Document Detail


Pharyngeal narrowing/occlusion during central sleep apnea.
MedLine Citation:
PMID:  7649916     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We hypothesized that subatmospheric intraluminal pressure is not required for pharyngeal occlusion during sleep. Six normal subjects and six subjects with sleep apnea or hypopnea (SAH) were studied during non-rapid-eye-movement sleep. Pharyngeal patency was determined by using fiber-optic nasopharyngoscopy during spontaneous central sleep apnea (n = 4) and induced hypocapnic central apnea via nasal mechanical ventilation (n = 10). Complete pharyngeal occlusion occurred in 146 of 160 spontaneously occurring central apneas in patients with central sleep apnea syndrome. During induced hypocapnic central apnea, gradual progressive pharyngeal narrowing occurred. More pronounced narrowing was noted at the velopharynx relative to the oropharynx and in subjects with SAH relative to normals. Complete pharyngeal occlusion frequently occurred in subjects with SAH (31 of 44 apneas) but rarely occurred in normals (3 of 25 apneas). Resumption of inspiratory effort was associated with persistent narrowing or complete occlusion unless electroencephalogram signs of arousal were noted. Thus pharyngeal cross-sectional area is reduced during central apnea in the absence of inspiratory effort. Velopharyngeal narrowing consistently occurs during induced hypocapnic central apnea even in normal subjects. Complete pharyngeal occlusion occurs during spontaneous or induced central apnea in patients with SAH. We conclude that subatmospheric intraluminal pressure is not required for pharyngeal occlusion to occur. Pharyngeal narrowing or occlusion during central apnea may be due to passive collapse or active constriction.
Authors:
M S Badr; F Toiber; J B Skatrud; J Dempsey
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of applied physiology (Bethesda, Md. : 1985)     Volume:  78     ISSN:  8750-7587     ISO Abbreviation:  J. Appl. Physiol.     Publication Date:  1995 May 
Date Detail:
Created Date:  1995-09-27     Completed Date:  1995-09-27     Revised Date:  2013-09-26    
Medline Journal Info:
Nlm Unique ID:  8502536     Medline TA:  J Appl Physiol (1985)     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1806-15     Citation Subset:  IM    
Affiliation:
Medical Service, William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin 53705, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Air Pressure
Airway Obstruction / physiopathology*
Electroencephalography
Electromyography
Female
Humans
Male
Middle Aged
Pharyngeal Diseases / physiopathology*
Pharynx / physiopathology*
Polysomnography
Respiratory Mechanics / physiology
Sleep / physiology
Sleep Apnea Syndromes / physiopathology*
Stimulation, Chemical
Grant Support
ID/Acronym/Agency:
HL-02588/HL/NHLBI NIH HHS; HL-42242/HL/NHLBI NIH HHS; RR-03186/RR/NCRR NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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