下颌骨在睡眠期间调节气流幅度中的关键作用。
The key role of the mandible in modulating airflow amplitude during sleep.
机构信息
Sleep Laboratory, CHU UCL Namur Site Sainte-Elisabeth, Belgium; Institute of Experimental and Clinical Research, UCL, Bruxelles Woluwe, Belgium.
Sunrise, Namur, Belgium.
出版信息
Respir Physiol Neurobiol. 2020 Aug;279:103447. doi: 10.1016/j.resp.2020.103447. Epub 2020 May 13.
RATIONALE
Mandibular position and motion during sleep rely on the balance between mandibular elevators and depressors. We hypothesized that vertical mandibular position (VMP) modulates airflow amplitude during sleep.
METHODS
VMP, tidal nasal flow pressure (NFP) and concurrent surface electromyographic activity of the masseters (sEMG-m) were recorded and processed by a customized algorithm from 100 polysomnographic fragments including a micro-arousal (25 obstructive sleep apnea patients). The relationship between mandibular position and changes in airflow was analysed.
RESULT
Concurrent VMP and sEMG-m activity changes routinely occurred before a new steady state of airflow documented by NFP. Vertical mandible depression was associated with a median (95% CI) reduction in NFP of 40.9% (14.6%-71.3%, p = 0.007) while vertical mandible elevation and mouth closure were associated with a median (95% CI) relative increase in NFP after arousal of 52.6% (17.9%-56.2%, p = 0.001).
CONCLUSION
Elevation and lowering of the mandible were associated with changes in masseteric EMG activity modulating airflow amplitude during sleep.
原理
下颌在睡眠中的位置和运动依赖于升颌肌和降颌肌之间的平衡。我们假设下颌垂直位置（VMP）会调节睡眠期间的气流幅度。
方法
从包括微觉醒的 100 个多导睡眠片段（25 例阻塞性睡眠呼吸暂停患者）中，使用自定义算法记录和处理 VMP、潮式鼻气流压力（NFP）和同期咀嚼肌表面肌电图活动（sEMG-m）。分析下颌位置与气流变化之间的关系。
结果
在 NFP 记录的新稳定气流之前，下颌垂直位置和 sEMG-m 活动的变化通常会同时发生。下颌垂直下降与 NFP 降低的中位数（95%CI）为 40.9%（14.6%-71.3%，p=0.007），而下颌垂直上升和闭口与觉醒后 NFP 相对增加的中位数（95%CI）为 52.6%（17.9%-56.2%，p=0.001）。
结论
下颌的抬高和降低与睡眠期间咀嚼肌 EMG 活动的变化有关，这些变化调节气流幅度。
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