Regulatory Control of the Upper Airway Muscle Genioglossus During Sleep

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Difficulty breathing during sleep is a major health problem. Obstructive Sleep Apnoea (OSA) is the most frequently occurring of these disorders, being found in approximately 4% of males and 2% of females. In OSA the upper airway (UA) collapses during sleep preventing airflow and causing a fall in oxygen levels in the blood. The airway collapses because during sleep muscles in the UA are unable to offset the negative pressure generated within the airway by the effort of inspiring. If the negative pressure is too great and the airway collapses the person has to wake up to reopen the airway. As the UA collapses again on the return of sleep, the cycle becomes repetitive, causing sleep disruption. OSA is a significant health risk causing heart disorders, increased mortality, daytime sleepiness, reduced daytime performance and increased risk of accidents. OSA is due to two interacting factors. First, people with a narrow airway have to generate a greater negative pressure during inspiration. Second, and critically, sleep reduces activity in the UA muscles. The importance of this sleep effect is indicated by the observation that OSA patients do not obstruct while awake. Thus, a respiratory abnormality during sleep is a necessary component of the disorder. However, progress in understanding motor control of UA muscles has been slow. We argue that this is in part because research has concentrated on analysing the activity of the UA muscles, rather than measuring the individual motor units that make up the muscles. In this project we propose to investigate the sleep related activity of individual motor units in the UA muscle, genioglossus (GG). GG plays a critical role in the UA as it keeps the tongue from collapsing backwards into the airway. We anticipate that this approach will provide insights into motor control of the tongue and the role of GG in the development of OSA.