WAKING GENIOGLOSSAL ELECTROMYOGRAM IN SLEEP-APNEA PATIENTS VERSUS NORMAL CONTROLS (A NEUROMUSCULAR COMPENSATORY MECHANISM)
WAKING GENIOGLOSSAL ELECTROMYOGRAM IN SLEEP-APNEA PATIENTS VERSUS NORMAL CONTROLS (A NEUROMUSCULAR COMPENSATORY MECHANISM)
复制标题
DOI：
10.1172/jci115751
复制
发表时间：
1992-05-01
影响因子：
15.9
通讯作者：
WHITE, DP
中科院分区：
文献类型：
--
作者：
MEZZANOTTE, WS;TANGEL, DJ;WHITE, DP
阻塞性睡眠呼吸暂停患者的咽部塌陷可能是睡眠相关的咽扩张肌活动减少叠加气道解剖异常的产物。我们推测，在清醒状态下，呼吸暂停患者咽扩张肌活动的增加弥补了气道大小的减少，从而保持通畅。我们研究了11名OSA患者和14名年龄匹配的对照者的清醒颏舌肌（GG）肌电图（EMG）活动，以确定呼吸暂停患者在清醒状态下的GG活动是否高于对照者。为了进行这一测定，我们开发了一种可重复的方法，从而可以定义真正的最大GG EMG，从而将基础活动定量为该最大值的百分比。因此，可以直接比较个体之间的基础活性。我们观察到呼吸暂停患者的基础颏舌活动显著高于对照组（40.6 +/- 5.6% vs. 12.7 +/- 1.7%）。当比较大小匹配的子集时，这种差异仍然存在。呼吸暂停患者的这种增强的GG活性可以通过气道正压通气来降低。我们推测呼吸暂停患者在清醒时的神经肌肉代偿可能在睡眠时丧失，导致气道塌陷。
Pharyngeal collapse in obstructive sleep apnea patients is likely a product of a sleep-related decrement in pharyngeal dilator muscle activity superimposed upon abnormal airway anatomy. We postulate that during wakefulness, increased pharyngeal dilator muscle activity in apnea patients compensates for diminished airway size thus maintaining patency. We studied the waking genioglossus (GG) electromyogram (EMG) activity in 11 OSA patients and 14 age-matched controls to determine if GG activity is higher in the awake state in apnea patients than controls. To make this determination, we developed a reproducible methodology whereby true maximal GG EMG could be defined and thus basal activity quantitated as a percentage of this maximal value. Therefore, direct comparisons of basal activity between individuals was possible. We observed apnea patients to have significantly greater basal genioglossal activity compared to controls (40.6 +/- 5.6% vs. 12.7 +/- 1.7% of maximum). This difference persisted when size-matched subsets were compared. This augmented GG activity in apnea patients could be reduced with positive airway pressure. We speculate that this neuromuscular compensation present during wakefulness in apnea patients may be lost during sleep leading to airway collapse.