Dyspnea following Experimentally Induced Increased Nasal Airway Resistance

1996 ◽  
Vol 33 (3) ◽  
pp. 231-235 ◽  
Author(s):  
Donald W. Warren ◽  
Robert Mayo ◽  
David J. Zajac ◽  
A. H. Rochet
Keyword(s):  
Airway Resistance ◽  
Upper Airway ◽  
Breathing Rate ◽  
Nasal Airway ◽  
Nasal Resistance ◽  
Nasal Breathing ◽  
Oral Breathing ◽  
A Value ◽  
Normal Breathing ◽  
Study Support

Nasal resistance (NRZ) values for healthy adults range from 1.0 to 3.5 cm H2O/L/sec. Some oral breathing tends to occur at values above 3.5. The purpose of the present study was to determine at what level of NRZ individuals sense that nasal breathing is difficult. A diaphragm was used to add four different resistance loads in random to 15 adult subjects. These loads were 5, 8, and 15 cm H2O/L/sec and a value 40% above the individual's normal NRZ. Loads were added under four conditions: normal breathing, fixed flow rate, fixed breathing rate, and fixed flow and breathing rate. The pressure-flow technique was used to measure NRZ under all conditions. The study revealed that the sensation of breathing difficulty occurred at a median resistance of 5 cm H2O/L/sec and, as subjects were constrained to maintain fixed flow and breathing rates, the magnitude of RZ, at which the sensation of dyspnea was noted, decreased. The values observed in this study support previous findings suggesting that individuals switch to some oral breathing to maintain an adequate level of upper airway resistance at values between 3.5 and 4.5 cm H2/L/sec. The findings also show that individuals attempt to minimize increases in airway resistance by modifying breathing behaviors.

Performance and work of nasal breathing

2021 ◽  
Vol 11 (41) ◽  
pp. 11-17
Author(s):  
Anita Bergmane ◽  
Klaus Vogt ◽  
Biruta Sloka
Keyword(s):  
Airway Resistance ◽  
Interquartile Range ◽  
Nasal Airway ◽  
Nasal Resistance ◽  
Nasal Breathing ◽  
First Line ◽  
Significant Difference ◽  
Before And After ◽  
Potential Parameters ◽  
Inspiratory Work

Abstract OBJECTIVE. To evaluate performance (Q) and work (W) of nasal breathing as potential parameters in functional diagnostic of nasal obstruction. MATERIAL AND METHODS. We included in our study 250 patients and we measured by 4-phase-rhinomanometry with decongestion test. We calculated performance Q of the “representative breath” in inspiration and expiration and in total breath, maximal performance Q (Qmax), Work W of nasal breathing in mJ and in mJ/litre and Q in J/min. RESULTS. The interquartile range of Win for representative breath before decongestion is 356 mJ/l, Wex 308 mJ/l, while after decongestion Win is 264 mJ/l and Wex 220 mJ/l. There is no significant difference between work before and after decongestion (p<0.001). Interquartile range for nasal breathing Q before decongestion is 19.2 J/min and after – 14.3 J/min. A significant correlation exists between logarithmic vertex resistance for inspiration and expiration and Qmax for inspiration and expiration (p<0.001). That means that the performance required by breathing depends in the first line on nasal resistance. CONCLUSION. Inspiratory work is 1.2 times higher than expiration work. Increase in nasal airway resistance is followed by increase in maximal nasal performance.

Total nasal airway resistance while sitting predicts airway collapse when lying down

2020 ◽  
Vol 134 (10) ◽  
pp. 917-924
Author(s):  
A Karlsson ◽  
M Persson ◽  
A-C Mjörnheim ◽  
G Gudnadottir ◽  
J Hellgren
Keyword(s):  
Nasal Obstruction ◽  
Supine Position ◽  
Airway Resistance ◽  
Upper Airway ◽  
Nasal Airway ◽  
Nasal Breathing ◽  
Nasal Airway Resistance ◽  
Airway Collapse ◽  
Before And After ◽  
Lying Down

AbstractBackgroundNasal obstruction when lying down is a common complaint in patients with chronic nasal obstruction, but rhinomanometry is typically performed in the sitting position. This study aimed to analyse whether adding rhinomanometry in a supine position is a useful examination.MethodA total of 41 patients with chronic nasal obstruction underwent rhinomanometry and acoustic rhinometry, sitting and supine, before and after decongestion, as well as an over-night polygraphy.ResultsTotal airway resistance was measurable in a supine position in 48 per cent (14 of 29) of the patients with total airway resistance of equal to or less than 0.3 Pa/cm3/second when sitting and in none (0 of 12) of the patients with total nasal airway resistance of more than 0.3 Pa/cm3/second when sitting. After decongestion, this increased to 83 per cent and 58 per cent, respectively.ConclusionIncreased nasal resistance when sitting predicts nasal breathing problems when supine. Rhinomanometry in a supine position should be performed to diagnose upper airway collapse when supine.

Mechanisms of control of alae nasi muscle activity

1992 ◽  
Vol 72 (3) ◽  
pp. 925-933 ◽  
Author(s):  
W. S. Mezzanotte ◽  
D. J. Tangel ◽  
D. P. White
Keyword(s):  
Upper Airway ◽  
Intraluminal Pressure ◽  
Emg Activity ◽  
Nasal Airway ◽  
Nasal Breathing ◽  
Oral Breathing ◽  
Load Response ◽  
Combined Anesthesia ◽  
Normal Men ◽  
Pressure Changes

Human upper airway dilator muscles are clearly influenced by chemical stimuli such as hypoxia and hypercapnia. Whether in humans there are upper airway receptors capable of modifying the activity of such muscles is unclear. We studied alae nasi electromyography (EMG) in normal men in an attempt to determine 1) whether increasing negative intraluminal pressure influences the activity of the alae nasi muscle, 2) whether nasal airway feedback mechanisms modify the activity of this muscle, and 3) if so, whether these receptor mechanisms are responding to mucosal temperature/pressure changes or to airway deformation. Alae nasi EMG was recorded in 10 normal men under the following conditions: 1) nasal breathing (all potential nasal receptors exposed), 2) oral breathing (nasal receptors not exposed), 3) nasal breathing with splints (airway deformation prevented), and 4) nasal breathing after nasal anesthesia (mucosal receptors anesthetized). In addition, in a separate group, the combined effects of anesthesia and nasal splints were assessed. Under each condition, EMG activity was monitored during basal breathing, progressive hypercapnia, and inspiratory resistive loading. Under all four conditions, both load and hypercapnia produced a significant increase in alae nasi EMG, with hypercapnia producing a similar increment in EMG regardless of nasal receptor exposure. On the other hand, loading produced greater increments in EMG during nasal than during oral breathing, with combined anesthesia plus splinting producing a load response similar to that observed during oral respiration. These observations suggest that nasal airway receptors have little effect on the alae nasi response to hypercapnia but appear to mediate the alae nasi response to loading or negative airway pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

Objective assessment of nasal resistance among electronic cigarette users

2021 ◽  
pp. 1-4
Author(s):  
S W Lim ◽  
AB Zulkiflee
Keyword(s):  
Tobacco Smoking ◽  
Repeated Measures ◽  
Airway Resistance ◽  
Electronic Cigarettes ◽  
Objective Assessment ◽  
Control Group ◽  
Nasal Airway ◽  
Nasal Resistance ◽  
Short Term ◽  
Nasal Airway Resistance

Abstract Background Electronic cigarettes have been a popular alternative to tobacco smoking. The effect of tobacco smoking on nasal airway resistance has been investigated before; however, the effect of the aerosol generated by electronic cigarettes is still unknown. This study aimed to evaluate the short-term effects of e-cigarettes on nasal airway resistance. Methods Sixty-one participants were recruited into a vapers group and a control group. The vapers group was instructed to smoke for 5 minutes, and their nasal resistance was measured pre-procedure and at 1 and 5 minutes post-procedure. The results were compared between both groups. Results Repeated measures analysis of variance demonstrated that vaping has no statistically significant effect on total nasal airway resistance. Conclusion Although the differences between both groups were not statistically significant overall, the vapers group showed a reduction in nasal airway resistance in the short term.

Alae nasi activation and nasal resistance in healthy subjects

1982 ◽  
Vol 52 (6) ◽  
pp. 1432-1437 ◽  
Author(s):  
K. P. Strohl ◽  
C. F. O'Cain ◽  
A. S. Slutsky
Keyword(s):  
Healthy Subjects ◽  
Airway Resistance ◽  
Upper Airway ◽  
Emg Activity ◽  
Nasal Resistance ◽  
Body Plethysmography ◽  
Surface Electrodes ◽  
Upper Airway Resistance

To investigate the effect of alae nasi (AN) activation on nasal resistance, we monitored AN electromyographic (EMG) activity in 17 healthy subjects using surface electrodes placed on either side of the external nares and measured inspiratory nasal resistance utilizing the method of posterior rhinometry. With CO2 inhalation (6 subj), AN EMG activity increased as nasal resistance fell 23 +/- 5% (P less than 0.01). In the same subjects, voluntary flaring of the external nares also increased AN EMG and decreased nasal resistance by 29 +/- 5% (P less than 0.01). Nasal resistance was altered by nasal flaring and CO2 inhalation even after administration of a topical nasal vasoconstrictive spray (8 subj). In six subjects, voluntary nasal flaring or inhibition with the mouth closed produced a 21 +/- 12% change (P less than 0.01) in total airway resistance as measured by body plethysmography. We conclude that activation of the alae nasi will decrease nasal and total airway resistance during voluntary nasal flaring and during CO2 inhalation and thus should be considered in any studies of upper airway resistance.

Objective Assessment of the Breathe-Right Device during Exercise in Adult Males

1997 ◽  
Vol 11 (5) ◽  
pp. 393-398 ◽  
Author(s):  
Louis G. Portugal ◽  
Rajeev H. Mehta ◽  
Bonnie E. Smith ◽  
Jaishiri B. Sabnani ◽  
Matthew J. Matava
Keyword(s):  
African American ◽  
Objective Assessment ◽  
Acoustic Rhinometry ◽  
Nasal Airway ◽  
Nasal Resistance ◽  
Adult Males ◽  
Nasal Breathing ◽  
Cross Sectional ◽  
American Group ◽  
Paradoxical Worsening

In order to improve nasal breathing during competition, many athletes recently have been wearing a spring-loaded, external nasal dilator referred to as the Breathe-Right device (BRD). Although there are many subjective claims that this device improves breathing during exercise, there are currently no controlled studies documenting its efficacy. To determine objectively whether the device improves the nasal airway, 20 subjects (10 Caucasian and 10 African-American) were studied during rest and after 15 minutes of exercise using anterior rhinomanometry and acoustic rhinometry to measure changes in airway resistance and minimal cross-sectional area, respectively. We found that the BRD exerts its main effect in the region of the nasal valve improving the airway an overall 21% in our group of subjects. This anatomic improvement in nasal airway resulted in an overall 27% reduction in nasal resistance in the Caucasian group. However, in the African-American group, a wider range of resistance changes was observed with application of the BRD with significant improvement in nasal resistance in some subjects but paradoxical worsening in others. In the African-American group as a whole, no significant change in nasal resistance occured with application of the BRD. These measured differences are likely due to variations in nasal anatomy that exist not only between races but also between individuals within a given race. In addition, this study confirms the well known decongestant effects of exercise providing anatomic data with acoustic rhinometry not previously documented in the literature. Overall improvement in nasal airway seen with application of the BRD occured independent of these exercise-related decongestant effects.

Influence of sleep on alae nasi EMG and nasal resistance in normal men

1993 ◽  
Vol 75 (2) ◽  
pp. 626-632 ◽  
Author(s):  
J. R. Wheatley ◽  
D. J. Tangel ◽  
W. S. Mezzanotte ◽  
D. P. White
Keyword(s):  
Eye Movement ◽  
Sleep Onset ◽  
Upper Airway ◽  
Nrem Sleep ◽  
Nasal Airway ◽  
Nasal Resistance ◽  
Rapid Eye Movement ◽  
Dilator Muscle ◽  
Stage 2 Sleep ◽  
Normal Men

The influence of sleep on the upper airway musculature varies considerably, with some muscles maintaining their activity at waking levels and others falling substantially. The influence of sleep on the alae nasi (AN), a dilator muscle of the nasal airway, has been minimally studied to date. Thus we determined the effect of non-rapid-eye-movement (NREM) sleep on the AN electromyogram and its relationship to nasal resistance (Rn) in nine normal supine males. Phasic inspiratory AN activity decreased from 20 +/- 6 arbitrary units during wakefulness to 5 +/- 1 arbitrary units (P < 0.001) at the onset of stage 2 NREM sleep and remained unchanged for two subsequent hours of NREM sleep. However, the Rn at the onset of NREM sleep remained similar to awake values (5.7 +/- 0.9 cmH2O.l-1 x s) and increased only after 1 h of NREM sleep (8.6 +/- 1.7 cmH2O.l-1 x s, P < 0.05), thus demonstrating little relationship to AN activity. We conclude that Rn increases slightly after 1 h of sleep, whereas AN activity decreases at stage 2 sleep onset. Thus AN activity has little influence on Rn during sleep.

scholarly journals Threshold of the upper airway cross-section for hypopnea onset during sleep and its identification under waking condition

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Hongyi Lin ◽  
Cunting Wang ◽  
Han Zhang ◽  
Huahui Xiong ◽  
Zheng Li ◽  
...  
Keyword(s):  
Cross Section ◽  
Airway Resistance ◽  
Upper Airway ◽  
The Body ◽  
Sigmoid Function ◽  
Fluid Accumulation ◽  
Normal Breathing ◽  
Obstructive Sleep ◽  
The Cross ◽  
Shape Changes

Abstract Background There is currently no method that can predict whether or under what condition hypopnea, even obstructive sleep apnea (OSA), will occur during sleep for individuals based on credible parameters measured under waking condition. We propose a threshold concept based on the narrowest cross-sectional area of the upper airway (CSA-UA) and aim to prove our hypothesis on the threshold of the area for hypopnea onset (TAHO), which can be used as an indicator of hypopnea onset during sleep and measured while awake. Methods We performed magnetic resonance imaging for 20 OSA patients to observe CSA-UA changes during fluid accumulation in the neck caused by elevating their legs, and identified TAHO by capturing the sudden enlargement in CSA-UA. Correlation analyses between TAHO and the body mass index (BMI), and between the reduction in CSA-UA and the increase in the neck circumference (NC) with fluid accumulation were performed. Logistic regression analysis was performed for identifying OSA patients based on the behaviors of their CSA-UA changes during leg raising. Shape changes of airway cross-section were also investigated. Results Four CSA-UA change patterns after fluid redistribution were identified. Six patients had similar CSA-UA variation behaviors observed in healthy subjects. From the other three change patterns involving 14 patients, a threshold value of CSA-UA 0.63 ± 0.21 cm2 was identified for normal breathing. Data showed a positive correlation between TAHO and BMI (r = 0.681, p = 0.0007), and a negative correlation between the reduction in CSA-UA and the increase in NC (r = − 0.513, p = 0.051) with fluid accumulation. A sigmoid function for the probability of being a OSA patient p = 1/[1 + exp. (4.836 + 3.850 t-8.4 h)] was obtained to effectively separate OSA patients from normal subjects. The upper airway narrowing occurred in anteroposterior, lateral, or both directions, suggesting different tendencies of upper airway collapse in patients. Three types of shape changes in the cross-section of the upper airway, which had different effects on airway resistance, were measured. Conclusions Our findings prove TAHO hypothesis. The threshold measured while awake for normal breathing can be used clinically as the indicator of hypopnea onset during sleep, and therefore to identify OSA patients under waking condition and design effective personalized treatments for OSA patients. Both shape and size changes in the cross-section of the upper airway affect airway resistance significantly. Shape change in the cross-section of the upper airway can provide key clinical information on the collapse patterns of the upper airway for individuals.

Influence of passive changes of lung volume on upper airways

1990 ◽  
Vol 68 (5) ◽  
pp. 2159-2164 ◽  
Author(s):  
F. Series ◽  
Y. Cormier ◽  
M. Desmeules
Keyword(s):  
Lung Volume ◽  
Airway Resistance ◽  
Upper Airway ◽  
Normal Subjects ◽  
Base Line ◽  
Nasal Resistance ◽  
Inspiratory Flow Rate ◽  
Upper Airways ◽  
Lung Volumes ◽  
Bias Flow

The total upper airway resistances are modified during active changes in lung volume. We studied nine normal subjects to assess the influence of passive thoracopulmonary inflation and deflation on nasal and pharyngeal resistances. With the subjects lying in an iron lung, lung volumes were changed by application of an extrathoracic pressure (Pet) from 0 to 20 (+Pet) or -20 cmH2O (-Pet) in 5-cmH2O steps. Upper airway pressures were measured with two low-bias flow catheters, one at the tip of the epiglottis and the other in the posterior nasopharynx. Breath-by-breath resistance measurements were made at an inspiratory flow rate of 300 ml/s at each Pet step. Total upper airway, nasal, and pharyngeal resistances increased with +Pet [i.e., nasal resistance = 139.6 +/- 14.4% (SE) of base-line and pharyngeal resistances = 189.7 +/- 21.1% at 10 cmH2O of +Pet]. During -Pet there were no significant changes in nasal resistance, whereas pharyngeal resistance decreased significantly (pharyngeal resistance = 73.4 +/- 7.4% at -10 cmH2O). We conclude that upper airway resistance, particularly the pharyngeal resistance, is influenced by passive changes in lung volumes, especially pulmonary deflation.

Partitioning of respiratory flow resistance in man

1964 ◽  
Vol 19 (4) ◽  
pp. 653-658 ◽  
Author(s):  
B. G. Ferris ◽  
J. Mead ◽  
L. H. Opie
Keyword(s):  
Chest Wall ◽  
Flow Resistance ◽  
Airway Resistance ◽  
Upper Airway ◽  
Mouth Breathing ◽  
Lower Airway ◽  
Nasal Breathing ◽  
Pulmonary Tissue ◽  
Tissue Resistance ◽  
Highly Nonlinear

Measurements of flow resistance of various components of the respiratory system were measured in adult male subjects in the sitting position. Nasal resistance is the largest single component being nearly one-half the total and two-thirds of the airway resistance during nose breathing. It is highly nonlinear, and shows much variability. During mouth breathing upper airway resistance (mouth, pharynx, glottis, larynx and upper trachea) is also markedly nonlinear, and accounts for one-third the total airway resistance. Lower airway resistance is approximately linear up to flows of 2 liters/sec. Pulmonary tissue resistance is low as reported in this study. Chest wall resistance is nearly linear up to flow rates of 2 liters/sec and accounts for slightly less than half the total respiratory resistance during mouth breathing and 10–19% during nasal breathing. larynx; airways; chest wall; nose Submitted on December 16, 1963

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