Genioglossal activation in patients with obstructive sleep apnea versus control subjects: Mechanisms of muscle control

R. B. Fogel, A. Malhotra, G. Pillar, J. K. Edwards, J. Beauregard, S. A. Shea, D. P. White

Research output: Contribution to journalArticle

140 Scopus citations

Abstract

Pharyngeal dilator muscle activation (GGEMG) during wakefulness is greater in patients with obstructive sleep apnea (OSA) than in healthy control subjects, representing a neuromuscular compensatory mechanism for a more collapsible airway. As previous work from our laboratory has demonstrated a close relationship between GGEMG and epiglottic pressure, we examined the relationship between genioglossal activity and epiglottic pressure in patients with apnea and in control subjects across a wide range of epiglottic pressures during basal breathing, negative-pressure (iron-lung) ventilation, heliox breathing, and inspiratory resistive loading. GGEMG was greater in the patients with apnea under all conditions (p < 0.05 for all comparisons), including tonic, phasic, and peak phasic GGEMG. In addition, patients with apnea generated a greater peak epiglottic pressure on a breath-by-breath basis. Although the relationship between GGEMG and epiglottic negative pressure was tight across all conditions in both groups (all R values ≥ 0.69), there were no significant differences in the slope of this relationship between the two groups (all p values > 0.30) under any condition. Thus, the increased GGEMG seen in the patient with apnea during wakefulness appears to be a product of an increased tonic activation of the muscle, combined with increased negative-pressure generation during inspiration.

Original languageEnglish (US)
Pages (from-to)2025-2030
Number of pages6
JournalAmerican journal of respiratory and critical care medicine
Volume164
Issue number11
DOIs
StatePublished - Dec 1 2001

Keywords

  • Genioglossus
  • Pharyngeal muscles
  • Sleep apnea

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

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