Wheatley J R, Mezzanotte W S, Tangel D J, White D P
Pulmonary Division, Denver VA Medical Center, CO 80220.
Am Rev Respir Dis. 1993 Sep;148(3):597-605. doi: 10.1164/ajrccm/148.3.597.
An important mechanism controlling genioglossus (GG) muscle activity is the reflex response to negative airway pressure. We hypothesize that this reflex response may be lost during sleep and believe that this loss may be important in the pathogenesis of airway collapse during sleep. Thus, we determined the effect of non-rapid eye movement (NREM) sleep on the GG electromyogram (EMG) response to brief (0.2 to 0.6 s) episodes of negative pressure generation (NPG) in the upper airway of six normal subjects. Up to 100 NPGs (mean 58 +/- 12) were recorded both awake and during stable NREM sleep. During wakefulness, the change in GG moving time average EMG from basal to peak levels (during NPG) was 17.1 +/- 2.5 au (a 154 +/- 22% increase above basal levels). This response was markedly reduced during NREM sleep (2.7 +/- 1.2 au; p < 0.01). The latency of the GG EMG response was 53.8 +/- 11.5 ms during wakefulness (n = 6), but much longer during sleep (132.7 +/- 24.5 ms; n = 3; p < 0.03). We conclude that in normal subjects (1) the GG muscle responds to negative airway pressure by reflex activation during wakefulness, and (2) this reflex activation is reduced or lost during NREM sleep. We speculate that loss of this mechanism during sleep may contribute to pharyngeal collapse in obstructive apnea patients.
控制颏舌肌（GG）活动的一个重要机制是对气道负压的反射反应。我们假设这种反射反应在睡眠期间可能会消失，并认为这种消失可能在睡眠期间气道塌陷的发病机制中起重要作用。因此，我们确定了非快速眼动（NREM）睡眠对6名正常受试者上气道短暂（0.2至0.6秒）负压产生（NPG）发作时GG肌电图（EMG）反应的影响。在清醒和稳定的NREM睡眠期间均记录了多达100次NPG（平均58±12次）。在清醒期间，GG移动时间平均EMG从基础水平到峰值水平（在NPG期间）的变化为17.1±2.5 au（比基础水平增加154±22%）。在NREM睡眠期间，这种反应明显降低（2.7±1.2 au；p<0.01）。GG肌电图反应的潜伏期在清醒时为53.8±11.5毫秒（n=6），但在睡眠期间长得多（132.7±24.5毫秒；n=
