The influence of obstructive sleep apnea and gender on genioglossus activity during rapid eye movement sleep.
The influence of obstructive sleep apnea and gender on genioglossus activity during rapid eye movement sleep.
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DOI：
10.1378/chest.08-2292
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发表时间：
2009-04
期刊：
影响因子：
9.6
通讯作者：
Jordan AS
中科院分区：
文献类型：
--
作者：
Eckert DJ;Malhotra A;Lo YL;White DP;Jordan AS
对快速眼动 (REM) 睡眠期间阻塞性睡眠呼吸暂停 (OSA) 恶化的机制的研究很少。上呼吸道肌张力降低可能是一个重要因素。由于呼吸事件和相关的血气变化会影响颏舌肌 (GG) 活动，因此我们使用持续气道正压通气 (CPAP) 比较了 OSA 患者和对照受试者在快速眼动睡眠期间的 GG 活动，以尽量减少上气道阻力 (RUA) 和血气紊乱对 GG 活动的影响。对 20 名受试者（10 名女性受试者）、12 名健康个体和 8 名 OSA 患者进行了过夜研究。记录睡眠分期、会厌压、每分钟通气量和 GG 肌电图 (GGEMG)。 GGEMG 对有（阶段性 REM）和无（强直性 REM）眼球运动的 REM 睡眠、非 REM (NREM) 睡眠和清醒状态进行了比较。呼吸频率从稳定的 NREM 睡眠到强直 REM 睡眠再到阶段性 REM 睡眠增加，而潮气量和 GGEMG 减少（即峰值 GGEMG：分别为 3.0 ± 0.7 vs 1.7 ± 0.4 vs 1.2 ± 0.3% max；p < 0.001）。 OSA 患者和对照受试者之间或性别之间，快速眼动睡眠期间 GGEMG 的减少没有差异。当 CPAP 使 RUA 和血气紊乱最小化时，OSA 和健康的男女个体中，颏舌活动从稳定的 NREM 到强直性 REM 到阶段性 REM 睡眠逐步减少，程度相似。因此，OSA 患者在 REM 睡眠期间 GG 神经控制的固有异常不太可能解释该睡眠阶段上气道塌陷的增加。相反，快速眼动期间 GG 活动的普遍减少可能会使高度依赖上气道扩张器肌肉的人在快速眼动睡眠期间容易出现咽部塌陷。
The mechanisms contributing to worsening of obstructive sleep apnea (OSA) during rapid eye movement (REM) sleep have been minimally studied. Reduced upper-airway muscle tone may be an important contributor. Because respiratory events and the associated blood gas changes can influence genioglossus (GG) activity, we compared GG activity between OSA patients and control subjects during REM sleep using continuous positive airway pressure (CPAP) to minimize the influences of upper-airway resistance (RUA) and blood gas disturbances on GG activity. Twenty subjects (10 female subjects), 12 healthy individuals, and 8 OSA patients, were studied overnight. Sleep staging, epiglottic pressure, minute ventilation, and GG electromyogram (GGEMG) were recorded. GGEMG was compared between REM sleep with (phasic REM) and without (tonic REM) eye movements, non-REM (NREM) sleep, and wakefulness. Breathing frequency increased from stable NREM, to tonic REM to phasic REM sleep, whereas tidal volume and GGEMG decreased (ie, peak GGEMG: 3.0 ± 0.7 vs 1.7 ± 0.4 vs 1.2 ± 0.3% max, respectively; p < 0.001). Reductions in GGEMG during REM sleep were not different between OSA patients and control subjects or between genders. When RUA and blood gas disturbances are minimized by CPAP, genioglossal activity is reduced in a stepwise manner from stable NREM, to tonic REM to phasic REM sleep to a similar extent in OSA and healthy individuals of both genders. Thus, an inherent abnormality in GG neural control in OSA patients during REM sleep is unlikely to explain the increased upper-airway collapse in this sleep stage. Rather, a generalized reduction in GG activity during REM likely renders individuals who are highly reliant on upper-airway dilator muscles vulnerable to pharyngeal collapse during REM sleep.
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DOI：
10.1164/ajrccm.153.6.8665050
发表时间：
1996-06-01
影响因子：
24.7
作者：
Mezzanotte, WS;Tangel, DJ;White, DP
通讯作者：
White, DP
影响因子：
9.6
作者：
Haba-Rubio, J;Janssens, JP;Sforza, E
通讯作者：
Sforza, E
影响因子：
3.3
作者：
MILLMAN, RP;KNIGHT, H;PACK, AI
通讯作者：
PACK, AI
DOI：
10.1164/ajrccm/138.4.874
发表时间：
1988-10-01
期刊：
AMERICAN REVIEW OF RESPIRATORY DISEASE
影响因子：
--
作者：
GOULD, GA;GUGGER, M;DOUGLAS, NJ
通讯作者：
DOUGLAS, NJ
影响因子：
3.3
作者：
Berry, RB;Asyali, MA;Khoo, MCK
通讯作者：
Khoo, MCK