HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) All Versions of this Article: 103/5/1662    most recent 00620.2007v1 Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Oliven, A. Articles by Tov, N. Search for Related Content PubMed PubMed Citation Articles by Oliven, A. Articles by Tov, N.

Effect of coactivation of tongue protrusor and retractor muscles on pharyngeal lumen and airflow in sleep apnea patients

¹Bnai Zion Medical Center, Technion, Haifa, Israel; and ²The Johns Hopkins Sleep Disorders Center, Baltimore, Maryland

Submitted 10 June 2007 ; accepted in final form 27 July 2007

The present study evaluated the effect of coactivation of tongue protrusors and retractors on pharyngeal patency in patients with obstructive sleep apnea. The effect of genioglossus (GG), hyoglossus (HG), and coactivation of both on nasal pressure (Pn):flow relationships was evaluated in a sleep study (SlS, n = 7) and during a propofol anesthesia study (AnS, n = 7). GG was stimulated with sublingual surface electrodes in SlS and with intramuscular electrodes in AnS, while HG was stimulated with surface electrodes in both groups. In the AnS, the cross-sectional area (CSA):Pn relationships was measured with a pharyngoscope to estimate velopharyngeal compliance . In the SlS, surface stimulation of GG had no effect on the critical pressure (Pcrit), HG increased Pcrit from 2.8 ± 1.7 to 3.7 ± 1.6 cmH₂O, but coactivation lowered Pcrit to 0.2 ± 1.9 cmH₂O (P < 0.01 for both). In the AnS, intramuscular stimulation of GG lowered Pcrit from 2.6 ± 1.3 to 1.0 ± 2.8 cmH₂O, HG increased Pcrit to 6.2 ± 2.5 cmH₂O (P < 0.01), and coactivation had a similar effect to that of GG (Pcrit = 1.2 ± 2.4 cmH₂O, P < 0.05). None of the interventions affected significantly velopharyngeal compliance. We conclude that the beneficial effect of coactivation depends on the pattern of GG fiber recruitment: although surface stimulation of GG failed to protrude the tongue, it prevented the occlusive effect of the retractor, thereby improving pharyngeal patency during coactivation. Stimulation of deeper GG fibers with intramuscular electrodes enlarged the pharynx, and coactivation had no additive effect.

tongue muscles; sleep apnea; pharynx; genioglossus; hyoglossus

This article has been cited by other articles:

				B. M. McGinley, A. R. Schwartz, H. Schneider, J. P. Kirkness, P. L. Smith, and S. P. Patil Upper airway neuromuscular compensation during sleep is defective in obstructive sleep apnea J Appl Physiol, July 1, 2008; 105(1): 197 - 205. [Abstract] [Full Text] [PDF]