigate cardiovascular autonomic activity during wakefulness, using cardiovascular tests, in a population of children with OSAS.

Design:

Prospective study.

Setting:

Sleep unit of an academic center.

Participants:

We included 25 children (mean age 10.2 ± 2.3 years) undergoing a diagnostic assessment for OSAS, and 25 age-matched healthy control subjects. All subjects underwent an overnight polysomnography and autonomic cardiovascular tests using parts of the Ewing test battery, which is a physiological test used for the assessment of autonomic function (head-up tilt test, Valsalva maneuver, deep breathing test).

Measurements and Results:

Eighteen of 25 children with OSAS (11 males, mean age 9.4 ± 1.7 years) concluded the study. OSAS patients had higher systolic blood pressure, diastolic blood pressure, baseline heart rate, the 30:15 index (which represents the RR interval at the 15th and 30th beats during the head up tilt test), and delta diastolic and systolic blood pressure during the head-up tilt test, while the heart rate variability during the deep breathing test was lower, compared with controls. A positive correlation between systolic and diastolic blood pressure and the apnea-hypopnea index (AHI), and negative between AHI and both the 30:15 index and Valsalva ratio, were found. Stepwise linear regression analysis detected a negative correlation between AHI and the 30:15 index and Valsalva ratio, a positive correlation between overnight mean oxygen saturation and delta heart rate, and between AHI and delta systolic blood pressure.

Conclusions:

Our data point to an increase in basal sympathetic activity during wakefulness and to an impaired reaction to several physiological stimuli, which is dependent on the severity of OSAS.

Citation:

Montesano M; Miano S; Paolino MC; Massolo AC; Ianniello F; Forlani M; Villa MP. Autonomic cardiovascular tests in children with obstructive sleep apnea syndrome. SLEEP 2010;33(10):1349-1355.     

Association between polysomnographic sleep measures and health-related quality of life in obstructive sleep apnea

Many facets of health-related quality of life are diminished in obstructive sleep apnea (OSA) as they are in other chronic medical conditions. We speculated that impairment in health-related quality of life (HRQoL) might result from the fatigue and daytime somnolence associated with the sleep disorder, as an indirect result from the fragmentation of night-time sleep in OSA. Our hypothesis was that sleep fragmentation measures would correlate with poorer HRQoL measured by medical outcomes study (MOS) subscales. Thirty-nine patients with polysomnographically-confirmed OSA participated in this study. Pearson's correlations were performed with the following sleep architecture variables: wake after sleep onset, the total number of brief arousals, the number of respiratory-related arousals, the rate of respiratory events per hour, and total sleep time. To our surprise, although the total number of arousals was associated with health distress (r=-0.481, P < 0.005), it did not correlate with any other subscales indicating poorer physical and mental health. The relatively insensitive measure of total sleep time (TST) correlated in the expected direction with most subscales. However, after controlling for age and gender, respiratory disturbance indices (RDI) and/or number of arousals emerged as significantly associated with mobility, cognitive functioning, social functioning, energy and fatigue, and health distress. Our findings suggest that polysomnographic indicators of sleep quality and sleep continuity may be an important influence determining many aspects of HRQoL in OSA patients.     

Association between obstructive sleep apnea severity and glucose control in patients with untreated versus treated diabetes

The purpose of this study was to determine whether the association between obstructive sleep apnea severity and glucose control differs between patients with newly diagnosed and untreated type 2 diabetes, and patients with known and treated type 2 diabetes. This multicentre cross‐sectional study included 762 patients investigated by sleep recording for suspected obstructive sleep apnea, 497 of whom were previously diagnosed and treated for type 2 diabetes (treated diabetic patients), while 265 had no medical history of diabetes but had fasting blood glucose ≥126 mg dL^?1 and/or glycated haemoglobin (HbA_1c) ≥6.5% consistent with newly diagnosed type 2 diabetes (untreated diabetic patients). Multivariate regression analyses were performed to evaluate the independent association between HbA_1c and obstructive sleep apnea severity in treated and untreated patients with diabetes. In untreated diabetic patients, HbA_1c was positively associated with apnea–hypopnea index (P = 0.0007) and 3% oxygen desaturation index (P = 0.0016) after adjustment for age, gender, body mass index, alcohol habits, metabolic dyslipidaemia, hypertension, statin use and study site. The adjusted mean value of HbA_1c increased from 6.68% in the lowest quartile of the apnea–hypopnea index (<17) to 7.20% in the highest quartile of the apnea–hypopnea index (>61; P = 0.033 for linear trend). In treated patients with diabetes, HbA_1c was associated with non‐sleep variables, including age, metabolic dyslipidaemia and insulin use, but not with obstructive sleep apnea severity. Obstructive sleep apnea may adversely affect glucose control in patients with newly diagnosed and untreated type 2 diabetes, but may have a limited impact in patients with overt type 2 diabetes receiving anti‐diabetic medications.     

阻塞性睡眠呼吸暂停综合征并发认知障碍的研究进展

阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS)患者常伴有不同程度的认知功能障碍,其认知功能下降的程度与OSAS的严重程度呈非线性关系.影响OSAS患者认知功能的关键因素是睡眠片段和夜间低氧血症.持续气道内正压通气(continuous positive airway Pressure,CPAP)是治疗OSAS的有效手段.     

Chronic intermittent hypoxia induces cardiac inflammation and dysfunction in a rat obstructive sleep apnea model

Chronic intermittent hypoxia is considered to play an important role in cardiovascular pathogenesis during the development of obstructive sleep apnea (OSA). We used a well-described OSA rat model induced with simultaneous intermittent hypoxia. Male Sprague Dawley rats were individually placed into plexiglass chambers with air pressure and components were electronically controlled. The rats were exposed to intermittent hypoxia 8 hours daily for 5 weeks. The changes of cardiac structure and function were examined by ultrasound. The cardiac pathology, apoptosis, and fibrosis were analyzed by H&E staining, TUNNEL assay, and picosirius staining, respectively. The expression of inflammation and fibrosis marker genes was analyzed by quantitative real-time PCR and Western blot. Chronic intermittent hypoxia/low pressure resulted in significant increase of left ventricular internal diameters (LVIDs), endsystolic volume (ESV), end-diastolic volume (EDV), and blood lactate level and marked reduction in ejection fraction and fractional shortening. Chronic intermittent hypoxia increased TUNNEL-positive myocytes, disrupted normal arrangement of cardiac fibers, and increased Sirius stained collagen fibers. The expression levels of hypoxia induced factor (HIF)-1α, NF-kB, IL-6, and matrix metallopeptidase 2 (MMP-2) were significantly increased in the heart of rats exposed to chronic intermittent hypoxia. In conclusion, the left ventricular function was adversely affected by chronic intermittent hypoxia, which is associated with increased expression of HIF-1α and NF-kB signaling molecules and development of cardiac inflammation, apoptosis and fibrosis.     

N-terminal pro-brain natriuretic peptide for detection of cardiovascular stress in patients with obstructive sleep apnea syndrome

Patients with obstructive sleep apnea syndrome (OSAS) have an elevated incidence of cardiovascular events that may be related to an increased ventricular load and hypoxemia caused by apneas and hypopneas. N-terminal pro-brain natriuretic peptide (NTproBNP) appears to be an excellent marker of myocardial stretch and could serve as an indicator of subclinical cardiac stress, thereby identifying a patient population at risk for cardiac effects from OSAS. Adult patients presenting with suspected OSAS and scheduled for nocturnal polysomnography were recruited. Patients with heart or renal failure or severe lung disease were excluded. NTproBNP was measured the evening before and the morning after sleep. Blood pressure (BP) was monitored intermittently throughout the night. Fifteen male and 15 female subjects with a mean +/- SD body mass index of 38.2 +/- 9.8 were studied. Mean Apnea-Hypopnea Index (AHI) was 38.4 +/- 26, with 17 subjects having severe OSAS (AHI > 30). No subject had a significant rise in BP. NTproBNP values overnight decreased in 19 patients and rose in 11 (mean change 3.8 +/- 33 pg mL(-1)), but only one patient had an abnormal morning value. Three patients had an abnormal NTproBNP value prior to sleep, but their levels decreased with sleep. No correlations were detected between the evening baseline or postsleep NTproBNP levels and OSAS. Monitoring pre- and postsleep NTproBNP levels revealed no association with the occurrence or degree of OSAS, making it unlikely that NTproBNP could serve as a marker of cardiac stress in OSAS patients with stable BP and without overt heart failure.     

Metrics of sleep apnea severity: beyond the apnea-hypopnea index

Obstructive sleep apnea (OSA) is thought to affect almost 1 billion people worldwide. OSA has well established cardiovascular and neurocognitive sequelae, although the optimal metric to assess its severity and/or potential response to therapy remains unclear. The apnea-hypopnea index (AHI) is well established; thus, we review its history and predictive value in various different clinical contexts. Although the AHI is often criticized for its limitations, it remains the best studied metric of OSA severity, albeit imperfect. We further review the potential value of alternative metrics including hypoxic burden, arousal intensity, odds ratio product, and cardiopulmonary coupling. We conclude with possible future directions to capture clinically meaningful OSA endophenotypes including the use of genetics, blood biomarkers, machine/deep learning and wearable technologies. Further research in OSA should be directed towards providing diagnostic and prognostic information to make the OSA diagnosis more accessible and to improving prognostic information regarding OSA consequences, in order to guide patient care and to help in the design of future clinical trials.     

Lung volumes and mean apnea duration in obstructive sleep apnea

Former studies suggested that lung volumes might play a role in pathomechanisms of obstructive sleep apnea (OSA). Mean apnea duration (MAD) is a rarely investigated parameter in OSA but is possibly a surrogate of arousal threshold. The aim of this study was to evaluate the influence of lung volumes to MAD in OSA. In 69 patients with obstructive sleep apnea (51 male und 18 female, BMI 34.2 ± 6.0 kg/m², age 53.6 ± 9.7 years, AHI 43.1 ± 21.1/h) we performed a polysomnography and pulmonary function testing in daytime. There was a significant correlation between MAD and residual volume (RV) (r = 0.51; p < 0.001), which was the highest correlation we found. In linear regression analysis RV remained the only independent variable with significant influence on MAD (p < 0.001). We could show that RV seems to play a role in the mechanisms of apnea termination in terms of MAD. MAD reflects the time until a specific negative intrathoracic pressure is reached to induce an arousal. In this process dependency on RV could explain our results. Despite some limitations these results provide some new aspects in understanding pathophysiology of OSA.     

Nitric oxide and obstructive sleep apnea

Obstructive sleep apnea is a common disease, affecting 16% of the working age population. Although sleep apnea has a well-established connection to daytime sleepiness presumably mediated through repetitive sleep disruption, some other consequences are less well understood. Clinical, epidemiological, and physiological investigations have demonstrated a connection between sleep apnea and daytime hypertension. The elevation of arterial pressure is evident during waking, when patients are not hypoxic, and is mediated by sustained sympathoexcitation and by altered peripheral vascular reactivity. This review summarizes data suggesting that both the sympathoexcitation and the altered vascular reactivity are, at least in part, a consequence of reduced expression of nitric oxide synthase, in neural tissue and in endothelium. Reduced nitric oxide generation in central and peripheral sites of sympathoregulation and in endothelium together may, in part, explain the elevations in waking pressures observed in sleep apnea patients.     

The severity of individual obstruction events is related to increased mortality rate in severe obstructive sleep apnea

Obstructive sleep apnea (OSA) is linked to an increased mortality rate. However, the severity of individual obstruction events is rarely considered quantitatively in clinical practice. We hypothesized that OSA with especially severe obstruction events would predispose a patient to greater health risks than OSA with a similar apnea–hypopnea index (AHI), but lower severity of individual events. This hypothesis was tested in a follow‐up (198.2 ± 24.7 months) of a population of 1068 men referred for ambulatory polygraphic recording due to suspected OSA. The recordings were analysed according to the guidelines of the American Academy of Sleep Medicine. Furthermore, a novel obstruction severity parameter was determined; this was defined as the product of duration of the individual obstruction event and area of the related desaturation event. Patients treated with continuous positive airway pressure (CPAP) were omitted. We identified 125 deceased patients from our original population and for 113 of these a matching alive patient with similar AHI, age, body mass index (BMI), smoking habits and follow‐up time could be found. The deceased patients with severe OSA (based on conventional AHI) showed higher obstruction severity values than their AHI‐matched alive controls. Based on the multivariate logistic regression analysis, obstruction severity was the only parameter which was related statistically significantly to mortality in the severe OSA category. Furthermore, 59% of all deceased patients and 83% of those who had severe OSA displayed higher obstruction severity than the AHI‐matched alive counterparts. To conclude, the obstruction severity parameter provided valuable prognostic information supplementing AHI. The obstruction severity parameter might improve recognition of the patients with the highest risk.     

No relation between apolipoprotein E alleles and obstructive sleep apnea

Apolipoprotein E (ApoE) is a genetic risk factor influencing the development of cardiovascular diseases and Alzheimer's disease. Patients with obstructive sleep apnea (OSA) suffer an excess mortality and morbidity from cardiovascular diseases. The frequencies of ApoE alleles were determined in 291 patients with OSA and 728 controls. The distribution of ApoE alleles and genotypes showed no difference between OSA and controls.     

OSAHS患者腭咽组织血管内皮生长因子水平与微血管密度相关性分析

目的 探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者腭咽组织中血管内皮生长因子(VEGF)水平与微血管密度(MVD)的相关性.方法 选择经多导睡眠监测仪(PSG)确诊的40例OSAHS患者组织标本(其中轻度7例,中度12例,重度21例),其中男性36例,女性4例;年龄29～62岁.6例无鼾症患者的软腭组织作为对照组,其中男性5例,女性1例;年龄18-58岁.采用苏木精-伊红(HE)染色法染色腭咽部组织,用光学显微镜观察其病理组织学改变,酶联免疫吸附分析检测血浆、腭咽组织匀浆中VEGF的含量,免疫组织化学技术检测MVD的表达情况.结果 酶联免疫吸附分析显示,OSAHS患者血浆及腭咽组织匀浆中VEGF水平均明显高于对照组,差异有显著统计学意义(P＜0.01);中、重度OSA HS组与对照组比较,MVD表达差异均有显著统计学意义(P＜0.01),轻度组与对照组比较差异无统计学意义(P＞0.05);组织匀浆中VEGF水平与MVD呈正相关(P＜0.01).结论 OSAHS患者腭咽部存在新生血管生成,与缺氧程度有关,VEGF在其发生发展过程中可能起到重要作用.     

Dry mouth upon awakening in obstructive sleep apnea

The aim was to assess the significance of dry mouth upon awakening as a symptom of obstructive sleep apnea (OSA). The participants were 668 consecutive adults referred for polysomnographic evaluation (PSG) because of snoring and suspected OSA, and 582 adults who were attending a general health check‐up. Data were obtained from self‐administered questionnaires and PSG evaluation. The participants were asked to answer the following question: ‘During the last month, did you experience waking up in the morning with a dry mouth?’. The response scale consisted of five categories: ‘never’, ‘rarely’, ‘sometimes’, often’, or ‘almost always’. We classified patients as having dry mouth upon awakening complaint only if they reported experiencing the symptom ‘almost always’. The prevalence of dry mouth upon awakening was twofold higher in patients with OSA (31.4%) than in primary snorers (16.4%, P < 0.001), and increased linearly from 22.4%, to 34.5%, and 40.7% in mild, moderate, and severe OSA respectively (P < 0.001). The prevalence of dry mouth upon awakening in the control group was 3.2%. Logistic regression results indicated that this symptom significantly differentiated OSA patients from primary snorers after adjusting for age, BMI, gender, hypertension, and other classical OSA symptoms (OR 2.33, 95% CI 1.34–4.07). Dry mouth upon awakening appears as a significant symptom of OSA. We suggest that increased sleep time spent with an open mouth is a likely explanation for these findings.     

The effect of obstructive sleep apnea therapy on cardiovascular autonomic function: a systematic review and meta-analysis

Study ObjectivesAutonomic function is impaired in obstructive sleep apnea (OSA) and may mediate the association between OSA and cardiovascular risk. We investigated the effect of OSA therapy on autonomic function through a systematic review and meta-analysis of intervention studies.MethodsA systematic search using three databases (Medline, Embase, and Scopus) was performed up to December 9, 2020. Studies of OSA patients ≥ 18 years with autonomic function assessed before and after treatment with positive airway pressure, oral appliance, positional therapy, weight loss, or surgical intervention were included for review. Random effects meta-analysis was carried out for five groups of autonomic function indices. Risk of bias was assessed using the Cochrane Collaboration tool.ResultsForty-three eligible studies were reviewed with 39 included in the meta-analysis. OSA treatment led to large decreases in muscle sympathetic nerve activity (Hedges’ g = −1.08; 95% CI −1.50, −0.65, n = 8) and moderate decreases in catecholamines (−0.60; −0.94, −0.27, n = 3) and radio nucleotide imaging (−0.61; −0.99, −0.24, n = 2). OSA therapy had no significant effect on baroreflex function (Hedges’ g = 0.15; 95% CI −0.09, 0.39, n = 6) or heart rate variability (0.02; −0.32, 0.36, n = 14). There was a significant risk of bias due to studies being primarily non-randomized trials.ConclusionsOSA therapy selectively improves autonomic function measures. The strongest evidence for the effect of OSA therapy on autonomic function was seen in reduced sympathetic activity as assessed by microneurography, but without increased improvement in parasympathetic function. OSA therapy may reduce the risk of cardiovascular disease in OSA through reduced sympathetic activity.     

Genomic approaches to understanding obstructive sleep apnea

Obstructive sleep apnea (OSA) is an increasingly recognized, common chronic disease in the developed nations and is a complex disease that has high social and economic costs. OSA and its associated 'intermediate' phenotypes-craniofacial structure, body fat distribution and metabolism, and neurological control of the upper airway muscles and of sleep and circadian rhythm-are under a substantial degree of genetic control. Investigating the genetic aetiology of OSA offers a means of better understanding its pathogenesis, with the goal of improving preventive strategies, diagnostic tools and therapies. Molecular studies of OSA itself are in their infancy, but considerable effort and expense has already been expended in attempts to detect genetic loci contributing to OSA-associated intermediate phenotypes, such as obesity. However, many of the fundamental questions relating to the genetic epidemiology of OSA and associated factors remain unanswered. This chapter reviews the current state of knowledge of the genetics of OSA, with a focus on genomic approaches to understanding sleep disorders.     

阻塞性睡眠呼吸暂停综合征病人术前心血管系统评估

目的对阻塞性睡眠呼吸暂停综合征(OSAS)病人术前心血管系统及其相关因素进行评估。方法通过调查行择期UPPP的57例病人,对心血管系统参数及其相关因素进行对比、统计和分析。结果OSAS病人合并高血压、冠心病的发生率显著增高。分别达75.44%和14.04%。心电图异常率达40.35%。OSAS病情越重,合并症越多且重。结论OSAS可继发高血压、冠心病等症,对机体造成严重损害。术前应认真对其心血管功能进行评估,以减少围术期危险心血管事件发生。     

Intact implicit probabilistic sequence learning in obstructive sleep apnea

Obstructive sleep apnea (OSA) belongs to the sleep-related breathing disorders and is associated with cognitive impairments in learning and memory functions. The impairments in attention-demanding cognitive functions such as working memory and executive functions are well established in OSA; however, it remains unknown if less attention-demanding implicit sequence learning is affected. In the present study, we examined implicit sequence learning in OSA to probe the functional integrity of this fundamental learning mechanism. We used listening span to measure complex working memory capacity and the alternating serial reaction time (ASRT) task, which enables us to measure general skill learning and sequence-specific learning separately. Twenty OSA patients and 20 healthy controls participated in this study. Our data show dissociation between working memory and implicit sequence learning in OSA. Surprisingly, OSA patients showed preserved general skill and sequence-specific learning in spite of the possible hypoxia and sleep restriction. In contrast, working memory performance measured by listening span task was impaired in the OSA group. This finding suggests selective susceptibility of more attention-demanding cognitive functions in this patient population, while implicit learning remains intact. Our findings draw attention the fact that disordered sleep may have less impact on the integrity of structures connected to implicit sequence learning.     

阻塞性睡眠呼吸暂停低通气综合征的MRI研究

目的：探讨磁共振成像（MRI）对确定阻塞性睡眠呼吸暂停低通气综合征（OSAHS）病人阻塞部位的作用。方法：通过对35例OSAHS男性患者行多导睡眠仪、MRI及纤维喉镜检查配合Muller’s运动检查（FEMM）、同时对30例男性健康人的上呼吸道进行MRI检查，将两者检查结果进行比较，判定OSAHS患者上呼吸道狭窄的部位及狭窄程度，客观评价MRI对检查OSAHS患者的应用价值。结果：OSAHS患者的上呼吸道截面积明显小于健康人，轻度OSAHS患者多存在腭咽平面狭窄；中重度组OSAHA患者大部分所有平面都存在狭窄，但中度组以腭咽狭窄较明显，而重度组所有平面均存在较明显的狭窄，这种狭窄主要是由于口咽部周围软组织增生及软腭过长、肥厚及舌根宽大、肥厚所致。结论：MRI检查可判定OSAHS患者上呼吸道狭窄的部位及狭窄程度，有助于治疗方案的选择，对预估手术疗效具有重要的意义。