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The Detection of Sleep Apnea in the Awake PatientThe 'Saw-Tooth' Sign
Mark H. Sanders, MD;
Richard J. Martin, MD;
Bernard E. Pennock, PhD;
Robert M. Rogers, MD
JAMA. 1981;245(23):2414-2418.
Abstract
We studied 21 subjects, 13 of whom had the sleep apnea hypersomnolence syndrome associated with upper airway obstruction during sleep (SAHS-UAO) to determine if "saw-toothing" on the flow-volume loop was significantly associated with the phenomenon of airway occlusion during sleep. A "saw-tooth" pattern was present on the flow-volume loop in 11 of 13 subjects with SAHS-UAO. The presence of saw-toothing correlated with fluttering of tissue that was visualized in the upper airway via the fiberoptic bronchoscope. The specificity of the saw-tooth pattern for SAHS-UAO was 100%. Generalized obesity may indirectly influence the presence of saw-toothing due to deposition of what appeared to be adipose tissue in the pharyngeal walls. Although the number of subjects in this study is small, saw-toothing on the flow-volume loop appears to be an important aid in the diagnosis of SAHS-UAO.
(JAMA 1981;245:2414-2418)
Author Affiliations
From the Pulmonary Disease Section, Department of Medicine, University of Oklahoma at Oklahoma City Health Sciences Center and Veterans Administration Medical Center, Oklahoma City. Dr Sanders is now with the University of Cincinnati Medical Center. Dr Martin is now with the National Jewish Hospital, Denver. Drs Pennock and Rogers are now with the University of Pittsburgh.
Footnotes
Reprint requests to University of Cincinnati Medical Center, Room 7511, Medical Sciences Bldg, Cincinnati, OH 45267 (Dr Sanders).
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