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Published ahead of print on August 24, 2006, doi:10.1164/rccm.200605-597OC

Am. J. Respir. Crit. Care Med., Volume 174, Number 11, December 2006, 1264-1273

A more recent version of this article appeared on December 1, 2006
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Submitted on May 3, 2006
Accepted on August 22, 2006

Endogenous Excitatory Drive Modulating Respiratory Muscle Activity Across Sleep-Wake States

Erin Chan1, Hendrik W Steenland1, Hattie Liu1, and Richard L Horner1*

1 Department of Medicine and Physiology, University of Toronto, Toronto, ON, Canada

* To whom correspondence should be addressed. E-mail: richard.horner{at}utoronto.ca.

Rationale: The concept of a tonic drive activating respiratory muscle in wakefulness but not sleep has been an important and enduring notion in respiratory medicine, not least because it is useful in modelling sleep effects on breathing and understanding the pathogenesis of sleep- related breathing disorders such as obstructive sleep apnea (OSA). However, a neurotransmitter substrate mediating respiratory muscle activation across sleep-wake states has not been identified. Objectives: To determine if {alpha}1 receptor antagonism at the hypoglossal motor nucleus (HMN) will decrease genioglossus activity consistent with a role for an endogenous noradrenergic drive contributing to genioglossus activation across sleep-wake states. We also determined if {alpha}1 receptor stimulation could counteract reduced endogenous noradrenergic drive and increase sleeping GG activity. Methods: Thirty-five rats were implanted with electroencephalogram and neck electrodes to record sleep-wake states, and genioglossus and diaphragm electrodes for respiratory muscle recordings. Microdialysis probes were inserted into the HMN. Measurements and Main Results: Microdialysis perfusion of the {alpha}1 receptor antagonist terazosin into the HMN significantly decreased genioglossus activity in wakefulness and non-rapid eye movement (non-REM) sleep but not REM sleep. The {alpha}1 receptor agonist phenylephrine increased genioglossus activity in wakefulness and sleep but periods of motor inactivity still persisted in REM; there was no potentiating effect of combined {alpha}1 and 5-HT2 receptor stimulation. Conclusions: Identification of an endogenous noradrenergic drive contributing to GG activation in wakefulness and non-REM sleep, but not REM, is important given the prevalence and clinical significance of sleep-induced hypoventilation and OSA in humans and potential for pharmacological treatment.


Key words: Sleep, Obstructive Sleep Apnea; Hypoglossal Motor Nucleus, Genioglossus Muscle, Noradrenaline




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