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https://hdl.handle.net/2440/57960
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Type: | Journal article |
Title: | Abdominal compression increases upper airway collapsibility during sleep in obese male obstructive sleep apnea patients |
Author: | Stadler, D. McEvoy, R. Sprecher, K. Thomson, K. Ryan, M. Thompson, C. Catcheside, P. |
Citation: | Sleep, 2009; 32(12):1579-1587 |
Publisher: | Amer Academy Sleep Medicine |
Issue Date: | 2009 |
ISSN: | 0161-8105 1550-9109 |
Statement of Responsibility: | Daniel L. Stadler, R. Doug McEvoy, Kate E. Sprecher, Kieron J. Thomson, Melissa K. Ryan, Courtney C. Thompson, Peter G. Catcheside |
Abstract: | <h4>Study objectives</h4>Abdominal obesity, particularly common in centrally obese males, may have a negative impact on upper airway (UA) function during sleep. For example, cranial displacement of the diaphragm with raised intra-abdominal pressure may reduce axial tension exerted on the UA by intrathoracic structures and increase UA collapsibility during sleep.<h4>Design</h4>This study aimed to examine the effect of abdominal compression on UA function during sleep in obese male obstructive sleep apnea patients.<h4>Setting</h4>Participants slept in a sound-insulated room with physiologic measurements controlled from an adjacent room.<h4>Participants</h4>Fifteen obese (body mass index: 34.5 +/- 1.1 kg/m2) male obstructive sleep apnea patients (apnea-hypopnea index: 58.1 +/- 6.8 events/h) aged 50 +/- 2.6 years participated.<h4>Interventions</h4>Gastric (PGA) and transdiaphragmatic pressures (P(DI)), UA closing pressure (UACP), UA airflow resistance (R(UA)), and changes in end-expiratory lung volume (EELV) were determined during stable stage 2 sleep with and without abdominal compression, achieved via inflation of a pneumatic cuff placed around the abdomen. UACP was assessed during brief mask occlusions.<h4>Measurements and results</h4>Abdominal compression significantly decreased EELV by 0.53 +/- 0.24 L (P=0.045) and increased PGA (16.2 +/- 0.8 versus 10.8 +/- 0.7 cm H2O, P < 0.001), P(DI) (11.7 +/- 0.9 versus 7.6 +/- 1.2 cm H2O, P < 0.001) and UACP (1.4 +/- 0.8 versus 0.9 +/- 0.9 cm H2O, P = 0.039) but not R(UA)(6.5 +/- 1.4 versus 6.9 +/- 1.4 cm H2O x L/s, P=0.585).<h4>Conclusions</h4>Abdominal compression negatively impacts on UA collapsibility during sleep and this effect may help explain strong associations between central obesity and obstructive sleep apnea. |
Keywords: | Obstructive sleep apnea abdominal loading lung volume caudal traction |
Rights: | Copyright © 2009 by the Associated Professional Sleep Societies, LLC |
DOI: | 10.1093/sleep/32.12.1579 |
Description (link): | http://www.ncbi.nlm.nih.gov/pubmed/20041593 |
Published version: | http://dx.doi.org/10.1093/sleep/32.12.1579 |
Appears in Collections: | Aurora harvest Physiology publications |
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