Chadwick G A, Crowley P, Fitzgerald M X, O'Regan R G, McNicholas W T
Department of Respiratory Medicine, University College, Dublin, Ireland.
Am Rev Respir Dis. 1991 Apr;143(4 Pt 1):810-3. doi: 10.1164/ajrccm/143.4_Pt_1.810.
Previous studies support the presence of an upper airway reflex mechanism that contributes to the maintenance of upper airway patency during sleep. We investigated the possibility that interference with this reflex mechanism contributes to the development of obstructive sleep apnea. Eight otherwise asymptomatic snorers (seven male and one female), age 39 +/- 5.3 yr (mean +/- SEM), underwent overnight sleep studies on three successive nights. An acclimatization night was followed by two study nights randomly assigned to control (C) and oropharyngeal anesthesia (OPA). On the OPA night topical anesthesia was induced using 10% lidocaine spray and 0.25% bupivacaine gargle. A saline placebo was used on night C. All subjects slept well on both study nights (mean sleep duration was 6.2 h on both study nights), and sleep stage distribution was similar on both nights. Obstructive apneas and hypopneas (OAH) rose from 114 +/- 43 during C to 170 +/- 49 during OPA (p less than 0.02). Central apneas and hypopneas (CAH) were unchanged between the two nights (8 +/- 4.9 versus 7 +/- 3). The duration of OAH was similar on both study nights (20 +/- 1.9 s during C versus 20 +/- 1.5 s during OPA). The frequency of movement arousals terminating OAH tended to be higher during OPA (7 +/- 2.9/h) than during C (3 +/- 0.7); P = NS. The frequency of oxyhemoglobin desaturations was also higher during OPA (5 +/- 2.1/h) than during C (3 +/- 1.4), p less than 0.07.(ABSTRACT TRUNCATED AT 250 WORDS)
先前的研究支持上气道反射机制的存在，该机制有助于在睡眠期间维持上气道通畅。我们研究了干扰这种反射机制是否会导致阻塞性睡眠呼吸暂停的发生。八名无其他症状的打鼾者（七名男性和一名女性），年龄39±5.3岁（平均±标准误），连续三个晚上接受了夜间睡眠研究。第一个晚上用于适应，随后两个研究晚上随机分配为对照（C）和口咽麻醉（OPA）。在OPA晚上，使用10%利多卡因喷雾剂和0.25%布比卡因漱口液诱导局部麻醉。在C晚上使用生理盐水安慰剂。所有受试者在两个研究晚上睡眠都良好（两个研究晚上的平均睡眠时间均为6.2小时），并且两个晚上的睡眠阶段分布相似。阻塞性呼吸暂停和呼吸不足（OAH）从C期间的114±43增加到OPA期间的170±49（p<0.02）。两个晚上之间中枢性呼吸暂停和呼吸不足（CAH）没有变化（8±4.9对7±3）。两个研究晚上OAH的持续时间相似（C期间为20±1.9秒，OPA期间为20±1.5秒）。终止OAH的运动觉醒频率在OPA期间（7±2.9/小时）往往高于C期间（3±0.7）；P=无显著性差异。氧合血红蛋白饱和度降低的频率在OPA期间（5±2.1/小时）也高于C期间（3±1.4），p<0.07。（摘要截断于250字）
