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在临床研究中,强迫振荡测量不会影响上气道肌肉张力或睡眠。

Forced oscillation measurements do not affect upper airway muscle tone or sleep in clinical studies.

作者信息

Badia J R, Farré R, Rigau J, Uribe M E, Navajas D, Montserrat J M

机构信息

Servei de Pneumologia i Allèrgia Respiratòria, Hospital Clínic, Barcelona, Spain.

出版信息

Eur Respir J. 2001 Aug;18(2):335-9. doi: 10.1183/09031936.01.00085001.

Abstract

Upper airway obstruction in the sleep apnoea/hypopnoea syndrome (SAHS) can be easily assessed by measuring respiratory impedance with the forced oscillation technique (FOT). This methodology has been proposed as a useful clinical tool both for the diagnosis of sleep breathing disorders and for continuous positive airway pressure (CPAP) titration. However, previous studies suggest that the application of high-frequency pressure oscillation to the upper airway may induce changes in the electroencephalogram (EEG) or upper airway muscle function. The effect of FOT measurements on upper airway muscle tone and EEG in clinical sleep studies was examined. Seven patients with moderate SAHS were included (age: 54+/-11 yrs; apnoea/hypopnoea index: 43+/-21 events x h(-1); body mass index: 30+/-2 kg x m(-2)). Genioglossus surface electromyogram activity (EMGgg) and EEG signal were analysed with and without FOT application (frequency: 5 Hz and 30 Hz; peak-to-peak pressure oscillation: 1 cmH2O) during stable sleep. Measurements were carried out in two different situations. Step 1: applying FOT during episodes of obstructive events or flow limitation; and step 2: during prolonged periods of normal breathing at optimal CPAP. The root mean square of EMGgg activity and fast Fourier analysis (alpha and delta bands) of the EEG signal were performed. The application of FOT did not increase EMGgg activity in any of the situations studied. In addition, no evidence of the effects on EEG was found: alpha/delta relationship: awake:0.70, baseline sleep:0.13, FOT(5 Hz):0.18, FOT(30 Hz):0.11. The presented results suggest that the use of forced oscillation technique over the ranges of frequency and amplitude proposed for clinical sleep studies does not induce changes in upper airway muscle activity and neurological variables in patients with sleep apnoea/hypopnoea syndrome.

摘要

睡眠呼吸暂停/低通气综合征(SAHS)中的上气道阻塞可通过用强迫振荡技术(FOT)测量呼吸阻抗来轻松评估。该方法已被提议作为诊断睡眠呼吸障碍和持续气道正压通气(CPAP)滴定的一种有用的临床工具。然而,先前的研究表明,对上气道施加高频压力振荡可能会引起脑电图(EEG)或上气道肌肉功能的变化。研究了FOT测量在临床睡眠研究中对上气道肌肉张力和EEG的影响。纳入了7例中度SAHS患者(年龄:54±11岁;呼吸暂停/低通气指数:43±21次事件×小时⁻¹;体重指数:30±2千克×米⁻²)。在稳定睡眠期间,在施加和不施加FOT(频率:5赫兹和30赫兹;峰-峰压力振荡:1厘米水柱)的情况下,分析颏舌肌表面肌电图活动(EMGgg)和EEG信号。测量在两种不同情况下进行。步骤1:在阻塞性事件或气流受限发作期间施加FOT;步骤2:在最佳CPAP下长时间正常呼吸期间。进行了EMGgg活动的均方根和EEG信号的快速傅里叶分析(α和δ频段)。在任何研究的情况下,FOT的应用均未增加EMGgg活动。此外,未发现对EEG有影响的证据:α/δ关系:清醒时:0.70,基础睡眠时:0.13,FOT(5赫兹)时:0.18,FOT(30赫兹)时:0.11。所呈现的结果表明,在临床睡眠研究提议的频率和幅度范围内使用强迫振荡技术不会引起睡眠呼吸暂停/低通气综合征患者上气道肌肉活动和神经学变量的变化。

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