Puberty and upper airway dynamics during sleep.
OBJECTIVE
The upper airway compensatory response to subatmospheric pressure loading declines with age. The epidemiology of obstructive sleep apnea suggests that sex hormones play a role in modulating upper airway function. Sex hormones increase gradually during puberty, from minimally detectable to adult levels. We hypothesized that the upper airway response to subatmospheric pressure loading decreased with increasing pubertal Tanner stage in males but remained stable during puberty in females.


METHODS
Upper airway dynamic function during sleep was measured over the course of puberty.


METHODS
Normal subjects of Tanner stages 1 to 5.


METHODS
During sleep, maximal inspiratory airflow was measured while varying the level of nasal pressure. The slope of the upstream pressure-flow relationship (SPF) was measured.


RESULTS
The SPF correlated with age and Tanner stage. However, the relationship with Tanner stage became nonsignificant when the correlation due to the mutual association with age was removed. Females had a lower SPF than males.


CONCLUSIONS
In both sexes, the upper airway compensatory response to subatmospheric pressure loading decreased with age rather than degree of pubertal development. Thus, changes in sex hormones are unlikely to be a primary modulator of upper airway function during the transition from childhood to adulthood. Although further studies of upper airway structural changes during puberty are needed, we speculate that the changes in upper airway function with age are due to the depressant effect of age on ventilatory drive, leading to a decrease in upper airway neuromotor tone.
Bandla
Preetam
P
Sleep Center, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, PA 19104, USA.
Huang
Jingtao
J
Karamessinis
Laurie
L
Kelly
Andrea
A
Pepe
Michelle
M
Samuel
John
J
Brooks
Lee
L
Mason
Thornton A
TA
Gallagher
Paul R
PR
Marcus
Carole L
CL
D000293:Adolescent; D000328:Adult; D000375:Aging; D002648:Child; D005260:Female; D012739:Gonadal Steroid Hormones / Q000378:metabolism*; D006801:Humans; D001239:Inhalation / Q000502:physiology*; D007320:Inspiratory Capacity / Q000502:physiology; D008297:Male; D017286:Polysomnography; D011627:Puberty / Q000502:physiology*; D012737:Sex Factors; D020181:Sleep Apnea, Obstructive / Q000378:metabolism*
D012739:Gonadal Steroid Hormones