Pharyngeal distensibility during expiration is an independent predictor of the severity of obstructive sleep apnoea
Corresponding Author
Ning-Hung Chen
Sleep Center, Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
Department of Respiratory Therapy, Chang Gung University, Taoyuan, Taiwan
Correspondence: Ning-Hung Chen, Sleep Center, Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Chang Gung University, 5, Fu-Shin Street, KweiShanShang, Taoyuan 333, Taiwan. Email: [email protected]Search for more papers by this authorShih-Wei Lin
Sleep Center, Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
Search for more papers by this authorLi-Pang Chuang
Sleep Center, Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
Search for more papers by this authorPeter A. Cistulli
Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, Sydney, NSW, Australia
Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
Search for more papers by this authorMeng-Jer Hsieh
Department of Respiratory Therapy, Chang Gung University, Taoyuan, Taiwan
Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan
Search for more papers by this authorKuo-Chin Kao
Sleep Center, Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
Department of Respiratory Therapy, Chang Gung University, Taoyuan, Taiwan
Search for more papers by this authorYu-Fang Liao
Sleep Center, Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
Search for more papers by this authorLi-Fu Li
Sleep Center, Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
Search for more papers by this authorCheng-Ta Yang
Sleep Center, Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
Department of Respiratory Therapy, Chang Gung University, Taoyuan, Taiwan
Search for more papers by this authorCorresponding Author
Ning-Hung Chen
Sleep Center, Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
Department of Respiratory Therapy, Chang Gung University, Taoyuan, Taiwan
Correspondence: Ning-Hung Chen, Sleep Center, Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Chang Gung University, 5, Fu-Shin Street, KweiShanShang, Taoyuan 333, Taiwan. Email: [email protected]Search for more papers by this authorShih-Wei Lin
Sleep Center, Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
Search for more papers by this authorLi-Pang Chuang
Sleep Center, Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
Search for more papers by this authorPeter A. Cistulli
Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, Sydney, NSW, Australia
Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
Search for more papers by this authorMeng-Jer Hsieh
Department of Respiratory Therapy, Chang Gung University, Taoyuan, Taiwan
Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan
Search for more papers by this authorKuo-Chin Kao
Sleep Center, Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
Department of Respiratory Therapy, Chang Gung University, Taoyuan, Taiwan
Search for more papers by this authorYu-Fang Liao
Sleep Center, Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
Search for more papers by this authorLi-Fu Li
Sleep Center, Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
Search for more papers by this authorCheng-Ta Yang
Sleep Center, Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
Department of Respiratory Therapy, Chang Gung University, Taoyuan, Taiwan
Search for more papers by this authorABSTRACT
Background and objective
Pharyngeal distensibility and collapsibility reflect the passive properties of tissue in the airway, are an indicator of the ease with which an airway can be deformed and are related to the severity of obstructive sleep apnoea (OSA). During normal tidal respiration, the collapsibility of the pharynx during expiration is passive without confounding by neuromuscular activation that occurs during inspiration. We evaluated the distensibility and collapsibility of the upper airway in subjects with OSA during wakefulness using sophisticated dynamic computed tomography (CT) imaging. We hypothesized that the dynamic changes of the upper airway during expiration would be related to the severity of OSA.
Methods
Twenty-three patients with OSA and eight normal subjects underwent simultaneous measurement of respiratory flow and airway calibre using ultrafast CT. The change in pharyngeal cross-sectional area divided by the change in concomitant flow (as distensibility or collapsibility) was measured and compared across different severities of OSA.
Results
The slope of this relationship between delta area and delta flow during expiration was significantly higher in severe OSA when compared with normal controls and mild–moderate OSA. Differences in airway distensibility or collapsibility between severity groups were significant in expiration but not in inspiration. Distensibility or collapsibility contributed most to the apnoea–hypopnoea index in regression modelling. Age, gender, and body mass index (BMI) were not significant independent predictors.
Conclusion
Our study demonstrates that airway distensibility during the expiratory phase of awake respiration is correlated with the severity of OSA.
Supporting Information
| Filename | Description |
|---|---|
| resp13474-sup-0001-TableS1.docxWord 2007 document , 14.4 KB | Table S1 Summary of the univariate correlation analysis via Spearman's and Pearson's correlation analysis. |
| resp13474-sup-0002-videoS1.mp4MPEG-4 video, 353.5 KB | Video S1 Dynamic narrowing of pharyngeal airway of an OSA patient. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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