| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH |
|
|
|
|||||||
|
|||||||||
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
1 The Eudowood Division of Pediatric Respiratory Sciences and the Division of Oncology Biostatistics, Johns Hopkins University, Baltimore, MD, USA
2 Department of Neurology and Internal Medicine, UNIFESP-EPM (Universidade Federal de Sao Paulo - Escola Paulista de Medicina), Sao Paulo, Brazil
* To whom correspondence should be addressed. E-mail: marcus{at}email.chop.edu.
Normal children have a less collapsible upper airway in response to subatmospheric pressure administration (PNEG) during sleep than normal adults, and this upper airway response appears to be modulated by the central ventilatory drive. Children have a greater ventilatory drive than adults. We therefore hypothesized that children have increased neuromotor activation of their pharyngeal airway during sleep compared to adults. As infants have few obstructive apneas during sleep, we hypothesized that infants would have an upper airway that was resistant to collapse. We therefore compared the upper airway pressure-flow relationship during sleep between normal infants, prepubertal children and adults. We evaluated the upper airway response to (i) intermittent, acute PNEG (infants, children and adults), and (ii) hypercapnia (children and adults). We found that adults had a more collapsible upper airway during sleep than either infants or children. The children exhibited a vigorous response to both PNEG and hypercapnia during sleep (P < 0.01), whereas adults had no significant change. Infants had an airway that was resistant to collapse, and showed a very rapid response to PNEG. We conclude that the upper airway is resistant to collapse during sleep in infants and children. Normal children have preservation of upper airway responses to PNEG and hypercapnia during sleep, whereas responses are diminished in adults. Infants appear to have a different pattern of upper airway activation than older children. We speculate that the pharyngeal airway responses present in normal children are a compensatory response for a relatively narrow upper airway.
This article has been cited by other articles:
|
|
 |
|
  A. R. Schwartz, S. P. Patil, H. Schneider, and P. L. Smith Modelling pathogenic mechanisms of upper airway dysfunction in the molecular age Eur. Respir. J., August 1, 2008; 32(2): 255 - 258. [Full Text] [PDF]
|
|
|
|
 |
|
 D. J. Eckert and A. Malhotra Pathophysiology of Adult Obstructive Sleep Apnea Proceedings of the ATS, February 15, 2008; 5(2): 144 - 153. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. S. Katz and C. M. D'Ambrosio Pathophysiology of Pediatric Obstructive Sleep Apnea Proceedings of the ATS, February 15, 2008; 5(2): 253 - 262. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Muzumdar and R. Arens Diagnostic Issues in Pediatric Obstructive Sleep Apnea Proceedings of the ATS, February 15, 2008; 5(2): 263 - 273. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. C. Halbower, S. L. Ishman, and B. M. McGinley Childhood Obstructive Sleep-Disordered Breathing: A Clinical Update and Discussion of Technological Innovations and Challenges Chest, December 1, 2007; 132(6): 2030 - 2041. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. F. Fregosi, S. F. Quan, W. L. Morgan, J. L. Goodwin, R. Cabrera, I. Shareif, K. W. Fridel, and R. R. Bootzin Pharyngeal critical pressure in children with mild sleep-disordered breathing J Appl Physiol, September 1, 2006; 101(3): 734 - 739. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. S. Katz, C. L. Marcus, and D. P. White Influence of Airway Pressure on Genioglossus Activity during Sleep in Normal Children Am. J. Respir. Crit. Care Med., April 15, 2006; 173(8): 902 - 909. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH |
| Visit Other APS Journals Online |
