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1 Department of Respiratory Medicine, University Hospital, Nice, and 2 Sleep Laboratory, PRETA-TIMC, UMR CNRS 5525, Grenoble, France
Aims of the study were 1)
to compare Hudgel's hyperbolic with Rohrer's polynomial model in
describing the pressure-flow relationship, 2) to use this
pressure-flow relationship to describe these resistances and to
evaluate the effects of sleep stages on pharyngeal resistances, and
3) to compare these resistances to the pressure-to-flow
ratio (
P/
). We studied 12 patients: three with upper airway
resistance syndrome (UARS), four with obstructive sleep hypopnea
syndrome (OSHS), three with obstructive sleep apnea syndrome (OSAS),
and two with simple snoring (SS). Transpharyngeal pressures were
calculated between choanae and epiglottis. Flow was measured by use of
a pneumotachometer. The pressure-flow relationship was established by
using nonlinear regression and was appreciated by the Pearson's square
(r2). Mean resistance at peak pressure (Rmax)
was calculated according to the hyperbolic model during stable
respiration. In 78% of the cases, the value of
r2 was greater when the hyperbolic model was
used. We demonstrated that Rmax was in excellent agreement with
P/
. UARS patients exhibited higher awake mean Rmax than normal
subjects and other subgroups and a larger increase from wakefulness to
slow-wave sleep than subjects with OSAS, OSHS, and SS. Analysis of
breath-by-breath changes in Rmax was also a sensitive method to detect
episodes of high resistance during sleep.
sleep-disordered breathing; upper airway; model of pressure-flow relationship
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