Abstract
The upper airway is a passage that provides air into and out of the lungs; heats, humidifies, and filters the air; and is involved in coughing, swallowing, and speech. Patients with obstructive sleep apnea and progressive neuromuscular diseases have changes in resistance and compliance that cause breathing difficulties due to muscle weakness or laryngeal alterations in this region. Mask choice is a fundamental factor for the success of a ventilatory strategy adaptation. Understanding airway dysfunctions, lung capacity, and disease progression may facilitate the best indication. This chapter describes upper airway disorders and strategies to minimize dysfunction in this region, including noninvasive ventilation (NIV) use and breathing exercises.
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References
Pierce R, Worsnop C. Upper airway function and dysfunction in respiration. Clin Exp Pharmacol Physiol. 1999;26(1):1–10. https://doi.org/10.1046/j.1440-1681.1999.02988.x.
Andersen T, Halvorsen T, Fondenes O, Heimdal J, et al. Larynx: the complex gateway to the lungs. Respir Care. 2019;64(7):866–9. https://doi.org/10.4187/respcare.06989.
Terzi N, Orlikowski D, Aegerter P, Lejaille M, Ruquet M, et al. Breathing-swallowing interaction in neuromuscular patients: a physiological evaluation. Am J Respir Crit Care Med. 2007;175(3):269–76. https://doi.org/10.1164/rccm.200608-1067OC.
Fretheim-Kelly Z, Halvorsen T, Heimdal J, Strand E, et al. Feasibility and tolerability of measuring translaryngeal pressure during exercise. Laryngoscope. 2019;129:2748. PMID: 30698834. PMCID: PMC6900056. https://doi.org/10.1002/lary.27846.
Ludlow C. Laryngeal reflexes: physiology, technique, and clinical use. J Clin Neurophysiol. 2015;32(4):284–93. PMCID: PMC4527097. PMID: 26241237. https://doi.org/10.1097/WNP.0000000000000187.
Leith D. Cough. Phys Ther. 1968;48(5):439–47.
Andersen T, Sandnes A, Hilland M, Halvorsen T, et al. Laryngeal response patterns to mechanical insufflation- exsufflation in healthy subjects. J Phys Med Rehabil. 2013;92(10):920–9. https://doi.org/10.1097/PHM.0b013e3182a4708f.
Andersen T, Sandnes A, Brekka A, Hilland M, et al. Laryngeal response patterns influence the efficacy of mechanical assisted cough in amyotrophic lateral sclerosis. Thorax. 2017;72(3):221–9. PMID: 27174631. PMCID: PMC5339574. https://doi.org/10.1136/thoraxjnl-2015-207555.
Owens R, Malhotra A, Eckert D, White D, Jordan A. The influence of end-expiratory lung volume on measurements of pharyngeal collapsibility. J Appl Physiol. 1985;108(2):445–51. PMID: 19940097; PMCID: PMC3774250. https://doi.org/10.1152/japplphysiol.00755.2009.
Schwartz AR, Smith PL, Wise RA, Gold AR. Induction of upper airway occlusion in sleeping individuals with subatmospheric nasal pressure. J Appl Physiol. 1988;64(2):535–42. https://doi.org/10.1152/jappl.1988.64.2.535.
Mead J. Mechanical properties of lungs. Physiol Rev. 1961;41(2):281–320. https://doi.org/10.1152/physrev.1961.41.2.281.
Valle ELT. Airway resistance: forced oscillation technique. J Pneumol. 2002;28(Supl 3)
Castro D, Freeman LA. Oropharyngeal airway. In: Stat Pearls. Treasure Island, FL: Stat Pearls Publishing; 2022.
Plowman EK, Tabor-Gray L, Rosado KM, et al. Impact of expiratory strength training in amyotrophic lateral sclerosis: results of a randomized, sham-controlled trial. Muscle Nerve. 2018;59(1):40–6. https://doi.org/10.1002/mus.26292.
Tomik B, Guiloff RJ. Dysarthria in amyotrophic lateral sclerosis: a review. Amyotroph Lateral Scler. 2010;11(1–2):4–15. https://doi.org/10.3109/17482960802379004.
Schellhas V, Glatz C, Beecken I, Okegwo A, et al. Upper airway obstruction induced by non-invasive ventilation using an oronasal interface. Sleep Breath. 2018;22(3):781–8. https://doi.org/10.1007/s11325-018-1640-8.
Oliven R, Cohen G, Dotan Y, Somri M. Alteration in upper airway dilator muscle coactivation during sleep: comparison of patients with obstructive sleep apnea and healthy subjects. J Appl Physiol. 2018;124(2):421–9. https://doi.org/10.1152/japplphysiol.01067.2016.
Deshpande S, Simon J, Turton A, Edwards BA, Landry S, Mansfield DR, Hamilton GS. Oronasal masks require a higher pressure than nasal and nasal pillow masks for the treatment of obstructive sleep apnea. J Clin Sleep Med. 2016;12(09):1263–8. https://doi.org/10.5664/jcsm.6128.
Vrijsen B, Buyse B, Belge C, Testelmans D. Upper airway obstruction during noninvasive ventilation induced by the use of an oronasal mask. J Clin Sleep Med. 2014;10(9):1033–5. PMID: 25142771; PMCID: PMC4153115. https://doi.org/10.5664/jcsm.4046.
Dorça A, Alcântara L, Diniz D, Sarmet M, Menezes M, et al. Comparison between breath stacking technique associated with expiratory muscle training and breath stacking technique in amyotrophic lateral sclerosis patients: protocol for randomized single blind trial. Contemp Clin Trials Commun. 2020;2 19:100647. PMID: 33005816; PMCID: PMC7511726. https://doi.org/10.1016/j.conctc.2020.100647.
Camacho M, Certal V, Abdullatif J, et al. Myofunctional therapy to treat obstructive sleep apnea: a systematic review and meta-analysis. Sleep. 2015;38(5):669–75. https://doi.org/10.5665/sleep.4652.
Attanasio R, Bailey DR. Dental management of sleep disorders. 1st ed. Ames, IA: Wiley-Blackwell; 2010.
Hsu B, Emperumal CP, Grbach VX, Padilla M, Enciso R. Effects of respiratory muscle therapy on obstructive sleep apnea: a systematic review and meta-analysis. J Clin Sleep Med. 2020;16(5):785–801. PMID: 32026802; PMCID: PMC7849810. https://doi.org/10.5664/jcsm.8318.
Gaziano J, Tabor L, Richter J, Plowman E. Prevalence, timing and source of aspiration in individuals with ALS. Chicago, IL: Paper presented at the Dysphagia Research Society; 2015.
Plowman E, Watts S, Tabor L, Robison R, Gaziano J, et al. Impact of expiratory strength training in amyotrophic lateral sclerosis. Muscle Nerve. 2016;54(1):48–53. PMID: 26599236; PMCID: PMC4879103. https://doi.org/10.1002/mus.24990.
Torres-Castro R, Solis-Navarro L, Puppo H, Alcaraz-Serrano V. Respiratory muscle training in patients with obstructive sleep apnea: a systematic review and meta-analysis. Clocks Sleep. 2022;4(2):219–29. PMID: 35466271; PMCID: PMC9036269. https://doi.org/10.3390/clockssleep4020020.
Dorça A, Sarmet M, de Sena Sousa Rocha EM, Marra MB, Million JL, Diniz DS, Maldaner V. A pilot study of the breath stacking technique associated with respiratory muscle endurance training in patients with amyotrophic lateral sclerosis: videofluoroscopic findings in the upper airway. Adv Respir Med. 2021;89(3):284–90. PMID: 34196381. https://doi.org/10.5603/ARM.a2021.0045.
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Dorça, A.C., de Macêdo Bezerra Alcântara, L.A. (2023). Noninvasive Ventilation and Upper Airway Obstruction in Neuromuscular Disease. In: Esquinas, A.M., De Vito, A., Barbetakis, N. (eds) Upper Airway Disorders and Noninvasive Mechanical Ventilation. Springer, Cham. https://doi.org/10.1007/978-3-031-32487-1_34
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DOI: https://doi.org/10.1007/978-3-031-32487-1_34
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