Upper airway anesthesia reduces phasic genioglossus activity during sleep apnea

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...

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Bibliographic Details
Published in:American journal of respiratory and critical care medicine 1997-07, Vol.156 (1), p.127-132
Main Authors: BERRY, R. B, MCNELLIS, M. I, KOUCHI, K, LIGHT, R. W
Format: Article
Language:English
Subjects:
Anesthesia, Local
Anesthetics, Local - pharmacology
Biological and medical sciences
Electromyography
Esophagus - drug effects
Esophagus - physiopathology
Humans
Larynx - drug effects
Larynx - physiopathology
Lidocaine - pharmacology
Male
Mechanoreceptors - drug effects
Mechanoreceptors - physiopathology
Medical sciences
Middle Aged
Muscles - drug effects
Muscles - physiopathology
Pneumology
Pressure
Respiratory system : syndromes and miscellaneous diseases
Sleep Apnea Syndromes - physiopathology
Sleep Stages - physiology
Tongue - drug effects
Tongue - physiopathology
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Summary: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.
ISSN:1073-449X
1535-4970
DOI:10.1164/ajrccm.156.1.9608037