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Oscillatory pressure wave transmission from the upper airway to the carotid artery

¹Ludwig Engel Centre for Respiratory Research, ²Westmead Millennium Institute, and ³University of Sydney, Westmead, New South Wales, Australia

Submitted 13 December 2006 ; accepted in final form 13 August 2007

Snoring-associated vibration energy transmission from the upper airway to the carotid artery has been hypothesized as a potential atherosclerotic plaque initiating/rupturing event that may provide a pathogenic mechanism linking snoring and embolic stroke. We examined transmission of oscillatory pressure waves from the pharyngeal lumen to the common carotid artery wall and lumen in seven male, anesthetized, spontaneously breathing New Zealand White rabbits. Airflow was monitored via a pneumotachograph inserted in series in the intact trachea. Fifteen 20-s runs of, separately, 40-, 60-, and 90-Hz oscillatory pressure waves [pressure amplitude in the trachea (Ptr_amp), amplitude 2–20 cmH₂O] were generated by a loudspeaker driven by a sine wave generator and amplifier and superimposed on tidal breathing via the cranial tracheal connector. Pressure transducer-tipped catheters measured pressure amplitudes in the tissues adjacent to the common carotid artery bifurcation (Pcti_amp) and within the lumen (carotid sinus; Pcs_amp). Data were analyzed using power spectrum analysis and linear mixed-effects statistical modeling. Both the frequency (f) and amplitude of the injected pressure wave influenced Pcti_amp and Pcs_amp, in that ln Pcti_amp = 1.2(Ptr_amp) + 0.02(f) – 5.2, and ln Pcs_amp = 0.6(Ptr_amp) + 0.02(f) – 4.9 (both P < 0.05). Across all frequencies tested, transfer of oscillatory pressure across the carotid artery wall was associated with an amplitude gain, as expressed by a Pcs_amp-to-Pcti_amp ratio of 1.8 ± 0.3 (n = 6). Our findings confirm transmission of oscillatory pressure waves from the upper airway lumen to the peripharyngeal tissues and across the carotid artery wall to the lumen. Further studies are required to establish the role of this incident energy in the pathogenesis of carotid artery vascular disease.

vibration; peripharyngeal tissue pressure; snoring