King's College London School of Medicine, King's Health Partners, London, England.
King's College London School of Medicine, King's Health Partners, London, England.
Chest. 2011 Oct;140(4):998-1007. doi: 10.1378/chest.10-2614. Epub 2011 Mar 31.
The therapeutic value of transcutaneous electrical stimulation of the genioglossus muscle in patients with obstructive sleep apnea (OSA) to reduce sleep-disordered breathing is unclear.
Contraction of the genioglossus muscles during transcutaneous stimulation was investigated using ultrasonography in 11 healthy subjects (seven men, mean [SD] age 30 [6] years; BMI, 24.2 [3.5] kg/m(2)). Esophageal and gastric pressures were measured with balloon catheters, and transesophageal diaphragm electromyogram (EMGdi) was recorded during polysomnography in 11 patients with OSA (eight men, aged 51 [16] years; BMI, 42.0 [9.7] kg/m(2)) while transcutaneous electrical stimulation of the genioglossus was applied in non-rapid eye movement sleep (stage N2).
Ultrasonography measurements showed a significant increase in tongue diameter during stimulation (sagittal: 10.0% [2.8%]; coronal: 9.4 % [3.7%]). The measurements were reproducible and repeatable. In patients with OSA, snoring decreased during stimulation (P < .001) and oxygenation improved (P = .001); the respiratory disturbance index (RDI) fell from 28.1 (26.3) to 10.2 (10.2) events per hour during stimulation (P = .002), returning to 26.6 (26.0) events per hour after stimulation was stopped. Transdiaphragmatic pressure swing decreased from 24.1 (13.5) cm H(2)O to 19.7 (7.1) cm H(2)O (P = .022), increasing to 24.2 (10.8) cm H(2)O afterward, and EMGdi fell from 23.8% max (12.6% max) to 15.7% max (6.4% max) (P < .001), rising to 22.6% max (10.4% max) post stimulation.
Continuous transcutaneous electrical stimulation of the genioglossus contracts the genioglossus muscle and reduces ventilatory load and neural respiratory drive in patients with OSA.
经皮颏舌肌电刺激治疗阻塞性睡眠呼吸暂停（OSA）患者以减少睡眠呼吸紊乱的治疗价值尚不清楚。
在 11 名健康受试者（7 名男性，平均[标准差]年龄 30[6]岁；BMI，24.2[3.5]kg/m(2))中，使用超声检查研究了经皮刺激期间颏舌肌的收缩。在 11 名 OSA 患者（8 名男性，年龄 51[16]岁；BMI，42.0[9.7]kg/m(2))进行多导睡眠图检查时，通过球囊导管测量食管和胃压，并记录经皮颏舌肌电刺激时的经食管膈肌肌电图（EMGdi），同时应用非快速眼动睡眠（N2 期）。
超声测量显示刺激时舌直径明显增加（矢状面：10.0%[2.8%]；冠状面：9.4%[3.7%]）。这些测量结果具有可重复性。在 OSA 患者中，刺激时鼾声减少（P<.001），氧合改善（P=.001）；呼吸紊乱指数（RDI）从刺激前的 28.1（26.3）降至 10.2（10.2）/小时（P=.002），刺激停止后恢复至 26.6（26.0）/小时。膈压摆动从 24.1（13.5）cmH(2)O 降至 19.7（7.1）cmH(2)O（P=.022），之后增加到 24.2（10.8）cmH(2)O，EMGdi 从 23.8%最大（12.6%最大）降至 15.7%最大（6.4%最大）（P<.001），刺激后升高至 22.6%最大（10.4%最大）。
连续经皮颏舌肌电刺激可收缩颏舌肌，降低 OSA 患者的通气负荷和神经呼吸驱动。
