Mechanisms of the deep, slow-wave, sleep-related increase of upper airway muscle tone in healthy humans.
Mechanisms of the deep, slow-wave, sleep-related increase of upper airway muscle tone in healthy humans.
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健康人上呼吸道肌张力深度、慢波、睡眠相关增加的机制。
DOI：
10.1152/japplphysiol.00872.2016
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Trinder,JohnA
中科院分区：
文献类型：
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作者：
Hicks,Amelia;Cori,JenniferM;Jordan,AmyS;Nicholas,ChristianL;Kubin,Leszek;Semmler,JohnG;Malhotra,Atul;McSharry,DavidGP;Trinder,JohnA
据报道，与较轻的睡眠阶段相比，慢波睡眠（SWS）期间上气道肌肉活动增加。为了揭示这种升高的可能机制，我们探讨了不同的中枢和反射性吸气驱动指数之间的相关性，如气道压力和呼气末CO2的变化，以及健康年轻男性颏舌肌（GG）和腭张肌（TP）肌肉活动的变化，伴随着从较轻的N2阶段过渡到较深的N3阶段的非快速眼动（NREM）睡眠。从NREM阶段N2到N3的32次过渡期间，从16名男性[年龄：20 ± 2.5（SD）岁;体重指数：22.5 ± 1.8 kg/m2]获得了46次GG和38次TP连续肌电记录。过渡到N3睡眠后，GG而不是TP活性增加，并且增加与更多的气道负压、潮气末CO2增加、吸气峰流量增加和分钟通气量增加呈正相关。这些相关性对于TP均无统计学显著性。GG和TP单运动单位的互补分析显示，在N2到N3的转换过程中，GG单位的轻度募集和TP单位的去募集。这些研究结果表明，在健康个体中，在SWS期间增加的GG活动主要是由气道机械感受器和中枢化学感受器的反射刺激驱动的。新&值得注意的是，在年轻健康个体中，在慢波睡眠期间上气道扩张肌颏舌肌的活动的特征性增加被发现与气道机械感受器和中枢化学感受器的刺激增加有关。没有证据表明，在年轻的健康个体中存在刺激颏舌肌活动的中央SWS特异性驱动。然而，阻塞性睡眠呼吸暂停患者是否存在中枢驱动仍有待确定。
Upper airway muscle activity is reportedly elevated during slow-wave sleep (SWS) when compared with lighter sleep stages. To uncover the possible mechanisms underlying this elevation, we explored the correlation between different indices of central and reflex inspiratory drive, such as the changes in airway pressure and end-expiratory CO2and the changes in the genioglossus (GG) and tensor palatini (TP) muscle activity accompanying transitions from the lighter N2 to the deeper N3 stage of non-rapid eye movement (NREM) sleep in healthy young adult men. Forty-six GG and 38 TP continuous electromyographic recordings were obtained from 16 men [age: 20 ± 2.5 (SD) yr; body mass index: 22.5 ± 1.8 kg/m2] during 32 transitions from NREM stages N2 to N3. GG but not TP activity increased following transition into N3 sleep, and the increase was positively correlated with more negative airway pressure, increased end-tidal CO2, increased peak inspiratory flow, and increased minute ventilation. None of these correlations was statistically significant for TP. Complementary GG and TP single motor unit analysis revealed a mild recruitment of GG units and derecruitment of TP units during the N2 to N3 transitions. These findings suggest that, in healthy individuals, the increased GG activity during SWS is driven primarily by reflex stimulation of airway mechanoreceptors and central chemoreceptors.NEW & NOTEWORTHYThe characteristic increase in the activity of the upper airway dilator muscle genioglossus during slow-wave sleep (SWS) in young healthy individuals was found to be related to increased stimulation of airway mechanoreceptors and central chemoreceptors. No evidence was found for the presence of a central SWS-specific drive stimulating genioglossus activity in young healthy individuals. However, it remains to be determined whether a central drive exists in obstructive sleep apnea patients.