Brown Elizabeth, Bilston Lynne
Neuroscience Research Australia (NeuRA) and University of New South Wales.
Prince of Wales Hospital, NSW, Australia.
J Clin Sleep Med. 2016 Nov 15;12(11):1563-1564. doi: 10.5664/jcsm.6290.
A 55-year-old woman who presented to the sleep clinic with severe sleep apnea (OSA) (apnea-hypopnea index [AHI] 62) and excessive somnolence (Epworth Sleepiness Scale score 18/24), was imaged with MRI using the Spatial Modulation of Magnetization tagging sequence awake and asleep to visualize upper airway tissue movement. Awake quiet breathing resulted in minimal movement of upper airway tissues. Asleep sequences taken during airway opening post-apnea demonstrated neck extension, mandibular advancement, and widespread tongue deformation accompanying contraction of genioglossus. At the end of the asleep image sequence, the nasopharyngeal airway had a cross-sectional area larger than during quiet breathing awake and there was antero-lateral movement in the lateral walls. In conclusion, the airway responds to apnea by widespread contraction of the genioglossus, followed by mandibular advancement and neck extension. All these maneuvers stabilize and open the airway.
一名55岁女性因严重睡眠呼吸暂停（OSA）（呼吸暂停低通气指数[AHI]为62）和过度嗜睡（爱泼沃斯嗜睡量表评分为18/24）前往睡眠诊所就诊，在清醒和睡眠状态下使用磁化标记空间调制序列进行MRI成像，以观察上气道组织的运动。清醒时安静呼吸导致上气道组织运动极小。呼吸暂停后气道开放期间的睡眠序列显示，随着颏舌肌收缩，颈部伸展、下颌前移，以及广泛的舌部变形。在睡眠图像序列结束时，鼻咽气道的横截面积大于清醒时安静呼吸时的横截面积，且侧壁有前外侧运动。总之，气道通过颏舌肌的广泛收缩对呼吸暂停作出反应，随后下颌前移和颈部伸展。所有这些动作使气道稳定并开放。
