Related Experiment Video
Updated: Jul 16, 2026
07:54
Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Mouth Closure and Airflow in Patients With Obstructive Sleep Apnea: A Nonrandomized Clinical Trial
Hyungchae Yang1,2, Phillip Huyett3, Tsai-Yu Wang1,4
1Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School and Chonnam National University Hospital, Gwangju, Republic of Korea.
JAMA Otolaryngology-- Head & Neck Surgery
|October 3, 2024
Summary
Closing the mouth during sleep improved inspiratory airflow overall for patients with obstructive sleep apnea (OSA). However, this intervention worsened airflow in those with high levels of mouth breathing and velopharyngeal obstruction, suggesting personalized treatment is key.
Area of Science:
- Sleep Medicine
- Respiratory Physiology
Background:
- Mouth breathing during sleep is linked to increased airway resistance, pharyngeal collapsibility, and obstructive sleep apnea (OSA) severity.
- While closing the mouth is commonly believed to alleviate negative effects, it may impede essential airflow bypassing nasal obstructions.
Purpose of the Study:
- To investigate the role of mouth breathing as a compensatory airway route in OSA patients.
- To assess the association between upper airway anatomical factors and the effect of mouth closure on airflow.
Main Methods:
- A nonrandomized clinical trial involving 54 OSA patients undergoing drug-induced sleep endoscopy.
- Patients were stratified into three quantiles based on their baseline oral breathing levels.
- The primary outcome was the change in total inspiratory airflow upon mouth closure.
Main Results:
- Mouth closure increased total inspiratory flow by 27.8% overall.
- Airflow improved in moderate mouth breathers but worsened significantly in severe mouth breathers, particularly those with velopharyngeal obstruction.
- Velopharyngeal obstruction correlated with increased mouth breathing and reduced airflow upon mouth closure.
Conclusions:
- Mouth closure can increase inspiratory airflow in OSA patients, but the effect is heterogeneous.
- In patients with significant mouth breathing and velopharyngeal obstruction, mouth closure can exacerbate airflow limitation.
- Personalized treatment strategies are crucial for managing mouth breathing in OSA.
Related Concept Videos
01:16Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen
Oxygen therapy is a pivotal aspect of medical care, particularly for patients with respiratory ailments. Two prominent oxygen-delivering systems include the Venturi mask and the transtracheal oxygen catheter.
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...
01:29Suctioning the Nasopharyngeal Airway
Nasopharyngeal suctioning is a procedure to remove secretions from the upper part of the respiratory tract that the patient cannot clear independently. It helps maintain airway patency and prevents complications such as aspiration pneumonia.
Equipment Required
Equipment Required
01:23Mechanical Ventilation III: Noninvasive Ventilation
Noninvasive positive-pressure ventilation (NIPPV), continuous positive airway pressure (CPAP), and bilevel positive airway pressure (BiPAP) are essential methods in respiratory care. These ventilation techniques offer unique benefits for patients with various respiratory conditions, providing adequate support without requiring intubation. Let's explore how each method is crucial in improving patient outcomes and enhancing respiratory therapy.
Noninvasive Positive-Pressure Ventilation (NIPPV)
Noninvasive Positive-Pressure Ventilation (NIPPV)
01:25Suctioning the Oropharyngeal Airway
In preparing for oropharyngeal airway suctioning, a nurse must gather all necessary equipment, including a suction unit with tubing, a prepackaged suction kit, sterile gloves, water or saline for irrigation, a water-soluble lubricant, and additional personal protective equipment (such as a gown, mask, and goggles) to control infections.
After assembling the equipment, the nurse should practice hand hygiene and don appropriate PPE according to infection control guidelines to avoid the...
After assembling the equipment, the nurse should practice hand hygiene and don appropriate PPE according to infection control guidelines to avoid the...
01:21Sleep Apnea
Sleep apnea is a condition where breathing stops intermittently during sleep, often leading to significant health issues. Each episode can last from 10 to 20 seconds or more and is frequently accompanied by a brief arousal from sleep. This disturbance, largely unnoticed by the individual, can lead to severe daytime fatigue. Commonly, individuals seek help after being informed by their partners about loud snoring and noticeable breathing pauses during sleep.
The condition is more prevalent among...
The condition is more prevalent among...
01:22Cardiopulmonary Resuscitation II: ACLS Airway Management
Airway management is a key skill in emergency and critical care settings, as maintaining a clear airway is essential for adequate oxygenation and ventilation.Head Tilt-Chin Lift TechniqueThe head tilt-chin lift maneuver is an essential technique primarily used in patients without suspected cervical spine injuries. To perform this maneuver, one hand is placed on the patient’s forehead, and gentle pressure is applied backward to tilt the head. The fingertips of the other hand are positioned under...