Tracheomalacia and Bronchomalacia: Causes, Symptoms and Solutions
Fact Checked
Intus Healthcare’s writers, customer service team, and sleep experts review and ensure this information is accurate.
Last updated on August 14th, 2024 at 04:15 pm
Chronic Respiratory Diseases (CRDs) affect many individuals around the world, impacting some during the day and others specifically during sleep.
There are many reasons for breathing difficulties, which can differ from person to person, but the symptoms can be managed with the correct treatment.
Some of the more typical conditions include Asthma, Chronic Obstructive Pulmonary Disease (COPD), Obstructive Sleep Apnoea (OSA), and Upper Airway Resistance Syndrome (UARS).
One of the lesser-known conditions is Airway Collapse Syndrome. Although it can present symptoms similar to other respiratory disorders, specifically Sleep Apnoea.
This article will explain the conditions Airway Collapse Syndrome encompasses, the specific causes, symptoms, solutions, and its differences from Sleep Apnoea.
Table of Contents
What is Airway Collapse Syndrome?
Airway Collapse Syndrome is a broad term used to describe conditions with a significant collapse of the airways, particularly the trachea and bronchi. This encompasses various conditions, not limited to any specific part of the respiratory cycle or sleep. Airway collapse is often exacerbated by inflammation, structural abnormalities, or external compression.
The condition can be seen in various clinical scenarios, including Tracheomalacia, Bronchomalacia, and Excessive Dynamic Airway Collapse.
It can be caused by genetic factors or developed causes. Treatment and management may vary depending on the specific underlying condition.
What is Tracheomalacia?
Tracheomalacia is a condition in which the tracheal walls weaken, leading to collapse, particularly during exhalation.
Types of Tracheomalacia
- Congenital Tracheomalacia: Occurs in newborns due to improper formation of the windpipe, resulting in floppy tracheal walls.
- Acquired Tracheomalacia: Rare but can develop at any age due to long-term damage or infections affecting the trachea.
Causes
Congenital Tracheomalacia is caused when the foetus’s windpipe does not develop correctly; instead, the walls of the windpipe are floppy instead of firm.
Acquired Tracheomalacia typically affects adults but can also affect anyone at any age. It can develop because of:
- Damage during surgery
- Long-term use of a breathing tube
- Chronic respiratory infections
- Acid reflux
- Inflammation of the windpipe
- Emphysema.
Symptoms
Common symptoms include:
- Noisy breathing, which may change with sleeping position.
- Wheezing
- Snoring
- Chronic coughing
- Difficulty swallowing
- Shortness of breath
- Frequent respiratory infections
- Difficulty breathing when eating, crying or coughing
What is Bronchomalacia?
Bronchomalacia is a weakness of the bronchial walls that causes a similar collapse in the bronchi. The bronchi are the airways to your lungs; they allow airflow into and out the lungs as you breathe.
It usually affects newborns and rarely affects those older.
Causes
It can develop as a result of:
- Heart disease
- Premature birth can affect the development of lung cartilage
- Williams-Campbell syndrome
- Chest injury
- Emphysema
- Long-term use of a ventilator
- Tuberculosis
- Tumours
Symptoms
- Barking cough
- Wheezing
- Shortness of breath
- Frequent respiratory infections such as the cold and flu.
- Noisy breathing
Home Sleep Studies
Not sure if you have Airway Collapse Syndrome, OSA or UARS? Our simple home sleep test can determine if you have Sleep Apnoea, and your results are returned to you in two working days.
Taking a test allows you to either rule out OSA or begin treating the condition, putting you one step closer to getting quality sleep.
Your sleep test also includes a clinical consultation follow-up call with one of our clinicians to explain your results in further detail.
What is Excessive Dynamic Airway Collapse?
Excessive Dynamic Airway Collapse (EDAC) is a specific type of airway collapse that falls under the broader category of Airway Collapse Syndrome.
It occurs when the airway walls of the trachea collapse forward and touch the anterior wall while breathing (1). EDAC can be present from birth or develop later.
Causes
It is often a comorbid condition found in those with obesity, asthma, Chronic Obstructive Pulmonary Disease, and Gastroesophageal Reflux Disease (GERD). These conditions can contribute to the development of EDAC as they can disrupt breathing.
Although, it can also develop from birth because of insufficient growth of cartilage (2).
Symptoms
Symptoms of EDAC can include:
- Difficulty breathing (dyspnoea)
- Poor sleep
- Waking up tired
- Wheezing or stridor (high-pitched breathing sounds)
- Recurrent respiratory infections
- Chronic barking cough
Diagnosing Airway Collapse Syndrome
Diagnosing Airway Collapse Syndrome can be difficult, as patients are often asymptomatic or may have nonspecific symptoms and overlapping comorbidities.
Diagnosis typically involves imaging studies like CT scans, bronchoscopy, chest X-rays, or dynamic MRI to visualise the airway during different phases of respiration.
Treatments and Home Remedies
The condition can improve independently, depending on the individual and their severity. However, there are many treatments and remedies to help manage symptoms.
Treatment methods
Nebulisers: A nebuliser is a small inhalation device that delivers medications like albuterol to help open the airways and make breathing easier.
Anti-inflammatory medicine: Corticosteroids can reduce inflammation in the airways.
Antibiotics: Used if there is an associated respiratory infection.
Endoscopic procedures: Laser Therapy can remove or reduce tissue causing airway collapse. Balloon Dilation can also temporarily open the airway by inflating a balloon into the narrowed portion of the airway.
Positive airway pressure: CPAP (Continuous Positive Airway Pressure) Therapy and BiPAP (Bi-level Positive Airway Pressure) Therapy is primarily used for Sleep Apnoea but can be adapted to help keep airways open in airway collapse syndromes.
CPAP Masks
CPAP Machines
Surgery
- Tracheostomy: This surgery creates a direct airway through an opening in the trachea, bypassing the collapsed segment.
- Airway Stenting: This procedure involves a stent placed into the airway to keep it open.
- Tracheoplasty: Surgical reconstruction of the trachea to reinforce and stabilise the trachea.
Home Remedies
Breathing Exercises: Pursed lip breathing and diaphragmatic breathing help keep the airways open longer, strengthen the diaphragm, and improve overall breathing efficiency.
Physical activity: Regular exercise can strengthen respiratory muscles and improve lung function.
Humidification: Adding moisture to the air with a humidifier can help reduce airway irritation and make breathing easier.
Removing irritants: Avoid exposure to smoke, dust, and other environmental pollutants that can aggravate the sinuses and airways.
Sleeping position: Sleeping in an elevated position (e.g., using additional pillows or a wedge pillow) can help prevent airway collapse.
Hydration: Staying well-hydrated helps keep the mucous membranes moist and less prone to irritation and collapse.
Diet: Maintaining a balanced diet and a healthy weight can reduce the strain on the respiratory system.
Speech therapy: In some cases, speech therapy can help improve breathing techniques and strengthen breathing muscles.
The Difference Between Airway Collapse Syndrome and Sleep Apnoea
Obstructive Sleep Apnoea and Airway Collapse Syndrome are both respiratory conditions that can affect breathing during sleep, and their symptoms can be similar.
Sleep Apnoea is characterised by upper airway obstruction during sleep. OSA occurs due to the relaxation of the muscles controlling the airway, leading to partial or complete collapse, which causes a breathing disruption.
Unlike Sleep Apnoea Airway Collapse Syndrome can occur at any time and is often triggered by exertion or other factors and may affect different parts of the respiratory system.
If you are having difficulty breathing, it is essential to determine the specific symptoms you are experiencing to identify the correct underlying condition causing them.
Obstructive Sleep Apnoea
Obstructive Sleep Apnoea is a specific type of sleep disorder characterised by repetitive episodes of complete or partial obstruction of the upper airway during sleep.
This obstruction leads to breathing pauses (apnoea’s) or shallow breathing (hypopnoea’s) and is often associated with reduced blood oxygen saturation.
Symptoms of Sleep Apnoea
- Breathing pauses: A person with OSA will frequently experience breathing pauses during sleep as the upper airway becomes blocked. For example, a bed partner may observe you stop breathing in your sleep.
- Choking: As the body struggles to regain oxygen to the lungs, it causes breathlessness at night, choking or gasping for air.
- Daytime Symptoms: OSA can result in excessive daytime sleepiness, morning headaches, and memory problems.
- Snoring: Loud snoring is a common sign, often reported by bed partners.
- Cardiovascular Impact: Long-term OSA can contribute to the development or worsening of hypertension, heart disease, and other cardiovascular problems.
Learn More:
Diagnosing Sleep Apnoea
Sleep Apnoea is diagnosed through a sleep study. The test monitors your blood oxygen levels, peripheral arterial tone, breathing patterns, snoring intensity and heart rate to determine if the condition is present.
Home Sleep Studies
We offer an At-Home Sleep Study, providing results within two working days. Our in-house NHS-trained sleep clinicians analyse one night of sleep data to determine the presence and severity of Sleep Apnoea. If diagnosed, the detailed results letter will provide treatment options tailored to you.
Your sleep test also includes a clinical consultation follow-up call with one of our clinicians to explain your results in further detail.
Treatment for Sleep Apnoea
The gold standard treatment method for OSA is CPAP therapy, which encompasses a machine and mask that delivers pressurised air. The airflow keeps your airway open to prevent an airway closure during sleep.
Other treatments include:
- Oral appliances
- Positional Therapy
- Lifestyle changes
- Surgical interventions to remove obstructions.
Summary
Understanding the distinctions between Airway Collapse Syndrome and other respiratory conditions like Sleep Apnoea is crucial for accurate diagnosis and effective treatment.
As Sleep Apnoea shares similar symptoms to Airway Collapse Syndrome, taking a sleep test can help you understand which condition you may have.
For more information or assistance with Sleep Apnoea, please contact us. Our team has helped over 200,000 individuals diagnose and treat OSA quickly and effectively.
About Our Editorial Team
Written By,
Danielle Myatt, Staff Writer
Danni is a degree-educated content writer who works closely with our clinical and customer services teams to ensure every article is well-researched and accurate. Each article is written to educate, help, and advise on Sleep Apnoea, spread awareness, and encourage treatment.
Medically Reviewed By,
Jay Gadher, Clinical Manager
Jay is an experienced Respiratory and Sleep Clinical Scientist. He completed his BSc in Healthcare Science, which has allowed him to gain expertise in scoring sleep studies. His knowledge and insights about sleep science and human health ensure every article reflects the latest data.
Related Articles
The link between COPD and Sleep Apnoea
The difference between Asthma and COPD
References
- University of Cincinnati Medical Center. If Poorly Controlled Asthma is Suspected, Consider Excessive Dynamic Airway Collapse (EDAC). Available at: https://www.uchealth.com/pulmonary-insights/poorly-controlled-asthma-suspected-consider-excessive-dynamic-airway-collapse-edac/. Accessed 01/07/2024.
- Aslam, A. Cardenas, J. Morrison, R. Legisetty, K. Limanovich, D. Sella, E. Lee, E, Agarwal, P. (2022). Tracheobronchomalacia and Excessive Dynamic Airway Collapse: Current Concepts and Future Directions. Available at: https://pubs.rsna.org/doi/full/10.1148/rg.210155. Accessed 01/07/2024.