ArticlePloS one2020
The effect of nasal and oral breathing on airway collapsibility in patients with obstructive sleep apnea: Computational fluid dynamics analyses.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 55 citations in OpenAlex.
- Mouth Closure and Airflow in Patients With Obstructive Sleep Apnea: A Nonrandomized Clinical Trial.JAMA otolaryngology-- head & neck surgery · 2024Trial
- Investigation on mouth breathing behavior of school-age children and analysis of health intervention strategies.BMC oral health · 2026Article
- Computational fluid dynamics simulation of upper airway flow and soft tissue deformation in a mouth-breathing patient: a case study.BMC oral health · 2026Article
- The role of nasal patency in obstructive sleep apnea: an expert consensus.Frontiers in sleep · 2026Article
- Measuring Nasal Airway Resistance to Personalize Surgery for Nasal Obstruction in OSA Patients.Journal of personalized medicine · 2025Article
- Numerical simulation and functional evaluation of upper airway before and after twin block treatment with different respiratory pathways.Clinical oral investigations · 2025Article
- Short-Term Risk of Complications Related to Obstructive Sleep Apnea After Sinonasal Surgery.Ochsner journal · 2025Article
- Dental Suction Interference and Acoustic Respiratory Monitoring.Anesthesia progress · 2024Article
- The hyoid bone position and upper airway morphology among children with and without adenotonsillar hypertrophy: a cross-sectional study.BMC oral health · 2024Article
- Modeling Realistic Geometries in Human Intrathoracic Airways.Diagnostics (Basel, Switzerland) · 2024Review
- Does obstructive sleep apnea-induced intermittent hypoxia increase the incidence of solitary pulmonary nodules, thyroid nodules, and other disorders? A retrospective study based on 750 cardiovascular disease patients.Sleep & breathing = Schlaf & Atmung · 2024Article
- [Effect of mouth breathing on upper airway structure in patients with obstructive sleep apnea].Lin chuang er bi yan hou tou jing wai ke za zhi = Journal of clinical otorhinolaryngology head and neck surgery · 2023Article
- Computational fluid-structure interaction analysis of flapping uvula on aerodynamics and pharyngeal vibration in a pediatric airway.Scientific reports · 2023Article
- Holistic care for obstructive sleep apnea (OSA) with an emphasis on restoring nasal breathing: A review and perspective.Journal of the Chinese Medical Association : JCMA · 2022Review
- Breathing Exercises for Improving Cognitive Function in Patients with Stroke.Journal of clinical medicine · 2022Review
- Article
- Breathing Re-Education and Phenotypes of Sleep Apnea: A Review.Journal of clinical medicine · 2021Review
- Article
- Respiratory sleep disorders, nasal obstruction and enuresis in children with non-syndromic Pierre Robin sequence.Brazilian journal of otorhinolaryngologyArticle
Corrections and comments
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Authors and funding
2 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe purpose of this study was to investigate the effect of breathing route on the collapsibility of the pharyngeal airway in patients with obstructive sleep apnea by using computational fluid dynamics technology.
methodsThis study examined Japanese men with obstructive sleep apnea. Computed tomography scans of the nose and pharynx were taken during nasal breathing with closed mouth, nasal breathing with open mouth, and oral breathing while they were awake. Three-dimensional reconstructed stereolithography models and digital unstructured grid models were created and airflow simulations were performed using computational fluid dynamics software.
resultsAirflow velocity was significantly higher during oral breathing than during nasal breathing with open or closed mouth. No significant difference in maximum velocity was noted between nasal breathing with closed and open mouth. However, airflow during nasal breathing with open mouth was slow but rapidly sped up at the lower level of the velopharynx, and then spread and became a disturbed, unsteady stream. In contrast, airflow during nasal breathing with closed mouth gradually sped up at the oropharyngeal level without spreading or disturbance. Negative static pressure during oral breathing was significantly decreased; however, there were no significant differences between nasal breathing with closed or open mouth.
conclusionsComputational fluid dynamics results during nasal and oral breathing revealed that oral breathing is the primary condition leading to pharyngeal airway collapse based on the concept of the Starling Resistor model. Airflow throughout the entirety of the breathing route was smoother during nasal breathing with closed mouth than that with open mouth.
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