Journal
JOURNAL OF APPLIED PHYSIOLOGY
Volume 88, Issue 4, Pages 1346-1354Publisher
AMER PHYSIOLOGICAL SOC
DOI: 10.1152/jappl.2000.88.4.1346
Keywords
upper airway dilator muscles; genioglossus muscle; pharyngeal muscles; neuromuscular adaptation; electromyogram; obstructive sleep apnea
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Funding
- NCRR NIH HHS [MO1 RR-02635] Funding Source: Medline
- NHLBI NIH HHS [1 P50 HL-60292, R01 HL-48531] Funding Source: Medline
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We examined whether topical upper airway anesthesia leads to a reduction in genioglossal (GG) electromyogram (EMG) in patients with obstructive sleep apnea (OSA). Airway mechanics were also evaluated. In 13 patients with OSA, we monitored GG EMG during tidal breathing and during the application of pulses of negative airway pressure (-10 to -12 cmH(2)O). Airflow resistance and airway collapsibility were determined. All measurements were performed with and without topical anesthesia (lidocaine). Anesthesia led to a significant fall in the peak GG EMG response to negative pressure from 36.1 +/- 4.7 to 24.8 +/- 5.3% (SE) of maximum (P < 0.01). This was associated with a fall in phasic and tonic EMG during tidal breathing (phasic from 24.4 +/- 4.1 to 16.4 +/- 3.4% of maximum and tonic from 10.9 +/- 1.6 to 8.0 +/- 1.3% of maximum, P < 0.01). A significant rise in pharyngeal airflow resistance was also observed. Our results demonstrate that topical receptor mechanisms in the nasopharynx importantly influence dilator muscle activity and are likely important in driving the augmented dilator muscle activity seen in the apnea patient.
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