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Oropharyngeal obstruction and respiratory system compliance are linked to ventilatory control parameters in pediatric

Plamen Bokov1, Imene Boujemla2, Boris Matrot3

  • 1Service de Physiologie Pédiatrique-Centre du Sommeil, AP-HP, Hôpital Robert Debré, INSERM NeuroDiderot, Université de Paris-Cité, 48, Boulevard Sérurier, 75019, Paris, France. plamen.bokov@aphp.fr.

Scientific Reports
|October 15, 2022
PubMed

Insights

In children with obstructive sleep apnea syndrome (OSAS), oropharyngeal obstruction is linked to unstable breathing control. Lower airway compliance also impacts ventilatory control in these children.

Area of Science:

  • Pediatric Pulmonology
  • Respiratory Physiology
  • Sleep Medicine

Background:

  • Obstructive sleep apnea syndrome (OSAS) in children is characterized by unstable ventilatory control.
  • Anatomical factors in both upper and lower airways may influence this instability.

Purpose of the Study:

  • To investigate the relationship between upper and lower airway anatomy and ventilatory control in children with moderate to severe OSAS.
  • To determine if oropharyngeal and nasal compromise affect chemical loop gain.

Main Methods:

  • Fifty children with moderate to severe OSAS underwent ENT examination and respiratory system impedance measurements.
  • Ventilatory control parameters, including steady-state controller gain (CG0) and loop gain (LG0), were calculated using a physiologically constrained model.
  • Peripheral lung mechanics were characterized using the extended Resistance-Inertance-Compliance model.

Main Results:

  • Oropharyngeal obstruction was significantly associated with decreased CG0 and LG0.
  • Nasal obstruction did not show a significant impact on ventilatory control parameters.
  • Multivariate analysis revealed a negative relationship between Medium-Frequency PG, minute ventilation, and respiratory system compliance.

Conclusions:

  • Oropharyngeal compromise, specifically tonsil hypertrophy, is linked to impaired ventilatory control in children with OSAS.
  • Lower airway characteristics, such as respiratory system compliance, also play a role in ventilatory control instability in this population.

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