.. sleep. J. Appl. Physiol.: Respirat. Environ. Exercise Physiol. 44ftik 931-938, 1978. -Ten patients with daytime somnolence and obesity were found to have periodic airway occlusion (AO) during nocturnal sleep. The cyclical ventilatory pattern consisted of a series of regular inspiratory efforts against an occluded airway (occlusive phase) alternating with a period of regular breathing (ventilatory phase). Significant periods of central respiratory apnea were observed only in one case. The effects of pharyngeal intubation and pharyngeal pressure recordings showed that the locus of airway closure lay in the oropharynx. The genioglossal electromyogram (EMG) consistently revealed periodicity: low level activity at the onset of occlusion and prominent discharge at the instant of pharyngeal opening. In one case, this activity was closely related to pharyngeal patency, whereas in other cases there was considerable overlap between EMG values recorded during occluded and ventilatory phases. In these cases, the relationship of genioglossal discharge to pharyngeal pressure correlated with the presence or absence of pharyngeal occlusion. We speculate that genioglossal force act,s to open the oropharynx and that negative pharyngeal pressure promotes pharyngeal closure. The results are consistent with the idea that, once the pharvnx has collapsed, relative recruitment of genioglossal and inspiratory muscle act.ivity is such that the latter influence outstrips the former, so that pharyngeal transmural pressure increases more than genioglossal force. Pharyngeal opening occurs coincident with arousal and preferential activation of the genioglossus muscle of the tongue.

Pathogenesis of upper airway occlusion during sleep

The sections in this article are:


1
Respiratory Homeostasis and Control of Respiratory Movements
1.1
Effectors of Ventilation

1.2
Respiratory Muscles and Their Innervation

1.3
Summary




2
Central Location of Respiratory Controller
2.1
Historical Background

2.2
Summary

2.3
Modern View

2.4
Brain Stem Anatomy

2.5
Classification of Respiratory Neurons

2.6
Connections Between Respiratory Neurons

2.7
Location and Mechanisms for Generation of Respiratory Patterns

2.8
Production of Respiratory Pattern

2.9
Central Pattern Generation and Respiration

2.10
Hypothesis for Role of Dorsal and Ventral Respiratory Groups in Generating Respiratory Pattern




3
Sensors
3.1
Time Course of Responses to Respiratory Afferent Stimulation

3.2
Integrated Responses to Changes in Carbon Dioxide

3.3
Integrated Responses to Changes in Oxygen

3.4
Summary




4
Mechanoreceptors
4.1
Pulmonary Stretch Receptors

4.2
Summary




5
Exercise—An Example of an Integrated Response
5.1
Critique




6
State Dependence

7
Conclusion

Neurophysiology of Breathing in Mammals

The sections in this article are:


1
Sleep-Wakefulness States
1.1
Identification and Organization

1.2
Mechanisms and Functions




2
Central Neuronal Sleep-Respiratory Interactions

3
Respiratory Muscle Function
3.1
General Concepts

3.2
Diaphragm and Intercostal Muscles

3.3
Upper Airway Muscles




4
Ventilation and Gas Exchange
4.1
NREM Sleep

4.2
REM Sleep




5
Pattern of Breathing
5.1
NREM Sleep

5.2
REM Sleep




6
Ventilatory Responses to Respiratory Stimuli
6.1
Response to CO2

6.2
Response to Hypoxia

6.3
Response to Upper Airway Stimulation

6.4
Response to Bronchopulmonary Stimulation

6.5
Response to Chest Wall Stimulation

6.6
Response to Thermal Stimuli




7
Arousal Responses to Respiratory Stimuli
7.1
Arousal Thresholds

7.2
Mechanisms of Arousal

7.3
Physiological Importance

Control of breathing during sleep

The relationship between hypothalamic temperature and metabolic heat production was measured during wakefulness, slow-wave sleep, and paradoxical sleep in unrestrained kangaroo rats (Dipodomys). Hypothalamic temperature was manipulated with chronically implanted, water-perfused thermodes while cortical electroencephalogram, electromyogram, metabolic rate, and body movement were continuously recorded. During slow-wave sleep, in comparison to wakefulness, there is a lowered threshold hypothalamic temperature for the metabolic heat production response and a lowered proportionality constant relating rate of metabolic heat production to hypothalamic temperature. During paradoxical sleep no increase in metabolic heat production could be elicited by lowering hypothalamic temperature, which indicates that the thermoregulatory system is inoperative. These results provide a basis for explaining the changes in various body temperatures, metabolic rate, and other thermoregulatory responses during sleep in a variety of mammals.

https://science.sciencemag.org/content/sci/194/4264/537.full.pdf

Luciano Sabattini

Papers

Electromyographic aspects of postural, respiratory and thermoregulatory mechanisms in sleeping cats.