New insights into the timing and potential mechanisms of respiratory-induced cortical arousals in obstructive sleep apnea

AuthorsAmatoury, J
Jordan, A.S.
Toson, A.S.
Nguyen, C.
Wellman, A.
Eckert, D.J.
TypeJournal Article (Original Research)
Year of Publication2018
AbstractA negative intrathoracic pressure threshold is one commonly proposed mechanism for triggering respiratory-induced arousals in obstructive sleep apnea (OSA). If so, they should occur during inspiration, shortly after maximal negative pressure swings. Alternatively, respiratory-induced arousals may occur throughout the respiratory cycle if other mechanisms also contribute. However, arousal timing has been minimally investigated. This study aimed to (1) determine the temporal relationship between respiratory-induced arousals and breathing phase and (2) characterize neuromuscular and load compensation responses prior to arousal.

Over one third of respiratory-induced arousals occur during expiration. These findings highlight the importance of nonpressure threshold mechanisms of respiratory-induced arousals in OSA and suggest that expiratory arousals may be a novel marker of enhanced tensor palatini neuromuscular compensation.

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