Tongue Protrusion Strength in Arousal State Is Predictive of the Airway Patency in Obstructive Sleep Apnea
Tongue Protrusion Strength in Arousal State Is Predictive of the Airway Patency in Obstructive Sleep Apnea
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DOI：
10.1620/tjem.236.241
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发表时间：
2015-08-01
影响因子：
2.2
通讯作者：
Izumi, Tadafumi
中科院分区：
文献类型：
--
作者：
Kanezaki, Masashi;Ogawa, Teruhiro;Izumi, Tadafumi
颏舌肌的收缩影响舌前伸强度或上气道扩张力。阻塞性睡眠呼吸暂停（OSA）患者的上气道被认为在睡眠期间塌陷，至少部分是因为与睡眠相关的颏舌肌活动减少。因此，虽然在睡眠期间由颏舌肌活动引起的舌头伸出强度有助于维持OSA患者的气道通畅，但是唤醒状态下舌头伸出强度与阻塞性睡眠呼吸暂停之间的关系尚未完全阐明。传统的舌前伸强度测量方法不能用于无牙颌患者和/或咬合力下降患者的舌前伸强度评估。在这项研究中，采用一种新的测量方法，不需要咬传感器，我们调查之间的关系舌头突出强度和多导睡眠图的结果。我们招募了20名正常人和26名OSA患者。所有受试者均完成舌前伸强度的测量。每例OSA受试者均通过完整的多导睡眠图进行评估。舌前伸强度的程度通过与应变计测力计连接的压舌板的最大自主收缩来评估。舌前伸强度与阻塞性呼吸暂停时间、呼吸暂停指数（AI）和睡眠第2阶段百分比呈负相关（分别为r =-0.61，p = 0.0001，r = -0.41，p = 0.03和r = -0.39，p =0.04）。在觉醒状态下测量的舌头伸出强度可预测OSA患者睡眠期间的气道通畅性。
Contraction of the genioglossus affects either tongue protrusion strength or dilating forces of the upper airway. The upper airway in patients with obstructive sleep apnea (OSA) is thought to collapse during sleep, at least in part because of a sleep related reduction in genioglossus muscle activity. Thus, although tongue protrusion strength by genioglossus activity during sleep contributes to the maintenance of airway patency in patients with OSA, the relationship between tongue protrusion strength in the arousal state and obstructive sleep apnea has not been fully elucidated. Conventional method of tongue protrusion strength cannot be used to evaluate in edentulous subjects and/or subjects with the decreased biting force. In this study, employing a novel measurement method that does not require biting a transducer, we investigated relationships between the tongue protrusion strength and polysomnographic findings. We enrolled twenty normal subjects and 26 subjects with OSA. All subjects completed the measurement of tongue protrusion strength. Each subject with OSA was evaluated by full polysomnography. The degree of tongue protrusion strength was assessed by maximum voluntary contraction against the tongue depressor connected with a strain gauge dynamometer. The tongue protrusion strength was negatively correlated with obstructive apnea time, apnea index (AI) and the percent of sleep stage 2 (r = -0.61, p < 0.0001, r = -0.41 p = 0.03 and r = -0.39 p =0.04, respectively). Tongue protrusion strength measured in the arousal state is predictive of the airway patency during sleep in OSA.