CRITICAL PRESSURES IN THE HUMAN UPPER AIRWAY

目前的证据表明，岩浆的可崩性受到干扰 阻塞性睡眠呼吸暂停患者睡眠时存在上呼吸道 和清醒。这项提议，通过应用流动的概念 可折叠管子(Starling电阻器)，将检查 正常人和慢性阻塞性肺疾病患者的上呼吸道 阻塞性睡眠呼吸暂停。这项建议是基于初步的 观察表明，在睡眠期间，正常人和 阻塞性睡眠呼吸暂停的患者可以通过不同的区别加以区分 在上呼吸道的塌陷性中，如反映在 上呼吸道的临界压力(P-Crit)。为了调查 P-Crit在健康和疾病(阻塞性睡眠呼吸暂停)中的作用，我们将 改变喷嘴上游压力以确定喷嘴的临界压力 上呼吸道。我们的第一个具体目标是确定 正常人、打鼾者的临界压力以及 阻塞性睡眠呼吸暂停患者。由于更多数据表明 上呼吸道临界压力异常反映上呼吸道功能紊乱 阻塞性睡眠呼吸暂停患者的气道塌陷性 具体目标将是确定降低严重程度的因素 睡眠呼吸暂停导致P-Crit的平行下降。具体来说，我们 将研究减肥和丙替林对上肢的影响 呼吸道P-Crit。我们的第三个具体目标将是确定 增加睡眠呼吸暂停严重程度的因素导致平行上升 上呼吸道的临界压力(P-Crit)。最后，我们的第四个 具体目的将是描述悬雍垂腭咽成形术对 阻塞性睡眠呼吸暂停和P-Crit的严重程度。具体来说，我们将 探讨术后上呼吸道大小变化之间的关系 重建上呼吸道和上呼吸道塌陷性。

Present evidence suggests that a disturbance in the collapsibility of the upper airway exists in patients with obstructive sleep apnea during sleep and wakefulness. This proposal, by applying concepts of flow through collapsible tubes (Starling resistor), will examine the collapsibility of the human upper airway in both normal individuals and in patients with obstructive sleep apnea. This proposal is based on preliminary observations which have shown that during sleep, normal individuals and patients with obstructive sleep apnea can be distinguished by differences in the collapsibility of the upper airway as refected by changes in the critical pressure (P-crit) of the upper airway. In order to investigate the role of P-crit in health and disease (obstructive sleep apnea), we will vary upstream pressure at the nose to determine critical pressures of the upper airway. Our first specific aim will be to determine the range of critical pressure in normal individuals, normal individuals who snore, and patients with obstructive sleep apnea. Since additional data suggests that abnormal upper airway critical pressures reflect a distrubance in upper airway collapsibility in patients with obstructive sleep apnea, second specific aim will be to determine whether factors that reduce the severity of sleep apnea result in a parallel decrease in P-crit. Specifically, we will investigate the effects of weight loss and protriptyline on upper airway P-crit. Our third specific aim will be to determine whether factors that increase the severity of sleep apnea lead to a parallel rise in critical pressure (P-crit) of the upper airway. Finally, our fourth specific aim will be to relate the effects of uvulopalatopharyngoplasty on the severity of obstructive sleep apnea and P-crit. Specifically, we will explore the relationship between changes in upper airway size following reconstruction of the upper airway and upper airway collapsibility.