The DOI matches its Crossref record; 8 of the 8 references it cites were found in a registry or an index.
Pathogenesis of Obstructive and Central Sleep Apnea
Abstract
Considerable progress has been made over the last several decades in our understanding of the pathophysiology of both central and obstructive sleep apnea. Central sleep apnea, in its various forms, is generally the product of an unstable ventilatory control system (high loop gain) with increased controller gain (high hypercapnic responsiveness) generally being the cause. High plant gain can contribute under certain circumstances (hypercapnic patients). On the other hand, obstructive sleep apnea can develop as the result of a variety of physiologic characteristics. The combinations of these may vary considerably between patients. Most obstructive apnea patients have an anatomically small upper airway with augmented pharyngeal dilator muscle activation maintaining airway patency awake, but not asleep. However, individual variability in several phenotypic characteristics may ultimately determine who develops apnea and how severe the apnea will be. These include: (1) upper airway anatomy, (2) the ability of upper airway dilator muscles to respond to rising intrapharyngeal negative pressure and increasing Co(2) during sleep, (3) arousal threshold in response to respiratory stimulation, and (4) loop gain (ventilatory control instability). As a result, patients may respond to different therapeutic approaches based on the predominant abnormality leading to the sleep-disordered breathing.
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Cites
Mezzanotte, W. S., Tangel, D. J., & White, D. P. (1992) · Journal of Clinical Investigation · doi:10.1172/jci115751 · Cited by 769
Self-citationA Mechanism of Central Sleep Apnea in Patients with Heart Failure
Javaheri, S. (1999) · New England Journal of Medicine · doi:10.1056/nejm199909233411304 · Cited by 498
Role of Arousals in the Pathogenesis of Obstructive Sleep Apnea
Younes, M. (2004) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200307-1023oc · Cited by 456 · cited 1×
“One would speculate therefore that an individual with a low arousal threshold would never reach stable sleep (77).”
BackgroundRespiratory Arousal From Sleep: Mechanisms and Significance
Berry, R. B., & Gleeson, K. (1997) · Sleep · doi:10.1093/sleep/20.8.654 · Cited by 308
Influence of sleep on tensor palatini EMG and upper airway resistance in normal men
Tangel, D. J., Mezzanotte, W. S., & White, D. P. (1991) · Journal of Applied Physiology · doi:10.1152/jappl.1991.70.6.2574 · Cited by 213
Self-citationGenioglossal But Not Palatal Muscle Activity Relates Closely to Pharyngeal Pressure
MALHOTRA, A., PILLAR, G., FOGEL, R. B., BEAUREGARD, J., EDWARDS, J. K., SLAMOWITZ, D. I., SHEA, S. A., & WHITE, D. P. (2000) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.162.3.9912067 · Cited by 148
Self-citationPharyngeal Pressure and Flow Effects on Genioglossus Activation in Normal Subjects
Malhotra, A., Pillar, G., Fogel, R. B., Edwards, J. K., Ayas, N., Akahoshi, T., Hess, D., & White, D. P. (2002) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.165.1.2011065 · Cited by 124
Self-citationInspiratory coactivation of the genioglossus enlarges retroglossal space in laryngectomized humans
Kobayashi, I., Perry, A., Rhymer, J., Wuyam, B., Hughes, P., Murphy, K., Innes, J. A., McIvor, J., Cheesman, A. D., & Guz, A. (1996) · Journal of Applied Physiology · doi:10.1152/jappl.1996.80.5.1595 · Cited by 85
Cited by
Control of sleep and wakefulness
Brown, R. E., Basheer, R., McKenna, J. T., Strecker, R. E., & McCarley, R. W. (2012) · Physiological Reviews · doi:10.1152/physrev.00032.2011 · Cited by 1,477
Goldberger, J. J., Cain, M. E., Hohnloser, S. H., Kadish, A. H., Knight, B. P., Lauer, M. S., Maron, B. J., Page, R. L., Passman, R. S., Siscovick, D., et al. (2008) · Circulation · doi:10.1161/circulationaha.107.189375 · Cited by 1,450
Obstructive sleep apnoea syndrome
Lévy, P., Kohler, M., McNicholas, W. T., Barbé, F., McEvoy, R. D., Somers, V. K., Lavie, L., & Pépin, J.-L. (2015) · Nature Reviews Disease Primers · doi:10.1038/nrdp.2015.15 · Cited by 1,235
Defining Phenotypic Causes of Obstructive Sleep Apnea. Identification of Novel Therapeutic Targets
Eckert, D. J., White, D. P., Jordan, A. S., Malhotra, A., & Wellman, A. (2013) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201303-0448oc · Cited by 1,173
Self-citationPathophysiology of Adult Obstructive Sleep Apnea
Eckert, D. J., & Malhotra, A. (2008) · Proceedings of the American Thoracic Society · doi:10.1513/pats.200707-114mg · Cited by 719
Metadata
- Authors
- White, D. P.
- Venue
- American Journal of Respiratory and Critical Care Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2005-12-01
- Volume
- 172
- Issue
- 11
- Pages
- 1363-1370
- ISSN
- 1073-449X (ISSN-L)
- 1535-4970
- OpenAlex
- W2104274405
- Cited by
- 681
- References
- 8
- FWCI
- 14.23
- Type
- journal article
- Language
- en
- Open access
- closed
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
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