title: Women have a greater ventilatory responses to upper airway obstruction than men.
abstract: We examined whether gender specific differences exist in defending inspiratory tidal volumes in the face of upper airway obstruction. In normal weight- and aged-matched men (n=9) and women (n=9), we induced upper airway obstruction with inspiratory flow limitation during NREM sleep by exposing individuals to sub-atmospheric nasal pressure. The mean inspiratory airflow was used to define three distinct levels of upper airway obstruction, based on a mean inspiratory airflow of 175-225 ml/s, 125-175 ml/s and 75-125 ml/s. While duty cycle responses were similar between genders, women had a greater response in T(TOT) at all flow limited conditions. (p<0.05). However, the greater response in T(TOT) led to a more pronounced decline in tidal volume in women compared to men (p<0.05), particularly during the mild and moderate upper airway obstruction. Our data demonstrate that the respiratory rate determines the tidal volume during periods of upper airway obstruction and indicate that individuals with a higher respiratory rate are at risk to develop hypoventilation in face of upper airway obstruction. Because women have a more brisk response in the respiratory rate than men, this may explain the difference in the expression of sleep disordered breathing between genders.
authors.affiliation: Division of Pulmonary Medicine, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: L E
authors.initials: LE
authors.lastname: Pichard
authors.forename: S P
authors.initials: SP
authors.lastname: Patil
authors.forename: E
authors.initials: E
authors.lastname: Gladmon
authors.forename: P L
authors.initials: PL
authors.lastname: Smith
authors.forename: A R
authors.initials: AR
authors.lastname: Schwartz
authors.forename: H
authors.initials: H
authors.lastname: Schneider