FLUCTUATION IN TIMING OF UPPER AIRWAY AND CHEST-WALL INSPIRATORY MUSCLE-ACTIVITY IN OBSTRUCTIVE SLEEP-APNEA
FLUCTUATION IN TIMING OF UPPER AIRWAY AND CHEST-WALL INSPIRATORY MUSCLE-ACTIVITY IN OBSTRUCTIVE SLEEP-APNEA
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DOI：
10.1152/jappl.1990.69.2.443
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发表时间：
1990-08-01
影响因子：
3.3
通讯作者：
HARASICK, T
中科院分区：
文献类型：
--
作者：
HUDGEL, DW;HARASICK, T
上呼吸道和胸壁吸气肌电活动幅度的不平衡与阻塞性睡眠呼吸暂停 (OSA) 中上呼吸道的塌陷和重新打开有关。本研究的目的是检查这些吸气肌的阶段性活动的时间是否也与 OSA 中上气道口径的变化相关。我们假设在胸壁泵肌激活之前激活上呼吸道肌肉阶段性电活动将有助于保持上呼吸道通畅。相反，我们预计这种模式的逆转以及上气道吸气肌的延迟激活将与上气道狭窄或塌陷相关。因此，对 6 名 OSA 患者 2 期睡眠中 58 个呼吸暂停周期的中线经下颌和肋缘移动时间平均 (MTA) 肌电图 (EMG) 信号的时间和幅度进行了分析。在 86% 的呼吸暂停后呼吸分析中，上气道 MTA 峰值活动先于胸壁峰值活动。在 86% 的阻塞性呼吸努力中，上呼吸道 MTA 峰值活动跟随胸壁峰值活动。阶段性电活动的开始遵循相同的模式。在吸气过程中，当阶段性吸气肌电图振幅从呼吸暂停前到呼吸暂停时没有变化时，不会发生上述时间变化。即使在呼吸内，上呼吸道和胸壁电活动的相对时间也与压力-流量关系的变化密切相关。我们得出的结论是，OSA 患者睡眠期间上呼吸道和胸壁吸气肌吸气活动的相对时间会发生波动。我们推测上呼吸道和胸壁吸气肌收缩的相对时间有助于睡眠期间上呼吸道的吸气口径。
An imbalance in the amplitude of electrical activity of the upper airway and chest wall inspiratory muscles is associated with both collapse and reopening the the upper airway in obstructive sleep apnea (OSA). The purpose of this study was to examine whether timing of the phasic activity of these inspiratory muscles also was associated with changes in upper airway caliber in OSA. We hypothesized that activation of upper airway muscle phasic electrical activity before activation of the chest wall pump muscles would help preserve upper airway patency. In contrast, we anticipated that the reversal of this pattern with delayed activation of upper airway inspiratory muscles would be associated with upper airway narrowing or collapse. Therefore the timing and amplitude of midline transmandibular and costal margin moving time average (MTA) electromyogram (EMG) signals were analyzed from 58 apnea cycles in stage 2 sleep in six OSA patients. In 86% of the postapnea breaths analyzed the upper airway MTA peak activity preceded the chest wall peak activity. In 86% of the obstructed respiratory efforts the upper airway MTA peak activity followed the chest wall peak activity. The onset of phasic electrical activity followed this same pattern. During inspiratory efforts when phasic inspiratory EMG amplitude did not change from preapnea to apnea, the timing changes not above occurred. Even within breaths the relative timing of the upper airway and chest wall electrial activities was closely associated with changes in the pressure-flow relationship. We conclude that the relative timing of inspiratory activity of the upper airway and chest wall inspiratory muscles fluctuates during sleep in OSA. We speculate that the relative timing of upper airway and chest wall inspiratory muscle contraction contributes to the inspiratory caliber of the upper airway during sleep.