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1 Department of Medicine, Long Beach VAMC/University California Irvine, Long Beach, CA, USA
2 Sleep Medicine and Pulmonary/Critical Care Divisions, Brigham and Women's Hospital and Massachusetts General Hospital, Boston, MA, USA
* To whom correspondence should be addressed. E-mail: sleep_doc{at}msn.com.
We hypothesized that the response of the genioglossus to negative pressure during wakefulness should be intact in obstructive sleep apnea (OSA) patients despite published evidence showing impairment of the response of palatal muscles. Thus, the response of the genioglossus to brief nasal negative pressure applications (NPA) in early inspiration was compared between obstructive sleep apnea (OSA) patients and an age matched group of normal subjects at two study sites (N = 11 per group in Long Beach, N = 14 per group in Boston). Subjects were studied in the sitting (Long Beach) or supine (Boston) posture and the genioglossus EMG (EMGgg) was measured with an intra-oral surface electrode (Long Beach) or intramuscular electrode (Boston). The response of the EMGgg was expressed as the percentage change from baseline where the baseline EMGgg was the value at the onset of the NPA. In Long Beach the EMGgg response was significantly higher in the OSA patients at a lower suction pressure of approximately 10 cm H2O (75.2 ± 8.4 versus 37.4 ± 4.0 % increase, p < 0.01 ) but not at a higher suction pressure of approximately 20 cm H2O. In Boston the response in the OSA patients was also greater (107.2 ± 25.9 versus 46.3 ± 8.3 %, P <0.05)at a mask suction pressure of approximately 13 cm H2O. We conclude that the response of the genioglossus to NPA during wakefulness is not impaired in OSA compared to normal subjects and is greater at low suction pressures.
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