Aronson R M, Alex C G, Onal E, Lopata M
Department of Medicine, University of Illinois College of Medicine at Chicago.
J Appl Physiol (1985). 1987 Oct;63(4):1642-7. doi: 10.1152/jappl.1987.63.4.1642.
Eight patients with occlusive sleep apnea were monitored during non-rapid-eye-movement (NREM) sleep to study the factors that contribute to negative inspiratory pressure generation and thus upper airway occlusion. End-expiratory lung volume assessed by respiratory inductive plethysmography [sum of end-expiratory levels (SUM EEL)] increased early and decreased late during the ventilatory phases (P less than 0.0001, one-way analysis of variance). Inspiratory change in esophageal pressure (Pes) and peak inspiratory diaphragmatic and genioglossal electromyograms (EMGdi and EMGge) decreased while the inspiratory pressure generated for a given diaphragmatic activity (Pes/EMGdi) increased during the preapneic phase (P less than 0.0001, for all). Multiple regression analysis with Pes/EMGdi as the dependent variable (R2 = 0.90) indicated that both the changes in SUM EEL and EMGge significantly contributed to the model (P less than 0.008 and 0.004, respectively). These results indicate that end-expiratory lung volume fluctuates during NREM sleep in patients with occlusive apnea and suggest that these changes along with the changes in upper airway muscle activity contribute to the generation of negative inspiratory pressure, leading to the passive collapse of the upper airways.
对8名阻塞性睡眠呼吸暂停患者在非快速眼动（NREM）睡眠期间进行监测，以研究导致产生负压吸气及进而导致上气道阻塞的因素。通过呼吸感应体积描记法评估的呼气末肺容积[呼气末水平总和（SUM EEL）]在通气阶段早期增加而在后期减少（P<0.0001，单因素方差分析）。在呼吸暂停前期，食管压力（Pes）的吸气变化以及膈肌和颏舌肌肌电图峰值（EMGdi和EMGge）降低，而给定膈肌活动产生的吸气压力（Pes/EMGdi）增加（所有P<0.0001）。以Pes/EMGdi作为因变量的多元回归分析（R2 = 0.90）表明，SUM EEL和EMGge的变化均对模型有显著贡献（分别为P<0.008和0.004）。这些结果表明，阻塞性呼吸暂停患者在NREM睡眠期间呼气末肺容积会波动，并提示这些变化以及上气道肌肉活动的变化有助于产生负压吸气，导致上气道被动塌陷。
