Respiratory-related displacement of the trachea in obstructive sleep apnea
| العنوان: | Respiratory-related displacement of the trachea in obstructive sleep apnea |
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| المؤلفون: | Lynne E. Bilston, Peter G R Burke, Danny J. Eckert, Joshua Tong, Lauriane Jugé, Jason Amatoury, F. Knapman |
| المصدر: | J Appl Physiol (1985) |
| بيانات النشر: | American Physiological Society, 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Adult, Male, medicine.medical_specialty, Physiology, Polysomnography, TRACHEAL DISPLACEMENT, 03 medical and health sciences, 0302 clinical medicine, Physiology (medical), Internal medicine, Humans, Medicine, Displacement (orthopedic surgery), Lung volumes, Respiratory system, Sleep Apnea, Obstructive, medicine.diagnostic_test, business.industry, Magnetic resonance imaging, Middle Aged, respiratory system, medicine.disease, respiratory tract diseases, Trachea, Obstructive sleep apnea, 030228 respiratory system, Respiratory Mechanics, Cardiology, Sleep disordered breathing, Pharynx, Female, business, Airway, 030217 neurology & neurosurgery, Research Article |
| الوصف: | Tracheal displacement is thought to be the primary mechanism by which changes in lung volume influence upper airway patency. Caudal tracheal displacement during inspiration may help preserve the integrity of the upper airway in response to increasing negative airway pressure by stretching and stiffening pharyngeal tissues. However, tracheal displacement has not been previously quantified in obstructive sleep apnea (OSA). Accordingly, we aimed to measure tracheal displacements in awake individuals with and without OSA. The upper head and neck of 34 participants [apnea-hypopnea index (AHI) = 2–74 events/h] were imaged in the midsagittal plane using dynamic magnetic resonance imaging (MRI) during supine awake quiet breathing. MRI data were analyzed to identify peak tracheal displacement and its timing relative to inspiration. Epiglottic pressure was measured separately for a subset of participants ( n = 30) during similar experimental conditions. Nadir epiglottic pressure and its timing relative to inspiration were quantified. Peak tracheal displacement ranged from 1.0–9.6 mm, with a median (25th–75th percentile) of 2.3 (1.7–3.5) mm, and occurred at 89 (78–99)% of inspiratory time. Peak tracheal displacement increased with increasing OSA severity (AHI) ( R2 = 0.28, P = 0.013) and increasing negative nadir epiglottic pressure ( R2 = 0.47, P = 0.023). Relative inspiratory timing of peak tracheal displacement also correlated with OSA severity, with peak displacement occurring earlier in inspiration with increasing AHI ( R2 = 0.36, P = 0.002). Tracheal displacements during quiet breathing are larger in individuals with more severe OSA and tend to reach peak displacement earlier in the inspiratory cycle. Increased tracheal displacement may contribute to maintenance of upper airway patency during wakefulness in OSA, particularly in those with severe disease. NEW & NOTEWORTHY Tracheal displacement is thought to play an important role in stabilizing the upper airway by stretching/stiffening the pharyngeal musculature. Using dynamic magnetic resonance imaging, this study shows that caudal tracheal displacement is more pronounced during inspiration in obstructive sleep apnea (OSA) compared with healthy individuals. Softer pharyngeal muscles and greater inspiratory forces in OSA may underpin greater tracheal excursion. These findings suggest that tracheal displacement may contribute to maintenance of pharyngeal patency during wakefulness in OSA. |
| تدمد: | 1522-1601 8750-7587 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::70ff691bb005766432ab304cc53152f1 https://doi.org/10.1152/japplphysiol.00660.2018 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....70ff691bb005766432ab304cc53152f1 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15221601 87507587 |
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