Pharyngeal critical pressure in children with mild sleep-disordered breathing

Ralph F Fregosi, Stuart F Quan, Wayne J Morgan, J. L. Goodwin, R. Cabrera, I. Shareif, K. W. Fridel, Richard R Bootzin

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

There is evidence that narrowing or collapse of the pharynx can contribute to obstructive sleep-disordered breathing (SDB) in adults and children. However, studies in children have focused on those with relatively severe SDB who generally were recruited from sleep clinics. It is unclear whether children with mild SDB who primarily have hypopneas, and not frank apnea, also have more collapsible airways. We estimated airway collapsibility in 10 control subjects (9.4 ± 0.5 yr old; 1.9 ± 0.2 hypopneas/h) and 7 children with mild SDB (10.6 ± 0.5 yr old; 11.5 ± 0.1 hypopneas/h) during stable, non-rapid eye movement sleep. None of the subjects had clinically significant enlargement of the tonsils or adenoids, nor had any undergone previous tonsillectomy or adenoidectomy. Airway collapsibility was measured by brief (2-breath duration) and sudden reductions in pharyngeal pressure by connecting the breathing mask to a negative pressure source. Negative pressure applications ranging from -1 to -20 cmH2O were randomly applied in each subject while respiratory airflow and mask pressure were measured. Flow-pressure curves were constructed for each subject, and the x-intercept gave the pressure at zero flow, the so-called critical pressure of the upper airway (Pcrit). Pcrit was significantly higher in children with SDB than in controls (-10.8 ± 2.8 vs. -15.7 ± 1.2 cmH2O; P < 0.05). There were no significant differences in the slopes of the pressure-flow relations or in baseline airflow resistance. These data support the concept that intrinsic pharyngeal collapsibility contributes to mild SDB in children.

Original languageEnglish (US)
Pages (from-to)734-739
Number of pages6
JournalJournal of Applied Physiology
Volume101
Issue number3
DOIs
StatePublished - 2006

Fingerprint

Sleep Apnea Syndromes
Pressure
Masks
Sleep
Adenoidectomy
Adenoids
Pulmonary Ventilation
Tonsillectomy
Palatine Tonsil
Apnea
Eye Movements
Pharynx
Respiration

Keywords

  • Apnea
  • Hypopnea
  • Upper airway

ASJC Scopus subject areas

  • Physiology
  • Endocrinology
  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Pharyngeal critical pressure in children with mild sleep-disordered breathing. / Fregosi, Ralph F; Quan, Stuart F; Morgan, Wayne J; Goodwin, J. L.; Cabrera, R.; Shareif, I.; Fridel, K. W.; Bootzin, Richard R.

In: Journal of Applied Physiology, Vol. 101, No. 3, 2006, p. 734-739.

Research output: Contribution to journalArticle

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