{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T23:49:08Z","timestamp":1790034548428,"version":"4.0.1"},"reference-count":17,"publisher":"European Respiratory Society (ERS)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur Respir J"],"accepted":{"date-parts":[[2002,3,15]]},"published-print":{"date-parts":[[2002,8]]},"abstract":"<jats:p>Instillation of surfactant into the pharyngeal lumen reduces the pressure required to reopen an occluded airway, and decreases the apnoea\/hypopnoea index (AHI). The authors hypothesised that surfactant also reduces the sleep-related increase in pharyngeal resistance. To test this hypothesis two single blind, crossover, placebo-controlled studies were performed.<\/jats:p><jats:p>In protocol A seven male, asymptomatic snoring subjects were studied during sleep. Inspiratory pharyngeal resistance was calculated from plots of airflow<jats:italic>versus<\/jats:italic>supraglottic pressure (seven breaths) before and after surfactant or saline instillation. In protocol B, in a different group of seven male subjects with sleep apnoea (AHI 15.2 (12) events\u00b7h<jats:sup>\u22121<\/jats:sup>) the effect of surfactant or saline on sleep disordered breathing was measured, for 1\u2005h immediately before and after surfactant or saline instillation.<\/jats:p><jats:p>Surfactant decreased pharyngeal resistance calculated at peak pressure (group mean (sd): pre<jats:italic>versus<\/jats:italic>post 83.7 (76.4)<jats:italic>versus<\/jats:italic>49.4 (71.1) cmH<jats:sub>2<\/jats:sub>O\u00b7L<jats:sup>\u22121<\/jats:sup>\u00b7s<jats:sup>\u22121<\/jats:sup>) and significantly reduced the respiratory disturbance index (RDI pre<jats:italic>versus<\/jats:italic>post 79.7 (58.7)<jats:italic>versus<\/jats:italic>59.6 (56.9) events\u00b7h<jats:sup>\u22121<\/jats:sup>). Saline did not decrease resistance (pre<jats:italic>versus<\/jats:italic>post 58.6 (31.1)<jats:italic>versus<\/jats:italic>72.5 (73.4) cmH<jats:sub>2<\/jats:sub>O\u00b7L<jats:sup>\u22121<\/jats:sup>\u00b7s<jats:sup>\u22121<\/jats:sup>) or RDI (pre<jats:italic>versus<\/jats:italic>post 75.3 (42.4)<jats:italic>versus<\/jats:italic>79.9 (46.1) events\u00b7h<jats:sup>\u22121<\/jats:sup>).<\/jats:p><jats:p>Surfactant reduced the collapsibility of the pharynx and led to a modest reduction in respiratory disturbance index. The authors speculate that surfactant may delay occlusion by reducing the liquid \u201cbridging\u201d within the folded pharyngeal lining.<\/jats:p>","DOI":"10.1183\/09031936.02.00273702","type":"journal-article","created":{"date-parts":[[2002,10,1]],"date-time":"2002-10-01T23:21:54Z","timestamp":1033514514000},"page":"451-457","source":"Crossref","is-referenced-by-count":43,"title":["Effect of surfactant on pharyngeal mechanics in sleeping humans: implications for sleep apnoea"],"prefix":"10.1183","volume":"20","author":[{"given":"M.J.","family":"Morrell","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.","family":"Arabi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.R.","family":"Zahn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.C.","family":"Meyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.B.","family":"Skatrud","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Safwan Badr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2002,8,1]]},"reference":[{"key":"2024101809413246000_20.2.451.1","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1152\/jappl.1980.48.3.500","volume":"48","year":"1980","journal-title":"J Appl Physiol"},{"key":"2024101809413246000_20.2.451.2","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1152\/jappl.1985.58.1.290","volume":"58","year":"1985","journal-title":"J Appl Physiol"},{"key":"2024101809413246000_20.2.451.3","doi-asserted-by":"crossref","first-page":"1379","DOI":"10.1164\/ajrccm\/137.6.1379","volume":"137","year":"1988","journal-title":"Am Rev Resp Dis"},{"key":"2024101809413246000_20.2.451.4","doi-asserted-by":"publisher","DOI":"10.1063\/1.349416"},{"key":"2024101809413246000_20.2.451.5","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1152\/jappl.1997.82.1.78","volume":"82","year":"1997","journal-title":"J Appl Physiol"},{"key":"2024101809413246000_20.2.451.6","doi-asserted-by":"crossref","first-page":"1522","DOI":"10.1164\/ajrccm.157.5.9708070","volume":"157","year":"1998","journal-title":"Am J Resp Crit Care Med"},{"key":"2024101809413246000_20.2.451.7","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1016\/S0196-0709(87)80009-1","volume":"8","year":"1987","journal-title":"Am J Otolryngol"},{"key":"2024101809413246000_20.2.451.8","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1183\/09031936.93.01090785","volume":"1","year":"1988","journal-title":"Eur Respir J"},{"key":"2024101809413246000_20.2.451.9","doi-asserted-by":"crossref","first-page":"2311","DOI":"10.1152\/jappl.1992.72.6.2311","volume":"72","year":"1992","journal-title":"J Appl Physiol"},{"key":"2024101809413246000_20.2.451.10","unstructured":"Rechtschaffen A, Kales A. 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