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• W2159950140 abstract "Study objectives: Previous studies have shownthat the level of flow through the upper airway in patients withobstructive sleep apnea (OSA) is determined by the critical closingpressure (Pcrit) and the upstream resistance (Rn). Wedeveloped a standardized protocol for delineating quasisteady-statepressure-flow relationships for the upper airway from which thesevariables could be derived. In addition, we investigated the effect of body position and sleep stage on these variables by determining Pcritand Rn, and their confidence intervals (CIs), for eachcondition. Design: Pressure-flow relationships wereconstructed in the supine and lateral recumbent positions (nonrapid eyemovement [NREM] sleep, n = 10) and in the supine position (rapideye movement [REM] sleep, n = 5). Setting: University Hospital Antwerp, Belgium. Patients: Tenobese patients (body mass index, 32.0 ± 5.6 kg/m2) withsevere OSA (respiratory disturbance index, 63.0 ± 14.6 events/h)were studied. Interventions: Pressure-flowrelationships were constructed from breaths obtained during a series of step decreases in nasal pressure (34.1 ± 6.5 runs over 3.6 ± 1.2h) in NREM sleep and during 7.8 ± 2.2 runs over 0.8 ± 0.6 h in REM sleep. Results: Maximal inspiratory airflowreached a steady state in the third through fifth breaths following adecrease in nasal pressure. Analysis of pressure-flow relationshipsderived from these breaths showed that Pcrit fell from 1.8 (95% CI,−0.1 to 2.7) cm H2O in the supine position to −1.1 cmH2O (95% CI, −1.8 to 0.4 cm H2O; p = 0.009)in the lateral recumbent position, whereas Rn did notchange significantly. In contrast, no significant effect of sleep stagewas found on either Pcrit or Rn. Conclusions: Our methods for delineating upper airwaypressure-flow relationships during sleep allow for multipledeterminations of Pcrit within a single night from which small yetsignificant differences can be discerned between studyconditions. Previous studies have shownthat the level of flow through the upper airway in patients withobstructive sleep apnea (OSA) is determined by the critical closingpressure (Pcrit) and the upstream resistance (Rn). Wedeveloped a standardized protocol for delineating quasisteady-statepressure-flow relationships for the upper airway from which thesevariables could be derived. In addition, we investigated the effect of body position and sleep stage on these variables by determining Pcritand Rn, and their confidence intervals (CIs), for eachcondition. Pressure-flow relationships wereconstructed in the supine and lateral recumbent positions (nonrapid eyemovement [NREM] sleep, n = 10) and in the supine position (rapideye movement [REM] sleep, n = 5). University Hospital Antwerp, Belgium. Tenobese patients (body mass index, 32.0 ± 5.6 kg/m2) withsevere OSA (respiratory disturbance index, 63.0 ± 14.6 events/h)were studied. Pressure-flowrelationships were constructed from breaths obtained during a series of step decreases in nasal pressure (34.1 ± 6.5 runs over 3.6 ± 1.2h) in NREM sleep and during 7.8 ± 2.2 runs over 0.8 ± 0.6 h in REM sleep. Maximal inspiratory airflowreached a steady state in the third through fifth breaths following adecrease in nasal pressure. Analysis of pressure-flow relationshipsderived from these breaths showed that Pcrit fell from 1.8 (95% CI,−0.1 to 2.7) cm H2O in the supine position to −1.1 cmH2O (95% CI, −1.8 to 0.4 cm H2O; p = 0.009)in the lateral recumbent position, whereas Rn did notchange significantly. In contrast, no significant effect of sleep stagewas found on either Pcrit or Rn. Our methods for delineating upper airwaypressure-flow relationships during sleep allow for multipledeterminations of Pcrit within a single night from which small yetsignificant differences can be discerned between studyconditions." @default.
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• W2159950140 date "2000-10-01" @default.
• W2159950140 modified "2023-10-15" @default.
• W2159950140 title "Abbreviated Method for Assessing Upper Airway Function in Obstructive Sleep Apnea" @default.
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• W2159950140 doi "https://doi.org/10.1378/chest.118.4.1031" @default.
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