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Upper airway and soft tissue structural changes induced by CPAP in normal subjects
R J Schwab1, A I Pack, K B Gupta
1Pulmonary and Critical Care Division in the Department of Medicine, University of Pennsylvania Medical Center, Philadelphia, USA.
American Journal of Respiratory and Critical Care Medicine
|October 1, 1996
Summary
Nasal continuous positive airway pressure (CPAP) therapy widens the upper airway by reducing lateral pharyngeal wall thickness. This study reveals CPAP
Area of Science:
- Sleep Medicine
- Respiratory Physiology
- Medical Imaging
Background:
- Nasal continuous positive airway pressure (CPAP) is a primary treatment for obstructive sleep apnea.
- While CPAP increases upper airway size, its precise effects on surrounding soft tissues are not fully understood.
Purpose of the Study:
- To investigate the direct effects of varying nasal CPAP levels on the upper airway and adjacent soft tissues.
- To determine how CPAP influences the dimensions and compliance of pharyngeal structures.
Main Methods:
- Utilized magnetic resonance imaging (MRI) to assess upper airway changes.
- Studied 10 healthy subjects at incremental CPAP levels (0, 5, 10, 15 cm H2O).
- Measured airway volume, area, and soft tissue dimensions in the retropalatal and retroglossal regions.
Main Results:
- Progressive CPAP increases led to greater lateral than anterior-posterior airway and soft tissue dimensional changes.
- Lateral pharyngeal wall thickness decreased, inversely related to CPAP level.
- Increased distance between lateral parapharyngeal fat pads observed, indicating lateral wall "compliance".
Conclusions:
- The lateral pharyngeal walls exhibit greater compliance to CPAP than the soft palate and tongue.
- Findings support the critical role of lateral pharyngeal walls in regulating upper airway caliber during CPAP therapy.