Genioglossus EMG Activity in Normal and Sleep Breathing Disorder Patients

Abstract

Obstructive sleep apnea (OSA) is a common type of sleep breathing disorder (SBD) in children. There are multiple etiologies of pediatric OSA but they can be broadly classified into conditions that result in intrinsic upper airway narrowing and those that result in increased upper airway collapsibility. OSA is part of sleep breathing disorder(SBD) spectrum which also includes primary snoring, upper airway resistance syndrome, and obstructive hypopnea syndrome, with snoring being the mildest form and OSA the most severe form. Primary snoring is produced by vibration of pharyngeal tissues due to turbulent air flow through a narrow oropharyngeal or nasopharyngeal space. Primary snoring shares similar predisposing factors and some of the morbidities of OSA. It is found that genioglossus EMG activity during wakefulness is greater in OSA group compared to control group. However, there is no study that compared patients who snore to either OSA group or control group. This study compared genioglossus activity and fatigability in children with OSA, children who snore, and children without any SBD during quiet/deep breathing and maximum tongue protrusion. During quiet breathing, OSA group had an average EMG signal of 0.185 mV.s, Snoring group had 0.173mV.s, and Control group had 0.168 mV.s. However, the values were not statistically significant. During deep breathing, OSA group showed EMG signal of 0.456 mV.s , Snoring group had 0.360 mV.s and Control group had 0.164mV.s. Difference between OSA and Control groups were statistically significant. However, differences between OSA and Snoring group or Snoring group to Control group were not statistically significant. During maximum tongue protrusion, OSA group had EMG activity at 0.144 mV.s, Snoring group had 0.226 mV.s , and Control group had 0.220 mV.s. There was no significant difference between any two groups. There were no statistically significant differences in fatigability as well. Although statistically not significant, Snoring group had EMG values intermediate of Control and OSA group, which is expected because snoring is a milder form of OSA. In conclusion, EMG could potentially provide additional tool to differentiate patients with various types of sleep disordered breathing with further studies.