Alice Hatt1, Elizabeth Brown1,2, David J Berlowitz3,4, Fergal O'Donoghue3,4,5, Hailey Meaklim3, Alan Connelly5, Graeme Jackson5, Kate Sutherland6,7, Peter A Cistulli6,7, Bon San Bonne Lee1,2, Lynne E Bilston1,8. 1. Neuroscience Research Australia, Randwick, Australia. 2. Prince of Wales Hospital, Randwick, Australia. 3. Institute for Breathing and Sleep, Austin Health, Heidelberg, Australia. 4. Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia. 5. The Florey Institute of Neuroscience and Menta l Health, Melbourne Brain Centre, Heidelberg, Australia. 6. Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, St. Leonards, Australia. 7. Charles Perkins Centre, University of Sydney, St. Leonards, Australia. 8. University of New South Wales, Randwick, Australia.
Abstract
Context/objective: Obstructive sleep apnoea (OSA) develops soon after cervical spinal cord injury (SCI) at rates higher than the general population, but the mechanisms are not understood. This study aimed to determine whether OSA in SCI is associated with altered pharyngeal muscle dilatory mechanics during quiet breathing, as has been observed in the non-SCI injured with obstructive sleep apnoea.Design: Cross sectional imaging study.Setting: Medical research institute.Participants: Eight cervical SCI patients with OSA were recruited and compared to 13 able-bodied OSA patients and 12 able-bodied healthy controls of similar age and BMI.Interventions and outcome measures: 3T MRI scans of upper airway anatomy and tagged-MRI to characterize airway muscle motion during quiet breathing were collected for analysis. Results: Considerable variation in the patterns of inspiratory airway muscle motion was observed in the SCI group, with some participants exhibiting large inspiratory airway dilatory motions, and others exhibiting counterproductive narrowing during inspiration. These patterns were not dissimilar to those observed in the able-bodied OSA participants. The increase in airway cross-sectional area of able-bodied control participants was proportional to increase in BMI, and a similar, but not significant, relationship was present in all groups. Conclusion: Despite the limited sample size, these data suggest that SCI OSA patients have heterogeneous pharyngeal dilator muscle responses to the negative pressures occurring during inspiration but, as a group, appear to be more similar to able-bodied OSA patients than healthy controls of similar age and BMI. This may reflect altered pharyngeal pressure reflex responses in at least some people with SCI.
Context/objective: Obstructive sleep apnoea (OSA) develops soon after cervical spinal cord injury (SCI) at rates higher than the general population, but the mechanisms are not understood. This study aimed to determine whether OSA in SCI is associated with altered pharyngeal muscle dilatory mechanics during quiet breathing, as has been observed in the non-SCI injured with obstructive sleep apnoea.Design: Cross sectional imaging study.Setting: Medical research institute.Participants: Eight cervical SCI patients with OSA were recruited and compared to 13 able-bodied OSA patients and 12 able-bodied healthy controls of similar age and BMI.Interventions and outcome measures: 3T MRI scans of upper airway anatomy and tagged-MRI to characterize airway muscle motion during quiet breathing were collected for analysis. Results: Considerable variation in the patterns of inspiratory airway muscle motion was observed in the SCI group, with some participants exhibiting large inspiratory airway dilatory motions, and others exhibiting counterproductive narrowing during inspiration. These patterns were not dissimilar to those observed in the able-bodied OSA participants. The increase in airway cross-sectional area of able-bodied control participants was proportional to increase in BMI, and a similar, but not significant, relationship was present in all groups. Conclusion: Despite the limited sample size, these data suggest that SCI OSA patients have heterogeneous pharyngeal dilator muscle responses to the negative pressures occurring during inspiration but, as a group, appear to be more similar to able-bodied OSA patients than healthy controls of similar age and BMI. This may reflect altered pharyngeal pressure reflex responses in at least some people with SCI.
Authors: E Stockhammer; A Tobon; F Michel; P Eser; W Scheuler; W Bauer; M Baumberger; W Müller; T H Kakebeeke; H Knecht; G A Zäch Journal: Spinal Cord Date: 2002-06 Impact factor: 2.772
Authors: David J Berlowitz; Rachel Schembri; Marnie Graco; Jacqueline M Ross; Najib Ayas; Ian Gordon; Bonne Lee; Allison Graham; Susan V Cross; Martin McClelland; Paul Kennedy; Pradeep Thumbikat; Cynthia Bennett; Andrea Townson; Timothy J Geraghty; Sue Pieri-Davies; Raj Singhal; Karen Marshall; Deborah Short; Andrew Nunn; Duncan Mortimer; Doug Brown; Robert J Pierce; Peter A Cistulli Journal: Thorax Date: 2018-12-11 Impact factor: 9.139