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Title: Genioglossus muscle responses to resistive loads in severe OSA patients and healthy controls.
Austin Authors: Ruehland, Warren R ;Rochford, Peter D ;Pierce, Robert J ;Trinder, John A;Jordan, Amy S ;Cori, Jennifer M ;O'Donoghue, Fergal J 
Affiliation: Department of Respiratory and Sleep Medicine, Institute for breathing and Sleep, Austin Health, Australia
Sleep Laboratory, Melbourne School of Psychological Sciences, University of Melbourne, Australia
Melbourne School of Psychological Sciences, University of Melbourne, Australia
Institute for Breathing and Sleep, Austin Health, Australia
Department of Respiratory and Sleep Medicine, Institute for Breathing and Sleep, Austin Health, Australia
Issue Date: 1-Dec-2019 2019-10-24
Publication information: Journal of applied physiology 2019; 127(6): 1586-1598
Abstract: This study aimed to determine whether there was impairment of genioglossus neuromuscular responses to small negative pressure respiratory stimuli, close to the conscious detection threshold, in obstructive sleep apnea (OSA). We compared genioglossus electromyogram (EMGgg) responses to mid-inspiratory resistive loads of varying intensity (≈1.2 to 6.2 cmH2O·L‑1·s), delivered via a nasal mask, between 16 severe OSA and 17 control participants while the subjects were awake and in a seated upright position. We examined the relationship between stimulus intensity and peak EMGgg amplitude in a 200ms post-stimulus window, and hypothesized that OSA patients would have an increased activation threshold and reduced sensitivity in the relationship between EMGgg activation and stimulus intensity. There was no significant difference between control and OSA participants in the threshold (P = 0.545) or the sensitivity (P = 0.482) of the EMGgg amplitude vs. stimulus intensity relationship, where change in epiglottic pressure relative to background epiglottic pressure represented stimulus intensity. These results do not support the hypothesis that deficits in neuromuscular response to negative upper airway pressure exist in OSA during wakefulness, however the results are likely influenced by a counterintuitive and novel genioglossus muscle suppression response observed in a significant proportion of both OSA and healthy control participants. This suppression response may relate to the inhibition seen in inspiratory muscles such as the diaphragm in response to sudden onset negative pressure, and its presence provides new insight into the upper airway neuromuscular response to the collapsing force of negative pressure.
DOI: 10.1152/japplphysiol.00186.2019
ORCID: 0000-0001-9626-7460
PubMed URL: 31647723
Type: Journal Article
Subjects: Genioglossus
Negative pressure reflex
Neuromuscular response
Obstructive sleep apnea
Resistive load
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