CRITICAL PRESSURES IN THE HUMAN UPPER AIRWAY

目前的证据表明，干扰的可扩展性， 阻塞性睡眠呼吸暂停患者睡眠时存在上气道 和清醒。 该提案通过应用流通概念， 可折叠管（Starling电阻器），将检查 正常人和患有 阻塞性睡眠呼吸暂停 这一建议是根据初步 观察表明，在睡眠期间，正常人和 阻塞性睡眠呼吸暂停综合征患者可以通过 在上气道的可膨胀性中， 上气道的临界压力（P-crit）。 为了研究 P-crit在健康和疾病（阻塞性睡眠呼吸暂停）中的作用，我们将 改变鼻端的上游压力，以确定 上呼吸道 我们的第一个具体目标是确定 正常人的临界压力，打鼾的正常人， 阻塞性睡眠呼吸暂停综合征患者。 由于更多的数据表明， 异常的上气道临界压反映了上气道的紊乱， 阻塞性睡眠呼吸暂停综合征患者的气道通透性 具体目标将是确定降低严重程度的因素是否 睡眠呼吸暂停导致P-crit平行下降。具体来说，我们 将研究减肥和普罗替林对上 我们的第三个具体目标将是确定是否 增加睡眠呼吸暂停严重程度的因素导致 在上气道的临界压力（P-crit）中。 最后，我们的第四 具体的目的是将悬雍垂腭咽成形术的影响， 阻塞性睡眠呼吸暂停的严重程度和P-crit。具体来说，我们将 探讨上气道大小变化与 上呼吸道重建和上呼吸道通畅性。

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.