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Load detection in subjects with sleep-induced upper airway obstruction
A A Clerk1, S R Dunan, C Guilleminault
1Stanford University Sleep Disorders Clinic, CA.
Summary
Nonobese individuals with obstructive sleep apnea and snorers show no difference in detecting inspiratory resistive loads compared to controls. This finding suggests respiratory load detection is preserved in nonobese patients with sleep-disordered breathing.
Area of Science:
- Respiratory Physiology
- Sleep Medicine
- Sensory Perception
Background:
- Impaired respiratory flow-resistive load detection is documented in obese individuals.
- The impact on nonobese patients with sleep-disordered breathing remains less understood.
Purpose of the Study:
- To investigate differences in inspiratory flow-resistive load detection between nonobese obstructive sleep apnea (OSA) patients, nonobese snorers, and normal control subjects.
- To test the hypothesis of no difference in load detection capabilities across these groups.
Main Methods:
- Nocturnal polysomnography with esophageal pressure (Pes) measurement was used.
- Awake pulmonary function tests, including airway resistance (Raw) and lung volumes via plethysmography, were conducted.
- Resistive load detection was assessed using standardized methods, determining the resistance for a 0.5 probability of detection (Weber fraction).
Main Results:
- No significant differences were found in inspiratory flow-resistive load detection between nonobese OSA patients, nonobese snorers, and normal control subjects.
- The Weber fraction, a measure of load detection sensitivity, was comparable across all groups.
- Severely obese patients (BMI > 35 kg/m2) were excluded from the study.
Conclusions:
- Inspiratory flow-resistive load detection is not impaired in nonobese patients with obstructive sleep apnea or in nonobese snorers compared to healthy controls.
- These findings indicate that respiratory load perception is preserved in nonobese individuals with sleep-disordered breathing.