Effects of pentobarbital on upper airway patency during sleep

Matthias Eikermann, Danny J. Eckert, Nancy L. Chamberlin, Amy S. Jordan, Sebastian Zaremba, Scott A. Smith, Carl E. Rosow, Atul Malhotra

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19 Citations (Scopus)

Abstract

We hypothesised that pentobarbital would improve upper airway mechanics based on an increase in latency to arousal and amplitude of the phasic genioglossus electromyogram (EMG), and a decrease in the active upper airway critical closing pressure (Pcrit). 12 healthy subjects received pentobarbital (100 mg) or placebo in a double-blind, crossover protocol. During wakefulness, we measured the genioglossus reflex response to negative pressure pulses. During sleep, carbon dioxide was insufflated into the inspired air. Airway pressure was then decreased in a stepwise fashion until arousal from sleep. With basal breathing during sleep: flow rate was lower in volunteers given pentobarbital; endtidal CO2 concentration and upper airway resistance were greater; and Pcrit was unaffected (pentobarbital mean±SD -11.7±4.5 versus placebo -10.25±3.6 cmH2O; p=0.11). Pentobarbital increased the time to arousal (297±63s versus 232±67 s; p<0.05), at which time phasic genioglossus EMG was higher (6.2±4.8% maximal versus 3.1±3%; p<0.05) as were CO2 levels. The increase in genioglossus EMG after CO2 administration was greater after pentobarbital versus placebo. Pentobarbital did not affect the genioglossus negative-pressure reflex. Pentobarbital increases the time to arousal and stimulates genioglossus muscle activity, but it also increases upper airway resistance during sleep. Copyright

Original languageEnglish
Pages (from-to)569-576
Number of pages8
JournalEuropean Respiratory Journal
Volume36
Issue number3
DOIs
Publication statusPublished - Sep 2010

Keywords

  • Airway
  • Arousal threshold
  • Lung
  • Obstructive sleep apnoea/hypopnoea syndrome
  • Sleep-disordered breathing

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    Eikermann, M., Eckert, D. J., Chamberlin, N. L., Jordan, A. S., Zaremba, S., Smith, S. A., Rosow, C. E., & Malhotra, A. (2010). Effects of pentobarbital on upper airway patency during sleep. European Respiratory Journal, 36(3), 569-576. https://doi.org/10.1183/09031936.00153809