Tetraplegic obstructive sleep apnoea patients dilate the airway similarly to able-bodied obstructive sleep apnoea patients.

Hatt, A; Brown, E; Berlowitz, DJ; O'Donoghue, F; Meaklim, H; Connelly, A; Jackson, G; Sutherland, K; Cistulli, PA; Lee, BSB; Bilston, LE

Tetraplegic obstructive sleep apnoea patients dilate the airway similarly to able-bodied obstructive sleep apnoea patients.

Hatt, A Brown, E Berlowitz, DJ O'Donoghue, F Meaklim, H Connelly, A Jackson, G Sutherland, K Cistulli, PA Lee, BSB Bilston, LE

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Publisher:: Informa UK Limited
Publication Type:: Journal Article
Citation:: J Spinal Cord Med, 2022, 45, (4), pp. 536-546
Issue Date:: 2022-07

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Field	Value	Language
dc.contributor.author	Hatt, A
dc.contributor.author	Brown, E
dc.contributor.author	Berlowitz, DJ
dc.contributor.author	O'Donoghue, F
dc.contributor.author	Meaklim, H
dc.contributor.author	Connelly, A
dc.contributor.author	Jackson, G
dc.contributor.author	Sutherland, K
dc.contributor.author	Cistulli, PA
dc.contributor.author	Lee, BSB
dc.contributor.author	Bilston, LE
dc.date.accessioned	2023-01-30T00:30:38Z
dc.date.available	2023-01-30T00:30:38Z
dc.date.issued	2022-07
dc.identifier.citation	J Spinal Cord Med, 2022, 45, (4), pp. 536-546
dc.identifier.issn	1079-0268
dc.identifier.issn	2045-7723
dc.identifier.uri	http://hdl.handle.net/10453/165565
dc.description.abstract	Context/objective: Obstructive sleep apnoea (OSA) develops soon after cervical spinal cord injury (SCI) at rates higher than the general population, but the mechanisms are not understood. This study aimed to determine whether OSA in SCI is associated with altered pharyngeal muscle dilatory mechanics during quiet breathing, as has been observed in the non-SCI injured with obstructive sleep apnoea.Design: Cross sectional imaging study.Setting: Medical research institute.Participants: Eight cervical SCI patients with OSA were recruited and compared to 13 able-bodied OSA patients and 12 able-bodied healthy controls of similar age and BMI.Interventions and outcome measures: 3T MRI scans of upper airway anatomy and tagged-MRI to characterize airway muscle motion during quiet breathing were collected for analysis.Results: Considerable variation in the patterns of inspiratory airway muscle motion was observed in the SCI group, with some participants exhibiting large inspiratory airway dilatory motions, and others exhibiting counterproductive narrowing during inspiration. These patterns were not dissimilar to those observed in the able-bodied OSA participants. The increase in airway cross-sectional area of able-bodied control participants was proportional to increase in BMI, and a similar, but not significant, relationship was present in all groups.Conclusion: Despite the limited sample size, these data suggest that SCI OSA patients have heterogeneous pharyngeal dilator muscle responses to the negative pressures occurring during inspiration but, as a group, appear to be more similar to able-bodied OSA patients than healthy controls of similar age and BMI. This may reflect altered pharyngeal pressure reflex responses in at least some people with SCI.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Informa UK Limited
dc.relation.ispartof	J Spinal Cord Med
dc.relation.isbasedon	10.1080/10790268.2020.1829418
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1103 Clinical Sciences, 1106 Human Movement and Sports Sciences
dc.subject.classification	Rehabilitation
dc.subject.mesh	Humans
dc.subject.mesh	Magnetic Resonance Imaging
dc.subject.mesh	Pharynx
dc.subject.mesh	Reflex
dc.subject.mesh	Sleep Apnea, Obstructive
dc.subject.mesh	Spinal Cord Injuries
dc.subject.mesh	Pharynx
dc.subject.mesh	Humans
dc.subject.mesh	Sleep Apnea, Obstructive
dc.subject.mesh	Spinal Cord Injuries
dc.subject.mesh	Magnetic Resonance Imaging
dc.subject.mesh	Reflex
dc.title	Tetraplegic obstructive sleep apnoea patients dilate the airway similarly to able-bodied obstructive sleep apnoea patients.
dc.type	Journal Article
utslib.citation.volume	45
utslib.location.activity	England
utslib.for	1103 Clinical Sciences
utslib.for	1106 Human Movement and Sports Sciences
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Science
utslib.copyright.status	closed_access	*
dc.date.updated	2023-01-30T00:30:34Z
pubs.issue	4
pubs.publication-status	Published
pubs.volume	45
utslib.citation.issue	4

Abstract:

Context/objective: Obstructive sleep apnoea (OSA) develops soon after cervical spinal cord injury (SCI) at rates higher than the general population, but the mechanisms are not understood. This study aimed to determine whether OSA in SCI is associated with altered pharyngeal muscle dilatory mechanics during quiet breathing, as has been observed in the non-SCI injured with obstructive sleep apnoea.Design: Cross sectional imaging study.Setting: Medical research institute.Participants: Eight cervical SCI patients with OSA were recruited and compared to 13 able-bodied OSA patients and 12 able-bodied healthy controls of similar age and BMI.Interventions and outcome measures: 3T MRI scans of upper airway anatomy and tagged-MRI to characterize airway muscle motion during quiet breathing were collected for analysis.Results: Considerable variation in the patterns of inspiratory airway muscle motion was observed in the SCI group, with some participants exhibiting large inspiratory airway dilatory motions, and others exhibiting counterproductive narrowing during inspiration. These patterns were not dissimilar to those observed in the able-bodied OSA participants. The increase in airway cross-sectional area of able-bodied control participants was proportional to increase in BMI, and a similar, but not significant, relationship was present in all groups.Conclusion: Despite the limited sample size, these data suggest that SCI OSA patients have heterogeneous pharyngeal dilator muscle responses to the negative pressures occurring during inspiration but, as a group, appear to be more similar to able-bodied OSA patients than healthy controls of similar age and BMI. This may reflect altered pharyngeal pressure reflex responses in at least some people with SCI.

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