Fitzpatrick M F, McLean H, Urton A M, Tan A, O'Donnell D, Driver H S
Dept of Medicine, Queen's University, Kingston, Ontario, Canada.
Eur Respir J. 2003 Nov;22(5):827-32. doi: 10.1183/09031936.03.00047903.
Healthy subjects with normal nasal resistance breathe almost exclusively through the nose during sleep. This study tested the hypothesis that a mechanical advantage might explain this preponderance of nasal over oral breathing during sleep. A randomised, single-blind, crossover design was used to compare upper airway resistance during sleep in the nasal and oral breathing conditions in 12 (seven male) healthy subjects with normal nasal resistance, aged 30+/-4 (mean+/-SEM) yrs, and with a body mass index of 23+/-1 kg x m2. During wakefulness, upper airway resistance was similar between the oral and nasal breathing routes. However, during sleep (supine, stage two) upper airway resistance was much higher while breathing orally (median 12.4 cmH2O x L(-1) x s(-1), range 4.5-40.2) than nasally (5.2 cmH2O x L(-1) x s(-1), 1.7-10.8). In addition, obstructive (but not central) apnoeas and hypopnoeas were profoundly more frequent when breathing orally (apnoea-hypopnoea index 43+/-6) than nasally (1.5+/-0.5). Upper airway resistance during sleep and the propensity to obstructive sleep apnoea are significantly lower while breathing nasally rather than orally. This mechanical advantage may explain the preponderance of nasal breathing during sleep in normal subjects.
鼻腔阻力正常的健康受试者在睡眠期间几乎完全通过鼻子呼吸。本研究检验了一种假设，即机械优势可能解释了睡眠期间鼻腔呼吸优于口腔呼吸的这种优势。采用随机、单盲、交叉设计，比较了12名（7名男性）鼻腔阻力正常、年龄30±4（平均±标准误）岁、体重指数为23±1 kg·m²的健康受试者在睡眠时鼻腔和口腔呼吸状态下的上气道阻力。在清醒状态下，口腔和鼻腔呼吸途径的上气道阻力相似。然而，在睡眠（仰卧位，第二阶段）期间，口腔呼吸时的上气道阻力（中位数12.4 cmH₂O·L⁻¹·s⁻¹，范围4.5 - 40.2）比鼻腔呼吸时（5.2 cmH₂O·L⁻¹·s⁻¹，1.7 - 10.8）高得多。此外，口腔呼吸时阻塞性（而非中枢性）呼吸暂停和呼吸浅慢比鼻腔呼吸时明显更频繁（呼吸暂停 - 呼吸浅慢指数43±6比1.5±0.5）。睡眠期间鼻腔呼吸时的上气道阻力和阻塞性睡眠呼吸暂停的倾向显著低于口腔呼吸时。这种机械优势可能解释了正常受试者睡眠期间鼻腔呼吸占优势的现象。
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