Mechanical parameters determining pharyngeal collapsibility in patients with sleep apnea

Arie Oliven, Eran Kaufman, Rotem Kaynan, Ron Oliven, Uri Steinfeld, Nave Tov, Majed Odeh, Luis Gaitini, Alan R Schwartz, Eitan Kimmel

Research output: Contribution to journalArticle

Abstract

The relative impact of mechanical factors on pharyngeal patency in patients with obstructive sleep apnea is poorly understood. The present study was designed to evaluate parameters of the "tube law" on pharyngeal pressure-flow relationships and ollapsibility in patients with obstructive sleep apnea. We developed a mathematical model that considered the collapsible segment of the pharynx to represent an orifice of varying diameter. The model enabled us to assess the effects of pharyngeal compliance (C), neutral cross-sectional area (Ao), external peripharyngeal pressure (P ex), and the resistance proximal to the site of collapse on flow mechanics and pharyngeal collapsibility [critical pressure (Pcrit)]. All parameters were measured in 15 patients with obstructive sleep apnea under propofol anesthesia, both at rest and during mandibular advancement and electrical stimulation of the genioglossus. The data was used both to confirm the validity of the model and to compare expected and actual relationships between the tube-law parameters and the pharyngeal pressure-flow relationship and collapsibility. We found a close correlation between predicted and measured Pcrit (R = 0.98), including changes observed during pharyngeal manipulations. C and Ao were closely and directly interrelated (R = 0.93) and did not correlate with Pcrit. A significant correlation was found between P ex and Pcrit (R = 0.77; P

Original languageEnglish (US)
Pages (from-to)1037-1044
Number of pages8
JournalJournal of Applied Physiology
Volume109
Issue number4
DOIs
StatePublished - Oct 2010

Fingerprint

Sleep Apnea Syndromes
Obstructive Sleep Apnea
Pressure
Mandibular Advancement
Propofol
Pharynx
Mechanics
Electric Stimulation
Compliance
Theoretical Models
Anesthesia

Keywords

  • Pharyngeal compliance

ASJC Scopus subject areas

  • Physiology
  • Physiology (medical)

Cite this

Oliven, A., Kaufman, E., Kaynan, R., Oliven, R., Steinfeld, U., Tov, N., ... Kimmel, E. (2010). Mechanical parameters determining pharyngeal collapsibility in patients with sleep apnea. Journal of Applied Physiology, 109(4), 1037-1044. https://doi.org/10.1152/japplphysiol.00019.2010

Mechanical parameters determining pharyngeal collapsibility in patients with sleep apnea. / Oliven, Arie; Kaufman, Eran; Kaynan, Rotem; Oliven, Ron; Steinfeld, Uri; Tov, Nave; Odeh, Majed; Gaitini, Luis; Schwartz, Alan R; Kimmel, Eitan.

In: Journal of Applied Physiology, Vol. 109, No. 4, 10.2010, p. 1037-1044.

Research output: Contribution to journalArticle

Oliven, A, Kaufman, E, Kaynan, R, Oliven, R, Steinfeld, U, Tov, N, Odeh, M, Gaitini, L, Schwartz, AR & Kimmel, E 2010, 'Mechanical parameters determining pharyngeal collapsibility in patients with sleep apnea', Journal of Applied Physiology, vol. 109, no. 4, pp. 1037-1044. https://doi.org/10.1152/japplphysiol.00019.2010
Oliven, Arie ; Kaufman, Eran ; Kaynan, Rotem ; Oliven, Ron ; Steinfeld, Uri ; Tov, Nave ; Odeh, Majed ; Gaitini, Luis ; Schwartz, Alan R ; Kimmel, Eitan. / Mechanical parameters determining pharyngeal collapsibility in patients with sleep apnea. In: Journal of Applied Physiology. 2010 ; Vol. 109, No. 4. pp. 1037-1044.
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