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Genioglossus activity during sleep in normal control subjects and children with obstructive sleep apnea

Eliot S Katz1, David P White

  • 1Division of Respiratory Diseases, Mailstop 208, Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA. eliot.katz@childrens.harvard.edu

American Journal of Respiratory and Critical Care Medicine
|June 3, 2004
PubMed

Insights

Children with obstructive sleep apnea syndrome (OSAS) exhibit reduced genioglossus muscle activity during apneic events, particularly in REM sleep. Continuous positive airway pressure (CPAP) further lowers this activity in OSAS patients.

Area of Science:

  • Pediatric Pulmonology
  • Sleep Medicine
  • Neurophysiology

Background:

  • Children with obstructive sleep apnea syndrome (OSAS) have collapsible airways but maintain breathing stability through neuromuscular compensation.
  • Pharyngeal dilator muscle activity, specifically the genioglossus (EMGgg), plays a crucial role in maintaining airway patency during sleep.

Purpose of the Study:

  • To evaluate genioglossus muscle activity (EMGgg) in children with OSAS during different sleep states and disordered breathing events.
  • To compare EMGgg in children with OSAS (with and without CPAP) to healthy controls.

Main Methods:

  • Overnight polysomnography was conducted in three groups: OSAS without CPAP (n=13), OSAS with CPAP (n=5), and controls (n=13).
  • Intraoral surface electrodes recorded genioglossus muscle activity (EMGgg), normalized to wakeful baseline.

Main Results:

  • In controls, EMGgg decreased from wakefulness to Stage 2 sleep and further in REM sleep.
  • In OSAS patients, EMGgg during apneic breaths in REM sleep was significantly lower than during stable breathing and wakefulness.
  • Continuous positive airway pressure (CPAP) reduced EMGgg in OSAS patients across all sleep states.

Conclusions:

  • Neuromuscular compensatory mechanisms are active during sleep in children with severe OSAS.
  • Reductions in EMGgg are temporally linked to sleep apnea events.
  • REM sleep is associated with the lowest and most variable EMGgg in children with OSAS.

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