★ respiratory activity during NREM sleep
☆ NREM respiratory characteristics
Relative to the arousal state, NREM sleep period is slower and more regular;
As the upper airway resistance increases, both the instantaneous airflow peak and the negative pressure peak increase to counter the airway stenosis;
The inspiratory time is prolonged, so the tidal volume is increased, but the minute ventilation is decreased, and the end-point CO2 concentration is increased;
Still maintaining a response to hypoxia and CO2;
The body's awakening stimulation of breathing is easy to make the upper airway trap in OSA patients.
☆ NREM medullary respiratory neuron activity
Decreased activity of spinal cord neurons;
Tensionary neurons, rhythmic neurons;
Non-respiratory - the active component of tonic neurons is proportional to sleep breathing;
During sleep, the respiratory modulation input signals of these cells do not disappear, but the disappearance of state-dependent excitatory inputs falls below the threshold.
☆ cerebral bridge, midbrain and telencephalon respiratory neuron activity
The respiratory modulation neuronal activity of the pons may be attenuated.
☆ NREM sleep period respiratory state depends on excitatory input weakening
â—Ž mesh structure
Stimulation of the reticular formation excites the respiratory system, stimulating the response of the genioglossus muscles.
â—Ž Behavioral control
Behavioral control can be reflexive, such as sneezing, speech, etc. during waking, and the effect on breathing during NREM is the result of a lack of behavioral control.
â—ŽAmine system
Brain stem serotoninergic and noradrenergic neurons are important sources of sleep-related respiratory changes;
After the sleep period declines, the REM period is reduced to the minimum or even disappears;
Both central and respiratory motor neurons have receptors for 5-HT and NE);
NE is mostly excitatory to motoneurons similar to 5-HT, but inhibits medullary respiratory neurons;
The blue spot is a typical neuron containing NE in the brainstem nucleus, and exhibits burst-like activation of various peripheral abnormalities or stress stimuli;
Therefore, in addition to the tonic effect of the decline in sleep correlation, NE has a phase effect on breathing when awake, especially in emotional activity or sensory activity.
â—Ž hypothalamic orexin neurons
The control of the respiratory system in the hypothalamus is related to thermoregulation, metabolism, and muscle activity;
Orexin neurons have extensive axonal connections with 5-HT, NE, histamine, and cholinergic neurons, including motoneurons and sympathetic preganglionic neurons;
Orx cells have the highest activity arousal, release the most during exercise, and have the potential to enhance respiratory output signals.
â—Ž Central PH/CO2 sensitive parts
O2, CO2 levels and pH in cerebrospinal fluid and blood are the main determinants of respiratory drive;
The chemical control of breathing during sleep continues;
Three chemically sensitive regions on the ventral surface of the medulla oblongata, cells adjacent to the surface, solitary tract cells, and brain stem 5-HT and NE cells all have sensitivity to pH/CO2.
★ REM sleep period respiratory activity
☆Respiratory characteristics of REM sleep period (excitatory, inhibitory)
Increased respiratory rate, decreased tidal volume, decreased minute ventilation, increased metabolic rate, presumably due to a significant increase in brain metabolism;
During REM sleep, the diaphragmatic activity decreases at the end of inspiratory, and due to the irregular irregularity of respiratory movement during REM sleep, central apnea and hyperventilation can occur;
The REM sleep breathing pattern does not depend on changes in chemoreceptors, vagus nerves, and intrathoracic afferent nerve activity;
In patients with OSA, the duration of sleep apnea in REM is long and the degree of hypoxemia in blood is the most serious. Similarly, the degree of hypoxia in REM sleep is usually the most serious in patients with lung disease.
Excitatory type leads to irregular breathing, insufficient ventilation and decreased oxygen saturation;
Inhibition leads to loss of intercostal muscle and assisted respiratory muscle tone, which may cause hypoxemia and upper airway obstruction.
☆ REM sleep period respiratory neuron activity enhancement (endogenous excitability drive)
Numerous studies have demonstrated the presence of respiratory excitability in REM sleep, and suggest that these drivers are centrally derived;
REM phase neuronal activation also includes respiratory-related parts, medullary neurons are activated in the REM phase, including neurons during the intensive and inspiratory phases, as well as partially enhanced expiratory neurons;
Like the medullary respiratory neurons, many (but not all) pons respiratory neurons have significantly increased activity during REM sleep;
Studies have shown that respiratory neuron activity is positively correlated with REM sleep activity. Excitability of respiratory neurons during REM sleep is the result of an endogenous process;
The rate of variation in respiratory amplitude is often related to the extent of physical activity in a dream.
☆ REM sleep period tension loss and carbachol model
During the REM sleep period, the intercostal muscles and some assisted respiratory muscles that are innervated by the spinal cord and intracranial motor neurons are declining or even missing;
Microinjection of muscarinic cholinergic receptor agonist (Carbachol) through the pons network to induce REM sleep state; injection of the dorsal medial side of the pons, such as PGO wave, hippocampal θ rhythm, orthostatic tension loss;
Similar to REM sleep XII (sublingual) motor nerve activity inhibition;
During natural REM sleep, acetylcholine is released in this area;
Experimental variability: not as fast as respiratory rate during REM sleep;
The activity of XII motor neurons in sleep is inhibited, mainly caused by the simultaneous blockade of 5-HT&NE.
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