Journal of Applied Physiology AJP: Gastrointestinal and Liver Physiology
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J Appl Physiol 94: 1949-1954, 2003. First published January 10, 2003; doi:10.1152/japplphysiol.00783.2002
8750-7587/03 $5.00
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Vol. 94, Issue 5, 1949-1954, May 2003

Active glottal closure during central apneas limits oxygen desaturation in premature lambs

Philippe Reix1, Julie Arsenault1, Valérie Dôme2, Pierre-Hugues Fortier3, Joëlle Rouillard Lafond1, François Moreau-Bussière1, Dominique Dorion3, and Jean-Paul Praud1,3

Departments of 1 Pediatrics and Physiology, 2 Gynecology and Obstetrics, and 3 Surgery (Ear, Nose, and Throat), Pulmonary Research Unit, University of Sherbrooke, Québec, Canada J1H 5N4

Our laboratory previously reported that active glottal closure was present in 90% of spontaneous central apneas in premature lambs while maintaining a high-apneic lung volume (Renolleau S, Letourneau P, Niyonsenga T, and Praud JP. Am J Respir Crit Care Med 159: 1396-1404, 1999.) The present study aimed at testing whether this mechanism limits postapnea oxygen desaturation. Four premature lambs were instrumented for recording states of alertness, thyroarytenoid muscle and diaphragm electromyographic (EMG) activity, nasal airflow, lung volume changes, and pulse oximetry. One thousand four hundred fifty-two spontaneous central apneas (isolated or during periodic breathing) were analyzed in nonsedated lambs. Apneas, with high lung volume maintained by active glottal closure, were compared with apneas, with a tracheostomy opened at apnea onset. Oxygen desaturation slopes were lower when high-apneic lung volume was actively maintained during both wakefulness and quiet sleep. Furthermore, oxygen desaturation slopes were lower after isolated apneas with continuous thyroarytenoid EMG during wakefulness, compared with apneas with noncontinuous thyroarytenoid EMG (= glottis opened shortly after apnea onset). These results highlight the importance of maintaining high-alveolar oxygen stores during central apneas by active glottal closure to limit desaturation in newborns.

larynx; sleep; lung volume; polysomnography


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