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J Appl Physiol 92: 84-92, 2002;
8750-7587/02 $5.00
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Vol. 92, Issue 1, 84-92, January 2002

Effects of neck flexion and mouth opening on inspiratory flow dynamics in awake humans

Eric Verin1,3,4,5, Frédéric Sériès3,5, Chrystèle Locher1,3, Christian Straus1,2,3, Marc Zelter2,3, Jean-Philippe Derenne1,3, and Thomas Similowski1,3

1 Laboratoire de Physiopathologie Respiratoire, Service de Pneumologie, 2 Service Central d'Explorations Fonctionnelles Respiratoires, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié Salpetrière, 75651 Paris; 3 Unité Propre de Recherche de l'Enseignement Supérieur EA 2397, Université Paris VI Pierre et Marie Curie, 75005 Paris; 4 Service de Physiologie, Centre Hospitalier Universitaire de Rouen, 76031 Rouen, France; and 5 Centre de Recherche, Hôpital Laval, Institut Universitaire de Cardiologie et de Pneumologie de l'Université Laval, Quebec, Canada G1V 4G5

Phrenic nerve stimulation (PNS) can assess airflow dynamics of the upper airway (UA) during wakefulness in man. Using PNS, we aimed to assess the impact of neck flexion and mouth opening in promoting UA unstability. Measurements were made during nasal breathing in seven healthy subjects (ages = 23-39 yr; one woman). Surface diaphragm electromyogram, esophageal pressure referenced to mask pressure, and flow were recorded during diaphragm twitches with neck in neutral position and mouth closed and then with neck flexion and/or mouth opening. Twitches always exhibited a flow-limited pattern. Flow-limiting driving pressure (Pd) and peak Pd were increased by neck flexion (P < 0.01) without significant change in the corresponding flows. UA resistances at these flow values were higher with the neck flexed (P < 0.05). Mouth opening alone did not exert any significant influence. We conclude that the position of the neck has a discernible impact on the flow behavior through the nonphasically active UA faced with a negative Pd.

obstructive sleep apnea syndrome; phrenic nerve stimulation; magnetic stimulation; diaphragm; respiratory mechanics


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