Praud J P, D'Allest A M, Delaperche M F, Bobin S, Gaultier C
Laboratory of Physiology, CNRS UA 1159, Hospital A. Béclère, Clamart, France.
Pediatr Res. 1988 Jan;23(1):1-4. doi: 10.1203/00006450-198801000-00001.
We studied the activity of the diaphragm and of the genioglossus at the onset and at the end of obstructive sleep apnea in children. Seven children (mean age 46 months, range 15-87) with obstructive sleep apneas mainly due to enlarged tonsils were tested during natural sleep. We recorded sleep stages (neurophysiological criteria), nasal and buccal air flow (thermistors), thoracoabdominal motion (magnetometers), genioglossus and diaphragm electromyographic activity (EMG) (surface electrodes), and transcutaneous partial pressure of oxygen (Radiometer 44 degrees C). A total of 153 obstructive apneas for the whole group of patients was studied. Compared to the preceding unoccluded breaths, genioglossus and diaphragm EMG data showed that 1) at the onset of obstructive apnea there was no significant decrease in genioglossus and/or diaphragm EMG, contrasting with published data for obese adults, and 2) at the end of obstructive apnea, significant preferential increase in genioglossus EMG, not related to the decrease in transcutaneous partial pressure of oxygen, was found as in obese adults. This study showed that different mechanisms may control the onset of obstructive apnea in children as compared to adults, whereas children and obese adults share the same preferential increase in genioglossus EMG at the end of obstructive apnea.
我们研究了儿童阻塞性睡眠呼吸暂停发作时及结束时膈肌和颏舌肌的活动情况。对7名主要因扁桃体肿大导致阻塞性睡眠呼吸暂停的儿童（平均年龄46个月，范围15 - 87个月）在自然睡眠状态下进行了测试。我们记录了睡眠阶段（神经生理学标准）、鼻腔和口腔气流（热敏电阻）、胸腹运动（磁力计）、颏舌肌和膈肌的肌电图活动（EMG）（表面电极）以及经皮氧分压（Radiometer 44摄氏度）。对该组患者总共153次阻塞性呼吸暂停进行了研究。与之前未阻塞的呼吸相比，颏舌肌和膈肌的肌电图数据显示：1）在阻塞性呼吸暂停发作时，颏舌肌和/或膈肌的肌电图没有显著下降，这与肥胖成年人的已发表数据形成对比；2）在阻塞性呼吸暂停结束时，与肥胖成年人一样，发现颏舌肌肌电图有显著的优先增加，且与经皮氧分压的降低无关。这项研究表明，与成年人相比，儿童阻塞性呼吸暂停发作可能受不同机制控制，而儿童和肥胖成年人在阻塞性呼吸暂停结束时颏舌肌肌电图都有相同的优先增加。
