Ventilatory Drive Withdrawal Rather Than Reduced Genioglossus Compensation as a Mechanism of Obstructive Sleep Apnea in REM Sleep
| العنوان: | Ventilatory Drive Withdrawal Rather Than Reduced Genioglossus Compensation as a Mechanism of Obstructive Sleep Apnea in REM Sleep |
|---|---|
| المؤلفون: | Luigi Taranto-Montemurro, Ludovico Messineo, Laura Gell, Scott A. Sands, Andrew Wellman, N. Calianese, Daniel Vena, David P. White, L Hess, Danny J. Eckert, Ali Azarbarzin |
| المصدر: | American Journal of Respiratory and Critical Care Medicine Am J Respir Crit Care Med |
| سنة النشر: | 2023 |
| مصطلحات موضوعية: | Pulmonary and Respiratory Medicine, Adult, Male, medicine.medical_specialty, Rapid eye movement sleep, Facial Muscles, Sleep, REM, Critical Care and Intensive Care Medicine, Non-rapid eye movement sleep, Compensation (engineering), Tongue, Internal medicine, mental disorders, medicine, Humans, Aged, Sleep Apnea, Obstructive, Genioglossus, Continuous Positive Airway Pressure, business.industry, Mechanism (biology), musculoskeletal, neural, and ocular physiology, Editorials, Original Articles, Middle Aged, medicine.disease, nervous system diseases, respiratory tract diseases, Obstructive sleep apnea, Breathing, Cardiology, Muscle Hypotonia, Pharynx, Female, business, Ventilatory drive, Sleep, psychological phenomena and processes |
| الوصف: | RATIONALE: REM sleep is associated with reduced ventilation and greater obstructive sleep apnea (OSA) severity than non-REM (nREM) sleep for reasons that have not been fully elucidated. OBJECTIVES: Here, we use direct physiological measurements to determine whether the pharyngeal compromise in REM sleep OSA is most consistent with 1) withdrawal of neural ventilatory drive or 2) deficits in pharyngeal pathophysiology per se (i.e., increased collapsibility and decreased muscle responsiveness). METHODS: Sixty-three participants with OSA completed sleep studies with gold standard measurements of ventilatory “drive” (calibrated intraesophageal diaphragm EMG), ventilation (oronasal “ventilation”), and genioglossus EMG activity. Drive withdrawal was assessed by examining these measurements at nadir drive (first decile of drive within a stage). Pharyngeal physiology was assessed by examining collapsibility (lowered ventilation at eupneic drive) and responsiveness (ventilation–drive slope). Mixed-model analysis compared REM sleep with nREM sleep; sensitivity analysis examined phasic REM sleep. MEASUREMENTS AND MAIN RESULTS: REM sleep (⩾10 min) was obtained in 25 patients. Compared with drive in nREM sleep, drive in REM sleep dipped to markedly lower nadir values (first decile, estimate [95% confidence interval], −21.8% [−31.2% to −12.4%] of eupnea; P |
| تدمد: | 1535-4970 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e5799d6b53c5856a4d59d43bb0fee6a6 https://pubmed.ncbi.nlm.nih.gov/34792435 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....e5799d6b53c5856a4d59d43bb0fee6a6 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15354970 |
|---|