期刊
CLINICAL SCIENCE
卷 116, 期 9-10, 页码 713-720出版社
PORTLAND PRESS LTD
DOI: 10.1042/CS20080321
关键词
fluid displacement; lower-body positive pressure; obstructive sleep apnoea; gender difference; upper airway critical closing pressure
资金
- Canadian Institutes of Health Research [MOP-82731]
- Toronto Rehabilitation Institute
- Chang Gung Memorial Hospital (Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan)
- China Medical University, Taichung, Taiwan
- ResMed and Respironics Inc.
- Siriraj Hospital (Bangkok, Thailand)
- Fuji Respironics Inc.
Fluid shift from the legs to the neck induced by LBPP (lower-body positive pressure) increases UA (upper airway) collapsibility in healthy men. Rostral fluid displacement during recumbency may therefore contribute to the pathogenesis of OSA (obstructive sleep apnoea). There is a higher prevalence of OSA in men than in women. We therefore hypothesized that UA collapsibility increases more in men in response to rostral fluid displacement than in women. UA collapsibility was assessed in healthy, non-obese men and women while awake by determining UA P-crit (critical closing pressure) during application of different suction pressures to the UA. Subjects were randomized to 5 min control or LBPP arms after which they crossed-over into the other arm following a 30 min washout. LBPP was applied by inflating anti-shock trousers wrapped around both legs to 40 mmHg. P-crit, leg fluid volume and neck circumference were measured at baseline and after 5 min of both control and LBPP periods. LBPP caused a decrease in leg fluid volume and an increase in neck circumference that did not differ between men and women. However, compared with the control period, LBPP induced a much greater increase in P-crit in men than in women (7.2 +/- 1.8 compared with 2.0 +/- 1.5 cmH(2)O, P = 0.035). We conclude that rostral fluid displacement by LBPP increases UA collapsibility more in healthy, non-obese men than in women. This may be one mechanism contributing to the higher prevalence of OSA in men than in women.
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