Genioglossus reflex responses to negative upper airway pressure are altered in people with tetraplegia and obstructive sleep apnoea.

AuthorsWijesuriya, N.S.
Gainche, L.
Jordan, A.S.
Berlowitz, D.J.
LeGuen, M.
Rochford, P.D.
O'Donoghue, F.J.
Ruehland, W.R.
Carberry, J.C.
Butler, J.E.
Eckert, D.J.
TypeJournal Article (Original Research)
JournalThe Journal of Physiology
PubMed ID29658103
Year of Publication2018
URLhttps://www.ncbi.nlm.nih.gov/pubmed/29658103
DOI/10.1113/jp275222
Download Wijesuriya_et_al-2017-The_Journal_of_Physiology_1.pdf (770.8 KB)
AbstractKEY POINTS: Protective reflexes in the throat area (upper airway) are crucial for breathing. Impairment of these reflexes can cause breathing problems during sleep such as obstructive sleep apnoea (OSA). OSA is very common in people with spinal cord injury for unknown reasons. This study shows major changes in protective reflexes that serve to keep the upper airway open in response to suction pressures in people with tetraplegia and OSA. These results help us understand why OSA is so common in people with tetraplegia and provide new insight into how protective upper airway reflexes work more broadly. ABSTRACT: More than 60% of people with tetraplegia have obstructive sleep apnoea (OSA). However, the specific causes are unknown. Genioglossus, the largest upper-airway dilator muscle, is important in maintaining upper-airway patency. Impaired genioglossus muscle function following spinal cord injury may contribute to OSA. This study aimed to determine if genioglossus reflex responses to negative upper-airway pressure are altered in people with OSA and tetraplegia compared to non-neurologically impaired able-bodied individuals with OSA. Genioglossus reflex responses measured via intramuscular electrodes to approximately 60 brief (250 ms) pulses of negative upper-airway pressure ( approximately -15 cmH2 O at the mask) were compared between 13 participants (2 females) with tetraplegia plus OSA and 9 able-bodied controls (2 females) matched for age and OSA severity. The initial short-latency excitatory reflex response was absent in 6/13 people with tetraplegia and 1/9 controls. Genioglossus reflex inhibition in the absence of excitation was observed in three people with tetraplegia and none of the controls. When the excitatory response was present, it was significantly delayed in the tetraplegia group compared to able-bodied controls: excitation onset latency (mean +/- SD) was 32 +/- 16 vs. 18 +/- 9 ms, P = 0.045; peak excitation latency was 48 +/- 17 vs. 33 +/- 8 ms, P = 0.038. However, when present, amplitude of the excitation response was not different between groups, 195 +/- 26 vs. 219 +/- 98% at baseline, P = 0.55. There are major differences in genioglossus reflex morphology and timing in response to rapid changes in airway pressure in people with tetraplegia and OSA. Altered genioglossus function may contribute to the increased risk of OSA in people with tetraplegia. The precise mechanisms mediating these differences are unknown.

http://www.ibas.org.au/what-we-do/publications/3872978


< More publications



SHiQ - COSAQSHIQ - COSAQ

Each year in Australia 260 people sustain a SCI, with over half losing full function in their arms and legs (quadriplegia). In addition to the primary disability, there is a very high rate of Obstructive...

Notch monitoring in sleepNOTCH MONITORING IN SLEEP

Sleep apnea is a condition where breathing is abnormal during sleep. There are two main forms of sleep apnea: obstructive and central. For obstructive sleep apnea, breathing is reduced because the airway...

IBAS Director Anna Burke unveiling of her portrait at Canberra's Parliament HouseIBAS DIRECTOR ANNA BURKE UNVEILING OF HER PORTRAIT AT CANBERRA'S PARLIAMENT HOUSE

Anna Burke had barely got into the swing of her speech at the unveiling of her portrait at Canberra's Parliament House when the ringing of bells caused half her audience to hurry away

Thunderstorm asthma expected to return in 2017THUNDERSTORM ASTHMA EXPECTED TO RETURN IN 2017

The Morning Show - Thunderstorm asthma expected to return in 2017. The Daily Edition - Thunderstorm Asthma is an unexpected killer. Better Health Channel - Thunderstorm asthma explained. Professor Christine McDonald

National study offers hope for breathlessnessNATIONAL STUDY OFFERS HOPE FOR BREATHLESSNESS

A national medication study is aiming to help thousands of Australians who struggle every day with shortness of breath

Helping Victorians breathe and sleep easy - A New Centre of Excellence in Respiratory and Sleep MedicineHELPING VICTORIANS BREATHE AND SLEEP EASY - A NEW CENTRE OF EXCELLENCE IN RESPIRATORY AND SLEEP MEDICINE

With your support we will build a life-changing Centre of Excellence in Respiratory and Sleep Medicine, improving quality of life and health outcomes for Victorians who struggle to breathe and sleep

Institute for Breathing and Sleep

Bowen Centre, Austin Hospital
145 Studley Road
Heidelberg, Victoria, 3084

(03) 9496 5390

Email Us

Donate