Relationship between upper airway and inspiratory pump muscle force in obstructive sleep apnea

Kelly L. Shepherd; Cathryn M. Jensen; Kathleen J. Maddison; David R. Hillman; Peter R. Eastwood

doi:10.1378/chest.130.6.1757

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Relationship between upper airway and inspiratory pump muscle force in obstructive sleep apnea

Journal article

Peer reviewed

Relationship between upper airway and inspiratory pump muscle force in obstructive sleep apnea

Kelly L. Shepherd, Cathryn M. Jensen, Kathleen J. Maddison, David R. Hillman and Peter R. Eastwood

Chest, Vol.130(6), pp.1757-1764

2006

DOI: https://doi.org/10.1378/chest.130.6.1757

PMID: 17166993

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Abstract

collapsibility

diaphragm

genioglossus

obstructive sleep apnea

respiratory muscle strength

tongue protrusion

upper airway

Background Upper airway (UA) patency during inspiration is determined by the balance between dilating forces generated by UA dilator muscle activity and collapsing forces related to the decreased intraluminal pressure that accompanies flow generated by inspiratory muscle activity. It is possible that the relative strengths of UA dilator and inspiratory pump muscles could be an important determinant of the susceptibility to UA collapse during sleep (ie, obstructive sleep apnea [OSA]). Methods Measurements of tongue protrusion (TP) force and maximum inspiratory pressure (Pimax) were obtained in 94 patients admitted for overnight polysomnography for suspected OSA, quantified by apnea-hypopnea index (AHI). Results There was a direct linear relationship between TP force and Pimax (r2 = 0.37, p < 0.001). A high ratio of TP force to Pimax (greater than group 90th percentile, 0.027 kg/cm H2O) appeared to protect against OSA, as moderate-to-severe OSA (AHI > 20/h) was not observed in any individual with a ratio above this threshold. AHI was not linearly related to TP force, Pimax, or the ratio of TP force to Pimax. Conclusions UA muscle strength is linearly related to inspiratory pump muscle strength. The ratio of UA muscle strength (TP force) and inspiratory pump muscle strength (Pimax) was not different between individuals with and without OSA; however, a high wakeful ratio of TP force to Pimax appears to be associated with a reduced propensity to moderate-to-severe OSA.

Details

Title: Relationship between upper airway and inspiratory pump muscle force in obstructive sleep apnea
Authors/Creators: Kelly L. Shepherd - West Australian Sleep Disorders Research Institute
Cathryn M. Jensen - Sir Charles Gairdner Hospital
Kathleen J. Maddison - West Australian Sleep Disorders Research Institute
David R. Hillman - West Australian Sleep Disorders Research Institute
Peter R. Eastwood - The University of Western Australia
Publication Details: Chest, Vol.130(6), pp.1757-1764
Publisher: Elsevier Inc
Identifiers: 991005592643107891
Murdoch Affiliation: Vice Chancellery
Language: English
Resource Type: Journal article

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Collaboration types: Domestic collaboration
Citation topics: 1 Clinical & Life Sciences; 1.137 Sleep Science & Circadian Systems; 1.137.382 Obstructive Sleep Apnea
Web Of Science research areas: Critical Care Medicine; Respiratory System
ESI research areas: Clinical Medicine