Dynamic modulation of upper airway function during sleep: a novel single-breath method.

Dynamic modulation of upper airway function during sleep: a novel single-breath method. Research Abstract Details 

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Dynamic modulation of upper airway function during sleep: a novel single-breath method. Abstract Text:

Jason P Kirkness,Alan R Schwartz,Susheel P Patil,Luis E Pichard,Jason J Marx,Philip L Smith,Harmut Schneider,

To examine the dynamic modulation of upper airway (UA) function during sleep, we devised a novel approach to measuring the critical pressure (Pcrit) within a single breath in tracheostomized sleep apnea patients. We hypothesized that the UA continuously modulates airflow dynamics during transtracheal insufflation. In this study, we examine tidal pressure-flow relationships throughout the respiratory cycle to compare phasic differences in UA collapsibility between closure and reopening. Five apneic subjects (with tracheostomy) were recruited (2 men, 3 women; 18-50 yr; 20-35 kg/m2; apnea-hypopnea index >20) for this polysomnographic study. Outgoing airflow through the UA (face mask pneumotachograph) and tracheal pressure were recorded during brief transtracheal administration of insufflated airflow via a catheter. Pressure-flow relationships were generated from deflation (approaching Pcrit) and inflation (after Pcrit) of the UA during non-rapid eye movement sleep. During each breath, UA function was described by a pressure-flow relationship that defined the collapsibility (Pcrit) and upstream resistance (Rus). UA characteristics were examined in the presence and absence of complete UA occlusion. We demonstrated that Pcrit and Rus changed dynamically throughout the respiratory cycle. The UA closing pressure (4.4 +/- 2.0 cm H2O) was significantly lower than the opening pressure (10.8 +/- 2.4 cm H2O). Rus was higher for deflation (18.1 +/- 2.4 cm H2O x l(-1) x s) than during inflation (7.5 +/- 1.9 cm H2O x l(-1) x s) of the UA. Preventing occlusion decreases UA pressure-flow loop hysteresis by approximately 4 cm H2O. These findings indicate that UA collapsibility varies dynamically throughout the respiratory cycle and that both local mechanical and neuromuscular factors may be responsible for this dynamic modulation of UA function during sleep.

Dynamic modulation of upper airway function during sleep: a novel single-breath method. Publishing Authors By Initials

JP Kirkness,AR Schwartz,SP Patil,LE Pichard,JJ Marx,PL Smith,H Schneider,

For similar diagnosis: diagnostic techniques and procedures: diagnostic techniques, respiratory system: respiratory function tests: work of breathing research abstracts see: diagnosis: diagnostic techniques and procedures: diagnostic techniques, respiratory system: respiratory function tests: work of breathing research

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Dynamic modulation of upper airway function during sleep: a novel single-breath method. Journal Published:

PUBLICATION TYPE: Research Support, Non-U.S. Gov

Journal: Journal of applied physiology (Bethesda, Md. : 198

VOLUME: 101

Page Numbers: 1489-94

Journal Abbreviation: J. Appl. Physiol.

ISSN: 8750-7587

DAY: 6

MONTH: 07

YEAR: 2006

Dynamic modulation of upper airway function during sleep: a novel single-breath method. Information

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LANGUAGE: eng

NlmUniqueID: 8502536

Dynamic modulation of upper airway function during sleep: a novel single-breath method. Keywords Mesh Terms:

KEYWORDS: Work of Breathing

MESH TERMS: physiology

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Grant and Affiliation Information for Dynamic modulation of upper airway function during sleep: a novel single-breath method.

AFFILIATION: John Hopkins Sleep Disorders Center, Baltimore, MD 21224, USA. jason_kirkness@jhmi.edu

Country: United States

AGENCY: United States NHLBI

GRANT: HL-50381

ACRONYM: HL

MEDLINETA: J Appl Physiol

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