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Vol. 84, Issue 1, 190-199, January 1998
Department of Medicine, William S. Middleton Memorial Veterans Hospital, and John Rankin Laboratory of Pulmonary Medicine, Department of Preventive Medicine, University of Wisconsin Medical School, Madison, Wisconsin 53705
Morrell, M. J., and M. S. Badr. Effects of NREM sleep
on dynamic within-breath changes in upper airway patency in humans. J. Appl. Physiol. 84(1): 190-199, 1998.
The purpose of our study was to compare inspiratory- and
expiratory-related changes in retropalatal cross-sectional area (CSA)
during wakefulness to those during non-rapid-eye-movement (NREM) sleep.
We studied 18 subjects in whom the severity of sleep-disordered
breathing varied. Relative changes in CSA were visualized by using
fiber-optic endoscopy. For each breath analyzed (wakefulness
n = 4-13; sleep
n = 7-16), the CSA was measured
at fixed points within inspiration and expiration (0, 25, 50, and 100%
of the inspiratory and expiratory duration); these measurements were
expressed as a percentage of the CSA that occurred at the start of
inspiration. During wakefulness, there was a statistically significant
increase in the retropalatal CSA (compared with the start of
inspiration) only during early expiration (group mean: expiration, 0% = 112.6 ± 3.2 (SE) %; 25% = 122.8 ± 6.2%; 50% = 110.6 ± 3.8%). In contrast, during sleep, significant changes in CSA occurred
during both inspiration and expiration (group mean: inspiration, 25% = 75.3 ± 6.0%; 50% = 66.7 ± 7.7%; 75% = 64.6 ± 8.1%;
expiration, 0% = 126.8 ± 11.8%; 25% = 125.3 ± 6.9%). The
expiratory-related increase in CSA was followed by narrowing such that
at end expiration the caliber of the airway was returned to that
occurring at the beginning of inspiration (group mean at end expiration = 98.6 ± 3.1%). The largest changes in CSA occurred in the
subjects with an increased body mass index (BMI). We conclude that,
during NREM sleep, significant changes in CSA occur during both
inspiration and expiration and that the magnitude of these changes is
significantly influenced by BMI.
respiratory control; breathing; sleep apnea; obstruction
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