| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH |
|
|
|
|||||||
|
|||||||||
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Articles in PresS, published online ahead of print July 5, 2002
J Appl Physiol, 10.1152/jap.00942.2001
Submitted on September 12, 2001
Accepted on June 24, 2002
1 Pulm & Critical Care Division, Dept. of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
2 Dept. of Otorhinolaryngology, Head and Neck Surgery, University Hospital Antwerp, Edegem, Belgium
3 Sleep Laboratory, Dept. of Internal Medicine, Philipps-University Marburg, Marburg, Hessen, Germany
* To whom correspondence should be addressed. E-mail: schwartz{at}jhmi.edu.
We hypothesized that upper airway collapsibility is modulated dynamically throughout the respiratory cycle in sleeping humans by alterations in respiratory phase and/or airflow regimen. To test this hypothesis, critical pressures were derived from upper airway pressure-flow relationships in six tracheostomized patients with obstructive sleep apnea. Pressure-flow relationships were generated by varying the pressure at the trachea and nose during (A) tracheostomy (inspiration and expiration) and (B) nasal (inspiration only) breathing, respectively. When a constant airflow regimen was maintained throughout the respiratory cycle (tracheostomy breathing), a small yet significant decrease in critical pressure was found at the inspiratory vs. end- and peak expiratory time point (7.1 ± 1.6 cmH2O to 6.6 ± 1.9 cmH2O to 6.1 ± 1.9 cmH2O, mean ± SE, p<0.05), indicating that phasic factors exerted only a modest influence on upper airway collapsibility. In contrast, we found that the inspiratory critical pressure fell markedly during nasal vs. tracheostomy breathing (1.1 ± 1.5 cmH2O vs. 6.1 ± 1.9 cmH2O, mean ± SE, p<0.01), indicating that upper airway collapsibility is markedly influenced by differences in airflow regimen. Tracheostomy breathing was also associated with a reduction in both phasic and tonic genioglossal muscle activity during sleep. Our findings indicate that both phasic factors and airflow regimen modulate upper airway collapsibility dynamically, and suggest that neuromuscular responses to alterations in airflow regimen can markedly lower upper airway collapsibility during inspiration.
This article has been cited by other articles:
|
|
 |
|
  A. Oliven, E. Aspandiarov, I. Gankin, L. Gaitini, and N. Tov Collapsibility of the relaxed pharynx and risk of sleep apnoea Eur. Respir. J., November 1, 2008; 32(5): 1309 - 1315. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. F. Fregosi Influence of tongue muscle contraction and dynamic airway pressure on velopharyngeal volume in the rat J Appl Physiol, March 1, 2008; 104(3): 682 - 693. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. S. Doherty, J. P. Cullen, P. Nolan, and W. T. McNicholas The human genioglossus response to negative airway pressure: stimulus timing and route of delivery Exp Physiol, February 1, 2008; 93(2): 288 - 295. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. Koutsourelakis, G. Georgoulopoulos, E. Perraki, E. Vagiakis, C. Roussos, and S. G. Zakynthinos Randomised trial of nasal surgery for fixed nasal obstruction in obstructive sleep apnoea Eur. Respir. J., January 1, 2008; 31(1): 110 - 117. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. P. Patil, H. Schneider, A. R. Schwartz, and P. L. Smith Adult Obstructive Sleep Apnea: Pathophysiology and Diagnosis Chest, July 1, 2007; 132(1): 325 - 337. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. P. Kirkness, A. R. Schwartz, S. P. Patil, L. E. Pichard, J. J. Marx, P. L. Smith, and H. Schneider Dynamic modulation of upper airway function during sleep: a novel single-breath method J Appl Physiol, November 1, 2006; 101(5): 1489 - 1494. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. M. Ryan and T. D. Bradley Pathogenesis of obstructive sleep apnea J Appl Physiol, December 1, 2005; 99(6): 2440 - 2450. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Farre, J.M. Montserrat, and D. Navajas Noninvasive monitoring of respiratory mechanics during sleep Eur. Respir. J., December 1, 2004; 24(6): 1052 - 1060. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Farre, J. Rigau, J. M. Montserrat, L. Buscemi, E. Ballester, and D. Navajas Static and Dynamic Upper Airway Obstruction in Sleep Apnea: Role of the Breathing Gas Properties Am. J. Respir. Crit. Care Med., September 15, 2003; 168(6): 659 - 663. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Schneider, S. P. Patil, S. Canisius, E. A. Gladmon, A. R. Schwartz, C. P. O'Donnell, P. L. Smith, and C. G. Tankersley Hypercapnic duty cycle is an intermediate physiological phenotype linked to mouse chromosome 5 J Appl Physiol, July 1, 2003; 95(1): 11 - 19. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH |
| Visit Other APS Journals Online |
