Esophageal and mouth pressure during sniffs with and without nasal occlusion

The sniff maneuver has recently been advocated for assessing inspiratory muscle strength. We characterized the relationship between mouth pressure (Pmo) and esophageal pressure (Pes) during sniffs performed with open, semi-occluded, and occluded nose. In seven normal subjects, pressure was simultaneously measured with a mouthpiece (Pmo) an esophageal balloon (Pes) during high- and low-intensity sniffs performed from FRC. With open nose, the mean ratio Pmo/Pes was 0.96 +/- 0.05 (mean +/- SE). The mean ratio Pmo/Pes was not significantly different in high- and low-intensity sniffs. With one nostril occluded, the mean ratio Pmo/Pes was 1.03 +/- 0.04. The ratio Pmo/Pes was significantly higher than with open nose for all sniffs (P less than 0.05) and low-intensity sniffs (P less than 0.01). With both nostrils occluded, the mean ratio Pmo/Pes was 1.06 +/- 0.03, with occasional marked overestimation of Pes by Pmo. We conclude that Pmo generally reflects Pes during sniffs performed with open and semi-occluded nose, but not with complete nasal occlusion.