E Thomas, A Osman, L Calonzo, L Hall, M Agzarian, M Slee
{"title":"P033 Assessment of Upper Airway Dilator Muscle Function and Collapsibility in People with Multiple Sclerosis with Versus without Sleep Apnea","authors":"E Thomas, A Osman, L Calonzo, L Hall, M Agzarian, M Slee","doi":"10.1093/sleepadvances/zpad035.118","DOIUrl":null,"url":null,"abstract":"Abstract Introduction Upper airway reflex responses to negative pressure are important to prevent upper airway narrowing and closure. Recent evidence indicates ~30% of people with multiple sclerosis (MS) have an impaired upper airway dilator reflex response. Thus, the aims of this study were to compare genioglossus muscle reflex responses and upper airway collapsibility in non-obese people with MS, with and without OSA. Methods Non-obese adults with MS and OSA vs MS without OSA were instrumented with pressure sensors at the choanae and epiglottis. Bipolar fine wires were inserted into the genioglossus. A nasal mask and pneumotachograph were attached to a breathing circuit to deliver brief (~250ms) suction pressure (~-12cmH2O) during early inspiration every 2-10 breaths while awake. Genioglossus reflex onset latency, peak latency and peak amplitude were quantified. The upper airway collapsibility index was the percent difference between choanal and epiglottic airway pressures during negative pressure. Results 15 people with MS (6 males), aged 48±13years, BMI=25±3kg/m-2 and AHI=13±17events/h (mean±SD) were studied. 47% had OSA (AHI>10events/h). Genioglossus reflex excitation onset latency (22±2 vs. 24±19ms), peak excitation latency (37±11 vs. 38±23ms) and peak amplitude (258±125 vs. 205±95%) were not different between OSA vs. non-OSA. The upper airway was more collapsible in people with OSA (49±32 vs. 17±16%, p=0.04). Conclusions There is a high prevalence of OSA among non-obese people with MS. There was no systematic difference in upper airway dilator muscle function. However, the upper airway is ~65% more collapsible in people with MS and OSA despite absence of obesity.","PeriodicalId":21861,"journal":{"name":"SLEEP Advances","volume":"131 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"SLEEP Advances","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/sleepadvances/zpad035.118","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Abstract Introduction Upper airway reflex responses to negative pressure are important to prevent upper airway narrowing and closure. Recent evidence indicates ~30% of people with multiple sclerosis (MS) have an impaired upper airway dilator reflex response. Thus, the aims of this study were to compare genioglossus muscle reflex responses and upper airway collapsibility in non-obese people with MS, with and without OSA. Methods Non-obese adults with MS and OSA vs MS without OSA were instrumented with pressure sensors at the choanae and epiglottis. Bipolar fine wires were inserted into the genioglossus. A nasal mask and pneumotachograph were attached to a breathing circuit to deliver brief (~250ms) suction pressure (~-12cmH2O) during early inspiration every 2-10 breaths while awake. Genioglossus reflex onset latency, peak latency and peak amplitude were quantified. The upper airway collapsibility index was the percent difference between choanal and epiglottic airway pressures during negative pressure. Results 15 people with MS (6 males), aged 48±13years, BMI=25±3kg/m-2 and AHI=13±17events/h (mean±SD) were studied. 47% had OSA (AHI>10events/h). Genioglossus reflex excitation onset latency (22±2 vs. 24±19ms), peak excitation latency (37±11 vs. 38±23ms) and peak amplitude (258±125 vs. 205±95%) were not different between OSA vs. non-OSA. The upper airway was more collapsible in people with OSA (49±32 vs. 17±16%, p=0.04). Conclusions There is a high prevalence of OSA among non-obese people with MS. There was no systematic difference in upper airway dilator muscle function. However, the upper airway is ~65% more collapsible in people with MS and OSA despite absence of obesity.
上呼吸道对负压的反射反应是防止上呼吸道狭窄和关闭的重要因素。最近的证据表明,约30%的多发性硬化症(MS)患者有上呼吸道扩张器反射反应受损。因此,本研究的目的是比较非肥胖多发性硬化症患者(伴和不伴OSA)的颏舌肌反射反应和上呼吸道塌陷性。方法对非肥胖成人多发性硬化症、阻塞性睡眠呼吸暂停与非阻塞性睡眠呼吸暂停的多发性硬化症患者在耳道和会厌处安装压力传感器。双极细导线插入颏舌肌。在清醒状态下,每2-10次呼吸,将鼻罩和气描仪连接到呼吸回路上,在早期吸气时提供短暂(~250ms)的吸入压力(~-12cmH2O)。对舌颏反射的起病潜伏期、峰潜伏期和峰幅进行量化。上呼吸道湿陷性指数为负压时后气道与会厌气道压力差的百分比。结果15例MS患者(男6例),年龄48±13岁,BMI=25±3kg/m-2, AHI=13±17events/h (mean±SD)。47%发生OSA (ahi10事件/小时)。舌颏反射兴奋发作潜伏期(22±2 vs. 24±19ms)、兴奋峰潜伏期(37±11 vs. 38±23ms)和峰幅(258±125 vs. 205±95%)在OSA与非OSA之间无显著差异。阻塞性睡眠呼吸暂停患者的上气道更易折叠(49±32比17±16%,p=0.04)。结论非肥胖多发性硬化症患者存在较高的阻塞性睡眠呼吸暂停患病率,两组患者上气道扩张肌功能无系统性差异。然而,尽管没有肥胖,MS和OSA患者的上呼吸道可折叠性要高出约65%。