Phasic electromyographic activity of the genioglossus increases in normals during slow-wave sleep

Basner, Robert C.; Ringler, J.; Schwartzstein, Richard M.; Weinberger, Steven E.; Weiss, J. Woodrow

doi:10.1016/0034-5687(91)90028-h

Cited by 58 publications

(34 citation statements)

References 15 publications

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“…As is discussed below, each event is typically associated with a cortical arousal such that the patient with OSA cycles between wakefulness and sleep, making it difficult to achieve deeper stages of sleep. Unlike the transition to sleep, slow wave sleep is associated with increased, not decreased, upper airway dilator muscle activity (21). Thus, when patients are able to achieve slow wave sleep, increased upper airway dilator muscle activity may be one important factor contributing to the improvement in apnea severity that is commonly observed in this sleep stage (21).…”

Section: Upper Airway Dilator Muscle Activity and Reflex Responsivenessmentioning

confidence: 99%

“…Unlike the transition to sleep, slow wave sleep is associated with increased, not decreased, upper airway dilator muscle activity (21). Thus, when patients are able to achieve slow wave sleep, increased upper airway dilator muscle activity may be one important factor contributing to the improvement in apnea severity that is commonly observed in this sleep stage (21). Alternatively, patients with apnea may be able to enter slow wave sleep only when muscle activity is increased and breathing is already stabilized.…”

Section: Upper Airway Dilator Muscle Activity and Reflex Responsivenessmentioning

confidence: 99%

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Pathophysiology of Adult Obstructive Sleep Apnea

Eckert¹,

Malhotra²

2008

Proceedings of the American Thoracic Society

527

321

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Obstructive sleep apnea (OSA) is a common disorder characterized by repetitive narrowing or collapse of the pharyngeal airway during sleep. The disorder is associated with major comorbidities including excessive daytime sleepiness and increased risk of cardiovascular disease. The underlying pathophysiology is multifactorial and may vary considerably between individuals. Important risk factors include obesity, male sex, and aging. However, the physiological mechanisms underlying these risk factors are not clearly understood. This brief review summarizes the current understanding of OSA pathophysiology in adults and highlights the potential mechanisms underlying the principal risk factors. In addition, some of the pathophysiological characteristics associated with OSA that may modulate disease severity are illustrated. Finally, the potential for novel treatment strategies, based on an improved understanding of the underlying pathophysiology, is also discussed with the ultimate aim of stimulating research ideas in areas where knowledge is lacking.

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Section: Upper Airway Dilator Muscle Activity and Reflex Responsivenessmentioning

confidence: 99%

Section: Upper Airway Dilator Muscle Activity and Reflex Responsivenessmentioning

confidence: 99%

Pathophysiology of Adult Obstructive Sleep Apnea

Eckert¹,

Malhotra²

2008

Proceedings of the American Thoracic Society

527

321

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“…In apparent contrast, passive upper airway function assessed via the critical closing pressure (P CRIT ) technique does not appear to improve in SWS 9. Increased genioglossus electromyography (EMG) activity during SWS compared with light sleep10 could indicate improved upper airway control, or simply reflect higher overall ventilatory drive associated with increased upper airway resistance 7. In healthy volunteers, the hypercapnic ventilatory response11 and the increase in respiratory effort following complete upper airway occlusion do not appear to be different between light sleep and SWS 3.…”

Section: Introductionmentioning

confidence: 99%

Upper airway function and arousability to ventilatory challenge in slow wave versus stage 2 sleep in obstructive sleep apnoea

Ratnavadivel

Stadler

Windler

et al. 2009

Thorax

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Patients with obstructive sleep apnoea (OSA) have reduced event rates during slow wave sleep (SWS) compared with stage 2 sleep. To explore this phenomenon, ventilatory and arousal timing responses to partial and complete airflow obstruction during SWS versus stage 2 sleep were examined. Methods Ten patients, mean6SD apnoeaehypopnoea index (AHI) 49.7616.5 events/h with reduced OSA frequency during SWS (SWS AHI 18.9614.0 events/h) slept with an epiglottic pressure catheter and nasal mask/ pneumotachograph. Patients underwent rapid continuous positive airway pressure (CPAP) dialdowns to three subtherapeutic levels and brief airway occlusions in random order. Results Post-dialdown, there were marked reductions in peak flow and minute ventilation, and progressive increases in inspiratory effort (p<0.001), but with limited ventilatory recovery and no differences between sleep stages. CPAP versus peak flow relationships on the third and second to last breath pre-arousal were not different between sleep stages. Arousals occurred later and post-dialdown arousal probability was lower during SWS compared with stage 2 sleep, Cox hazard ratio (95% CI) 0.65 (0.48 to 0.88), p¼0.006. During SWS occlusions, time to arousal (mean6SEM) was prolonged (23.062.6 vs 17.161.7 s, p¼0.02). Inspiratory effort developed more rapidly (À1.060.2 vs À0.660.1 cm H 2 O/s, p¼0.019) and was more negative (À28.762.7 vs À20.361.6 cm H 2 O, p<0.001) on the breath preceding arousal. Conclusions Except for a heightened ventilatory drive response during airway occlusion, airway function and ventilatory compensation to ventilatory challenge appear to be similar, but with consistently and substantially delayed arousal responses, in SWS versus stage 2 sleep.

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“…Consequently, the muscle is active during respiration and particularly during inspiration in alert humans [84]. During sleep, the muscle shows more or less continuous activity, elevated during inspiration, with the exception of intermittent quiescent activity during REM sleep [85,86]. Consequently, activity in the Genioglossus is producing low-level strains in the mandible whether or not speaking is taking place.…”

Section: The Chin and Languagementioning

confidence: 99%

The Human Mandible and the Origins of Speech

Daegling

2012

Journal of Anthropology

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Among the unique traits of human mandibles is the finding of relatively greater utilization of cortical bone with respect to other hominoids. The functional significance of this trait is not plausibly linked to masticatory demands given the diminution of the masticatory musculature in human evolution and the behavioral universal of extraoral food preparation in recent humans. Similarly, the presence of more mandibular bone is not a correlated effect of systemic skeletal robusticity, since gracilization of the skeleton is a feature diagnostic of modern humans. The mandibular symphysis in modern humans is manifested as the chin, and it is here where cortical bone hypertrophy is most pronounced. The potential covariation between the expression of the chin and bone hypertrophy is explored in an attempt to clarify their respective biomechanical roles. Current developments in skeletal biomechanics implicate low magnitude, high frequency strains in bone hypertrophy. The physiology of speech production likely produces strains in mandibular bone of greater frequency and lesser magnitude than those associated with mastication. Consequently, language acquisition plausibly accounts for cortical hypertrophy in modern human mandibles. Its role in the evolution and development of the chin is less clear.

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Phasic electromyographic activity of the genioglossus increases in normals during slow-wave sleep

Cited by 58 publications

References 15 publications

Pathophysiology of Adult Obstructive Sleep Apnea

Pathophysiology of Adult Obstructive Sleep Apnea

Upper airway function and arousability to ventilatory challenge in slow wave versus stage 2 sleep in obstructive sleep apnoea

The Human Mandible and the Origins of Speech

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