Abstract

IntroductionAlthough the precise cause of obstructive sleep apnea (OSA) remains unknown, various anatomical or structural factors are thought to influence upper airway patency. Recent clinical studies show that OSA is frequently observed among patients with fluid‐retaining states, such as heart/renal failure and postsurgery. It is important to note that a cause–effect relationship is not yet established, and our understanding of the effects of fluid overload is limited. The goal of this study was to investigate an animal model that can characterize the physiological changes that occur in response to fluid overload.MethodAcute nonsurvival experiments were conducted in 16 Sprague–Dawley rats. Rats were initially anesthetized by inhaled isoflurane, while the femoral vein was cannulated and urethane (1.2–1.5 g/Kg body weight) was gradually delivered intravenously to induce anesthesia. Additional doses of urethane were delivered as necessary to maintain a surgical plane of anesthesia. A surgical incision was made on the cervical area to catheterize carotid artery to measure blood pressure. A pair of stainless‐steel wires was injected into the tongue to measure genioglossus muscle activity (GGEMG). All physiological measurements were recorded as intravenous infusion of saline was provided to the rat (infusion rate = 22 ml/kg over 30 min).ResultsAcute saline overloading resulted in a 33% decrease in GGEMG, when compared to baseline. There was also a gradual drop in the respiratory rate (13% decrease) that reached statistical significance at 10 min after infusion was stopped. The blood pressure exhibited a 14% increase which subsequently returned to baseline within 40 min stopping infusion. There were no significant changes in the heart rate.ConclusionThe results of this study indicate that systemic fluid overload can affect significant changes in different physiological systems including reduction in genioglossus muscle activity, increase in blood pressure, and change autonomic nervous system function.

Highlights

  • The precise cause of obstructive sleep apnea (OSA) remains unknown, various anatomical or structural factors are thought to influence upper airway patency

  • Data were collected from 16 experiments, where genioglossus muscle activity (GGEMG), electrocardiogram (ECG), heart rate (HR), and blood pressure (BP) were measured across three time intervals (Figure 1): baseline, infusion (30 min), and postinfusion (30 min)

  • Our results showed that “fluid overloading” caused a significant decrease in upper airway dilator muscle activity, which is a characteristic biomarker observed in OSA patients (Remmers, deGroot, Sauerland, & Anch, 1978)

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Summary

Introduction

The precise cause of obstructive sleep apnea (OSA) remains unknown, various anatomical or structural factors are thought to influence upper airway patency. All physiological measurements were recorded as intravenous infusion of saline was provided to the rat (infusion rate = 22 ml/kg over 30 min). Conclusion: The results of this study indicate that systemic fluid overload can affect significant changes in different physiological systems including reduction in genioglossus muscle activity, increase in blood pressure, and change autonomic nervous system function. Continuous positive airway pressure (CPAP) therapy remains the gold standard therapy for treating patients with OSA. A universally known second-line therapy does not exist; oral appliance therapy, upper airway reconstructive surgery, weight loss, positional therapy, and more recently, hypoglossal cranial nerve stimulation therapy can provide effective management in patients with OSA (Soose et al, 2016)

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