Title: Concerning the Importance of Pharyngeal Muscles in the Maintenance of Upper Airway Patency during Sleep An Opinion
Abstract: While it is known that neural activation of pharyngeal muscle exhibits respiratory periodicity and is an integral part of the respiratory control system, 1 van Lunteren E Strohl KP The muscles of the upper airway. in: Widdicome J Saunders, Clinics in chest medicine, Philadelphia1986: 171-188 Google Scholar the mechanical consequences of neuromuscular activity in upper airway muscles are not well understood. Clinical and physiologic studies of Remmers et al, 2 Remmers JE de Groot W Sauerland EK Anch AM Pathogenesis of upper airway occlusion during sleep. J Appl Physiol. 1978; 44: 931-938 Crossref PubMed Scopus (1381) Google Scholar Brouillete and Thach, 3 Brouillette RT Thach BT A neuromuscular mechanism maintaining extrathoracic airway patency. J Appl Physiol. 1979; 46: 772-779 Crossref PubMed Scopus (289) Google Scholar and others 4 Mathew OP Remmers JE Respiratory function of the upper airway. in: Saunders NA Sullivan CE Sleep and breathing. Marcel Dekker, New York1984: 163-200 Google Scholar are evidence to presume a relationship between pharyngeal muscle activation and upper airway obstruction during sleep. In these studies, reduction in upper airway muscle activity—genioglossus, geniohyoid, etc—was associated with the onset of upper airway obstruction. Comments on the cause-effect relationship of this association acknowledged that basic mechanical properties of the airways and on the link(s) between upper airway muscle activity and airway patency were not well understood. Yet, the usual interpretation of these studies involves an implicit assumption of a direct relationship between muscle activity and airway patency. This interpretation has led to theories concerning a central pathogenesis for obstructive apneas and too often unsuccessful therapeutic attempts to treat these apneas by altering respiratory drive. 5 Strohl KP Cherniack NS Gothe B Physiologic basis of therapy for sleep apnea. Am Rev Respir Dis. 1986; 134: 791-802 PubMed Google Scholar We have evolved a different theory of the maintenance of pharyngeal patency and will argue for the relative unimportance of muscle activation in the initiation of obstructive apneas during sleep.
Publication Year: 1987
Publication Date: 1987-11-01
Language: en
Type: article
Indexed In: ['crossref', 'pubmed']
Access and Citation
Cited By Count: 17
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