Genioglossal but not palatal muscle activity relates closely to pharyngeal pressure.

The stimuli controlling pharyngeal dilator muscles are poorly defined. Local mechanoreceptors are a leading possibility. To address this, we assessed the relationship between two dilator muscle electromyograms (EMGs, i.e., genioglossus [GG-an inspiratory phasic muscle], tensor palatini [TP-a tonically active muscle]) and potential stimuli (i.e., epiglottic pressure [Pepi], airflow [V], and pharyngeal resistance [Rpha]). Fifteen normal subjects were studied, during wakefulness and stable non-rapid eye movement (NREM) sleep. The GGEMG and TPEMG were assessed during basal breathing and during inspiratory resistive loading (four loads, done in triplicate), while quantifying Pepi and choanal pressures (Pcho, Millar catheters) plus V. There was a strong correlation between Pepi and GGEMG during wakefulness in most subjects (9 of 15 had absolute R > 0.7 [p < 0.05], group mean R = -0.62, p < 0.05). These correlations were less robust during NREM sleep (8 of 15 absolute R > 0.6 [p < 0.05], group mean R = -0.39, ns). The slope of the Pepi versus GGEMG relationship was greater during wakefulness than sleep (-0.67 versus -0.39% max/ cm H(2)O, p < 0.05). No significant correlations were observed between TPEMG and any of the measured potential stimuli. We conclude that intrapharyngeal pressure may modulate genioglossus activity during wakefulness, with a fall in muscle responsiveness during sleep. The activity of the TP was not clearly influenced by any measured local stimulus either awake or asleep.

[1]  A. Guz,et al.  Afferent pathway(s) for pharyngeal dilator reflex to negative pressure in man: a study using upper airway anaesthesia. , 1991, The Journal of physiology.

[2]  D. Roberts,et al.  Effect of inspiratory flow rate on respiratory rate in intubated ventilated patients. , 1997, American journal of respiratory and critical care medicine.

[3]  R. Hubmayr,et al.  The determinants of respiratory rate during mechanical ventilation. , 1997, American journal of respiratory and critical care medicine.

[4]  D. White,et al.  Influences of NREM sleep on the activity of tonic vs. inspiratory phasic muscles in normal men. , 1992, Journal of applied physiology.

[5]  N. Anthonisen,et al.  Effects of non-REM sleep on the response of respiratory output to varying inspiratory flow. , 1996, American journal of respiratory and critical care medicine.

[6]  A. Malhotra,et al.  Reduced genioglossal activity with upper airway anesthesia in awake patients with OSA. , 2000, Journal of applied physiology.

[7]  D. White,et al.  Influence of sleep onset on upper-airway muscle activity in apnea patients versus normal controls. , 1996, American journal of respiratory and critical care medicine.

[8]  D. White,et al.  Influence of sleep on tensor palatini EMG and upper airway resistance in normal men. , 1991, Journal of applied physiology.

[9]  P. Lavie,et al.  Impaired respiratory response to resistive loading during sleep in healthy offspring of patients with obstructive sleep apnea. , 1997, American journal of respiratory and critical care medicine.

[10]  D. White,et al.  Influence of sleep on response to negative airway pressure of tensor palatini muscle and retropalatal airway. , 1993, Journal of applied physiology.

[11]  M. Younes,et al.  Effect of ventilator flow rate on respiratory timing in normal humans. , 1999, American journal of respiratory and critical care medicine.

[12]  D. White,et al.  Sleep and the ventilatory response to resistive loading in normal men. , 1988, Journal of applied physiology.

[13]  P. D. Chinh Uncertainty limits for the macroscopic elastic moduli of random polycrystalline aggregates , 2000 .

[14]  M. Younes,et al.  Effect of inspiratory flow rate on respiratory output in normal subjects. , 1992, The American review of respiratory disease.

[15]  A. Malhotra,et al.  Local mechanisms drive genioglossus activation in obstructive sleep apnea. , 2000, American journal of respiratory and critical care medicine.

[16]  D. White,et al.  Influence of sleep on genioglossus muscle activation by negative pressure in normal men. , 1993, The American review of respiratory disease.

[17]  K. Murphy,et al.  Evidence for reflex upper airway dilator muscle activation by sudden negative airway pressure in man. , 1991, The Journal of physiology.

[18]  D. White,et al.  Local reflex mechanisms: influence on basal genioglossal muscle activation in normal subjects. , 1998, Sleep.

[19]  J. C. Hwang,et al.  Afferent pathways for hypoglossal and phrenic responses to changes in upper airway pressure. , 1984, Respiration physiology.

[20]  J. C. Hwang,et al.  Receptors responding to changes in upper airway pressure. , 1984, Respiration physiology.

[21]  M. Younes,et al.  Effects of pulmonary and intercostal denervation on the response of breathing frequency to varying inspiratory flow. , 1998, The European respiratory journal.

[22]  D. White,et al.  The influence of sleep on pharyngeal reflexes. , 1993, Sleep.

[23]  O. P. Mathew,et al.  Influence of upper airway pressure changes on genioglossus muscle respiratory activity. , 1982, Journal of applied physiology: respiratory, environmental and exercise physiology.