{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T09:23:34Z","timestamp":1789809814350,"version":"4.0.1"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2000,11,1]],"date-time":"2000-11-01T00:00:00Z","timestamp":973036800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2000,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The male predominance in obstructive sleep apnea (OSA) is currently poorly understood although differences in pharyngeal airway anatomy and physiology have been proposed. As the response to inspiratory resistive loading (IRL) provides important information on both airway collapsibility (mechanics) and ventilatory control, we compared this respiratory response in eight normal women and eight age and body mass index (BMI)-matched men, during stable nonrapid eye movement (NREM) sleep. Upper airway mechanics, ventilation, plus activation of two dilator muscles (genioglossus [GG] and tensor palatini [TP]) were monitored during basal breathing (BL), followed by four sequentially applied loads (5, 10, 15, 25 cm H2O\/L\/s) for three breaths each. Men developed more severe hypopnea in response to identical applied external loads than did women. At a resistance of 25 cm H2O\/L\/s, Vt decreased by 26 \u00b1 1% in women compared with 44 \u00b1 1% in men (differences between sexes p &amp;lt; 0.05). Pharyngeal resistance (Rpha) in response to IRL increased significantly more in men than women (37.3 \u00b1 11.2 cm H2O\/L\/s in men at maximal load, compared with an increase of 6.6 \u00b1 3.9 cm H2O\/L\/s in women, p &amp;lt; 0.05). Men and women had near identical minute ventilation responses to total load (applied extrinsic plus measured intrinsic), implying no differences in central drive or load response. There were no significant increases in GG or TP activation in response to IRL in either sex. We conclude that normal men are more vulnerable to load-induced hypoventilation than women, due to increased upper airway collapse, which could not be explained by differences in dilator muscle activation. This implies a fundamental difference in the upper airway anatomy and\/or tissue characteristics between the two sexes.<\/jats:p>","DOI":"10.1164\/ajrccm.162.5.2003131","type":"journal-article","created":{"date-parts":[[2013,4,4]],"date-time":"2013-04-04T14:25:08Z","timestamp":1365085508000},"page":"1627-1632","source":"Crossref","is-referenced-by-count":152,"title":["Airway Mechanics and Ventilation in Response to Resistive Loading during Sleep"],"prefix":"10.1093","volume":"162","author":[{"given":"GIORA","family":"PILLAR","sequence":"first","affiliation":[{"name":"Sleep Disorders Section, Divisions of Endocrinology and Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ATUL","family":"MALHOTRA","sequence":"additional","affiliation":[{"name":"Sleep Disorders Section, Divisions of Endocrinology and Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ROBERT","family":"FOGEL","sequence":"additional","affiliation":[{"name":"Sleep Disorders Section, Divisions of Endocrinology and Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JOS\u00c9E","family":"BEAUREGARD","sequence":"additional","affiliation":[{"name":"Sleep Disorders Section, Divisions of Endocrinology and Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ROBERT","family":"SCHNALL","sequence":"additional","affiliation":[{"name":"Sleep Disorders Section, Divisions of Endocrinology and Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"DAVID P.","family":"WHITE","sequence":"additional","affiliation":[{"name":"Sleep Disorders Section, Divisions of Endocrinology and Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2000,11,1]]},"reference":[{"key":"2026032708333267500_B1","doi-asserted-by":"crossref","first-page":"1230","DOI":"10.1056\/NEJM199304293281704","article-title":"The occurrence of sleep-disordered breathing among middle-aged adults.","volume":"32","author":"Young","year":"1993","journal-title":"N Engl J Med"},{"key":"2026032708333267500_B2","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1093\/sleep\/6.4.312","article-title":"Incidence of sleep apnea in a presumably healthy working population: a significant relationship with excessive daytime sleepiness.","volume":"6","author":"Lavie","year":"1983","journal-title":"Sleep"},{"key":"2026032708333267500_B3","doi-asserted-by":"crossref","first-page":"1394","DOI":"10.1164\/ajrccm\/146.6.1394","article-title":"Size and mechanical properties of the pharynx in healthy men and women.","volume":"146","author":"Brooks","year":"1992","journal-title":"Am Rev Respir Dis"},{"key":"2026032708333267500_B4","doi-asserted-by":"crossref","first-page":"890","DOI":"10.1152\/jappl.1986.61.3.890","article-title":"Pharyngeal cross-sectional area in normal men and women.","volume":"61","author":"Brown","year":"1986","journal-title":"J Appl Physiol"},{"key":"2026032708333267500_B5","doi-asserted-by":"crossref","first-page":"1375","DOI":"10.1164\/ajrccm\/148.5.1385","article-title":"Dynamic upper airway imaging during awake respiration in normal subjects and patients with sleep disordered breathing.","volume":"148","author":"Schwab","year":"1993","journal-title":"Am Rev Respir Dis"},{"key":"2026032708333267500_B6","doi-asserted-by":"crossref","first-page":"1986","DOI":"10.1152\/jappl.1997.83.6.1986","article-title":"Gender differences in airway resistance during sleep.","volume":"83","author":"Trinder","year":"1997","journal-title":"J Appl Physiol"},{"key":"2026032708333267500_B7","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1152\/jappl.1982.52.3.607","article-title":"Ventilatory adaptations to resistive loading during wakefulness and non-REM sleep.","volume":"52","author":"Iber","year":"1982","journal-title":"J Appl Physiol"},{"key":"2026032708333267500_B8","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1152\/jappl.1990.68.3.1195","article-title":"Effect of mechanical loading on expiratory and inspiratory muscle activity during NREM sleep.","volume":"68","author":"Badr","year":"1990","journal-title":"J Appl Physiol"},{"key":"2026032708333267500_B9","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1152\/jappl.1987.63.2.603","article-title":"Neuromuscular and mechanical responses to inspiratory resistive loading during sleep.","volume":"63","author":"Hudgel","year":"1987","journal-title":"J Appl Physiol"},{"key":"2026032708333267500_B10","doi-asserted-by":"crossref","first-page":"1221","DOI":"10.1152\/jappl.1992.72.4.1221","article-title":"Load compensation and respiratory muscle function during sleep.","volume":"72","author":"Henke","year":"1992","journal-title":"J Appl Physiol"},{"key":"2026032708333267500_B11","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1152\/jappl.1991.70.1.158","article-title":"Effect of sleep- induced increases in upper airway resistance on respiratory muscle activity.","volume":"70","author":"Henke","year":"1991","journal-title":"J Appl Physiol"},{"key":"2026032708333267500_B12","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1152\/jappl.1990.69.2.617","article-title":"Effects of sleep-induced increases in upper airway resistance on ventilation.","volume":"69","author":"Henke","year":"1990","journal-title":"J Appl Physiol"},{"key":"2026032708333267500_B13","doi-asserted-by":"crossref","first-page":"1602","DOI":"10.1164\/ajrccm.155.5.9154864","article-title":"Impaired respiratory response to resistive loading during sleep in healthy offspring of patients with obstructive sleep apnea.","volume":"155","author":"Pillar","year":"1997","journal-title":"Am J Respir Crit Care Med"},{"key":"2026032708333267500_B14","doi-asserted-by":"crossref","first-page":"2117","DOI":"10.1152\/jappl.1993.75.5.2117","article-title":"Influence of sleep on response to negative airway pressure of tensor palatini muscle and retropalatal airway.","volume":"75","author":"Wheatley","year":"1993","journal-title":"J Appl Physiol"},{"key":"2026032708333267500_B15","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1164\/ajrccm\/148.3.597","article-title":"Influence of sleep on genioglossus muscle activation by negative pressure in normal men.","volume":"148","author":"Wheatley","year":"1993","journal-title":"Am Rev Respir Dis"},{"key":"2026032708333267500_B16","first-page":"299","article-title":"Electromyography of the human pharynx: discharge patterns of the superior pharyngeal constrictor during respiration.","volume":"21","author":"Hairston","year":"1981","journal-title":"Electromyogr Clin Neurophysiol"},{"key":"2026032708333267500_B17","doi-asserted-by":"crossref","first-page":"1461","DOI":"10.1164\/ajrccm.157.5.9708008","article-title":"Detection of flow limitation with a nasal cannula\/pressure transducer.","volume":"157","author":"Hosselet","year":"1998","journal-title":"Am J Respir Crit Care Med"},{"key":"2026032708333267500_B18","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1164\/ajrccm.158.3.9708056","article-title":"Assessment of inspiratory flow limitation invasively and noninvasively during sleep.","volume":"158","author":"Clark","year":"1998","journal-title":"Am J Respir Crit Care Med"},{"key":"2026032708333267500_B19","doi-asserted-by":"crossref","first-page":"1186","DOI":"10.1152\/jappl.1988.64.3.1186","article-title":"Sleep and the ventilatory response to resistive loading in normal men.","volume":"64","author":"Wiegand","year":"1988","journal-title":"J Appl Physiol"},{"key":"2026032708333267500_B20","first-page":"157","article-title":"Sleep and resistive loading influences on human upper airway collapsibility.","volume":"345","author":"Wiegand","year":"1990","journal-title":"Prog Clin Biol Res"},{"key":"2026032708333267500_B21"},{"key":"2026032708333267500_B22","doi-asserted-by":"crossref","first-page":"2087","DOI":"10.1183\/09031936.97.10092087","article-title":"The effect of age, sex, obesity and posture on upper airway size.","volume":"10","author":"Martin","year":"1997","journal-title":"Eur Respir J"},{"key":"2026032708333267500_B23","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1183\/09031936.93.02040344","article-title":"Lung volume-related changes in the pharyngeal area of obese females with and without obstructive sleep apnoea.","volume":"2","author":"Rubinstein","year":"1989","journal-title":"Eur Respir J"},{"key":"2026032708333267500_B24","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1152\/jappl.1985.58.2.365","article-title":"Pharyngeal resistance in normal humans: influence of gender, age, and obesity.","volume":"58","author":"White","year":"1985","journal-title":"J Appl Physiol"},{"key":"2026032708333267500_B25","first-page":"A170","article-title":"The influences of aging and gender on upper airway structure and function [abstract].","volume":"159","author":"Malhotra","year":"1999","journal-title":"Am J Respir Crit Care Med"},{"key":"2026032708333267500_B26","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1136\/thx.54.4.323","article-title":"Neck soft tissue and fat distribution: comparison between normal men and women by magnetic resonance imaging [see comments].","volume":"54","author":"Whittle","year":"1999","journal-title":"Thorax"},{"key":"2026032708333267500_B27","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1152\/jappl.1998.84.3.1055","article-title":"Upper airway muscle activity in normal women: influence of hormonal status.","volume":"84","author":"Popovic","year":"1998","journal-title":"J Appl Physiol"},{"key":"2026032708333267500_B28","doi-asserted-by":"crossref","first-page":"1571","DOI":"10.1172\/JCI115751","article-title":"Waking genioglossal EMG in sleep apnea patients versus normal controls (a neuromuscular compensatory mechanisms).","volume":"89","author":"Mezzanotte","year":"1992","journal-title":"J Clin Invest"}],"container-title":["American Journal of Respiratory and Critical Care Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ajrccm\/article-pdf\/162\/5\/1627\/67544055\/ajrccm_162_5_1627.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajrccm\/article-pdf\/162\/5\/1627\/67544055\/ajrccm_162_5_1627.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T12:33:42Z","timestamp":1774614822000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajrccm\/article\/162\/5\/1627\/8541049"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2000,11,1]]},"references-count":28,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2000,11,1]]},"published-print":{"date-parts":[[2000,11,1]]}},"URL":"https:\/\/doi.org\/10.1164\/ajrccm.162.5.2003131","relation":{},"ISSN":["1073-449X","1535-4970"],"issn-type":[{"value":"1073-449X","type":"print"},{"value":"1535-4970","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2000,11]]},"published":{"date-parts":[[2000,11,1]]}}}