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In vitro validation of some flow assumptions for the prediction of the pressure distribution during obstructive sleep apnoea

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Abstract

An adequate description of the pressure distribution exerted by the fluid flow on pharyngeal walls is a first requirement to enhance the understanding, modelling and, consequently, the prediction of airway collapse during obstructive sleep apnoea. From a fluid mechanical point of view, several flow assumptions can be formulated to reduce the governing flow equations. The relevance of some major flow assumptions and the accuracy of the resulting flow description with respect to obstructive sleep apnoea was investigated on a rigid geometrical replica of the pharynx. Special attention was given to the influence of geometrical asymmetry and to the position of the flow separation point. An in vitro experimental and theoretical study of steady pharyngeal fluid flow is presented for different constriction heights and upstream pressures. Pressure and velocity distributions along a rigid in vitro replica of the oro-pharyngeal cavity were compared with different flow predictions based on various assumptions. Fluid flow models were tested for volume flow rates ranging from 5 to 120 l min−1 and for minimum apertures between 1.45 and 3.00 mm. Two-dimensional flow models were required and predicted experimental results with an accuracy of 15%. Flow theories classically used in the case of a Starling resistor provided poor agreement.

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References

  • Ayappa, I., andRapoport, D. (2003): ‘The upper airway in sleep: physiology of the pharynx’,Sleep Med. Rev.,7, pp. 9–33

    Article  Google Scholar 

  • Blevins, R. (1992): ‘Applied fluid dynamics handbook’ (Krieger Publishing Company, Malabar, 1992)

    Google Scholar 

  • Bridgman, S., andDunn, K. (2002): ‘Surgery for obstructive sleep apnoea’,Cochrane Database Syst. Rev.,2, CD001004

  • Deverge, M., Pelorson, X., Vilain, C., Lagree, P., Chentouf, F., Willems, J., andHirschberg, A. (2003): ‘Influence of collision on the flow through in-vitro rigid models of the vocal folds’,J. Acoust. Soc. Am.,114, pp. 1–9

    Article  Google Scholar 

  • Fishman, A., Macklem, P., Mead, J., andGeiger, S. (1986): ‘The respiratory system’, in ‘Handbook of physiology’, (Am. Phys. Soc., Maryland, 1986)

    Google Scholar 

  • Flemons, W. (2002): ‘Obstructive sleep apnea’,New Engl. J. Med.,347, pp. 498–504

    Article  Google Scholar 

  • Flemons, W., andReimer, M. (2002): ‘Measurement properties of the calgary sleep apnea quality of life index’,Am. J. Respir. Crit. Care Med.,165, pp. 159–164

    Google Scholar 

  • Grotberg, J., andJensen, O. (2004): ‘Biofluid mechanics in flexible tubes’,Ann. Rev. Fluid Mech.,36, pp. 121–147

    Article  MathSciNet  Google Scholar 

  • Henke, K. (1998): ‘Upper airway muscle activity and upper airway resistance in young adults during sleep’,J. Appl. Physiol.,84, pp. 486–491

    Google Scholar 

  • Hofmans, G., Groot, G., Ranucci, M., andGraziani, G. (2003): ‘Unsteady flow throughin-vitro models of the glottis’,J. Acoust. Soc. Am.,113, pp. 1658–1675

    Article  Google Scholar 

  • Hui, D., Choy, D., Ko, F., Li, T., andLai, C. (2000): ‘Obstructive sleep apnoea syndrome: treatment update’,Med. Pract.,6, pp. 209–217

    Google Scholar 

  • Lambert, K., andWilson, T. (1972): ‘Flow limitation in a collapsible tube’,J. Appl. Physiol.,33, pp. 150–153

    Google Scholar 

  • Leith, D. (1995): ‘Cough’,Eur. Respir. J.,8, pp. 1993–1202

    Google Scholar 

  • Lipton, A., andGozal, D. (2003): ‘Treatment of obstructive sleep apnea in children: do we really know how?’,Sleep Med. Rev.,7, pp. 61–80

    Article  Google Scholar 

  • Mansour, K., Rowley, J., Meshenish, A., Shkoukani, M., andBadr, M. (2002): ‘A mathematical model to detect inspiratory flow limitation during sleep’,J. Appl. Physiol.,93, pp. 1084–1092

    Google Scholar 

  • Matsuzaki, Y., andFung, Y. (1976): ‘On separation of a divergent flow at moderate Reynolds numbers’,ASME J. Appl. Mech.,43, pp. 227–231

    Google Scholar 

  • Mayer, P., Pepin, J., Bettega, G., Veale, D., Ferreti, G., Deschaux, C., andLevy, P. (1996): ‘Relationship between body mass index, age and upper airway measurements in snorers and sleep apnea patients’,Eur. Respir. J.,9, pp. 1801–1809

    Article  Google Scholar 

  • McNicholas, W. (2003): ‘Sleep apnoea syndrome today: much done, more to do’,Sleep Med. Rev.,7, pp. 1087–1093

    Article  Google Scholar 

  • Payan, Y., Chabanas, M., Pelorson, X., Vilain, C., Levy, P., Luboz, V. andPerrier, P. (2002): ‘Biomechanical models to stimulate consequences of maxillofacial surgery’,C. R. Biol.,325, pp. 407–417.

    Google Scholar 

  • Pedley, T., andLuo, X. (1998): ‘Modelling flow and oscillations in collapsible tubes’,J. Theor. Comp. Fluid Dyn.,10, pp. 277–294

    Google Scholar 

  • Pelorson, X., Hirschberg, A., Hasselt, R. V., Wijnands, A., andAuregan, Y. (1994): ‘Theoretical and experimental study of quasi steady-flow separation within the glottis during phonation. Application to a modified two-mass model’,J. Acoust. Soc. Am.,96, pp. 3416–3431

    Article  Google Scholar 

  • Penzel, T., McNames, J., de Chazal, P., Raymond, B., Murray, A., andMoody, G. (2002): ‘Systematic comparison of different algorithms for apnoea detection based on electrocardiogram recordings’,Med. Biol. Eng. Comput.,40, pp. 402–407

    Google Scholar 

  • Peppard, P., Young, T., Palta, M., andSkatrud, J. (2000): ‘Prospective study of the association between sleep-disordered breathing and hypertension’,New Engl. J. Med.,342, pp. 1378–1374

    Article  Google Scholar 

  • Rama, A., Tekwant, S., andKushida, C. (2002): ‘Sites of obstruction in obstructive sleep apnea’,Chest,122, pp. 1139–1147

    Article  Google Scholar 

  • Schlichting, H., andGersten, K. (2000): ‘Boundary layer theory’ (Springer Verlag, Berlin, 2000)

    Google Scholar 

  • Schwab, R., Gefter, W., Hoffman, E., Gupta, K., andPack, A. (1990): ‘Dynamic upper airway imaging during awake respiration in normal subjects and patients with sleep disordered breathing’,Am. J. Respir. Crit. Care Med.,148, pp. 1385–1400

    Google Scholar 

  • Sher, A., Schechtman, K., andPiccirillo, J. (1996): ‘The efficacy of surgical modifications of the upper airway in adults with obstructive sleep apnea syndrome’,Sleep,19, pp. 156–177

    Google Scholar 

  • Shome, B., Wang, L., Santare, M., Prasad, A., Szeri, A., andRoberts, D. (1998): ‘Modeling of airflow in the pharynx with application to sleep apnea’,J. Biomech. Eng.,120, pp. 416–422

    Google Scholar 

  • Teran-Santos, J., Jiminez-Gomez, A., Cordero-Guevara, J. (1999): ‘The association between sleep apnea and the risk of traffic accidents’,New Engl. J. Med.,340, pp. 847–851

    Article  Google Scholar 

  • Young, T., Palta, M., Dempsey, J., Skatrud, J., Weber, S., andBadr, S. (1993): ‘The occurrence of sleep-disordered breathing among middle-aged adults’,New Eng. J. Med.,17, pp. 1230–1235

    Google Scholar 

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Van Hirtum, A., Pelorson, X. & Lagrée, P.Y. In vitro validation of some flow assumptions for the prediction of the pressure distribution during obstructive sleep apnoea. Med. Biol. Eng. Comput. 43, 162–171 (2005). https://doi.org/10.1007/BF02345139

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