The influence of aging on pharyngeal collapsibility during sleep
The influence of aging on pharyngeal collapsibility during sleep
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DOI：
10.1378/chest.06-2653
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发表时间：
2007-06-01
期刊：
影响因子：
9.6
通讯作者：
Malhotra, Atul
中科院分区：
文献类型：
--
作者：
Eikermann, Matthias;Jordan, Amy S.;Malhotra, Atul
背景：衰老会增加患阻塞性睡眠呼吸暂停（OSA）的可能性，但其潜在机制仍不清楚。最近在清醒的健康志愿者中的数据显示，随着年龄的增长，颏舌肌负压反射和解剖学损害会减少，这表明与年龄相关的咽塌陷倾向。然而，睡眠期间衰老对咽塌陷的影响尚未得到广泛研究。我们测试了上气道关闭压 (P-CLOSE) 和睡眠期间咽部阻力增加（主要结果）以及唤醒阈值（次要结果）随着年龄的增长而增加的假设。 方法：我们研究了 21 名健康个体（8 名女性 [平均 (+/- SD) 年龄，36 +/- 18 岁] 和 13 名男性 [平均年龄，41-23 岁]），年龄介于 IS 和 75 岁之间。 年龄。在夜间多导睡眠监测期间，我们测量了气道闭塞（外阀）之前和之后的第二阶段睡眠期间的鼻压 (PMASK) 和会厌压 (PEPI)，直至觉醒。 PCLOSE 定义为尽管 PEPI 进一步下降，PMASK 仍保持稳定的压力。 结果：年龄的增加与咽部塌陷性 ([PCLOSE] r = 0.69；p < 0.01) 和睡眠期间咽部阻力的增加 (r = 0.56；p < 0.01) 相关，与体重指数 (BMI) 和性别无关。没有证据表明年龄对第 2 阶段睡眠期间气道闭塞后的唤醒阈值有影响。结论：年龄较大与睡眠期间咽部气道塌陷性增加相关，与性别和 BMI 无关。这些数据至少可以部分解释老年人咽塌陷倾向的潜在机制。
Background: Aging increases vulnerability to obstructive sleep apnea (OSA), but the underlying mechanisms remain unclear. Recent data in awake healthy volunteers show a decrease in the genioglossus negative pressure reflex and anatomic compromise with increasing age, suggesting an age-related predisposition to pharyngeal collapse. However, aging effects on pharyngeal collapsibility have not been studied extensively during sleep. We tested the hypotheses that upper airway closing pressure (P-CLOSE) and the increase in pharyngeal resistance during sleep (primary outcomes) as well as measures of arousal threshold (secondary outcomes) increase with age.Methods: We studied 21 healthy individuals (8 women [mean (+/- SD) age, 36 +/- 18 years] and 13 men [mean age, 41 23 years]) who were between IS and 75 years of age. During overnight polysommography, we measured nasal pressure (PMASK) and epiglottic pressure (PEPI) during stage 2 sleep before and after airway occlusion (external valve) until arousal. PCLOSE was defined as the pressure at which PMASK plateaued despite further decreases in PEPI.Results: Increasing age was correlated with both pharyngeal collapsibility ([PCLOSE] r = 0.69; p < 0.01) and an increase in pharyngeal resistance during sleep (r = 0.56; p < 0.01) independent of body mass index (BMI) and gender. There was no evidence for an effect of age on arousal threshold after airway occlusion during stage 2 sleep.Conclusions: Older age is associated with increased pharyngeal airway collapsibility during sleep independent of gender and BMI. These data may at least partially explain the mechanisms underlying the predisposition for pharyngeal collapse in the elderly.