Nocturnal swallowing augments arousal intensity and arousal tachycardia

P. Burke*, S. Carter , Fiona Knapman, J. Patti, M. Butlin, S. Gandevia, J. Butler, D. J. Eckert, L. E. Bilston

*Corresponding author for this work

    Research output: Contribution to journalMeeting abstractpeer-review


    Introduction : Cortical arousals from sleep vary considerably in their
    frequency, duration and in their effects on the autonomic nervous
    system. Yet mechanisms that modify the arousal intensity and autonomic activity remain enigmatic. We wondered if nocturnal episodic
    swallowing – an essential airway defence mechanism regulated by
    brainstem Central Pattern Generator (CPG) networks – influenced
    sleep arousability and cardiac autonomic activity.
    Methods : 24 healthy volunteers participated. One group ( N = 14; 8
    female) were examined for supine blood pressure and heart rate responses to swallows during wakefulness with epiglottic manometry.
    The second group ( N = 10; 5 female) undertook overnight polysomnography to examine the relationships between EEG arousal, swallows, heart rate and breathing during sleep.
    Results : In all subjects we observed swallows trigger robust and patterned tachycardia conserved across wake, sleep and arousal states.
    Tachycardia onset was temporally matched to glottic closure – the
    first phase of swallow motor program. Multiple swallows increases
    the magnitude of tachycardia via temporal summation, and blood
    pressure increases as a function of the degree of tachycardia. During
    sleep, swallows were overwhelmingly associated with arousal.
    Swallows were causally linked to the intense, prolonged cortical
    arousals and marked tachycardia. Arousal duration and tachycardia
    increased in parallel as a function of swallow incidence.
    Conclusions : Our findings identify a fundamental mechanism driving
    both autonomic activity and heightened arousal via cortical feedback
    from swallow Central Pattern Generator networks of the brainstem.
    These findings challenge the widely held view that arousal generates
    stereotyped autonomic responses by feedforward inputs from cortical and subcortical systems implicated in the arousal.
    Original languageEnglish
    Article numberP146
    Number of pages1
    JournalJournal of Sleep Research
    Issue numberSupplement 1
    Publication statusPublished - Oct 2019
    EventSleep DownUnder 2019, 31st Annual Scientific Meeting of Australasian Sleep Association and the Australasian Sleep Technologists Association - Sydney, Australia
    Duration: 16 Oct 201919 Oct 2019


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