Sleep Disturbance – Richard J. Schwab, MD, DABSM, Head of Sleep Medicine, University of Pennsylvania – Why Does Sleep Apnea Exist, and How Can We Correct It?

Richard J. Schwab, MD, DABSM, Head of Sleep Medicine, University of Pennsylvania, and the Co-Medical Director, Penn Sleep Center, discusses the pathogenesis of obstructive sleep apnea, and obstructive sleep apnea treatment. Podcast Points:

• What is obstructive sleep apnea?
• What causes sleep apnea in some, when others seem to avoid it, and what can you do about it?
• How do soft tissues impact sleep?

Dr. Schwab provides some background on his work and the various sleep problems that exist. He talks about sleep apnea, and why there is so much left to understand. Why does it happen when we sleep? He discusses soft tissue structures and lateral walls and other factors that can lead to airway paths collapsing. Dr. Schwab's extensive research seeks to target the pathogenesis of obstructive sleep apnea by using advanced upper airway imaging techniques. His studies help further explain the motion of various key structures of the upper airway and the role they play in airway closure. Dr. Schwab talks about the biomechanics of apneic events. He provides information on how they utilize magnetic resonance imaging and electronic beam computed tomography during sleep, as well as wakefulness, to study patients. Dr. Schwab talks about abnormal craniofacial structures as well as soft tissue, and how they can potentially impact sleep apnea occurrences. He discusses mouth breathing, studies they conducted on tongue fat, and how it all could impact breathing issues. As he states, if you naturally have a narrow airway, as movement occurs when you sleep, apnea could be initiated. He provides an in-depth discussion of how tissues move, and studies they have done on wakefulness. But he states there are more studies on sleep and breathing that they plan to do in the near future. Dr. Schwab, through his exhaustive research annually, collaborates regularly with members of the Departments of Radiology and Biomechanical and Computer Engineering. And together, the scientific researcher/developers have designed an extremely advanced, computer graphics-based analysis software that can assist with modeling, in three dimensions, of the biomechanical interrelationships that exist between soft tissue structures and the upper airway.