scholarly journals Neostigmine but not sugammadex impairs upper airway dilator muscle activity and breathing

2008 ◽  
Vol 101 (3) ◽  
pp. 344-349 ◽  
Author(s):  
M. Eikermann ◽  
S. Zaremba ◽  
A. Malhotra ◽  
A.S. Jordan ◽  
C. Rosow ◽  
...  
Keyword(s):  
Muscle Activity ◽  
Upper Airway ◽  
Dilator Muscle

scholarly journals Upper airway muscle activity in normal women: influence of hormonal status

1998 ◽  
Vol 84 (3) ◽  
pp. 1055-1062 ◽  
Author(s):  
Rainer M. Popovic ◽  
David P. White
Keyword(s):  
Postmenopausal Women ◽  
Muscle Activity ◽  
Airway Resistance ◽  
Upper Airway ◽  
Resistive Load ◽  
Substantial Impact ◽  
Upper Airway Resistance ◽  
Female Hormones ◽  
Dilator Muscle ◽  
Obstructive Sleep

Obstructive sleep apnea is a disorder with a strong male predominance. One possible explanation could be an effect of female hormones on pharyngeal dilator muscle activity. Therefore, we determined the level of awake genioglossus electromyogram (EMGgg) and upper airway resistance in 12 pre- and 12 postmenopausal women under basal conditions and during the application of an inspiratory resistive load (25 cmH2O ⋅ l−1 ⋅ s). In addition, a subgroup of eight postmenopausal women were studied a second time after 2 wk of combined estrogen and progesterone replacement in standard doses. Peak phasic and tonic genioglossus activity, expressed as a percentage of maximum, were highest in the luteal phase of the menstrual cycle (phasic 23.9 ± 3.8%, tonic 10.2 ± 1.0%), followed by the follicular phase (phasic 15.5 ± 2.2%, tonic 7.3 ± 0.8%), and were lowest in the postmenopausal group (phasic 11.3 ± 1.6%, tonic of 5.0 ± 0.6), whereas upper airway resistance did not differ. There was a weak but significant positive correlation between progesterone levels and both peak phasic ( P < 0.05) and tonic ( P < 0.01) EMGgg. Finally, there was a significant increase in EMGgg in the postmenopausal group restudied after hormone therapy. In conclusion, female hormones (possibly progesterone) have a substantial impact on upper airway dilator muscle activity.

Reduced genioglossal activity with upper airway anesthesia in awake patients with OSA

2000 ◽  
Vol 88 (4) ◽  
pp. 1346-1354 ◽  
Author(s):  
Robert B. Fogel ◽  
Atul Malhotra ◽  
Steven A. Shea ◽  
Jill K. Edwards ◽  
David P. White
Keyword(s):  
Muscle Activity ◽  
Upper Airway ◽  
Significant Rise ◽  
Tidal Breathing ◽  
Airflow Resistance ◽  
Dilator Muscle ◽  
Obstructive Sleep ◽  
Airway Mechanics ◽  
Airway Collapsibility ◽  
Negative Airway Pressure

We examined whether topical upper airway anesthesia leads to a reduction in genioglossal (GG) electromyogram (EMG) in patients with obstructive sleep apnea (OSA). Airway mechanics were also evaluated. In 13 patients with OSA, we monitored GG EMG during tidal breathing and during the application of pulses of negative airway pressure (−10 to −12 cmH2O). Airflow resistance and airway collapsibility were determined. All measurements were performed with and without topical anesthesia (lidocaine). Anesthesia led to a significant fall in the peak GG EMG response to negative pressure from 36.1 ± 4.7 to 24.8 ± 5.3% (SE) of maximum ( P < 0.01). This was associated with a fall in phasic and tonic EMG during tidal breathing (phasic from 24.4 ± 4.1 to 16.4 ± 3.4% of maximum and tonic from 10.9 ± 1.6 to 8.0 ± 1.3% of maximum, P < 0.01). A significant rise in pharyngeal airflow resistance was also observed. Our results demonstrate that topical receptor mechanisms in the nasopharynx importantly influence dilator muscle activity and are likely important in driving the augmented dilator muscle activity seen in the apnea patient.

Effect of inspired air temperature on genioglossus activity during nose breathing in awake humans

1990 ◽  
Vol 69 (3) ◽  
pp. 1098-1103 ◽  
Author(s):  
R. C. Basner ◽  
J. Ringler ◽  
S. Berkowitz ◽  
R. M. Schwartzstein ◽  
S. E. Weinberger ◽  
...  
Keyword(s):  
Air Temperature ◽  
Muscle Activity ◽  
Upper Airway ◽  
Nasal Breathing ◽  
Air Breathing ◽  
Cold Air ◽  
Bipolar Electrodes ◽  
Dilator Muscle ◽  
Inspiratory Resistance ◽  
Pressure Changes

Experimental data suggest the presence of sensory receptors specific to the nasopharynx that may reflexly influence respiratory activity. To investigate the effects of inspired air temperature on upper airway dilator muscle activity during nose breathing, we compared phasic genioglossus electromyograms (EMGgg) in eight normal awake adults breathing cold dry or warm humidified air through the nose. EMGgg was measured with peroral bipolar electrodes during successive trials of cold air (less than or equal to 15 degrees C) and warm air (greater than or equal to 34 degrees C) nasal breathing and quantified for each condition as percent activity at baseline (room temperature). In four of the subjects, the protocol was repeated after topical nasal anesthesia. For all eight subjects, mean EMGgg was greater during cold air breathing than during baseline (P less than 0.005) or warm air breathing (P less than 0.01); mean EMGgg during warm air breathing was not significantly changed from baseline. Nasal anesthesia significantly decreased the mean EMGgg response to cold air breathing. Nasal airway inspiratory resistance, measured by posterior rhinomanometry in six subjects under similar conditions, was no different for cold or warm air nose breathing [cold 1.4 +/- 0.7 vs. warm 1.4 +/- 1.1 (SD) cmH2O.l-1.s at 0.4 l/s flow]. These data suggest the presence of superficially located nasal cold receptors that may reflexly influence upper airway dilating muscle activity independently of pressure changes in awake normal humans.

scholarly journals Differential Effects of Isoflurane and Propofol on Upper Airway Dilator Muscle Activity and Breathing

2008 ◽  
Vol 108 (5) ◽  
pp. 897-906 ◽  
Author(s):  
Matthias Eikermann ◽  
Atul Malhotra ◽  
Philipp Fassbender ◽  
Sebastian Zaremba ◽  
Amy S. Jordan ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Flow Rate ◽  
Muscle Activity ◽  
Upper Airway ◽  
Respiratory Drive ◽  
Apparent Paradox ◽  
Arterial Blood ◽  
Dilator Muscle ◽  
Spontaneously Breathing ◽  
Intact Rats

Background Anesthesia impairs upper airway integrity, but recent data suggest that low doses of some anesthetics increase upper airway dilator muscle activity, an apparent paradox. The authors sought to understand which anesthetics increase or decrease upper airway dilator muscle activity and to study the mechanisms mediating the effect. Methods The authors recorded genioglossus electromyogram, breathing, arterial blood pressure, and expiratory carbon dioxide in 58 spontaneously breathing rats at an estimated ED50 (median effective dose) of isoflurane or propofol. The authors further evaluated the dose-response relations of isoflurane under different study conditions: (1) normalization of mean arterial pressure, or end-expiratory carbon dioxide; (2) bilateral lesion of the Kölliker-Fuse nucleus; and (3) vagotomy. To evaluate whether the markedly lower inspiratory genioglossus activity during propofol could be recovered by increasing flow rate, a measure of respiratory drive, the authors performed an additional set of experiments during hypoxia or hypercapnia. Results In vagally intact rats, tonic and phasic genioglossus activity were markedly higher with isoflurane compared with propofol. Both anesthetics abolished the genioglossus negative pressure reflex. Inspiratory flow rate and anesthetic agent predicted independently phasic genioglossus activity. Isoflurane dose-dependently decreased tonic and increased phasic genioglossus activity, and increased flow rate, and its increasing effects were abolished after vagotomy. Impairment of phasic genioglossus activity during propofol anesthesia was reversed during evoked increase in respiratory drive. Conclusion Isoflurane compared with propofol anesthesia yields higher tonic and phasic genioglossus muscle activity. The level of respiratory depression rather than the level of effective anesthesia correlates closely with the airway dilator muscle function during anesthesia.

scholarly journals Arousal from Sleep Does Not Lead to Reduced Dilator Muscle Activity or Elevated Upper Airway Resistance on Return to Sleep in Healthy Individuals

SLEEP ◽  
2015 ◽  
Vol 38 (1) ◽  
pp. 53-59 ◽  
Author(s):  
Amy S. Jordan ◽  
Jennifer M. Cori ◽  
Andrew Dawson ◽  
Christian L. Nicholas ◽  
Fergal J. O'Donoghue ◽  
...  
Keyword(s):  
Muscle Activity ◽  
Airway Resistance ◽  
Upper Airway ◽  
Healthy Individuals ◽  
Upper Airway Resistance ◽  
Dilator Muscle

scholarly journals Upper Airway Collapsibility (Pcrit) and Pharyngeal Dilator Muscle Activity are Sleep Stage Dependent

SLEEP ◽  
2016 ◽  
Vol 39 (3) ◽  
pp. 511-521 ◽  
Author(s):  
Jayne C. Carberry ◽  
Amy S. Jordan ◽  
David P. White ◽  
Andrew Wellman ◽  
Danny J. Eckert
Keyword(s):  
Muscle Activity ◽  
Sleep Stage ◽  
Upper Airway ◽  
Dilator Muscle ◽  
Airway Collapsibility ◽  
Upper Airway Collapsibility

Effects of positive airway pressure on upper airway dilator muscle activity and ventilatory timing

1996 ◽  
Vol 81 (1) ◽  
pp. 470-479 ◽  
Author(s):  
P. C. Deegan ◽  
P. Nolan ◽  
M. Carey ◽  
W. T. McNicholas
Keyword(s):  
Muscle Activity ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Upper Airway ◽  
Normal Subjects ◽  
Emg Activity ◽  
Ventilatory Responses ◽  
Dilator Muscle ◽  
Before And After ◽  
Expiratory Positive Airway Pressure

To determine upper airway (UA) and ventilatory responses to nasal continuous positive airway pressure (CPAP) and expiratory positive airway pressure (EPAP), we quantitated changes in alae nasi (AN) and genioglossus (GG) electromyographic (EMG) activity, ventilatory timing, and end-expiratory lung volume (EELV) at various levels of CPAP and EPAP in six normal subjects during wakefulness and in seven during sleep. The same measurements were also made before and after UA anesthesia in six normal subjects during wakefulness. During both wakefulness and sleep, CPAP application significantly increased EELV and decreased AN and GG EMG activities. In contrast, EPAP significantly increased EMG activities of both muscles while also increasing EELV during wakefulness. The EMG responses were less marked during sleep. Anesthesia of the UA abolished the EMG responses to CPAP but not to EPAP. These results suggest that, in normal subjects, CPAP application causes a reflex reduction in UA dilator muscle activity mediated by UA sensory receptors. In contrast, EPAP increases UA dilator muscle activity, with the response mediated by conscious influences or reflexes arising outside of the UA.

Upper airway muscle responsiveness to rising Pco 2 during NREM sleep

2000 ◽  
Vol 89 (4) ◽  
pp. 1275-1282 ◽  
Author(s):  
Giora Pillar ◽  
Atul Malhotra ◽  
Robert B. Fogel ◽  
Josee Beauregard ◽  
David I. Slamowitz ◽  
...  
Keyword(s):  
Muscle Activation ◽  
Slow Wave Sleep ◽  
Minute Ventilation ◽  
Upper Airway ◽  
Nrem Sleep ◽  
Dilator Muscle ◽  
Pharyngeal Muscles ◽  
Stage 2 Sleep ◽  
Significant Change ◽  
End Tidal

Although pharyngeal muscles respond robustly to increasing Pco 2 during wakefulness, the effect of hypercapnia on upper airway muscle activation during sleep has not been carefully assessed. This may be important, because it has been hypothesized that CO2-driven muscle activation may importantly stabilize the upper airway during stages 3 and 4 sleep. To test this hypothesis, we measured ventilation, airway resistance, genioglossus (GG) and tensor palatini (TP) electromyogram (EMG), plus end-tidal Pco 2(Pet CO2 ) in 18 subjects during wakefulness, stage 2, and slow-wave sleep (SWS). Responses of ventilation and muscle EMG to administered CO2(Pet CO2 = 6 Torr above the eupneic level) were also assessed during SWS ( n = 9) or stage 2 sleep ( n = 7). Pet CO2 increased spontaneously by 0.8 ± 0.1 Torr from stage 2 to SWS (from 43.3 ± 0.6 to 44.1 ± 0.5 Torr, P < 0.05), with no significant change in GG or TP EMG. Despite a significant increase in minute ventilation with induced hypercapnia (from 8.3 ± 0.1 to 11.9 ± 0.3 l/min in stage 2 and 8.6 ± 0.4 to 12.7 ± 0.4 l/min in SWS, P < 0.05 for both), there was no significant change in the GG or TP EMG. These data indicate that supraphysiological levels of Pet CO2 (50.4 ± 1.6 Torr in stage 2, and 50.4 ± 0.9 Torr in SWS) are not a major independent stimulus to pharyngeal dilator muscle activation during either SWS or stage 2 sleep. Thus hypercapnia-induced pharyngeal dilator muscle activation alone is unlikely to explain the paucity of sleep-disordered breathing events during SWS.

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