Airway stability in sleep apnea: Assessing continuous positive airway pressure efficiency

IF 1.9 4区 医学 Q3 PHYSIOLOGY Respiratory Physiology & Neurobiology Pub Date : 2024-04-21 DOI:10.1016/j.resp.2024.104265
Suvash C. Saha , Xinlei Huang , Isabella Francis, Goutam Saha
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Abstract

Obstructive Sleep Apnea Syndrome (OSAS) disrupts millions of lives with its burden of airway obstruction during sleep. Continuous Positive Airway Pressure (CPAP) therapy has been scrutinized for its biomechanical impact on the respiratory tract. This study leverages computational fluid dynamics to investigate CPAP's effects at 9 cm H2O (882.6 Pa) on the computed-tomography-based nasal-to-14-generation full respiratory tract model compared to ambient conditions, focusing on static pressure, airflow velocity, and shear stress. Our findings reveal that CPAP significantly increases static pressure, enhancing airway patency without adverse changes in airflow velocity or harmful shear stress on lung tissue, challenging prior concerns about its safety. Notably, the larynx experiences the highest shear stress due to its narrow anatomy, yet CPAP therapy overall supports airway walls against collapse. This investigation highlights CPAP's critical role in OSAS treatment, offering reassurance about its safety and efficacy. By clarifying CPAP therapy's physiological impacts, our study contributes vital insights for optimizing OSAS management strategies, affirming CPAP's benefit in maintaining open airways with minimal tissue strain.

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睡眠呼吸暂停的气道稳定性:评估持续气道正压的效率
阻塞性睡眠呼吸暂停综合症(OSAS)在睡眠期间造成气道阻塞,扰乱了数百万人的生活。持续气道正压疗法(CPAP)因其对呼吸道的生物力学影响而备受关注。本研究利用计算流体动力学研究了 CPAP 在 9 cm H2O(882.6 Pa)条件下对基于计算机断层成像的鼻腔至 14 代全呼吸道模型的影响,与环境条件进行了比较,重点研究了静压、气流速度和剪应力。我们的研究结果表明,CPAP 可显著提高静压,增强气道通畅性,同时不会对气流速度产生不利影响,也不会对肺组织产生有害的剪切应力,这对之前有关 CPAP 安全性的担忧提出了质疑。值得注意的是,喉部因其狭窄的解剖结构而承受着最大的剪切应力,但 CPAP 治疗在整体上可支持气道壁防止塌陷。这项调查强调了 CPAP 在 OSAS 治疗中的关键作用,为其安全性和有效性提供了保证。通过阐明 CPAP 疗法的生理影响,我们的研究为优化 OSAS 的管理策略提供了重要的见解,肯定了 CPAP 在维持开放气道的同时将组织压力降至最低的益处。
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来源期刊
CiteScore
4.80
自引率
8.70%
发文量
104
审稿时长
54 days
期刊介绍: Respiratory Physiology & Neurobiology (RESPNB) publishes original articles and invited reviews concerning physiology and pathophysiology of respiration in its broadest sense. Although a special focus is on topics in neurobiology, high quality papers in respiratory molecular and cellular biology are also welcome, as are high-quality papers in traditional areas, such as: -Mechanics of breathing- Gas exchange and acid-base balance- Respiration at rest and exercise- Respiration in unusual conditions, like high or low pressure or changes of temperature, low ambient oxygen- Embryonic and adult respiration- Comparative respiratory physiology. Papers on clinical aspects, original methods, as well as theoretical papers are also considered as long as they foster the understanding of respiratory physiology and pathophysiology.
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