Tagaito Y, Isono S, Remmers JE, Tanaka A, Nishino T: Lung volume and collapsibility of the passive pharynx in patients with sleep-disordered breathing

The University of Calgary, Calgary, Alberta, Canada
Journal of Applied Physiology (Impact Factor: 3.06). 11/2007; 103(4):1379-85. DOI: 10.1152/japplphysiol.00026.2007
Source: PubMed


Lung volume dependence of pharyngeal airway patency suggests involvement of lung volume in pathogenesis of obstructive sleep apnea. We examined the structural interaction between passive pharyngeal airway and lung volume independent of neuromuscular factors. Static mechanical properties of the passive pharynx were compared before and during lung inflation in eight anesthetized and paralyzed patients with sleep-disordered breathing. The respiratory system volume was increased by applying negative extrathoracic pressure, thereby leaving the transpharyngeal pressure unchanged. Application of -50-cmH(2)O negative extrathoracic pressure produced an increase in lung volume of 0.72 (0.63-0.91) liter [median (25-75 percentile)], resulting in a significant reduction of velopharyngeal closing pressure of 1.22 (0.14-2.03) cmH(2)O without significantly changing collapsibility of the oropharyngeal airway. Improvement of the velopharyngeal closing pressure was directly associated with body mass index. We conclude that increase in lung volume structurally improves velopharyngeal collapsibility particularly in obese patients with sleep-disordered breathing.

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    • "Obesity-related reductions in lung volumes (ie, FRC and TLC) also increase passive closing pressures at the pharynx.32 Heinzer et al33 demonstrated that a 1.3 L increase in FRC during sleep decreased the apnea/hypopnea index (AHI) from 62.3 events per hour to 31.2 events per hour. "
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