Suratt P M, McTier R F, Wilhoit S C
Department of Internal Medicine, University of Virginia School of Medicine, Charlottesville 22908.
Am Rev Respir Dis. 1988 Apr;137(4):889-94. doi: 10.1164/ajrccm/137.4.889.
Although phasic electromyographic (EMG) activity of upper airway muscles in patients with obstructive sleep apnea (OSA) decreases at apnea onset, the presence of phasic activity in normal subjects has not been studied and compared with that in patients. We consequently compared the percentage of total sleep time in which phasic activity of the genioglossal EMG activity was present in 8 adult patients with OSA and 3 control groups without OSA, one consisting of 6 young, normal subjects, one matched for age, and one matched for age and obesity. From wakefulness to sleep, genioglossal EMG phasic activity time increased in patients but not in control subjects. Patients with OSA had more phasic genioglossal group EMG activity during non-REM sleep than did control subjects. At apnea onset, phasic EMG activity decreased in patients but remained greater than zero. In many control subjects, phasic activity was not detected, yet their pharyngeal airway remained patent. We conclude that phasic genioglossal group EMG activity occurs more frequently during sleep in patients with OSA than in control subjects, suggesting that it is a compensatory mechanism that occurs when patency of the pharyngeal airway is precarious.
尽管阻塞性睡眠呼吸暂停（OSA）患者上气道肌肉的阶段性肌电图（EMG）活动在呼吸暂停开始时会降低，但正常受试者中阶段性活动的存在情况尚未得到研究，也未与患者进行比较。因此，我们比较了8名成年OSA患者和3个无OSA的对照组中颏舌肌EMG活动出现阶段性活动的总睡眠时间百分比，其中一个对照组由6名年轻的正常受试者组成，一个与患者年龄匹配，另一个与患者年龄和肥胖程度匹配。从清醒到睡眠，患者的颏舌肌EMG阶段性活动时间增加，而对照组受试者则没有。与对照组相比，OSA患者在非快速眼动睡眠期间有更多的颏舌肌组EMG阶段性活动。在呼吸暂停开始时，患者的阶段性EMG活动降低，但仍大于零。在许多对照组受试者中，未检测到阶段性活动，但其咽部气道仍保持通畅。我们得出结论，与对照组相比，OSA患者睡眠期间颏舌肌组EMG阶段性活动更频繁出现，这表明它是一种在咽部气道通畅性不稳定时发生的代偿机制。
