Laura H White1, Shveta Motwani1, Takatoshi Kasai1, Dai Yumino1, Vinoban Amirthalingam1, T Douglas Bradley2. 1. Sleep Research Laboratory, Toronto Rehabilitation Institute, Canada; Sleep Research Laboratory, Mount Sinai Hospital, Canada. 2. Sleep Research Laboratory, Toronto Rehabilitation Institute, Canada; Sleep Research Laboratory, Mount Sinai Hospital, Canada; Sleep Research Laboratory, Centre for Sleep Medicine and Circadian Biology of the University of Toronto, Canada; Sleep Research Laboratory, Department of Medicine of the University Health Network Toronto General Hospital, Canada. Electronic address: douglas.bradley@utoronto.ca.
Abstract
BACKGROUND:Obstructive sleep apnea (OSA) relates to overnight rostral fluid shift, possibly because fluid accumulation around the pharynx increases pharyngeal resistance (Rph). We hypothesised that Rph will increase more in men with than without OSA in response to rostral fluid redistribution. METHODS:Seventeen men with, and 12 without OSA were randomized to lower body positive pressure (LBPP) for 15min or control, then crossed over. Leg fluid volume (LFV) and Rph were measured before and after each period. RESULTS:LBPP displaced similar amounts of fluid from the legs in both groups. However, compared to the non-OSA group, Rph increased significantly more during LBPP in the OSA group (-0.38±2.87 vs. 2.52±2.94cmH2O/l/s, p=0.016). Change in Rph during LBPP correlated directly with baseline Rph in the OSA group, but inversely in the non-OSA group. CONCLUSION:OSA patients have increased susceptibility to pharyngeal obstruction in response to rostral fluid redistribution, which could predispose to pharyngeal collapse during sleep.
RCT Entities:
BACKGROUND:Obstructive sleep apnea (OSA) relates to overnight rostral fluid shift, possibly because fluid accumulation around the pharynx increases pharyngeal resistance (Rph). We hypothesised that Rph will increase more in men with than without OSA in response to rostral fluid redistribution. METHODS: Seventeen men with, and 12 without OSA were randomized to lower body positive pressure (LBPP) for 15min or control, then crossed over. Leg fluid volume (LFV) and Rph were measured before and after each period. RESULTS: LBPP displaced similar amounts of fluid from the legs in both groups. However, compared to the non-OSA group, Rph increased significantly more during LBPP in the OSA group (-0.38±2.87 vs. 2.52±2.94cmH2O/l/s, p=0.016). Change in Rph during LBPP correlated directly with baseline Rph in the OSA group, but inversely in the non-OSA group. CONCLUSION: OSA patients have increased susceptibility to pharyngeal obstruction in response to rostral fluid redistribution, which could predispose to pharyngeal collapse during sleep.
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