what-when-how
In Depth Tutorials and Information
FIGURE 35.2
Anteroposterior (AP) and lateral chest radiographs from adults with OI. (A) and (B): chest X-rays of a 22-year-old male with
severe OI and marked kyphoscoliotic changes in chest architecture. (C) and (D): from a 29-year-old female with milder changes to the chest
wall. (E) and (F): from a 40-year-old female somewhat intermediate between the first two patients. These images also demonstrate some of the
difficulties in evaluating X-rays in OI with hardware blocking some views and various atypical positioning required.
bolsters to the lab on the night of a study. There is a
growing acceptance of evaluation techniques that permit
testing in the home setting as well.
The most common sleep disorder in OI tends to be
obstructive sleep apnea or OSA. In classic OSA, the
pharynx tends to relax during sleep to an extent that
the upper airway becomes totally obstructed, often for
minutes at a time. During these obstructed episodes,
oxygen levels in blood tend to drop, often precipitously,
and sleep itself is disrupted so that the patient awakens
unrested in the morning. In OI, these obstructive epi-
sodes can be magnified by distortion of the upper tra-
chea and pharynx, by a shortened neck and/or by the
necessity for unusual sleep positions.
Another type of sleep disorder is referred to as central
sleep apnea or central hypoventilation. Individuals with
this type of sleep apnea have drops in air movement
during sleep without actual obstruction, often with
