The condition of the respiratory muscles in obstructive sleep disordered breathing according to electromyographic data
https://doi.org/10.36604/1998-5029-2020-78-92-98
Abstract
Aim. To study functional state of respiratory muscles in patients with obstructive sleep-disordered breathing (oSDB) of varying severity based on changes in electrical activity when using a stepwise-increasing respiratory load.
Materials and methods. According to results of cardiorespiratory monitoring, the examined patients were divided into 4 groups. Group 1 included 16 patients without oSDB, group 2 – 16 patients with mild oSDB, group 3 – 8 patients with moderate oSDB, group 4 – 8 patients with severe oSDB. The assessment of electrical activity of inspiratory muscles and expiratory muscles was carried out using electromyography (EMG) when performing tests with a stepwise-increasing inspiratory and expiratory load.
Results. During inspiratory test, a decrease in EMG frequency was observed, indicating respiratory muscles fatigue development, with a simultaneous increase in EMG amplitude due to the involvement of additional motoneurons in muscle contraction. In all cases, degree of increase in EMG amplitude prevailed over degree of decrease in EMG frequency. In patients of groups 3 and 4, there were no signs of diaphragm fatigue. Results of expiratory test in group 1, degree of increase in EMG amplitude prevailed over degree of decrease in EMG frequency. In the groups of patients with oSDB, prevalence of decrease in the EMG frequency over increase in EMG amplitude was observed, which indicates development of neuromuscular fatigue of expiratory muscles.
Conclusion. Changes in functional state of respiratory muscles are associated with severity of oSDB and are characterized by different dynamics of the electrical activity of inspiratory and expiratory muscles in response to a functional test.
Materials and methods. According to results of cardiorespiratory monitoring, the examined patients were divided into 4 groups. Group 1 included 16 patients without oSDB, group 2 – 16 patients with mild oSDB, group 3 – 8 patients with moderate oSDB, group 4 – 8 patients with severe oSDB. The assessment of electrical activity of inspiratory muscles and expiratory muscles was carried out using electromyography (EMG) when performing tests with a stepwise-increasing inspiratory and expiratory load.
Results. During inspiratory test, a decrease in EMG frequency was observed, indicating respiratory muscles fatigue development, with a simultaneous increase in EMG amplitude due to the involvement of additional motoneurons in muscle contraction. In all cases, degree of increase in EMG amplitude prevailed over degree of decrease in EMG frequency. In patients of groups 3 and 4, there were no signs of diaphragm fatigue. Results of expiratory test in group 1, degree of increase in EMG amplitude prevailed over degree of decrease in EMG frequency. In the groups of patients with oSDB, prevalence of decrease in the EMG frequency over increase in EMG amplitude was observed, which indicates development of neuromuscular fatigue of expiratory muscles.
Conclusion. Changes in functional state of respiratory muscles are associated with severity of oSDB and are characterized by different dynamics of the electrical activity of inspiratory and expiratory muscles in response to a functional test.
About the Authors
А. I. Miroshnichenko
Orenburg State Medical University
Russian Federation
Russian Federation
Anastasia I. Miroshnichenko, Postgraduate Student of the Department of Propaedeutic of Internal Medicine
6 Sovetskaya Str., Orenburg, 460000
А. К. Kunarbaeva
Orenburg State Medical University
Russian Federation
Russian Federation
Adel K. Kunarbaeva, Postgraduate Student of the Department of Propaedeutic of Internal Medicine
6 Sovetskaya Str., Orenburg, 460000
К. М. Ivanov
Orenburg State Medical University
Russian Federation
Russian Federation
Konstantin M. Ivanov, MD, PhD, D.Sc. (Med.), Professor, Head of the Department of Propaedeutic of Internal Medicine
6 Sovetskaya Str., Orenburg, 460000
I. V. Miroshnichenko
Orenburg State Medical University
Russian Federation
Russian Federation
Igor V. Miroshnichenko, MD, PhD, D.Sc. (Med.), Professor, Head of the Department of Normal Physiology
6 Sovetskaya Str., Orenburg, 460000
References
1. Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force. Sleep 1999; 22(5):667–689.
2. Wilcox P.G., Pare P.D., Road J.D., Fleetham J.A. Respiratory muscle function during obstructive sleep apnea. ́ Am. Rev. Respir. Dis. 1990; 142(3):533–539. doi: 10.1164/ajrccm/142.3.533
3. Stănescu D., Kostianev S., Sanna A., Liistro G., Veriter C. Expiratory flow limitation during sleep in heavy snorers. Eur. Respir. J. 1996; 9(10): 2116–2121. doi: 10.1183/09031936.96.09102116
4. Praud J.P., D'allest A.M., Nedelcoux H., Curzi-Dascalova L., Guilleminault C., Gaultier C. Sleep-related abdominal muscle behavior during partial or complete obstructed breathing in prepubertal children. Pediatr. Res. 1989; 26(4):347‒350. doi: 10.1203/00006450-198910000-00012
5. Martin R.J., Fernandez E., Hudgel D.W., Hill P. The association of sleep apnea to the high/low ratio of the diaphragmatic EMG (abstract). Am. Rev. Respir. Dis. 1982; 125:107.
6. Montserrat J.M., Kosmas E.N., Cosio M.G., Kimoff R.J. Lack of evidence for diaphragmatic fatigue over the course of the night in obstructive sleep apnea. Eur. Respir. J. 1997; 10(1):133–138. doi: 10.1183/09031936.97.10010133
7. Vincken W., Guilleminault C., Silvestri L., Cosio M., Grassino A. Inspiratory muscle activity as a trigger causing the airways to open in obstructive sleep apnea. Am. Rev. Respir. Dis. 1987; 135(2):372–377. doi: 10.1164/arrd.1987.135.2.372
8. Griggs G.A., Findley L.J., Suratt P.M., Esau S.A., Wilhoit S.C., Rochester D.F. Prolonged relaxation rate of inspiratory muscles in patients with sleep apnea. Am. Rev. Respir. Dis. 1989; 140(3):706–710. doi: 10.1164/ajrccm/140.3.706
9. Ershov S.P., Perelman J.M. Respiratory muscle electrophysiological evaluation in patients with chronic bronchitis. Bûlleten' fiziologii i patologii dyhaniâ = Bulletin Physiology and Pathology of Respiration 1999; (5):28−35 (in Russian).
10. Miller K.J., Garland S.J., Ivanova T., Ohtsuki T. Motor-unit behavior in humans during fatiguing arm movements. J. Neurophysiol. 1996; 75(4):1629‒1636. doi: 10.1152/jn.1996.75.4.1629
11. Solnushkin S.D., Chihman V.N., Segizbaeva M.O., Aleksandrov V.G. Hardware and software for EMG recording and analysis of respiratory muscles of human. Human Physiology 2014; 40(2):220–223. doi: 10.1134/S0362119714010174
12. Segizbayeva M.O., Alexandrova N.P., Timofeev N.N., Kur'yanovich E.N. Functional condition of inspiratory muscles of the person under exercise stresses "to refusal": EMG-analysis. Actual Problems of Physical and Special Training of Law Enforcement Agencies 2015; (3):79‒90 (in Russian).
13. Timofeev N.N., Segizbayeva M.O., Kur'yanovich E.N., Alexandrova N.P. The inspiratory muscles training influence on the resistance to fatigue development under intensive muscle exercising. Actual Problems of Physical and Special Training of Law Enforcement Agencies 2015; (3):91‒101 (in Russian).
14. Geddes E.L., O'Brien K., Reid W.D., Brooks D., Crowe J. Inspiratory muscle training in adults with chronic obstructive pulmonary disease: an update of a systematic review. Respir. Med. 2008; 102(12):1715‒1729. doi: 10.1016/j.rmed.2008.07.005
15. Hoppeler H., Vogt M. Muscle tissue adaptations to hypoxia. J. Exp. Biol. 2001; 204 (Pt 18): 3133‒3139.
Review
For citations:
Miroshnichenko А.I., Kunarbaeva А.К., Ivanov К.М., Miroshnichenko I.V. The condition of the respiratory muscles in obstructive sleep disordered breathing according to electromyographic data. Bulletin Physiology and Pathology of Respiration. 2020;(78):92-98. (In Russ.) https://doi.org/10.36604/1998-5029-2020-78-92-98
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