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Abstract：
Ventilatory after-discharge (sustained elevation of ventilation following stimulus removal) occurs during sleep but not when hypocapnia is present. Genioglossus after-discharge also occurs during sleep, but CO2 effects have not been assessed. The relevance is that postarousal after-discharge may protect against upper airway collapse. This study aimed to determine whether arousal elicits genioglossus after-discharge that persists into sleep, and whether it is influenced by CO2.
Twenty-four healthy individuals (6 female) slept with a nasal mask and ventilator. Sleep (EEG, EOG, EMG), ventilation (pneumotachograph), end-tidal CO2 (PETCO2), and intramuscular genioglossus EMG were monitored. NREM eucapnia was determined during 5 minutes on continuous positive airway pressure (4 cmH2O). Inspiratory pressure support was increased until PETCO2 was ≥2 mm Hg below NREM eucapnia. Supplemental CO2 was added to reproduce normocapnia, without changing ventilator settings. Arousals were induced by auditory tones and genioglossus EMG compared during steady-state hypocapnia and normocapnia.
Eleven participants (4 female) provided data. Prearousal PETCO2 was less (p < .05) during hypocapnia (40.74 ± 2.37) than normocapnia (43.82 ± 2.89), with differences maintained postarousal. After-discharge, defined as an increase in genioglossus activity above prearousal levels, occurred following the return to sleep. For tonic activity, after-discharge lasted four breaths irrespective of CO2 condition. For peak activity, after-discharge lasted one breath during hypocapnia and 6 breaths during normocapnia. However, when peak activity following the return to sleep was compared between CO2 conditions no individual breath differences were observed.
Postarousal genioglossal after-discharge may protect against upper airway collapse during sleep. Steady-state CO2 levels minimally influence postarousal genioglossus after-discharge.
Twenty-four healthy individuals (6 female) slept with a nasal mask and ventilator. Sleep (EEG, EOG, EMG), ventilation (pneumotachograph), end-tidal CO2 (PETCO2), and intramuscular genioglossus EMG were monitored. NREM eucapnia was determined during 5 minutes on continuous positive airway pressure (4 cmH2O). Inspiratory pressure support was increased until PETCO2 was ≥2 mm Hg below NREM eucapnia. Supplemental CO2 was added to reproduce normocapnia, without changing ventilator settings. Arousals were induced by auditory tones and genioglossus EMG compared during steady-state hypocapnia and normocapnia.
Eleven participants (4 female) provided data. Prearousal PETCO2 was less (p < .05) during hypocapnia (40.74 ± 2.37) than normocapnia (43.82 ± 2.89), with differences maintained postarousal. After-discharge, defined as an increase in genioglossus activity above prearousal levels, occurred following the return to sleep. For tonic activity, after-discharge lasted four breaths irrespective of CO2 condition. For peak activity, after-discharge lasted one breath during hypocapnia and 6 breaths during normocapnia. However, when peak activity following the return to sleep was compared between CO2 conditions no individual breath differences were observed.
Postarousal genioglossal after-discharge may protect against upper airway collapse during sleep. Steady-state CO2 levels minimally influence postarousal genioglossus after-discharge.
摘要：
排气后通气（去除刺激后通气持续升高）发生在睡眠期间，但不存在低碳酸血症时。在睡眠过程中也会发生遗传舌肌放电后，但二氧化碳的影响尚未评估。相关性是出院后可以防止上呼吸道塌陷。这项研究旨在确定唤醒是否会在放电后持续进入睡眠，以及它是否受到二氧化碳的影响。
24名健康人（6名女性）用鼻罩和呼吸机睡觉。睡眠（脑电图，EOG,EMG),通气（呼吸速度记录仪），潮气末二氧化碳(PETCO2)，并监测肌内膝舌肌肌电图。在持续气道正压（4cmH2O）下，在5分钟内确定NREMeucapnia。增加吸气压力支持，直到PETCO2低于NREMeucapnia≥2mmHg。补充二氧化碳是为了复制正常碳酸血症，无需更改呼吸机设置。在稳态低碳酸血症和正常碳酸血症期间，听觉音调和膝舌肌肌电图会引起声调。
11名参与者（4名女性）提供了数据。低碳酸血症（40.74±2.37）期间的觉醒前PETCO2低于正常碳酸血症（43.82±2.89），分歧保持迟钝。放电后,定义为在超过唤醒前水平的膝舌肌活动增加，在恢复睡眠后发生。对于补品活动，无论CO2状况如何，出院后持续四次呼吸。对于峰值活动，出院后在低碳酸血症期间持续一次呼吸，在正常碳酸血症期间持续6次呼吸。然而,当在CO2条件下比较恢复睡眠后的峰值活动时，未观察到个体呼吸差异。
在睡眠过程中，膝舌后放电可以防止上呼吸道塌陷。稳态CO2水平最低程度地影响出院后的the舌。
24名健康人（6名女性）用鼻罩和呼吸机睡觉。睡眠（脑电图，EOG,EMG),通气（呼吸速度记录仪），潮气末二氧化碳(PETCO2)，并监测肌内膝舌肌肌电图。在持续气道正压（4cmH2O）下，在5分钟内确定NREMeucapnia。增加吸气压力支持，直到PETCO2低于NREMeucapnia≥2mmHg。补充二氧化碳是为了复制正常碳酸血症，无需更改呼吸机设置。在稳态低碳酸血症和正常碳酸血症期间，听觉音调和膝舌肌肌电图会引起声调。
11名参与者（4名女性）提供了数据。低碳酸血症（40.74±2.37）期间的觉醒前PETCO2低于正常碳酸血症（43.82±2.89），分歧保持迟钝。放电后,定义为在超过唤醒前水平的膝舌肌活动增加，在恢复睡眠后发生。对于补品活动，无论CO2状况如何，出院后持续四次呼吸。对于峰值活动，出院后在低碳酸血症期间持续一次呼吸，在正常碳酸血症期间持续6次呼吸。然而,当在CO2条件下比较恢复睡眠后的峰值活动时，未观察到个体呼吸差异。
在睡眠过程中，膝舌后放电可以防止上呼吸道塌陷。稳态CO2水平最低程度地影响出院后的the舌。
