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Upper airway collapsibility during wakefulness in children with sleep disordered breathing, as determined by the

Helena Larramona Carrera1, Joseph M McDonough, Paul R Gallagher

  • 1Corporacio Sanitaria Parc Taulí, Sabadell, Spain.

Sleep
|June 2, 2011
PubMed

Insights

The negative expiratory pressure (NEP) technique can identify children with sleep disordered breathing (SDB), including snoring and obstructive sleep apnea syndrome (OSAS), by detecting upper airway collapsibility during wakefulness.

Area of Science:

  • Pediatric Pulmonology
  • Sleep Medicine
  • Respiratory Physiology

Background:

  • Upper airway (UA) collapsibility is a key factor in sleep disordered breathing (SDB) pathophysiology.
  • Distinguishing SDB from normal breathing patterns is crucial for diagnosis and treatment.

Purpose of the Study:

  • To investigate if the negative expiratory pressure (NEP) technique can differentiate children with SDB from healthy children during wakefulness.
  • To assess UA collapsibility in children with snoring and obstructive sleep apnea syndrome (OSAS) using NEP.

Main Methods:

  • The study involved 60 children: 20 with snoring, 20 with OSAS, and 20 controls.
  • Negative expiratory pressure (NEP) of -5 and -10 cm H2O was applied during expiration in seated and supine positions.
  • Upper airway muscle activity (EMG) was measured, and the ratio of expiratory flow-volume curves during NEP to tidal breathing (RatioNEP) was calculated.

Main Results:

  • RatioNEP significantly differed between controls and children with SDB (snorers and OSAS) in both seated and supine positions (P < 0.0001).
  • No significant differences in RatioNEP were found between the snoring and OSAS groups.
  • No significant differences in upper airway muscle activity (RatioEMG) were observed between any of the groups.

Conclusions:

  • The NEP technique effectively distinguishes children with SDB (snoring or OSAS) from normal children, indicating increased UA collapsibility even during wakefulness.
  • The NEP technique does not differentiate between snoring and OSAS, suggesting other factors like UA muscle activity during sleep are important.
  • NEP does not elicit different UA muscle activity responses between SDB and control groups.
Abstract

Keywords:
Obstructive sleep apneaelectromyogramsnoring

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