| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
Guest Access | Sign In via User Name/Password
|
|
|
|||||||
Guest Access | Sign In via User Name/Password |
|||||||||
Chest, Vol 98, 317-324, Copyright © 1990 by American College of Chest Physicians
ARTICLES |
MH Sanders and N Kern
Division of Pulmonary and Critical Care Medicine, University of Pittsburgh School of Medicine.
Treatment of obstructive sleep apnea with nasal continuous positive airway pressure mandates simultaneous increases of both inspiratory and expiratory positive airway pressures to eliminate apneas as well as nonapneic oxyhemoglobin desaturation events. We hypothesized that the forces acting to collapse the upper airway during inspiration and expiration are of different magnitudes and that obstructive sleep- disordered breathing events (including apneas, hypopneas and nonapneic desaturation events) could be eliminated at lower levels of EPAP than IPAP. To test these hypotheses, a device was built that allows the independent adjustment of EPAP and IPAP (nasal BiPAP). Our data support the hypotheses that expiratory phase events are important in the pathogenesis of OSA and that there are differences in the magnitudes of the forces destabilizing the upper airway during inspiration and expiration. Finally, applying these concepts, we have shown that by using a device that permits independent adjustment of EPAP and IPAP, obstructive sleep-disordered breathing can be eliminated at lower levels of expiratory airway pressure compared with conventional nasal CPAP therapy. This may reduce the adverse effects associated with nasal CPAP therapy and improve long-term therapeutic compliance.
This article has been cited by other articles:
|
|
 |
|
  R. K. Kakkar and R. B. Berry Positive Airway Pressure Treatment for Obstructive Sleep Apnea Chest, September 1, 2007; 132(3): 1057 - 1072. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Nilius, A. Happel, U. Domanski, and K.-H. Ruhle Pressure-Relief Continuous Positive Airway Pressure vs Constant Continuous Positive Airway Pressure: A Comparison of Efficacy and Compliance. Chest, October 1, 2006; 130(4): 1018 - 1024. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C Philippe, M Stoica-Herman, X Drouot, B Raffestin, P Escourrou, L Hittinger, P-L Michel, S Rouault, and M-P d'Ortho Compliance with and effectiveness of adaptive servoventilation versus continuous positive airway pressure in the treatment of Cheyne-Stokes respiration in heart failure over a six month period Heart, March 1, 2006; 92(3): 337 - 342. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. G. Johnson and D. C. Johnson Bilevel Positive Airway Pressure Worsens Central Apneas During Sleep Chest, October 1, 2005; 128(4): 2141 - 2150. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. B. Yoo and D. M. Durand Effects of selective hypoglossal nerve stimulation on canine upper airway mechanics J Appl Physiol, September 1, 2005; 99(3): 937 - 943. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. S. Aloia, M. Stanchina, J. T. Arnedt, A. Malhotra, and R. P. Millman Treatment Adherence and Outcomes in Flexible vs Standard Continuous Positive Airway Pressure Therapy Chest, June 1, 2005; 127(6): 2085 - 2093. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P Gordon and M H Sanders Sleep {middle dot} 7: Positive airway pressure therapy for obstructive sleep apnoea/hypopnoea syndrome Thorax, January 1, 2005; 60(1): 68 - 75. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.-P. Janssens, S. Derivaz, E. Breitenstein, B. de Muralt, J.-W. Fitting, J.-C. Chevrolet, and T. Rochat Changing Patterns in Long-term Noninvasive Ventilation: A 7-Year Prospective Study in the Geneva Lake Area Chest, January 1, 2003; 123(1): 67 - 79. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Padman, C. Hyde, P. Foster, and W. Borkowski Jr The Pediatric Use of Bilevel Positive Airway Pressure Therapy for Obstructive Sleep Apnea Syndrome: A Retrospective Review with Analysis of Respiratory Parameters Clinical Pediatrics, April 1, 2002; 41(3): 163 - 169. [Abstract] [PDF]
|
|
|
|
 |
|
 B. FAUROUX, J. PIGEOT, M. I. POLKEY, G. ROGER, M. BOULE, A. CLEMENT, and F. LOFASO Chronic Stridor Caused by Laryngomalacia in Children . Work of Breathing and Effects of Noninvasive Ventilatory Assistance Am. J. Respir. Crit. Care Med., November 15, 2001; 164(10): 1874 - 1878. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Juhasz, H. Becker, W. Cassel, S. Rostig, and J-H. Peter Proportional positive airway pressure: a new concept to treat obstructive sleep apnoea Eur. Respir. J., March 1, 2001; 17(3): 467 - 473. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. MEHTA and N. S. HILL Noninvasive Ventilation Am. J. Respir. Crit. Care Med., February 1, 2001; 163(2): 540 - 577. [Full Text]
|
|
|
|
|
|
Clinical Indications for Noninvasive Positive Pressure Ventilation in Chronic Respiratory Failure Due to Restrictive Lung Disease, COPD, and Nocturnal HypoventilationA Consensus Conference Report Chest, August 1, 1999; 116(2): 521 - 534. [Full Text] [PDF]
|
|
|
|
 |
|
 G. Roger, M.-P. Morisseau-Durand, T. Van Den Abbeele, R. Nicollas, J.-M. Triglia, P. Narcy, V. Abadie, Y. Manac'h, and E.-N. Garabedian The CHARGE Association: The Role of Tracheotomy Arch Otolaryngol Head Neck Surg, January 1, 1999; 125(1): 33 - 38. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Series and I. Marc Effects of inspiratory and expiratory positive pressure difference on airflow dynamics during sleep J Appl Physiol, November 1, 1998; 85(5): 1855 - 1862. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. G. Caronia, J. Gorvoy, P. Silver, C. Quinn, L. Nimkoff, and M. Sagy Use of Bilevel Positive Airway Pressure (BIPAP) in End-Stage Patients with Cystic Fibrosis Awaiting Lung Transplantation Clinical Pediatrics, September 1, 1998; 37(9): 555 - 559. [Abstract] [PDF]
|
|
|
|
|
|
R. FARRE, R. PESLIN, J. M. MONTSERRAT, M. ROTGER, and D. NAVAJAS Flow-dependent Positive Airway Pressure to Maintain Airway Patency in Sleep Apnea-Hypopnea Syndrome Am. J. Respir. Crit. Care Med., June 1, 1998; 157(6): 1855 - 1863. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Statement on Health Outcomes Research in Sleep Apnea THIS OFFICIAL STATEMENT WAS APPROVED BY THE ATS BOARD OF DIRECTORS, JUNE 1997 Am. J. Respir. Crit. Care Med., January 1, 1997; 157(1): 335 - 341. [Full Text]
|
|
|
|
 |
|
 P. J. Strollo and R. M. Rogers Obstructive Sleep Apnea N. Engl. J. Med., January 11, 1996; 334(2): 99 - 104. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
