Changes in upper airway size during tidal breathing in children with obstructive sleep apnea syndrome

Raanan Arens, Sanghun Sin, Joseph M. McDonough, John M. Palmer, Troy Dominguez, Heiko Meyer, David M. Wootton, Allan I. Pack

Research output: Contribution to journalArticlepeer-review

79 Scopus citations


We performed respiratory-gated magnetic resonance imaging to evaluate airway dynamics during tidal breathing in 10 children with obstructive sleep apnea syndrome (OSAS; age, 4.3 ± 2.3 years) and 10 matched control subjects (age, 5.0 ± 2.0 years). We hypothesized that respiratory cycle fluctuations in upper airway cross-sectional area would be larger in children with OSAS. Methods: Studies were performed under sedation. Respiratory gating was performed automatically at 10, 30, 50, 70, and 90% of Inspiratory and expiratory volume. Airway cross-sectional area was measured at four ascending oropharyngeal levels at each increment of the respiratory cycle. Results: We noted the following in subjects with OSAS compared with control subjects: (1) a smaller upper airway cross-sectional area, particularly during inspiration; (2) airway narrowing occurred during inspiration without evidence of complete airway collapse; (3) airway dilatation occurred during expiration, particularly early in the phase; and (4) magnitude of cross-sectional areas fluctuations during tidal breathing noted in OSAS at levels 1 through 4 were 317, 422, 785, and 922%, compared with 19, 1517, and 24% in control subjects (p < 0.001, p < 0.005, p < 0.001, and p < 0.001, respectively). Conclusions: Fluctuations in airway area during tidal breathing are significantly greater in subjects with OSAS compared with control subjects. Resistive pressure loading is a probable explanation, although increased airway compliance may be a contributing factor.

Original languageEnglish (US)
Pages (from-to)1298-1304
Number of pages7
JournalAmerican journal of respiratory and critical care medicine
Issue number11
StatePublished - Jun 1 2005
Externally publishedYes


  • Magnetic resonance imaging (MRI)
  • Respiratory-gated MRI
  • Upper airway

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine


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