Preventing Upper Airway Collapse Using CPAP With and Without Pressure Oscillations

2016 ◽  
Author(s):  
Sherif Ashaat ◽  
Ahmed M. Al-Jumaily ◽  
Loulin Huang
Keyword(s):  
Nasal Congestion ◽  
Upper Airway ◽  
Operating Pressure ◽  
Invasive Treatment ◽  
Pressure Oscillations ◽  
Pressure Distributions ◽  
Airway Collapse ◽  
Upper Airway Collapse ◽  
Obstructive Sleep ◽  
Mri Scans

During respiration, upper airway collapse occurs when the forces generated from the airway negative pressures become greater than the forces of the airway wall muscles. For patients diagnosed with moderate to severe obstructive sleep apnea (OSA), Continuous Positive Airway Pressure (CPAP) is the most effective non-invasive treatment. The CPAP provides a continuous humidified and pressurized air to prevent airway collapse. The use of the CPAP has been reported to be associated with some side effects including nasal congestion and dry nose. Also stroke symptoms were recorded for cardiovascular disease patients due to the high operating pressure. Using MRI scans, this paper investigates the effects of using the pressure oscillations superimposed on the CPAP to keep the airway open at lower pressure distributions inside the upper airway and consequently increase the patients’ comfort and reduce their rejection to the CPAP.

scholarly journals Much Ado about Sleep: Current Concepts on Mechanisms and Predisposition to Pediatric Obstructive Sleep Apnea

Children ◽  
2021 ◽  
Vol 8 (11) ◽  
pp. 1032
Author(s):  
Ashley L. Saint-Fleur ◽  
Alexa Christophides ◽  
Prabhavathi Gummalla ◽  
Catherine Kier
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Upper Airway ◽  
Biomechanical Properties ◽  
Primary Role ◽  
Airway Narrowing ◽  
Airway Collapse ◽  
Upper Airway Collapse ◽  
Obstructive Sleep ◽  
Review Current

Obstructive Sleep Apnea (OSA) is a form of sleep-disordered breathing characterized by upper airway collapse during sleep resulting in recurring arousals and desaturations. However, many aspects of this syndrome in children remain unclear. Understanding underlying pathogenic mechanisms of OSA is critical for the development of therapeutic strategies. In this article, we review current concepts surrounding the mechanism, pathogenesis, and predisposing factors of pediatric OSA. Specifically, we discuss the biomechanical properties of the upper airway that contribute to its primary role in OSA pathogenesis and examine the anatomical and neuromuscular factors that predispose to upper airway narrowing and collapsibility.

Control of segmental upper airway resistance in patients with obstructive sleep apnea

1993 ◽  
Vol 74 (6) ◽  
pp. 2694-2703 ◽  
Author(s):  
M. J. Wasicko ◽  
J. S. Erlichman ◽  
J. C. Leiter
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Upper Airway ◽  
Normal Subjects ◽  
Emg Activity ◽  
Electromyographic Activity ◽  
Resistive Load ◽  
Airway Collapse ◽  
Upper Airway Collapse ◽  
Obstructive Sleep

We sought to determine if the upper airway response to an added inspiratory resistive load (IRL) during wakefulness could be used to predict the site of upper airway collapse in patients with obstructive sleep apnea (OSA). In 10 awake patients with OSA, we investigated the relationship between resistance in three segments of the upper airway (nasal, nasopharyngeal, and oropharyngeal) and three muscles known to influence these segments (alae nasi, tensor veli palatini, and genioglossus) while the patient breathed with or without a small IRL (2 cmH2O.l–1.s). During IRL, patients with OSA exhibited increased nasopharyngeal resistance and no significant increase in either the genioglossus or tensor veli palatini activities. Neither nasal resistance nor alae nasi EMG activity was affected by IRL. We contrasted this to the response of five normal subjects, in whom we found no change in the resistance of either segment of the airway and no change in the genioglossus EMG but a significant activation of the tensor palatini. In six patients with OSA, we used the waking data to predict the site of upper airway collapse during sleep and we had limited success. The most successful index (correct in 4 of 6 patients) incorporated the greatest relative change in segmental resistance during IRL at the lowest electromyographic activity. We conclude, in patients with OSA, IRL narrows the more collapsible segment of the upper airway, in part due to inadequate activation of upper airway muscles. However, it is difficult to predict the site of upper airway collapse based on the waking measurements where upper airway muscle activity masks the passive airway characteristics.

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