INFLUENCE OF GENDER ON WAKING GENIOGLOSSAL ELECTROMYOGRAM AND UPPER AIRWAY-RESISTANCE
INFLUENCE OF GENDER ON WAKING GENIOGLOSSAL ELECTROMYOGRAM AND UPPER AIRWAY-RESISTANCE
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DOI：
10.1164/ajrccm.152.2.7633734
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发表时间：
1995-08-01
影响因子：
24.7
通讯作者：
WHITE, DP
中科院分区：
文献类型：
--
作者：
POPOVIC, RM;WHITE, DP
阻塞性睡眠呼吸暂停综合征一般认为男性比女性更常见。这可能与性别差异，无论是呼吸控制机制或结构和功能的咽气道。大多数研究表明，女性的咽部气道在结构上比男性小，这可能会使她们更容易发生气道塌陷，而不是保护她们。然而，咽气道通畅实际上是解剖结构和咽肌活动之间的动态相互作用。因此，我们假设女性可能增加了咽扩张肌的活动，从而保护他们在睡眠期间气道塌陷。为了验证这一假设，我们比较了颏舌EMC（CC-EMC，测量为最大肌肉活动的百分比）和上气道阻力在22名健康受试者，11名男性和31名女性，在清醒状态。咽部阻力在性别间无显著差异。然而，女性的吸气峰相位和呼气紧张性GG-EMG活动均显著更大（CG-EMC峰相位;最大值的24.3 +/- 3.8比13.1 +/- 4.5%，p < 0.02; GG-EMG紧张性;最大值的12.2 +/- 2.8比4.7 +/- 1.2%，p < 0.01）。此外，女性表现出显着的肌电图反应，吸气负荷，没有观察到在男性。我们的结论是，妇女，在基础条件下清醒，增强颏舌肌活动与男性相比。在这种增强的肌肉活动在不同状态下保持的程度上，女性气道可能更稳定且更不易塌陷。
Obstructive sleep apnea is generally recognized as more common in men than in women. This could relate to gender differences in either ventilatory control mechanisms or the structure and function of the pharyngeal airway. Most studies suggest that women have a structurally smaller pharyngeal airway than men, which would likely predispose rather than protect them from airway collapse. However, pharyngeal airway patency is actually a dynamic interaction between anatomy and pharyngeal muscle activity. We therefore hypothesized that females may have increased pharyngeal dilator muscle activity, thereby protecting them from airway collapse during sleep. To test this hypothesis, we compared genioglossal EMC (CC-EMC, measured as a percentage of maximal muscle activity) and upper airway resistance in 22 healthy subjects, 11 males and 31 females, during wakefulness. No significant difference in pharyngeal resistance could be found between the genders. However, inspiratory peak phasic and expiratory tonic GG-EMG activity were both significantly greater in females (CG-EMC peak phasic; 24.3 +/- 3.8 versus 13.1 +/- 4.5% of maximum, p < 0.02; GG-EMG tonic; 12.2 +/- 2.8 versus 4.7 +/- 1.2% of maximum, p < 0.01). In addition, females demonstrated a significant EMG response to inspiratory loading that was not observed in men. We conclude that women have, under basal conditions during wakefulness, augmented genioglossal muscle activity compared with men. To the extent that this augmented muscle activity is maintained across states, the female airway may be more stable and less collapsible.