help button home button
AJRCCM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
Published ahead of print on July 11, 2003, doi:10.1164/rccm.200301-092OC

Am. J. Respir. Crit. Care Med., Volume 168, Number 6, September 2003, 664-670

A more recent version of this article appeared on September 15, 2003
This Article
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
200301-092OCv1
168/6/664    most recent
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Katz, E. S
Right arrow Articles by White, D. P
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Katz, E. S
Right arrow Articles by White, D. P

Submitted on February 6, 2003
Accepted on July 3, 2003

GENIOGLOSSUS ACTIVITY IN CHILDREN WITH OBSTRUCTIVE SLEEP APNEA DURING WAKEFULNESS AND SLEEP ONSET

Eliot S Katz1* and David P White2

1 Medicine, Children's Hospital, Boston, MA, USA; Medicine, Brigham and Women's Hospital, Boston, MA, USA, 2 Medicine, Brigham and Women's Hospital, Boston, MA, USA

* To whom correspondence should be addressed. E-mail: eliot.katz{at}tch.harvard.edu.

A prominent role for upper airway neuromuscular control mechanisms in the pathophysiology of pediatric obstructive sleep apnea syndrome(OSAS) is suggested by the observation that obstruction does not occur during wakefulness, and is infrequently seen during NREM sleep. Using a custom intra-oral surface electrode to record genioglossal activity(EMGgg), normalized with a maximal maneuver, we studied 10 children with OSAS and 6 normal controls to determine EMGgg activity during 1) wakefulness; 2) the sleep onset period; and 3) stable NREM sleep. We observed that the EMGgg activity in OSAS patients compared to controls was significantly greater during wakefulness(3.6±1.8 versus 1.6±1.8% Maximum, p<0.05), and had a greater decline during the early and late sleep onset period(p<0.05). During stable NREM sleep, EMGgg remained below the wakeful baseline in all normal controls, but increased above the baseline in four of the OSAS patients. We speculate that the increased EMGgg activity during wakefulness represents a reflex-driven neuromuscular compensation for an anatomically compromised airway. Further, the larger decline in EMGgg at sleep onset observed in OSAS patients is consistent with the relative loss of this reflex. Finally, the return of EMGgg activity above baseline in severe OSAS patients suggests that some chemical or mechanical compensatory mechanisms remain active during stable NREM sleep in children.
Key words: Intra-oral surface electrode, Sleep apnea, Genioglossal EMG




This article has been cited by other articles:


Home page
 Proc Am Thorac SocHome page
E. S. Katz and C. M. D'Ambrosio
Pathophysiology of Pediatric Obstructive Sleep Apnea
Proceedings of the ATS, February 15, 2008; 5(2): 253 - 262.
[Abstract] [Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
R. F. Fregosi, S. F. Quan, W. L. Morgan, J. L. Goodwin, R. Cabrera, I. Shareif, K. W. Fridel, and R. R. Bootzin
Pharyngeal critical pressure in children with mild sleep-disordered breathing
J Appl Physiol, September 1, 2006; 101(3): 734 - 739.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
E. S. Katz, C. L. Marcus, and D. P. White
Influence of Airway Pressure on Genioglossus Activity during Sleep in Normal Children
Am. J. Respir. Crit. Care Med., April 15, 2006; 173(8): 902 - 909.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
R. Arens, S. Sin, J. M. McDonough, J. M. Palmer, T. Dominguez, H. Meyer, D. M. Wootton, and A. I. Pack
Changes in Upper Airway Size during Tidal Breathing in Children with Obstructive Sleep Apnea Syndrome
Am. J. Respir. Crit. Care Med., June 1, 2005; 171(11): 1298 - 1304.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
E. S. Katz and D. P. White
Genioglossus Activity During Sleep in Normal Control Subjects and Children with Obstructive Sleep Apnea
Am. J. Respir. Crit. Care Med., September 1, 2004; 170(5): 553 - 560.
[Abstract] [Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
C. L. Marcus, L. B. Fernandes Do Prado, J. Lutz, E. S. Katz, C. A. Black, P. Galster, and K. A. Carson
Developmental changes in upper airway dynamics
J Appl Physiol, July 1, 2004; 97(1): 98 - 108.
[Abstract] [Full Text] [PDF]

Home page
 J. Physiol.Home page
L. C. McKay, W. A. Janczewski, and J. L. Feldman
Episodic hypoxia evokes long-term facilitation of genioglossus muscle activity in neonatal rats
J. Physiol., May 15, 2004; 557(1): 13 - 18.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
C. L. Marcus
Evaluating the Upper Airway during Wakefulness: What Can It Tell Us about Sleep?
Am. J. Respir. Crit. Care Med., January 15, 2004; 169(2): 140 - 141.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
M. J. Tobin
Sleep-Disordered Breathing, Control of Breathing, Respiratory Muscles, Pulmonary Function Testing in AJRCCM 2003
Am. J. Respir. Crit. Care Med., January 15, 2004; 169(2): 254 - 264.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
M. J. Tobin
Pediatrics, Surfactant, and Cystic Fibrosis in AJRCCM 2003
Am. J. Respir. Crit. Care Med., January 15, 2004; 169(2): 277 - 287.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
Proc. Am. Thorac. Soc. Am. J. Respir. Cell Mol. Biol.
Copyright © 2003 American Thoracic Society 		  ATS State of the Art 2009