Effect of nasal or oral breathing route on upper airway resistance during sleep

Fitzpatrick, Michael; McLean, Heather; Urton, A M; Tan, Alfonse; OʼDonnell, Dennis; Driver, Helen S.

doi:10.1183/09031936.03.00047903

Cited by 221 publications

(163 citation statements)

References 42 publications

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“…In 1 study of sleep in normal subjects, upper airway resistance was shown to be lower with imposed nasal breathing than with imposed oral breathing, in contrast to the supine and upright awake states, in which nasal resistance is higher than oral resistance. In normal sleeping subjects, nasal breathing is expected to be the preferred route, unless it is impaired and associated with increased work of breathing or destabilized ventilation, in which case a switch to the oral route may be seen [23,24].…”

Section: Nasal Surgerymentioning

confidence: 99%

Surgical Therapy of Obstructive Sleep Apnea: A Review

2012

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Obstructive sleep apnea (OSA) is a disease characterized by intermittent and repetitive narrowing of the airway during sleep. Surgical therapies for the treatment of OSA aim to improve airway patency by addressing selected site(s) of obstruction. Because several areas may each be responsible for the narrowing, different surgical modalities have also been developed. In this review, we give an overview of surgery for each of potential obstruction site(s). As a consequence of the multi-factorial and heterogeneous etiology of OSA, surgical therapies need to be selected and performed specifically for each patient, as there is no perfect surgery that will fit all patients. As with any other treatment modalities for OSA, surgical therapies have variable efficacy, but are a very important tool on OSA management in selected patients and have been shown effectiveness in decreasing the morbidity and mortality associated with the disease.

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Section: Nasal Surgerymentioning

confidence: 99%

Surgical Therapy of Obstructive Sleep Apnea: A Review

2012

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“…1 It has been reported that upper airway collapsibility and resistance during sleep were significantly higher in subjects who were breathing through the mouth than in those who were breathing through the nose, which is different from that seen during the conscious state. 2,3 Other reasons for nasal breathing over mouth breathing during normal sleep are based on the physiological effects of decreased nasal airflow. First, bypassing the nasal airway can lead to reduced nasal receptor activation, deactivation of the nasal ventilatory reflex, and reduced spontaneous ventilation.…”

Section: Of Patterns the Nasal Airway And Sdbmentioning

confidence: 99%

“…Mouth opening increased upper airway collapsibility during sleep, which is different from that seen when awake. 2 Fitzpatrick et al 3 confi rmed that during sleep, upper airway resistance during oral breathing was 2.5 times higher than that during nasal breathing. Mouth opening may be associated with narrowing of the pharyngeal lumen and decreases in the retroglossal diameter.…”

mentioning

confidence: 99%

Relationship between Oral Flow Patterns, Nasal Obstruction, and Respiratory Events during Sleep

Suzuki

Furukawa

Sugimoto

et al. 2015

Journal of Clinical Sleep Medicine

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We conducted an observational cross-sectional study of 85 Japanese adult patients examined by our sleep laboratory for Study Objectives: Sleep breathing patterns are altered by nasal obstruction and respiratory events. This study aimed to describe the relationships between specifi c sleep oral fl ow (OF) patterns, nasal airway obstruction, and respiratory events. Methods: Nasal fl ow and OF were measured simultaneously by polysomnography in 85 adults during sleep. OF was measured 2 cm in front of the lips using a pressure sensor. Results: OF could be classifi ed into three patterns: postrespiratory event OF (postevent OF), during-respiratory event OF (during-event OF), and spontaneous arousal-related OF (SpAr-related OF). Postevent OFs begin at the end of airfl ow reduction, are preceded by respiratory arousal, and are accompanied by postapneic hyperventilation; duringevent OFs occur during nasal fl ow reduction; and SpAr-related OFs to OF begin during stable breathing, and are preceded by spontaneous arousal but are rarely accompanied by apnea/hypopnea. Multivariate regression showed that nasal obstruction was predictive of SpAr-related OF. The relative frequency of SpAr-related OF events was negatively correlated with the apnea-hypopnea index. The fraction of SpAr-related OF duration relative to total OF duration was signifi cantly greater in patients with nasal obstruction than in those without. Conclusions: SpAr-related OF was associated with nasal obstruction, but not respiratory events. This pattern thus functions as a "nasal obstruction bypass", mainly in normal subjects and patients with mild sleep disordered breathing (SDB). By contrast, the other two types were related to respiratory events and were typical patterns seen in patients with moderate and severe SDB. 1 showed that oral breathing during sleep is induced by increased nasal resistance. Mouth opening increased upper airway collapsibility during sleep, which is different from that seen when awake.2 Fitzpatrick et al. 3 confi rmed that during sleep, upper airway resistance during oral breathing was 2.5 times higher than that during nasal breathing. Mouth opening may be associated with narrowing of the pharyngeal lumen and decreases in the retroglossal diameter. Mouth opening and oral breathing may, but not necessarily, lead to hypopnea or apnea. However, Lavie et al. 4 showed that nasal obstruction caused a signifi cant increase in the number of arousals during sleep in patients with nonapneic breathing disorders. In another recent study, Hsia et al.5 described a snoring pattern during nasal breathing in patients with nasal obstruction that was alleviated with oral breathing.Against this background, we hypothesized that different kinds of oral fl ow (OF) patterns exist during sleep and are associated with distinct sleep related respiratory events. The BRIEF SUMMARYCurrent Knowledge/Study Rationale: The relationship between oral fl ow (OF) patterns, nasal obstruction, and obstructive respiratory events is unclear. We hypothesized that specifi c O...

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“…• Nocturnal mouth breathing (which is sometimes occurs in the daytime) reflects an obstruction in the nasal air passageways and the preferred route of air to reach the lungs; it implies a greater resistance to nasal air flow than to buccal air flow 26 . In healthy children, the resistance to passage of air through the mouth is greater than it is through the nose 44 and 70% of inspired air, accordingly, takes the nasal route; but in children suffering from apnea mouth breathing is a protective mechanism that is a detour around the nasal obstacles.…”

Section: -1 -Nocturnal Symptomsmentioning

confidence: 99%

How to detect Obstructive Sleep Apnea Syndrome (OSAS) in children

Seailles¹,

Couloigner²,

Cohen-Lévy³

2009

J Dentofacial Anom Orthod

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Obstructive Sleep Apnea Syndrome (OSAS) is a frequently occurring childhood malady, whose is incidence is largely underestimated, that can lead to serious complications. Because of their understanding of the anatomy and physiology of the masticatory apparatus and of the upper airways, orthodontist are in a strategic position to detect in their young patients developing disorders in these regions; accordingly when they suspect the existence of OSAS they should ask systematic and well targeted questions of parents who may not be aware of the relationship between certain symptoms their children display and sleep breathing problems. The goal of this article is to provide practitioners with a better understanding of the symptoms and the physio-pathological mechanics of OSAS so that they can spare their afflicted patients the complications it provokes by seeing that early treatment is undertaken. KEYWORDSObstructive sleep apnea syndrome Children Diagnosis Polysomnography.

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Effect of nasal or oral breathing route on upper airway resistance during sleep

Cited by 221 publications

References 42 publications

Surgical Therapy of Obstructive Sleep Apnea: A Review

Surgical Therapy of Obstructive Sleep Apnea: A Review

Relationship between Oral Flow Patterns, Nasal Obstruction, and Respiratory Events during Sleep

How to detect Obstructive Sleep Apnea Syndrome (OSAS) in children

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