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Cited by 330Obstructive Sleep Apnea ResearchNeuroscience of respiration and sleepRespiratory and Cough-Related Research

Pathophysiology of obstructive sleep apnoea

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Deegan, PC, McNicholas, WT·1995·European Respiratory Journal
DOI 10.1183/09031936.95.08071161
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Abstract

The pathophysiology of obstructive sleep apnoea (OSA) is complex and incompletely understood. A narrowed upper airway is very common among OSA patients, and is usually in adults due to nonspecific factors such as fat deposition in the neck, or abnormal bony morphology of the upper airway. Functional impairment of the upper airway dilating muscles is particularly important in the development of OSA, and patients have a reduction both in tonic and phasic contraction of these muscles during sleep when compared to normals. A variety of defective respiratory control mechanisms are found in OSA, including impaired chemical drive, defective inspiratory load responses, and abnormal upper airway protective reflexes. These defects may play an important role in the abnormal upper airway muscle responses found among patients with OSA. Local upper airway reflexes mediated by surface receptors sensitive to intrapharyngeal pressure changes appear to be important in this respect. Arousal plays an important role in the termination of each apnoea, but may also contribute to the development of further apnoea, because of reduction in respiratory drive related to the hypocapnia which results from postapnoeic hyperventilation. A cyclical pattern of repetitive obstructive apnoeas may result. A better understanding of the integrated pathophysiology of OSA should help in the development of new therapeutic techniques.

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  • The pattern of recurring apnea frequently observed in obstructive sleep apnea supports an instability of ventilatory control similar to periodic breathing, and upper airway obstruction is most likely when diaphragmatic and genioglossal inspiratory electromyogram activity is at the lowest point of the cycle.

    “The pattern of recurring apnea frequently observed in OSA supports an instability of ventilatory control similar to periodic breathing and upper airway obstruction is most likely when diaphragmatic and genioglossal inspiratory electromyogram (EMG) activity is at the lowest point of the cycle (Deegan & McNicholas, 1995).”

    From Obstructive sleep apnea: transition from pathophysiology to an integrative disease model (2022) · cites this paper as Deegan & McNicholas, 1995

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  • Fat in the neck results in oropharyngeal narrowing and abdominal obesity reduces traction on the upper airway, which further predisposes to increased collapsibility.

    “Fat in the neck results in oropharyngeal narrowing and abdominal obesity reduces traction on the upper airway, which further predisposes to increased collapsibility (Deegan & McNicholas, 1995).”

    From Obstructive sleep apnea: transition from pathophysiology to an integrative disease model (2022) · cites this paper as Deegan & McNicholas, 1995

    The Obesity section says fat around the pharynx and superficial neck fat may narrow the upper airway. It also says obese subjects may have smaller lung volumes that indirectly contribute to narrowing, but it does not specifically attribute this to abdominal obesity or say that reduced traction is the mechanism. (LLM, conf=0.88)

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Authors
Deegan, P., & McNicholas, W.
Affiliations
University College Dublin (IE)
Venue
European Respiratory Journal
Publisher
European Respiratory Society (ERS)
Published
1995-07-01
Volume
8
Issue
7
Pages
1161-1178
ISSN
  • 0903-1936 (ISSN-L)
  • 1399-3003
DOI
10.1183/09031936.95.08071161
OpenAlex
W2116502512
Cited by
330
References
9
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FWCI
1.14
Type
journal article
Language
en
Open access
Locations
  • European Respiratory Journal (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Neuroscience of respiration and sleep
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory and Cough-Related Research
Keywords
obstructive sleep apnea, upper airway narrowing, upper airway dilator muscles, respiratory control, arousal, hypocapnia
MeSH terms
Adult, Airway Resistance, Arousal, Female, Humans, Male, Middle Aged, Obesity, Posture, Respiratory Center, Respiratory Muscles, Risk Factors, Sleep Apnea Syndromes

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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