Somesthetic perception of upper airway airflow in individuals with and without obstructive sleep apnea: a prospective study

Patients with obstructive sleep apnea (OSA) often present altered upper airways (UA) receptors. This study aimed to validate conscious sensory abilities related to oropharyngeal airflow perception in individuals with OSA and controls, as a first step toward developing a clinical screening approach based on airflow perception. The oropharynx was subjected to experimenter-induced mechanical modifications, generating variations in its volume and wall tension. Seven conditions modified airflow in an aggravating or facilitating manner, each item scored 1 when matching the expected response and 0 otherwise, yielding a total sensitivity score ranging from 0 to 7. This prospective study included 112 participants: 41 with OSA and 71 controls (60 questionnaire-negative and 11 PSG-confirmed non-OSA). To limit bias, experimenters were blinded to participants' group assignment, and participants were blinded to their PSG results and questionnaire scores. Participants demonstrated significant somesthetic perception of airflow variations, with scores above zero (p < 0.01) and exceeding predefined pragmatic thresholds (up to 51%). Between-group differences were small (p = 0.0367 or > 0.05) and largely compatible with clinical equivalence (δ ± 1). All participants perceived airflow variations, consistent with expected somesthetic perceptions. This proof-of-concept supports measuring airflow perception in at-risk OSA populations. Registered at clinicaltrials.gov, ID: NCT06092710, URL: https://clinicaltrials.gov/study/NCT06092710