help button home button
AJRCCM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
Published ahead of print on April 7, 2004, doi:10.1164/rccm.200309-1239OC

Am. J. Respir. Crit. Care Med., Volume 170, Number 1, July 2004, 86-93

A more recent version of this article appeared on July 1, 2004
This Article
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
200309-1239OCv1
170/1/86    most recent
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Patil, S. P
Right arrow Articles by Schwartz, A. R
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Patil, S. P
Right arrow Articles by Schwartz, A. R

Submitted on September 8, 2003
Accepted on April 5, 2004

A Simplified Method for Measuring Critical Pressures during Sleep in the Clinical Setting

Susheel P Patil1*, Naresh M Punjabi1, Hartmut Schneider1, Christopher P O'Donnell1, Philip L Smith1, and Alan R Schwartz1

1 Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University, Baltimore, MD, USA

* To whom correspondence should be addressed. E-mail: spatil{at}jhmi.edu.

Upper airway critical pressure measurements correlate with the degree of upper airway obstruction during sleep, and may have a role in the diagnosis and treatment of obstructive sleep apnea. Nevertheless, the utility of the critical pressure has not yet been realized in the clinical setting because significant technical expertise is still required for the acquisition and analysis of pressure-flow data. Using segmented regression and repeated measure analyses, we developed and validated a simplified approach to analyze the pressure-flow relationship and to determine the effects of protocol-related factors in forty-four subjects with sleep apnea. When compared to expert visual analysis, segmented regression methodology was found to accurately determine the critical pressure (-0.98 ± 2.47 cm H2O vs. -1.07 ± 2.47 cm H2O respectively; p=0.46). Furthermore, it was found that two series of measurements acquired at varying nasal pressure levels with two or more breaths per level were sufficient to determine the critical pressure with a minimum of variability. Therefore, this analytical approach has the potential for standardizing and simplifying the ascertainment of the critical pressure for studies examining the effect of therapeutic devices and agents on upper airway collapsibility during sleep.
Key words: sleep apnea, critical pressure, pathophysiology, upper airway




This article has been cited by other articles:


Home page
 J. Appl. Physiol.Home page
M. Younes
Role of respiratory control mechanisms in the pathogenesis of obstructive sleep disorders
J Appl Physiol, November 1, 2008; 105(5): 1389 - 1405.
[Abstract] [Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
A. Liu, L. Pichard, H. Schneider, S. P. Patil, P. L. Smith, V. Polotsky, and A. R. Schwartz
Neuromechanical control of the isolated upper airway of mice
J Appl Physiol, October 1, 2008; 105(4): 1237 - 1245.
[Abstract] [Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
J. P. Kirkness, A. R. Schwartz, H. Schneider, N. M. Punjabi, J. J. Maly, A. M. Laffan, B. M. McGinley, T. Magnuson, M. Schweitzer, P. L. Smith, et al.
Contribution of male sex, age, and obesity to mechanical instability of the upper airway during sleep
J Appl Physiol, June 1, 2008; 104(6): 1618 - 1624.
[Abstract] [Full Text] [PDF]

Home page
 ERRHome page
A. Boudewyns, M. Marklund, and W. Hochban
Alternatives for OSAHS treatment: selection of patients for upper airway surgery and oral appliances
Eur. Respir. Rev., December 1, 2007; 16(106): 132 - 145.
[Abstract] [Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
J. A. Rowley, I. Deebajah, S. Parikh, A. Najar, R. Saha, and M. S. Badr
The influence of episodic hypoxia on upper airway collapsibility in subjects with obstructive sleep apnea
J Appl Physiol, September 1, 2007; 103(3): 911 - 916.
[Abstract] [Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
S. P. Patil, H. Schneider, J. J. Marx, E. Gladmon, A. R. Schwartz, and P. L. Smith
Neuromechanical control of upper airway patency during sleep
J Appl Physiol, February 1, 2007; 102(2): 547 - 556.
[Abstract] [Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
R. L. Horner
Contributions of passive mechanical loads and active neuromuscular compensation to upper airway collapsibility during sleep
J Appl Physiol, February 1, 2007; 102(2): 510 - 512.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
T. D. Bradley, Y. E. Miller, F. J. Martinez, D. C. Angus, W. MacNee, and E. Abraham
Interstitial Lung Disease, Lung Cancer, Lung Transplantation, Pulmonary Vascular Disorders, and Sleep-disordered Breathing in AJRCCM in 2004
Am. J. Respir. Crit. Care Med., April 1, 2005; 171(7): 675 - 685.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
Proc. Am. Thorac. Soc. Am. J. Respir. Cell Mol. Biol.
Copyright © 2004 American Thoracic Society 		  ATS Best of the Web