Chest
Effect of Nasal Obstruction on Upper Airway Muscle Activation in Normal Subjects
Section snippets
METHODS AND MATERIALS
We studied seven men whose anthropometric characteristics are described in Table 1. Subjects were studied on two consecutive nights; on the first night, their nose was not occluded and on the second night it was. Since this investigation was performed as part of a study of prolonged nasal occlusion, nasal occlusion night was not randomized to the first or second night.
Nasal occlusion was produced by inserting strips of gauze impregnated with petrolatum into the anterior 2 cm of the nostrils.
RESULTS
Nasal occlusion produced obstructive sleep apnea in all patients (Fig 1). In all subjects, the percentage of time in which phasic activity in both alae nasi and genioglossus EMC was present was greater when the nose was occluded than when it was not occluded (p<0.05) (Figs 2, 3).
Phasic alae nasi activity was present at apnea onset in six of seven subjects, although the magnitude of activity decreased at apnea onset in five of the seven subjects (Fig 4).
DISCUSSION
This study has shown that nasal occlusion which produces obstructive sleep apnea in normal subjects increases phasic EMG activity of the AN and GG throughout sleep. Phasic activity was present even at apnea onset in most subjects, although the magnitude of change was decreased from immediately prior to the apnea. Apnea did not occur during the unoccluded night, even when there was no phasic activity.
The increase in phasic EMG activity during sleep suggests that nasal occlusion augments
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Nasal Surgery for Obstructive Sleep Apnea Syndrome
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Maxillomandibular Expansion and Advancement for the Treatment of Sleep-Disordered Breathing in Children and Adults
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Childhood obstructive sleep-disordered breathing: A clinical update and discussion of technological innovations and challenges
2007, ChestCitation Excerpt :Nasal obstruction may be especially important in infants with “obligate nose breathing,”70 where life-threatening breathing obstruction can occur, as seen with choanal stenosis at birth. Nasal resistance can lead to airflow limitation without affecting the collapsibility of the airway.71 Airflow limitation impacted by nasal obstruction has been implicated in symptomatic cases of UARS.72
Sleep, breathing and the nose
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Supported by grants from the National Institutes of Health, HL 20318 and RR 00847.
Manuscript received April 6; revision accepted May 26.