ArticleThe European respiratory journal2018
Palatal prolapse as a signature of expiratory flow limitation and inspiratory palatal collapse in patients with obstructive sleep apnoea.
Article in The European respiratory journal, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 41 citations in OpenAlex.
- Pooled it
- Anatomical determinants of upper airway collapsibility in obstructive sleep apnea: A systematic review and meta-analysis.Sleep medicine reviews · 2023Pooled it
- Mouth Closure and Airflow in Patients With Obstructive Sleep Apnea: A Nonrandomized Clinical Trial.JAMA otolaryngology-- head & neck surgery · 2024Trial
- Mandibular Advancement Device Treatment Efficacy Is Associated with Polysomnographic Endotypes.Annals of the American Thoracic Society · 2021Trial
- CT and finite element analysis of mandibular advancement device mechanics in a participant with obstructive sleep apnea: a proof-of-concept study.BMC oral health · 2026Article
- Mandibular Advancement for Obstructive Sleep Apnea: Efficacy and the Trade-off of Expiratory Velopharyngeal Obstruction During Sleep Endoscopy - An Exploratory Observational Study.Nature and science of sleep · 2026Article
- Phenotypes of Velopharyngeal Tube Law in Obstructive Sleep Apnea.Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2025Article
- Polysomnographic airflow shapes and site of collapse during drug-induced sleep endoscopy.The European respiratory journal · 2024Article
- Mafa-dependent GABAergic activity promotes mouse neonatal apneas.Nature communications · 2022Article
- Perceptual snoring as a basis for a psychoacoustical modeling and clinical patient profiling.Sleep & breathing = Schlaf & Atmung · 2022Article
- Comparison of Drug-Induced Sleep Endoscopy and Natural Sleep Endoscopy in the Assessment of Upper Airway Pathophysiology During Sleep: Protocol and Study Design.Frontiers in neurology · 2021Article
- The Importance of Mask Selection on Continuous Positive Airway Pressure Outcomes for Obstructive Sleep Apnea. An Official American Thoracic Society Workshop Report.Annals of the American Thoracic Society · 2020Article
- Article
- Predicting sleep apnea responses to oral appliance therapy using polysomnographic airflow.Sleep · 2020Article
- Qualitative Phenotyping of Obstructive Sleep Apnea and Its Clinical Usefulness for the Sleep Specialist.International journal of environmental research and public health · 2020Review
- Structure and severity of pharyngeal obstruction determine oral appliance efficacy in sleep apnoea.The Journal of physiology · 2019Article
- More Than the Sum of the Respiratory Events: Personalized Medicine Approaches for Obstructive Sleep Apnea.American journal of respiratory and critical care medicine · 2019Review
- Precision Medicine for Obstructive Sleep Apnea.Sleep medicine clinics · 2019Review
- Phenotypic Labelling Using Drug-Induced Sleep Endoscopy Improves Patient Selection for Mandibular Advancement Device Outcome: A Prospective Study.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2019Article
- Article
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 3 countries.
Funding
Abstract
In some individuals with obstructive sleep apnoea (OSA), the palate prolapses into the velopharynx during expiration, limiting airflow through the nose or shunting it out of the mouth. We hypothesised that this phenomenon causes expiratory flow limitation (EFL) and is associated with inspiratory "isolated" palatal collapse. We also wanted to provide a robust noninvasive means to identify this mechanism of obstruction.Using natural sleep endoscopy, 1211 breaths from 22 OSA patients were scored as having or not having palatal prolapse. The patient-level site of collapse (tongue-related, isolated palate, pharyngeal lateral walls and epiglottis) was also characterised. EFL was quantified using expiratory resistance at maximal epiglottic pressure. A noninvasive EFL index (EFLI) was developed to detect the presence of palatal prolapse and EFL using the flow signal alone. In addition, the validity of using nasal pressure was assessed.A cut-off value of EFLI >0.8 detected the presence of palatal prolapse and EFL with an accuracy of >95% and 82%, respectively. The proportion of breaths with palatal prolapse predicted isolated inspiratory palatal collapse with 90% accuracy.This study demonstrates that expiratory palatal prolapse can be quantified noninvasively, is associated with EFL and predicts the presence of inspiratory isolated palatal collapse.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.