Berry R B, McNellis M I, Kouchi K, Light R W
Pulmonary Section, Long Beach VAMC, CA 90622, USA.
Am J Respir Crit Care Med. 1997 Jul;156(1):127-32. doi: 10.1164/ajrccm.156.1.9608037.
We hypothesize that stimulation of upper-airway mechanoreceptors during obstructive apnea augments upper airway muscle activity. If so, upper-airway anesthesia (UAA) should reduce mechanoreceptor output and therefore upper-airway muscle activity. To test this hypothesis, we studied the effect of UAA on the relationship between the phasic activity of the moving-time average (MTA) of the genioglossus electromyogram (EMG-GG) and the esophageal pressure deflection (DP) during obstructive apneas in non-rapid-eye-movement (NREM) sleep in a group of six men with severe sleep apnea. Before UAA, the phasic EMG-GG was linearly related to the deflections in esophageal pressure (DP) during the last three occluded breaths (both progressively increased). After UAA, the mean ratio of EMG-GG to DP decreased to 23% of the control value, from 0.17 +/- 0.04 to 0.04 +/- 0.01 (mean +/- SEM) arbitrary units/cm H2O (p < 0.05). The mean slope of the EMG-GG-versus-DP regression lines also decreased to 23% of the control value, from 0.22 +/- 0.03 to 0.05 +/- 0.01 arbitrary units/ cm H2O (p < 0.01). These findings suggest that stimulation of upper-airway mechanoreceptors during obstructive apnea in NREM sleep augments phasic genioglossus activity.
我们推测，在阻塞性呼吸暂停期间对上气道机械感受器的刺激会增强上气道肌肉活动。如果是这样，上气道麻醉（UAA）应该会减少机械感受器的输出，从而降低上气道肌肉活动。为了验证这一假设，我们研究了UAA对一组6名患有严重睡眠呼吸暂停的男性在非快速眼动（NREM）睡眠期间阻塞性呼吸暂停时颏舌肌肌电图（EMG-GG）的移动时间平均值（MTA）的相位活动与食管压力偏转（DP）之间关系的影响。在进行UAA之前，在最后三次阻塞呼吸期间，EMG-GG的相位与食管压力（DP）的偏转呈线性相关（两者均逐渐增加）。进行UAA后，EMG-GG与DP的平均比值从0.17±0.04降至0.04±0.01（平均值±标准误）任意单位/厘米水柱，降至对照值的23%（p<0.05）。EMG-GG与DP回归线的平均斜率也从0.22±0.03降至0.05±0.01任意单位/厘米水柱，降至对照值的23%（p<0.01）。这些发现表明，在NREM睡眠期间阻塞性呼吸暂停时对上气道机械感受器的刺激会增强颏舌肌的相位活动。
