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The Effects of Experimental Sleep Fragmentation and Sleep Deprivation on the Response of the Genioglossus Muscle to Inspiratory Resistive Loads.

ABSTRACT: STUDY OBJECTIVES:Poor upper airway dilator muscle function may contribute to obstructive sleep apnea (OSA). Sleep deprivation reduces dilator muscle responsiveness, but sleep fragmentation, which is most characteristic of OSA, has not been assessed. This study compared the effects of sleep deprivation and fragmentation on dilator muscle responsiveness during wakefulness. METHODS:Twenty-four healthy individuals (10 female) participated in two consecutive overnight polysomnography (PSG) sessions. The first was an adaptation PSG of normal sleep. The second was an experimental PSG, where participants were allocated to groups of either normal sleep, no sleep, or fragmented sleep. Inspiratory resistive loading assessment occurred the morning following each PSG. Four 10 cmH2O and four 20 cmH2O loads were presented in random order for 60 seconds while participants were awake and supine. Sleep (electroencephalogram, electrooculogram, electromyogram [EMG]), intramuscular genioglossus activity (EMGGG), and ventilation were measured throughout the loading sessions. RESULTS:Five controls, seven sleep deprivation participants, and seven sleep fragmentation participants provided data. Contrary to expectations, neither EMGGG nor ventilation showed significant interaction effects (group × session × load) during resistive loading. There was a main effect of load, with peak EMGGG (mean % max ± standard error) significantly higher for the 20 cmH2O load (4.1 ± 0.6) than the 10 cmH2O load (3.3 ± 0.6) across both sessions and all groups. Similar results were observed for peak inspiratory flow, duty cycle, and mask pressure. CONCLUSIONS:Upper airway function was not affected by 1 night of no sleep or poor-quality sleep. This raises doubt as to whether fragmented sleep in OSA increases disorder severity via reduced upper airway dilator responses.

SUBMITTER: Cori JM

PROVIDER: S-EPMC5940421 | biostudies-literature | 2018 May

REPOSITORIES: biostudies-literature

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The Effects of Experimental Sleep Fragmentation and Sleep Deprivation on the Response of the Genioglossus Muscle to Inspiratory Resistive Loads.

Cori Jennifer M JM Nicholas Christian L CL Avraam Joanne J Lee V Vien VV Schembri Rachel R Jackson Melinda L ML Jordan Amy S AS

Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine 20180515 5

<h4>Study objectives</h4>Poor upper airway dilator muscle function may contribute to obstructive sleep apnea (OSA). Sleep deprivation reduces dilator muscle responsiveness, but sleep fragmentation, which is most characteristic of OSA, has not been assessed. This study compared the effects of sleep deprivation and fragmentation on dilator muscle responsiveness during wakefulness.<h4>Methods</h4>Twenty-four healthy individuals (10 female) participated in two consecutive overnight polysomnography ( ...[more]

PMID: 29734983

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Project description:Inspiratory tongue dilatory movement is believed to be mediated via changes in neural drive to genioglossus. However, this has not been studied during quiet breathing in humans. Therefore, this study investigated this relationship and its potential role in obstructive sleep apnoea (OSA). During awake supine quiet nasal breathing, inspiratory tongue dilatory movement, quantified with tagged magnetic resonance imaging, and inspiratory phasic genioglossus EMG normalised to maximum EMG were measured in nine controls [apnoea-hypopnea index (AHI) ≤5 events/h] and 37 people with untreated OSA (AHI >5 events/h). Measurements were obtained for 156 neuromuscular compartments (85%). Analysis was adjusted for nadir epiglottic pressure during inspiration. Only for 106 compartments (68%) was a larger anterior (dilatory) movement associated with a higher phasic EMG [mixed linear regression, beta = 0.089, 95% CI [0.000, 0.178], t(99) = 1.995, P = 0.049, hereafter EMG↗/mvt↗]. For the remaining 50 (32%) compartments, a larger dilatory movement was associated with a lower phasic EMG [mixed linear regression, beta = -0.123, 95% CI [-0.224, -0.022], t(43) = -2.458, P = 0.018, hereafter EMG↘/mvt↗]. OSA participants had a higher odds of having at least one decoupled EMG↘/mvt↗ compartment (binary logistic regression, odds ratio [95% CI]: 7.53 [1.19, 47.47] (P = 0.032). Dilatory tongue movement was minimal (>1 mm) in nearly all participants with only EMG↗/mvt↗ compartments (86%, 18/21). These results demonstrate that upper airway dilatory mechanics cannot be predicted from genioglossus EMG, particularly in people with OSA. Tongue movement associated with minimal genioglossus activity suggests co-activation of other airway dilator muscles. KEY POINTS: Inspiratory tongue movement is thought to be mediated through changes in genioglossus activity. However, it is unknown if this relationship is altered by obstructive sleep apnoea (OSA). During awake supine quiet nasal breathing, inspiratory tongue movement, quantified with tagged magnetic resonance imaging (MRI), and inspiratory phasic genioglossus EMG normalised to maximum EMG were measured in four tongue compartments of people with and without OSA. Larger tongue anterior (dilatory) movement was associated with higher phasic genioglossus EMG for 68% of compartments. OSA participants had an ∼7-times higher odds of having at least one compartment for which a larger anterior tongue movement was not associated with a higher phasic EMG than controls. Therefore, higher genioglossus phasic EMG does not consistently translate into tongue dilatory movement, particularly in people with OSA. Large dilatory tongue movements can occur despite minimal genioglossus inspiratory activity, suggesting co-activation of other pharyngeal muscles.

Project description:Inspiratory muscle warm-up (IMW) has been used as a resource to enhance exercises and sports performance. However, there is a lack of studies in the literature addressing the effects of different IMW loads (especially in combination with a shorter and applicable protocol) on high-intensity running and recovery phase. Thus, this study aimed to investigate the effects of three different IMW loads using a shorter protocol on mechanical, physiological and muscle oxygenation responses during and after high-intensity running exercise. Sixteen physically active men, randomly performed four trials 30 s all-out run, preceded by the shorter IMW protocol (2 × 15 breaths with a 1-min rest interval between sets, accomplished 2 min before the 30 s all-out run). Here, three IMW load conditions were used: 15%, 40%, and 60% of maximal inspiratory pressure (MIP), plus a control session (CON) without the IMW. The force, velocity and running power were measured (1000 Hz). Two near-infrared spectroscopy (NIRS) devices measured (10 Hz) the muscle's oxygenation responses in biceps brachii (BB) and vastus lateralis (VL). Additionally, heart rate (HR) and blood lactate ([Lac]) were also monitored. IMW loads applied with a shorter protocol promoted a significant increase in mean and minimum running power as well as in peak and minimum force compared to CON. In addition, specific IMW loads led to higher values of peak power, mean velocity (60% of MIP) and mean force (40 and 60% of MIP) in relation to CON. Physiological responses (HR and muscles oxygenation) were not modified by any IMW during exercise, as well as HR and [Lac] in the recovery phase. On the other hand, 40% of MIP presented a higher tissue saturation index (TSI) for BB during recovery phase. In conclusion, the use of different loads of IMW may improve the performance of a physically active individual in a 30 s all-out run, as verified by the increased peak, mean and minimum mechanical values, but not in performance assessed second by second. In addition, 40% of the MIP improves TSI of the BB during the recovery phase, which can indicate greater availability of O2 for lactate clearance.

Dataset Information

The Effects of Experimental Sleep Fragmentation and Sleep Deprivation on the Response of the Genioglossus Muscle to Inspiratory Resistive Loads.

Publications

The Effects of Experimental Sleep Fragmentation and Sleep Deprivation on the Response of the Genioglossus Muscle to Inspiratory Resistive Loads.

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