title: Parasternal intercostal and diaphragm function during sleep.
abstract: Action of the uppermost medial internal intercostal muscles-the parasternals-during rapid eye movement (REM) is uncertain; no direct recordings exist of shortening of these muscles during sleep. Historically, motor inhibition of skeletal muscles during REM sleep is thought to cause global loss of chest wall muscle function, REM "atonia," with preservation of only diaphragm function. However, recent evidence during wakefulness shows parasternals as distinctive obligatory inspiratory muscles. Therefore we hypothesized that attenuation of chest wall function during sleep may spare the parasternals along with the diaphragm, as essential muscles of inspiration during REM. We studied seven canines, comparing costal and crural diaphragm and parasternal intercostal muscle function during wakefulness and non-REM (NREM) and REM sleep, during normal spontaneous sleep, continuously recording ventilation and simultaneous muscle electromyogram (EMG) and length from sonomicrometry microtransducers. Ventilation during sleep declined significantly from wakefulness. From wakefulness to NREM and REM, costal and crural tidal EMG increased, while parasternal tidal EMG was preserved unchanged. Costal and crural shortening per breath during NREM and REM did not change significantly from wakefulness. Concurrently, parasternal shortening decreased equally in both NREM and REM despite preservation of the parasternal EMG. We conclude that diaphragm and parasternals are not inhibited, and both remain active together as essential inspiratory muscles, during REM sleep. The lesser contraction of parasternal intercostals compared with diaphragm may be attributed to net changes in mechanics affecting the chest wall during sleep.
authors.affiliation: Department of Medical Laboratory Sciences, Kitasato University School of Allied Health Sciences, Kanagawa, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Yokoba
authors.affiliation: Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada; and.
authors.forename: Harvey G
authors.initials: HG
authors.lastname: Hawes
authors.affiliation: Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada; and.
authors.forename: Teresa M
authors.initials: TM
authors.lastname: Kieser
authors.affiliation: Department of Medical Laboratory Sciences, Kitasato University School of Allied Health Sciences, Kanagawa, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Katagiri
authors.affiliation: Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada; and peaston@ucalgary.ca.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Easton
mesh_terms: D000818:Animals; D003964:Diaphragm / Q000502:physiology*; D004285:Dogs; D004576:Electromyography / Q000379:methods; D007366:Intercostal Muscles / Q000502:physiology*; D009119:Muscle Contraction / Q000502:physiology; D012119:Respiration; D012132:Respiratory Muscles / Q000502:physiology; D012890:Sleep / Q000502:physiology*; D012895:Sleep, REM / Q000502:physiology; D035441:Thoracic Wall / Q000502:physiology; D014851:Wakefulness / Q000502:physiology
keywords: REM; diaphragm; parasternal