Characteristics of genioglossus neuromuscular activity in patients with obstructive sleep apnea during drug-induced sleep
10.3760/cma.j.cn115330-20221104-00661
- VernacularTitle:不同患病程度的阻塞性睡眠呼吸暂停患者药物诱导睡眠下颏舌肌肌电的特征分析
- Author:
Yingqian ZHOU
1
;
Jinkun XU
;
Guoping YIN
;
Xin CAO
;
Jingjing LI
;
Yuhuan ZHANG
;
Jingying YE
Author Information
1. 清华大学附属北京清华长庚医院耳鼻咽喉头颈外科 清华大学临床医学院，北京 102218
- Keywords:
Obstructive sleep apnea;
Drug-induced sleep;
Genioglossus neuromuscular activity;
Negative pressure reflex
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2023;58(10):951-958
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze genioglossus (GG) activation responses to the negative pressure of upper airway cavity during awake and different sleep stages in patients with different obstructive sleep apnea (OSA) graduation.Methods:This prospective cohort study started from August 2019 to January 2021, recruited 42 male OSA patients aged from 21 to 59 (38.77±8.42) years. After completing whole night polysomnography (PSG) and upper airway CT, each subject underwent drug-induced sleep with simultaneous monitoring of genioglossal electromyography (GGEMG) and pressure of epiglottis (P epi). Subjects were divided into three groups of mild OSA(7 males), moderate OSA(12 males), and severe OSA(23 males). The differences in upper airway CT measurements, parameters of GGEMG and P epi during awake and induced sleep were compared. Statistical analysis was conducted by SPSS 21.0. Results:There was no significant difference in the GGEMG parameters between the mild and moderate groups. In wakefulness, the peak phasic GGEMG of the severe group was higher than the mild group ( t=1.249, P=0.025), with no statistically difference in the corresponding P epi. In the sleep onset, the GGEMG parameters and P epi in severe group were higher than the other two groups. Linear regression analysis of the maximum GGEMG and maximum P epi at the end of obstructive apnea (OA) in all moderate plus severe patients ( n=35) was shown nonlinear correlation ( r=0.28, P=0.694). The airway length of the glossopharyngeal cavity was linearly correlated with the maximum P epi of OA ( r=0.468, R2=0.219, P=0.005). Conclusions:The individual difference of GG activation in OSA patients is related to the severity of the disease (frequency of respiratory events) and negative pressure stimulation. In moderate and severe OSA patients, GG activity is not in harmony with the corresponding negative pressure stimulation, which may be one of the mechanisms leading to the aggravation of OSA.
