Sommeil et respiration à l'hôpital universitaire d'Anvers : revue clinique et scientifique

The Multidisciplinary Sleep Disorders Centre of the Antwerp University Hospital started its activities in 1982 and developed various research lines in the field of sleep disordered breathing. The first PhD project focused on “Mechanisms of unstable breathing during sleep in adults” and studied the control of breathing mechanisms involved in sleep apnea. This led to more interest in the physiopathology of sleep apnea, which was further elaborated based on pharyngoesophageal pressure measurements to determine the site of collapse, and measurement of the critical closing pressure (Pcrit). The new insights were applied in the development of new treatment modalities, which lead to the implantation of the first hypoglossal nerve pacemaker. The centre also participated in multicentric trials looking at the efficacy of promising techniques, like radiofrequency ablation technique for snoring and sleep apnea, the hyoid expansion technique (titanium implant), the titratable tongue anchor implant technique (Advance®), and boile and bite as well as custom made mandibular advancement devices. New diagnostic techniques, like forced oscillation technique and computational fluid dynamics, have been introduced in the field and have enlarged our insight in physiopathology and in outcome of therapeutic interventions. More recently, research was developed in pediatric sleep apnea, investigating the mechanisms underlying the link between sleep-disordered breathing and the metabolic syndrome in obese children. Many studies have been published in peer-reviewed journals and this has certainly improved the prestige of the Belgian (respiratory) sleep medicine in Europe.