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Sleep-related abdominal muscle behavior during partial or complete obstructed breathing in prepubertal children
J P Praud1, A M D'Allest, H Nedelcoux
1Laboratory of Physiology, CNRS UA, Clamart, France.
Insights
Abdominal muscle contractions during sleep apnea in children are linked to arousal, regardless of sleep stage. These contractions intensify during non-REM sleep apneas and occur during arousal from REM sleep apneas.
Area of Science:
- Pediatric Sleep Medicine
- Respiratory Physiology
- Neuromuscular Control
Background:
- Obstructive sleep apnea (OSA) is prevalent in children, often presenting as habitual snoring.
- Abdominal muscle activity during sleep-disordered breathing is not fully understood in pediatric populations.
Purpose of the Study:
- To investigate the role of sleep stages (NREM, REM) and arousal in modulating abdominal muscle activity during snoring and obstructive apneas in children.
Main Methods:
- Electromyography (EMG) of abdominal muscles was recorded in 10 prepubertal children with habitual snoring and OSA.
- Analysis focused on abdominal muscle EMG during non-rapid eye movement (NREM) sleep, rapid eye movement (REM) sleep, and arousal events.
Main Results:
- Expiratory abdominal muscle EMG discharges were present during non-apneic snoring in NREM sleep.
- Abdominal muscle EMG activity increased throughout NREM sleep apneas, peaking during arousal.
- Abdominal muscle EMG was absent during REM sleep breathing and apneas, but present during REM sleep arousal.
Conclusions:
- Arousal triggers abdominal muscle EMG discharges, irrespective of the preceding sleep stage (NREM or REM).
- Abdominal muscle activation is a key component of the arousal response during obstructive sleep events in children.
Abstract:
We have evaluated the influence of nonrapid eye movement (NREM), REM sleep, and arousal on abdominal muscle contractions during snoring and/or obstructive apnea in 10 prepubertal children. All children were known habitual snorers and eight had a sleep apnea index above 10. During stage 3-4 non-REM sleep, non-apneic breathing with snoring was always associated with the presence of expiratory abdominal muscle electromyogram (EMG) discharges. During non-REM sleep apneas, abdominal muscle EMG discharges increased from the beginning to the end of each apnea. Termination of non-REM sleep apnea was marked by an "EEG arousal" in 12% of the apneic events and by a "movement arousal" in the other 88%. The highest abdominal muscle EMG discharge was always observed during the arousal response. During "phasic" REM sleep, abdominal muscle EMG discharges were absent during both nonapneic breathing (with or without snoring) and obstructive apneas. All REM sleep apneas ended with a "movement arousal," during which abdominal muscle EMG discharges were observed. Thus, abdominal muscle EMG discharges associated with "arousal" were seen independent of the immediately preceding sleep state.