Presentation: PSG and HST: Interpretation and Review Russell Rosenberg, Ph.D, D.ABSM, is the founder and Director of the Atlanta School of Sleep Medicine and Technology. A clinical psychologist and board certified sleep specialist, Dr. Rosenberg lectures and teaches internationally on a range of sleep medicine topics. His areas of expertise include insomnia and disorders of excessive daytime sleepiness. In addition to teaching, Dr. Rosenberg is actively involved in clinical research at NeuroTrials Research Inc. He currently serves on the board of directors of the National Sleep Foundation. Dr. Rosenberg, a native of St. Louis, received his Ph.D. at Ohio State University and completed his sleep residency at Rush Presbyterian-St. Luke's Medical Center in Chicago. His teaching and leadership at the Atlanta School are rooted in his professional, clinical, and research experience as Director of the Northside Hospital Sleep Medicine Institute in Atlanta for sixteen years.
Obstructive Sleep Apnea has been linked in the research to both upper and lower airway inflammation and systemic inflammation. CPAP use may exacerbate these problems. Inflammation in the upper airway (pharyngeal area) plays a role in upper airway collapse (Caples, et al, 2005), and systematic inflammation found in Obstructive Sleep Apnea is tied to cardiovascular morbidity (Bergeron et al., 2005; Boisvert et al., 1998). CPAP may exacerbate these issues; CPAP’s use was found to be associated with the development of Airway Hyperresponsiveness, or AHR (Devouassoux et al., 2007). AHR is found in diseases like asthma or COPD and is characterized by an increased constrictive response, or simply, an increased tendency of the airway to constrict itself in response to environmental or physical stimuli (OByrne & Inman, 2003). CPAPs use has also been linked to inflammatory responses. In a recent study seeking to determine whether CPAP was pro-inflammatory in human subjects, AlAhmari (2012) and his team at the University College Medical School, London, studied both humans (in vivo) and their cells (in vitro). It was found that CPAP results in dose-dependent release of cytokines. Cytokines recruit and activate immune cells, which establish inflammation in the body (Lynch et al, 2003). Conclusion: Obstructive Sleep Apnea is linked to upper and lower airway inflammation as well as systematic inflammation. Upper airway collapse and/or cardiovascular morbidity are connected to these inflammatory responses in the body. CPAP treatment used to treat Obstructive Sleep Apnea may add to these inflammatory responses. CPAP has been tied to Airway Hyperresponsiveness and release of cytokines, which activate immune cells and the body’s inflammatory response.