Nasal airflow dynamics: mechanisms and responses associated with an external nasal dilator strip

Kirkness, Jason P.; Wheatley, John R.; Amis, Terence C.

doi:10.1034/j.1399-3003.2000.15e20.x

Cited by 34 publications

(32 citation statements)

References 27 publications

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“…In the present study, we again demonstrated considerable variability in the effectiveness of ENDS in lowering resting Rn and also showed that individuals may "respond" to ENDS during one or both phases of respiration. In our laboratory's previous study (10), there was a tendency for subjects with higher values of resting Rn to respond to ENDS. This finding was maintained in the present study, which included some subjects who also participated in that previous study (see Fig.…”

Section: Discussionmentioning

confidence: 69%

“…Vermoen and co-workers (23) have recently shown that, in normal subjects, ENDS increases the forced inspiratory volume in 1 s (FIV 1 ). Our laboratory has also shown that ENDS decreases inspiratory Rn (at 1.0 l/s) during voluntary hyperpnea (10). Limited studies that examined the effect of ENDS on gas exchange and performance characteristics during exercise in athletes have been performed (20), but there are no studies addressing the effect of ENDS on nasal airflow dynamics during exercise.…”

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confidence: 99%

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Nasal resistance and flow resistive work of nasal breathing during exercise: effects of a nasal dilator strip

Gehring

Garlick

Wheatley

et al. 2000

Journal of Applied Physiology

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Using posterior rhinomanometry, we measured nasal airflow resistance (Rn) and flow-resistive work of nasal breathing (WONB), with an external nasal dilator strip (ENDS) and without (control), in 15 healthy adults (6 men, 9 women) during exclusive nasal breathing and graded (50-230 W) exercise on a cycle ergometer. ENDS decreased resting inspiratory and/or expiratory Rn (at 0.4 l/s) by >0.5 cmH(2)O. l(-1). s in 11 subjects ("responders"). Inspired ventilation (VI) increased with external work rate, but tended to be greater with ENDS. Inspiratory and expiratory Rn (at 0.4 l/s) decreased as VI increased but, in responders, tended to remain lower with ENDS. Inspiratory (but not expiratory) Rn at peak nasal airflow (Vn) increased as VI increased but, again, was lower with ENDS. At a VI of approximately 35 l/min, ENDS decreased flow limitation and hysteresis of the inspiratory transnasal pressure-flow curve. In responders, ENDS reduced inspiratory WONB per breath and inspiratory nasal power values during exercise. We conclude that ENDS stiffens the lateral nasal vestibule walls and, in responders, may reduce the energy required for nasal ventilation during exercise.

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Section: Discussionmentioning

confidence: 69%

mentioning

confidence: 99%

Nasal resistance and flow resistive work of nasal breathing during exercise: effects of a nasal dilator strip

Gehring

Garlick

Wheatley

et al. 2000

Journal of Applied Physiology

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“…However, the two types of devices look and feel much different, and NDSs are typically less intrusive than CPAP masks. Because NDSs are widely advocated for the prevention of snoring and the promotion of nasal breathing during exercise (13), they may serve as a potential control intervention for controlled trials evaluating CPAP. However, it is unclear the extent to which NDSs may influence study outcomes due to an active rather than a placebo effect, which would therefore attenuate the estimates of intervention effects associated with the use of CPAP.…”

Section: Introductionmentioning

confidence: 99%

The use of nasal dilator strips as a placebo for trials evaluating continuous positive airway pressure

Amaro¹,

Duarte²,

Jallad³

et al. 2012

Clinics

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OBJECTIVES:The aim of the current study was to compare the objective and subjective effects of continuous positive airway pressure to the use of nasal dilator strips in patients with acromegaly and moderate to severe obstructive sleep apnea.METHODS:We studied 12 patients with acromegaly and moderate to severe obstructive sleep apnea (male/females = 8/4, age = 52±8 ys, body mass index = 33.5±4.6 Kg/m2, apnea–hypopnea index = 38±14 events/h) who had been included in a randomized, crossover study to receive three months of treatment with continuous positive airway pressure and nasal dilator strips. All patients were evaluated at study entry and at the end of each treatment by polysomnography, and Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index and treatment satisfaction questionnaires. ClinicalTrials.gov: NCT01265121RESULTS:The apnea–hypopnea index values decreased significantly with continuous positive airway pressure treatment but did not change with the use of nasal dilator strips. All of the subjective symptoms improved with both treatments, but these improvements were significantly greater with continuous positive airway pressure than with the nasal dilator strips.CONCLUSION:The use of nasal dilator strips had a much smaller effect on the severity of obstructive sleep apnea in patients with acromegaly and moderate to severe obstructive sleep apnea in comparison to the use of continuous positive airway pressure. Moreover, the improvement in several subjective parameters without any significant objective improvement in obstructive sleep apnea resulting from the use of nasal dilator strips is compatible with a placebo effect.

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“…It is known that dynamic changes in the width of the nasal vestibule lead to a different course of the inspiratory arm of the pressure‐flow relationship (hysteresis) in rhinomanometry. The extent of this hysteresis is described in connection with the elasticity or rigidity of the nasal wing 3–5 …”

Section: Introductionmentioning

confidence: 99%

“…The extent of this hysteresis is described in connection with the elasticity or rigidity of the nasal wing. [3][4][5] . The aim of this investigation was to document information concerning the collapse of the nasal wing using a pressure-flow relationship graph as a diagnostic tool.…”

Section: Introductionmentioning

confidence: 99%

Investigations for the Diagnostic Recording of Nasal Wing Collapse

et al. 2005

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The medial movement of the nasal wing causes a hysteresis in the inspiratory arm of the pressure-flow curve. At this point, the graph runs on or between two border curves, termed the "no collapse curve" (for the maximally opened valve or a stable nasal wing) and the "collapse curve" (for the subtotally closed valve or a collapsed nasal wing), respectively. Analogous to the nasal wing motion, the descending course of hysteresis runs in two phases, and the ascending course runs in three phases. The medial movement of the nasal wing is expressed by a deviation of the graph from the "no collapse curve." The flow, at which the graph leaves this curve, depends on the elasticity module of the nasal wing. The extent of nasal wing collapse is reflected by the approximation of the pressure-flow curve to the "collapse curve" of the graph. The hysteresis appears because of a late opening of the collapsed nasal wing.

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Nasal airflow dynamics: mechanisms and responses associated with an external nasal dilator strip

Cited by 34 publications

References 27 publications

Nasal resistance and flow resistive work of nasal breathing during exercise: effects of a nasal dilator strip

Nasal resistance and flow resistive work of nasal breathing during exercise: effects of a nasal dilator strip

The use of nasal dilator strips as a placebo for trials evaluating continuous positive airway pressure

Investigations for the Diagnostic Recording of Nasal Wing Collapse

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