Analysis of the myoelectric characteristics of genioglossus in REM sleep and its improvement by CPAP treatment in OSA patients
Analysis of the myoelectric characteristics of genioglossus in REM sleep and its improvement by CPAP treatment in OSA patients
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OSA患者REM睡眠期颏舌肌肌电特征分析及CPAP治疗对其的改善
DOI：
10.1007/s11325-019-01875-7
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发表时间：
2019-07
影响因子：
2.5
通讯作者：
Ye JY
中科院分区：
文献类型：
--
作者：
Zhou YQ;Zhao D;Yin GP;Li JJ;Cao X;Zhang YH;Ye JY
目的揭示中、重度阻塞性睡眠呼吸暂停(OSA)患者快速眼动(REM)睡眠与非快速眼动(NREM)睡眠状态下颧舌肌(GG)激活的特点，探讨持续正压(CPAP)能否改善OSA患者睡眠状态下GG的激活。研究对象仅包括被诊断为中、重度OSA的受试者，并在第二天晚上通过GGEMG记录用CPAP手动滴定以达到治疗性压力(PT)。阻塞性睡眠呼吸暂停患者在清醒(p= 0.003)和非快速眼动睡眠(p= 0.015)状态下的强直性GGEMG较高，而在快速眼动睡眠(p= 0.862)状态下则不明显。阻塞性睡眠呼吸暂停患者的平均时相活动在包括觉醒(p= 0.007)、非快速眼动睡眠(p= 0.005)和快速眼动睡眠(p= 0.021)在内的各个阶段均显著升高。睡眠时相GGEMG峰值与正常对照组比较差异无统计学意义(p= 0.240)，但阻塞性睡眠呼吸暂停综合征患者非快速眼动睡眠(p= 0.001)和快速眼动睡眠(p= 0.021)时相GGEMG峰值明显高于正常对照组(P= 0.027；P= 0.001)。与REM睡眠时相成分相比，GGEMG的紧张性成分的代偿性增加较少，提示这可能是REM睡眠中UA崩塌的病理机制之一。此外，CPAP治疗可使GGEMG活动恢复正常，并使睡眠时相GGEMG的峰值降低。
ObjectivesTo reveal the characteristics of genioglossus (GG) activation in moderate and severe obstructive sleep apnea (OSA) patients during rapid eye movement (REM) sleep compared with non-rapid eye movement (NREM) sleep and to determine whether continuous positive airway pressure (CPAP) could improve GG activation in OSA patients during sleep.MethodsAll subjects underwent polysomnography (PSG) with synchronous GG electromyography (GGEMG) recording with intra-oral surface electrodes at baseline on the first night. Only those subjects diagnosed with moderate and severe OSA were included and were manually titrated with CPAP to achieve a therapeutic pressure (Pt) with GGEMG recording on the second night.ResultsNine OSA patients and six normal controls were analyzed in this study. The tonic GGEMG was higher in OSA patients during wakefulness (p= 0.003) and NREM sleep (p= 0.015), but it was not higher in REM sleep (p= 0.862). The average phasic activity of OSA patients was significantly higher in all stages, including wakefulness (p= 0.007), NREM sleep (p= 0.005), and REM sleep (p= 0.021). The peak phasic GGEMG was not different in wakefulness compared with normal controls (p= 0.240), but it was higher in OSA patients in NREM sleep (p= 0.001) and REM sleep (p= 0.021), and it was significantly reduced by using CPAP during sleep (NREM sleep:p= 0.027; REM sleep:p= 0.001).ConclusionsOur results demonstrate that GG activation during NREM and REM sleep is associated with component differences. The tonic component of GGEMG exhibited less of a compensatory increase compared with the phasic component in REM sleep, suggesting that it may be one of the pathological mechanisms of UA collapsibility in REM sleep. In addition, treatment with CPAP can normalize GGEMG activity and mostly reduced the peak phasic GGEMG during sleep.
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影响因子：
5.6
作者：
A. Sankari;S. Pranathiageswaran;S. Maresh;A. M. Hosni;M. Badr
通讯作者：
A. Sankari;S. Pranathiageswaran;S. Maresh;A. M. Hosni;M. Badr
影响因子：
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作者：
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作者：
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影响因子：
3.4
作者：
Osman AM;Carter SG;Carberry JC;Eckert DJ
通讯作者：
Eckert DJ
DOI：
10.5664/jcsm.27133
发表时间：
2008-04
期刊：
Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine
影响因子：
--
作者：
C. Kushida;A. Chediak;R. Berry;L. Brown;D. Gozal;C. Iber;S. Parthasarathy;S. Quan;J. Rowley
通讯作者：
C. Kushida;A. Chediak;R. Berry;L. Brown;D. Gozal;C. Iber;S. Parthasarathy;S. Quan;J. Rowley