JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY) ›› 2016, Vol. 30 ›› Issue (5): 9-12.doi: 10.6040/j.issn.1673-3770.0.2016.317

Previous Articles     Next Articles

Relationship between obstructive sleep apnea and pharyngeal muscles and structure.

XUE Rong, ZHANG Xilong   

  1. Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu, China
  • Received:2016-07-20 Online:2016-10-20 Published:2016-10-20

PDF (PC)

779

Abstract: The upper airway is composed of the nose, pharynx, larynx, and extrathoracic trachea. The segment of great interest is the pharynx, where partial or complete airway obstruction occurs during sleep in patients with obstructive sleep apnea syndrome(OSAS). Under the neural and chemical control, contraction of pharyngeal muscles surrounding the collapsible conduit of the pharynx modulates the size and stiffness according to the required purpose. The objective of this review is to describe normal pharyngeal airway maintenance achieved by interaction between the pharyngeal muscles and structures during sleep, and to share new information that may relate to the pathophysiology of sleep-disordered breathing.

Key words: Obstructive sleep apnea syndrome, Pharyngeal muscles

CLC Number: 

  • R766.7
[1] Sériès F. Upper airway muscles awake and asleep[J]. Sleep Medicine Reviews, 2002, 6(3):229-242.
[2] Susarla S M, Thomas R J, Abramson Z R, et al. Biomechanics of the upper airway: changing concepts in the pathogenesis of obstructive sleep apnea[J]. International Journal of Oral and Maxillofacial Surgery, 2010, 39(12):1149-1159.
[3] Feroah T R, Forster H V, Fuentes C G, et al. Effects of spontaneous swallows on breathing in awake goats[J]. Journal of Applied Physiology, 2002, 92(5):1923-1935.
[4] Kuna S T, Smickley J S. Superior pharyngeal constrictor activation in obstructive sleep apnea[J]. American Journal of Respiratory and Critical Care Medicine, 1997, 156(3):874-880.
[5] Miki H, Hida W, Kikuchi Y, et al. Effects of pharyngeal lubrication on the opening of obstructed upper airway[J]. Journal of Applied Physiology, 1992, 72(6):2311-2316.
[6] Fuller D D, Williams J S, Janssen P L, et al. Effect of co-activation of tongue protrudor and retractor muscles on tongue movements and pharyngeal airflow mechanics in the rat[J]. The Journal of Physiology, 1999, 519(2):601-613.
[7] Remmers J E. Wagging the tongue and guarding the airway: reflex control of the genioglossus[J]. American Journal of Respiratory and Critical Care Medicine, 2001, 164(11):2013-2014.
[8] Edwards B A, White D P. Control of the pharyngeal musculature during wakefulness and sleep: implications in normal controls and sleep apnea[J]. Head & Neck, 2011, 33(S1):S37-S45.
[9] Mezzanotte W S, Tangel D J, White D P. Influence of sleep onset on upper-airway muscle activity in apnea patients versus normal controls[J]. American Journal of Respiratory and Critical Care Medicine, 1996, 153(6):1880-1887.
[10] Fogel R B, Trinder J, White D P, et al. The effect of sleep onset on upper airway muscle activity in patients with sleep apnoea versus controls[J]. The Journal of Physiology, 2005, 564(2):549-562.
[11] Genta P R, Owens R L, Edwards B A, et al. Influence of pharyngeal muscle activity on inspiratory negative effort dependence in the human upper airway[J]. Respiratory Physiology & Neurobiology, 2014, 201:55-59.
[12] Remmers J E. Wagging the tongue and guarding the airway: reflex control of the genioglossus[J]. American Journal of Respiratory and Critical Care Medicine, 2001, 164(11):2013-2014.
[13] Isono S. Obstructive sleep apnea of obese adults pathophysiology and perioperative airway management[J]. The Journal of the American Society of Anesthesiologists, 2009, 110(4):908-921.
[14] Kairaitis K, Verma M, Fish V, et al. Pharyngeal muscle contraction modifies peri-pharyngeal tissue pressure in rabbits[J]. Respiratory Physiology & Neurobiology, 2009, 166(2):95-101.
[15] Hudgel D W. The role of upper airway anatomy and physiology in obstructive sleep apnea[J]. Clinics in Chest Medicine, 1992, 13(3):383-398.
[16] Isono S, Tanaka A, Nishino T. Dynamic interaction between the tongue and soft palate during obstructive apnea in anesthetized patients with sleep-disordered breathing[J]. Journal of Applied Physiology, 2003, 95(6):2257-2264.
[17] Hollowell D E, Suratt P M. Mandible position and activation of submental and masseter muscles during sleep[J]. Journal of Applied Physiology, 1991, 71(6):2267-2273.
[18] Kato T, Katase T, Yamashita S, et al. Responsiveness of jaw motor activation to arousals during sleep in patients with obstructive sleep apnea syndrome[J]. Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine, 2013, 9(8):759.
[19] Tsai W H, Vazquez J C, Oshima T, et al. Remotely controlled mandibular positioner predicts efficacy of oral appliances in sleep apnea[J]. American Journal of Respiratory and Critical Care Medicine, 2004, 170(4):366-370.
[20] Ishikawa T, Isono S, Aiba J, et al. Prone position increases collapsibility of the passive pharynx in infants and small children[J]. American Journal of Respiratory and Critical Care Medicine, 2002, 166(5):760-764.
[1] LIU Dawei, ZHANG Yu, LI Chenglin, CHEN Xiumei, SONG Xicheng. Use of enhanced recovery after surgery in children with obstructive sleep apnea syndrome during the perioperative period [J]. J Otolaryngol Ophthalmol Shandong Univ, 2018, 32(5): 19-22.
[2] WU Hao,DING Xiao-jun,ZHOU Wei-rong,LU Jun,YOU Yi-wen,NIU Guan-yi,CHENG Ya-quan . Hard palate shortening combined with uvulopalatopharyngolasty in the treatment of obstructive sleep apnea syndrome [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2007, 21(4): 297-299 .
[3] LUO Xin-an,SUN Zheng-liang . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(4): 343-344 .
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Website Copyright: Editorial Office of Journal of Otolaryngology and Ophthalmology of Shandong University
Address: No.27 Shanda South Road, Jinan, Shandong, China. Post code: 250100 Tel: +86-0531-88366912 Email: ebhxb@sdu.edu.cn Supported by Beijing Magtech Co.Ltd