Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/57960
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Type: Journal article
Title: Abdominal compression increases upper airway collapsibility during sleep in obese male obstructive sleep apnea patients
Author: Stadler, D.
McEvoy, R.
Sprecher, K.
Thomson, K.
Ryan, M.
Thompson, C.
Catcheside, P.
Citation: Sleep, 2009; 32(12):1579-1587
Publisher: Amer Academy Sleep Medicine
Issue Date: 2009
ISSN: 0161-8105
1550-9109
Statement of
Responsibility: 
Daniel L. Stadler, R. Doug McEvoy, Kate E. Sprecher, Kieron J. Thomson, Melissa K. Ryan, Courtney C. Thompson, Peter G. Catcheside
Abstract: <h4>Study objectives</h4>Abdominal obesity, particularly common in centrally obese males, may have a negative impact on upper airway (UA) function during sleep. For example, cranial displacement of the diaphragm with raised intra-abdominal pressure may reduce axial tension exerted on the UA by intrathoracic structures and increase UA collapsibility during sleep.<h4>Design</h4>This study aimed to examine the effect of abdominal compression on UA function during sleep in obese male obstructive sleep apnea patients.<h4>Setting</h4>Participants slept in a sound-insulated room with physiologic measurements controlled from an adjacent room.<h4>Participants</h4>Fifteen obese (body mass index: 34.5 +/- 1.1 kg/m2) male obstructive sleep apnea patients (apnea-hypopnea index: 58.1 +/- 6.8 events/h) aged 50 +/- 2.6 years participated.<h4>Interventions</h4>Gastric (PGA) and transdiaphragmatic pressures (P(DI)), UA closing pressure (UACP), UA airflow resistance (R(UA)), and changes in end-expiratory lung volume (EELV) were determined during stable stage 2 sleep with and without abdominal compression, achieved via inflation of a pneumatic cuff placed around the abdomen. UACP was assessed during brief mask occlusions.<h4>Measurements and results</h4>Abdominal compression significantly decreased EELV by 0.53 +/- 0.24 L (P=0.045) and increased PGA (16.2 +/- 0.8 versus 10.8 +/- 0.7 cm H2O, P < 0.001), P(DI) (11.7 +/- 0.9 versus 7.6 +/- 1.2 cm H2O, P < 0.001) and UACP (1.4 +/- 0.8 versus 0.9 +/- 0.9 cm H2O, P = 0.039) but not R(UA)(6.5 +/- 1.4 versus 6.9 +/- 1.4 cm H2O x L/s, P=0.585).<h4>Conclusions</h4>Abdominal compression negatively impacts on UA collapsibility during sleep and this effect may help explain strong associations between central obesity and obstructive sleep apnea.
Keywords: Obstructive sleep apnea; abdominal loading; lung volume; caudal traction
Rights: Copyright © 2009 by the Associated Professional Sleep Societies, LLC
RMID: 0020094087
DOI: 10.1093/sleep/32.12.1579
Description (link): http://www.ncbi.nlm.nih.gov/pubmed/20041593
Appears in Collections:Physiology publications

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