{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T17:17:43Z","timestamp":1775063863713,"version":"3.50.1"},"reference-count":61,"publisher":"European Respiratory Society (ERS)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur Respir J"],"accepted":{"date-parts":[[2012,3,20]]},"published-print":{"date-parts":[[2013,1]]},"abstract":"<jats:p>Pharyngeal collapsibility during sleep is believed to increase due to a decline in dilator muscle activity. However, genioglossus electromyogram (EMG) often increases during apnoeas and hypopnoeas, often without mechanical effect.<\/jats:p><jats:p>17 patients with obstructive sleep apnoea were anaesthetised and evaluated from termination of propofol administration to awakening. Genioglossus EMG, flow and pharyngeal area (pharyngoscopy) were monitored. Prolonged hypopnoeas enabled evaluation of the relationships between genioglossus EMG and mechanical events, before and after awakening. Additional dilator muscle EMGs were recorded and compared to the genioglossus. Electrical stimulation of the genioglossus was used to evaluate possible mechanical dysfunction.<\/jats:p><jats:p>Prolonged hypopnoeas during inspiration before arousal triggered an increase in genioglossus EMG, reaching mean\u00b1<jats:sc>sd<\/jats:sc>62.2\u00b132.7% of maximum. This augmented activity failed to increase flow and pharyngeal area. Awakening resulted in fast pharyngeal enlargement and restoration of unobstructed flow, with marked reduction in genioglossus EMG. Electrical stimulation of the genioglossus under propofol anaesthesia increased the inspiratory pharyngeal area (from 25.1\u00b128 to 66.3\u00b175.5 mm<jats:sup>2<\/jats:sup>; p&lt;0.01) and flow (from 11.5\u00b16.5 to 18.6\u00b19.2 L\u00b7min<jats:sup>\u22121<\/jats:sup>; p&lt;0.001), indicating adequate mechanical response. All additional dilators increased their inspiratory activity during hypopnoeas.<\/jats:p><jats:p>During propofol anaesthesia, pharyngeal occlusion persists despite large increases in genioglossus EMG, in the presence of a preserved mechanical response to electrical stimulation.<\/jats:p>","DOI":"10.1183\/09031936.00159611","type":"journal-article","created":{"date-parts":[[2012,5,4]],"date-time":"2012-05-04T02:42:45Z","timestamp":1336099365000},"page":"74-84","source":"Crossref","is-referenced-by-count":36,"title":["Dissociation of electromyogram and mechanical response in sleep apnoea during propofol anaesthesia"],"prefix":"10.1183","volume":"41","author":[{"given":"Yaniv","family":"Dotan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giora","family":"Pillar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nave","family":"Tov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ron","family":"Oliven","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Uri","family":"Steinfeld","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis","family":"Gaitini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Majed","family":"Odeh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan R.","family":"Schwartz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arie","family":"Oliven","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"81","published-online":{"date-parts":[[2012,5,3]]},"reference":[{"key":"2024102021091432000_41.1.74.1","doi-asserted-by":"crossref","first-page":"1746","DOI":"10.1164\/ajrccm.161.5.9907109","article-title":"Local mechanisms drive genioglossus activation in obstructive sleep apnea","volume":"161","author":"Malhotra","year":"2000","journal-title":"Am J Respir Crit Care Med"},{"key":"2024102021091432000_41.1.74.2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200412-1631SO"},{"key":"2024102021091432000_41.1.74.3","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200302-201OC"},{"key":"2024102021091432000_41.1.74.4","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00282.2006"},{"key":"2024102021091432000_41.1.74.5","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200509000-00003"},{"key":"2024102021091432000_41.1.74.6","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00139407"},{"key":"2024102021091432000_41.1.74.7","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1152\/jappl.1959.14.5.760","article-title":"Upper airway obstruction in the unconscious patient","volume":"14","author":"Safar","year":"1959","journal-title":"J Appl Physiol"},{"key":"2024102021091432000_41.1.74.8","doi-asserted-by":"publisher","DOI":"10.1016\/0014-4886(76)90061-3"},{"key":"2024102021091432000_41.1.74.9","doi-asserted-by":"crossref","unstructured":"Fogel RB Trinder J White DP . The effect of sleep onset on upper airway muscle activity in patients with sleep apnoea versus controls. J Physiol 2005; 15;564: 549\u2013562.","DOI":"10.1113\/jphysiol.2005.083659"},{"key":"2024102021091432000_41.1.74.10","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00049907"},{"key":"2024102021091432000_41.1.74.11","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.90408.2008"},{"key":"2024102021091432000_41.1.74.12","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1152\/jappl.1980.49.4.638","article-title":"Activation of upper airway muscles before onset of inspiration in normal humans","volume":"49","author":"Strohl","year":"1980","journal-title":"J Appl Physiol"},{"key":"2024102021091432000_41.1.74.13","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/S0272-5231(21)00414-7","article-title":"The muscles of the upper airways","volume":"7","author":"Van Lunteren","year":"1986","journal-title":"Clin Chest Med"},{"key":"2024102021091432000_41.1.74.14","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.157.4.9706067"},{"key":"2024102021091432000_41.1.74.15","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00312.2011"},{"key":"2024102021091432000_41.1.74.16","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00203.2003"},{"key":"2024102021091432000_41.1.74.17","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00131106"},{"key":"2024102021091432000_41.1.74.18","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1152\/jappl.1978.44.6.931","article-title":"Pathogenesis of upper airway occlusion during sleep","volume":"44","author":"Remmers","year":"1978","journal-title":"J Appl Physiol"},{"key":"2024102021091432000_41.1.74.19","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.2007.132332"},{"key":"2024102021091432000_41.1.74.20","doi-asserted-by":"crossref","first-page":"1275","DOI":"10.1152\/jappl.2000.89.4.1275","article-title":"Upper airway muscle responsiveness to rising P CO2 during NREM sleep","volume":"89","author":"Pillar","year":"2000","journal-title":"J Appl Physiol"},{"key":"2024102021091432000_41.1.74.21","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.01214.2007"},{"key":"2024102021091432000_41.1.74.22","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1164\/ajrccm.156.1.9608037","article-title":"Upper airway anesthesia reduces phasic genioglossus activity during sleep apnea","volume":"156","author":"Berry","year":"1997","journal-title":"Am J Respir Crit Care Med"},{"key":"2024102021091432000_41.1.74.23","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/147.1.190"},{"key":"2024102021091432000_41.1.74.24","doi-asserted-by":"crossref","first-page":"1052","DOI":"10.1152\/jappl.1981.50.5.1052","article-title":"Diaphragmatic and genioglossal electromyogram responses to CO2 rebreathing in humans","volume":"50","author":"Onal","year":"1980","journal-title":"J Appl Physiol"},{"key":"2024102021091432000_41.1.74.25","doi-asserted-by":"publisher","DOI":"10.1016\/0034-5687(94)00135-M"},{"key":"2024102021091432000_41.1.74.26","doi-asserted-by":"crossref","first-page":"1950","DOI":"10.1152\/jappl.1995.78.5.1950","article-title":"Dilatory effects of upper airway muscle contraction induced by electrical stimulation in awake humans","volume":"78","author":"Schnall","year":"1995","journal-title":"J Appl Physiol"},{"key":"2024102021091432000_41.1.74.27","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.01462.2005"},{"key":"2024102021091432000_41.1.74.28","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.91501.2008"},{"key":"2024102021091432000_41.1.74.29","doi-asserted-by":"publisher","DOI":"10.1152\/jn.00940.2005"},{"key":"2024102021091432000_41.1.74.30","doi-asserted-by":"publisher","DOI":"10.1378\/chest.110.4.1077"},{"key":"2024102021091432000_41.1.74.31","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1152\/jappl.1997.83.3.851","article-title":"Interaction of cross sectional area, driving pressure, and airflow of passive velopharynx","volume":"83","author":"Isono","year":"1997","journal-title":"J Appl Physiol"},{"key":"2024102021091432000_41.1.74.32","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00019.2010"},{"key":"2024102021091432000_41.1.74.33","first-page":"157","article-title":"Electrical stimulation of the genioglossus to improve pharyngeal patency in obstructive sleep apnea: comparison of results obtained during sleep and anesthesia","volume":"148","author":"Oliven","year":"2009","journal-title":"Harefuah"},{"key":"2024102021091432000_41.1.74.34","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00125810"},{"key":"2024102021091432000_41.1.74.35","unstructured":"Tov N Odeh M Weiman Y . Force and endurance of the tongue protrusors in patients with obstructive sleep apnea (OSA): volitional and electrophysiological properties. Proc Am Thorac Soc 2006; A314."},{"key":"2024102021091432000_41.1.74.36","first-page":"233","article-title":"Differential activation of respiratory muscles during wakefulness and sleep","volume":"345","author":"Hudgel","year":"1990","journal-title":"Prog Clin Biol Res"},{"key":"2024102021091432000_41.1.74.37","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1152\/jappl.1990.69.2.443","article-title":"Fluctuation in timing of upper airway and chest wall inspiratory muscle activity in obstructive sleep apnea","volume":"69","author":"Hudgel","year":"1990","journal-title":"J Appl Physiol"},{"key":"2024102021091432000_41.1.74.38","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1111\/j.1096-3642.1985.tb01178.x","article-title":"Tongues, tentacles and trunks: the biomechanics and movement of muscular hydrostats","volume":"83","author":"Kier","year":"1985","journal-title":"Zool J Linn Soc"},{"key":"2024102021091432000_41.1.74.39","doi-asserted-by":"publisher","DOI":"10.1016\/j.resp.2007.07.009"},{"key":"2024102021091432000_41.1.74.40","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e318173f103"},{"key":"2024102021091432000_41.1.74.41","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00620.2007"},{"key":"2024102021091432000_41.1.74.42","doi-asserted-by":"publisher","DOI":"10.1016\/S0034-5687(99)00110-3"},{"key":"2024102021091432000_41.1.74.43","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1113\/jphysiol.2007.139584","article-title":"Neural drive to human genioglossus in obstructive sleep apnoea","volume":"582","author":"Saboisky","year":"2007","journal-title":"J Physiol"},{"key":"2024102021091432000_41.1.74.44","doi-asserted-by":"publisher","DOI":"10.1152\/jn.00766.2010"},{"key":"2024102021091432000_41.1.74.45","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra0808281"},{"key":"2024102021091432000_41.1.74.46","doi-asserted-by":"publisher","DOI":"10.1152\/jn.00865.2007"},{"key":"2024102021091432000_41.1.74.47","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1093\/sleep\/31.4.525","article-title":"Discharge patterns of human genioglossus motor units during sleep onset","volume":"31","author":"Wilkinson","year":"2008","journal-title":"Sleep"},{"key":"2024102021091432000_41.1.74.48","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1093\/sleep\/33.3.379","article-title":"Discharge patterns of human genioglossus motor units during arousal from sleep","volume":"33","author":"Wilkinson","year":"2010","journal-title":"Sleep"},{"key":"2024102021091432000_41.1.74.49","doi-asserted-by":"crossref","first-page":"2124","DOI":"10.1152\/jappl.1988.65.5.2124","article-title":"Thoracic influence on upper airway patency","volume":"65","author":"Van de Graaff","year":"1988","journal-title":"J Appl Physiol"},{"key":"2024102021091432000_41.1.74.50","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.156.2.9607115"},{"key":"2024102021091432000_41.1.74.51","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00373.2010"},{"key":"2024102021091432000_41.1.74.52","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1183\/09059180.00010604","article-title":"Alternatives for OSAHS treatment: selection of patients for upper airway surgery and oral appliances","volume":"106","author":"Boudewyns","year":"2007","journal-title":"Eur Respir Rev"},{"key":"2024102021091432000_41.1.74.53","first-page":"50","article-title":"Midazolam premedication delays recovery after propofol without modifying involuntary movements","volume":"85","author":"Bevan","year":"1997","journal-title":"Anesth Analg"},{"key":"2024102021091432000_41.1.74.54","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aeh080"},{"key":"2024102021091432000_41.1.74.55","doi-asserted-by":"crossref","first-page":"1674","DOI":"10.1213\/01.ANE.0000060455.94684.69","article-title":"The effects of enflurane, isoflurane, and intravenous anesthetics on rat diaphragmatic function and fatigability","volume":"96","author":"Nishina","year":"2003","journal-title":"Anesth Analg"},{"key":"2024102021091432000_41.1.74.56","doi-asserted-by":"publisher","DOI":"10.1097\/AIA.0b013e318181a8ca"},{"key":"2024102021091432000_41.1.74.57","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.0913008107"},{"key":"2024102021091432000_41.1.74.58","first-page":"A5369","article-title":"Sleep-induced dissociation between neural drive and mechanical response of the genioglossus in obstructive sleep apnea","volume":"185","author":"Dotan","year":"2012","journal-title":"Am J Resp Crit Care Med"},{"key":"2024102021091432000_41.1.74.59","doi-asserted-by":"publisher","DOI":"10.1172\/JCI115751"},{"key":"2024102021091432000_41.1.74.60","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00080.2010"},{"key":"2024102021091432000_41.1.74.61","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2006.070300"}],"container-title":["European Respiratory Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1183\/09031936.00159611","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T06:37:28Z","timestamp":1740379048000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.ersnet.org\/lookup\/doi\/10.1183\/09031936.00159611"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,5,3]]},"references-count":61,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2012,12,31]]},"published-print":{"date-parts":[[2013,1]]}},"alternative-id":["10.1183\/09031936.00159611"],"URL":"https:\/\/doi.org\/10.1183\/09031936.00159611","relation":{},"ISSN":["0903-1936","1399-3003"],"issn-type":[{"value":"0903-1936","type":"print"},{"value":"1399-3003","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,5,3]]}}}