scholarly journals Tidal breathing flow volume profiles during sleep in wheezing infants measured by impedance pneumography

2019 ◽  
Vol 126 (5) ◽  
pp. 1409-1418 ◽  
Author(s):  
Javier Gracia-Tabuenca ◽  
Ville-Pekka Seppä ◽  
Milla Jauhiainen ◽  
Anne Kotaniemi-Syrjänen ◽  
Kristiina Malmström ◽  
...  
Keyword(s):  
Lung Function ◽  
Airway Obstruction ◽  
Eye Movement ◽  
Rapid Eye Movement ◽  
Flow Volume ◽  
Tidal Breathing ◽  
Sleep Phase ◽  
Asthma Risk ◽  
Impedance Pneumography ◽  
At Home

Overnight analysis of tidal breathing flow volume (TBFV) loops, recorded by impedance pneumography (IP), has been successfully applied in the home monitoring of children with wheezing disorders. However, little is known on how sleep physiology modifies the relationship between TBFV profiles and wheeze. We studied such interactions in wheezing infants. Forty-three infants recruited because of recurrent lower airway symptoms were divided into three groups based on their risk of asthma: high (HR), intermediate (IR), or low (LR). Sedated patients underwent infant lung function testing including assessment of airway responsiveness to methacholine at the hospital and a full-night recording of TBFV profiles at home with IP during natural sleep. Overnight TBFV indexes were estimated from periods of higher and lower respiration variability, presumably belonging to active [rapid eye movement (REM)] and quiet [non-REM (NREM)] sleep, respectively. From 35 valid recordings, absolute time indexes showed intrasubject sleep phase differences. Peak flow relative to time and volume was lower in HR compared with LR only during REM, suggesting altered expiratory control. Indexes estimating the concavity/convexity of flow decrease during exhalation suggested limited flow during passive exhale in HR compared with IR and LR, similarly during NREM and REM. Moreover, during REM convexity was negatively correlated with maximal flow at functional residual capacity and methacholine responsiveness. We conclude that TBFV profiles determined from overnight IP recordings vary because of sleep phase and asthma risk. Physiological changes during REM, most likely decrease in respiratory muscle tone, accentuate the changes in TBFV profiles caused by airway obstruction. NEW & NOTEWORTHY Impedance pneumography was used to investigate overnight tidal breathing flow volume (TBFV) indexes and their interactions with sleep phase [rapid eye movement (REM) vs. non-REM] at home in wheezing infants. The study shows that TBFV indexes vary significantly because of sleep phase and asthma risk of the infant and that during REM the changes in TBFV indexes caused by airway obstruction are accentuated and better associated with lung function of the infant.

scholarly journals Measurement of tidal breathing flows in infants using impedance pneumography

2016 ◽  
Vol 49 (2) ◽  
pp. 1600926 ◽  
Author(s):  
Leo Pekka Malmberg ◽  
Ville-Pekka Seppä ◽  
Anne Kotaniemi-Syrjänen ◽  
Kristiina Malmström ◽  
Merja Kajosaari ◽  
...  
Keyword(s):  
Lung Function ◽  
Tidal Flow ◽  
Mean Deviation ◽  
Flow Volume ◽  
Tidal Breathing ◽  
Impedance Pneumography ◽  
Similar Association ◽  
Residual Capacity ◽  
The Mean ◽  
Airway Conductance

Tidal breathing flow volume (TBFV) profiles have been used to characterise altered lung function. Impedance pneumography (IP) is a novel option for assessing TBFV curves noninvasively. The aim of this study was to extend the application of IP for infants and to estimate the agreement between IP and direct pneumotachograph (PNT) measurements in assessing tidal airflow and flow-derived indices.Tidal flow profiles were recorded for 1 min simultaneously with PNT and uncalibrated IP at baseline in 44 symptomatic infants, and after methacholine-induced bronchoconstriction in a subgroup (n=20).The agreement expressed as the mean deviation from linearity ranged between 3.9 and 4.3% of tidal peak inspiratory flow, but was associated with specific airway conductance (p=0.002) and maximal flow at functional residual capacity (V′maxFRC) (p=0.004) at baseline. Acute bronchoconstriction induced by methacholine did not significantly affect the agreement of IP with PNT. TBFV indices derived from IP were slightly underestimated compared to PNT, but were equally well repeatable and associated with baseline V′maxFRC (p=0.012 and p=0.013, respectively).TBFV profiles were consistent between IP and PNT in most infants, but the agreement was affected by reduced lung function. TBFV parameters were not interchangeable between IP and PNT, but had a similar association with lung function in infants.

Thyroarytenoid muscle activity during wakefulness and sleep in normal adults

1988 ◽  
Vol 65 (3) ◽  
pp. 1332-1339 ◽  
Author(s):  
S. T. Kuna ◽  
G. Insalaco ◽  
G. E. Woodson
Keyword(s):  
Eye Movement ◽  
Progressive Increase ◽  
Rapid Eye Movement ◽  
Rapid Eye Movement Sleep ◽  
Adult Males ◽  
Tidal Breathing ◽  
Quiet Breathing ◽  
Discharge Patterns ◽  
Normal Adults ◽  
Thyroarytenoid Muscle

To determine the respiratory-related activity of the thyroarytenoid (TA) muscle in normal adults, intramuscular electromyographic recordings were performed in eight normal adult males during wakefulness and sleep. Phasic expiratory TA activity was present during normal tidal breathing in all subjects during wakefulness. Tonic activity was frequently present during inspiration. After an initial rapid rise in activity near the onset of expiration, phasic TA activity generally exhibited one of three different discharge patterns: a plateau, a progressive increase, or, less commonly, a progressive decrease in activity. In four of five subjects examined, peak TA activity during quiet breathing in wakefulness appeared to be directly related to time of expiration. At a particular lung volume above end-expiratory volume during wakefulness, measurements of expiratory resistance were directly related to the level of TA activity. TA activity disappeared during stable periods of non-rapid-eye-movement sleep and exhibited paroxysmal bursts of activity during rapid-eye-movement sleep. The results during wakefulness indicate that the TA contributes to an active adduction of the vocal cords in expiration and suggest the presence of an active laryngeal braking mechanism during exhalation.

Effect of sleep deprivation on responses to airway obstruction in the sleeping dog

1994 ◽  
Vol 77 (4) ◽  
pp. 1811-1818 ◽  
Author(s):  
C. P. O'Donnell ◽  
E. D. King ◽  
A. R. Schwartz ◽  
P. L. Smith ◽  
J. L. Robotham
Keyword(s):  
Sleep Deprivation ◽  
Airway Obstruction ◽  
Eye Movement ◽  
Rem Sleep ◽  
Recovery Period ◽  
Sleep Time ◽  
Inspiratory Effort ◽  
Sleep Architecture ◽  
Rapid Eye Movement ◽  
Obstructive Sleep

The effect of sleep deprivation on sleep architecture and respiratory responses to repetitive airway obstruction during sleep was investigated in four chronically instrumented tracheostomized dogs during 12-h nocturnal experiments. A 24-h period of prior sleep deprivation increased (P < 0.05) the rate at which airway obstruction could be induced from 20 +/- 3 (SE) to 37 +/- 10 times/h compared with non-sleep-deprived dogs. During non-rapid-eye-movement sleep the duration of obstruction, minimum arterial hemoglobin saturation, and peak negative inspiratory effort at arousal were 20.5 +/- 1.0 s, 91.7 +/- 0.5%, and 28.4 +/- 1.8 mmHg, respectively, in non-sleep-deprived dogs. Sleep deprivation increased (P < 0.01) the duration of obstruction to 28.0 +/- 0.9 s, worsened (P < 0.05) the minimal arterial hemoglobin desaturation to 85.4 + 3.1%, and increased (P < 0.025) the peak negative inspiratory effort at arousal to 36.1 +/- 1.6 mmHg. Sleep deprivation also caused increases (P < 0.025) in total sleep time, rapid-eye-movement (REM) sleep time, and percentage of time in REM sleep in a 2-h recovery period without airway obstruction at the end of the study. We conclude that airway obstruction in the sleeping dog can reproduce the disturbances in sleep architecture and respiration that occur in obstructive sleep apnea and that prior sleep deprivation will increase apnea severity, degree of somnolence, and REM sleep rebound independent of change in upper airway collapsibility.

scholarly journals Airway obstruction is associated with reduced variability in specific parts of the tidal breathing flow–volume curve in young children

2019 ◽  
Vol 5 (2) ◽  
pp. 00028-2019 ◽  
Author(s):  
Ville-Pekka Seppä ◽  
Anton Hult ◽  
Javier Gracia-Tabuenca ◽  
Marita Paassilta ◽  
Jari Viik ◽  
...  
Keyword(s):  
Young Children ◽  
Airway Obstruction ◽  
Flow Volume ◽  
Tidal Breathing ◽  
Volume Curve ◽  
Flow Volume Curve

Can Tidal Breathing Flow Volume Loops Be Used To Measure Airway Obstruction In Infants?

2012 ◽  
Author(s):  
Avigdor Hevroni ◽  
Shlomo Cohen ◽  
Lior Bendov ◽  
Aliza Goldman ◽  
Avraham Avital ◽  
...  
Keyword(s):  
Airway Obstruction ◽  
Flow Volume ◽  
Tidal Breathing

scholarly journals Tidal flow variability measured by impedance pneumography relates to childhood asthma risk

2016 ◽  
Vol 47 (6) ◽  
pp. 1687-1696 ◽  
Author(s):  
Ville-Pekka Seppä ◽  
Anna S. Pelkonen ◽  
Anne Kotaniemi-Syrjänen ◽  
Jari Viik ◽  
Mika J. Mäkelä ◽  
...  
Keyword(s):  
Lung Function ◽  
Young Children ◽  
Inhaled Corticosteroids ◽  
Risk Groups ◽  
Lower Airway ◽  
Flow Profile ◽  
Predictive Index ◽  
Flow Variability ◽  
Impedance Pneumography ◽  
At Home

Lung function variability is a fundamental feature of asthma but has been difficult to quantify in children due to methodological limitations. We assessed the feasibility and clinical implications of overnight flow variability measurement at home using impedance pneumography in young children.44 children aged 3–7 years with recurrent or persistent lower airway symptoms were recruited. Patients were divided into high- or lower-risk groups (HR and LR groups) based on their risk of asthma (modified Asthma Predictive Index), and a third group was formed of children who had a history of wheeze and who were treated with inhaled corticosteroids (ICS group). Tidal volume and the derived flow were recorded through skin electrodes using impedance pneumography at home during sleep. Quantities describing overnight change in expiratory flow–volume minimum curve shape correlation (CSRmin) and respiratory chaoticity (minimum noise limit (NLmin)) were derived.Recordings were successful in 34 children. CSRmin differed between the HR and LR groups (p=0.002) and between the HR and ICS groups (p=0.003), indicating a stronger change in flow profile shape in the HR group. NLmin differed between the HR and LR groups (p=0.014), indicating momentarily lowered chaoticity in the HR group.Impedance pneumography was found feasible for quantifying nocturnal lung function variability and the measured variability was associated with risk of asthma in young children.

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