期刊
CURRENT OPINION IN PULMONARY MEDICINE
卷 14, 期 6, 页码 519-524出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MCP.0b013e3283130f66
关键词
control of ventilation; lung; pharynx; upper airway; upper airway muscle activation
资金
- NHLBI NIH HHS [R01 HL073146, K24 HL093218, R01 HL073146-04] Funding Source: Medline
- NIA NIH HHS [K23 AG024837, K23 AG024837-01] Funding Source: Medline
Purpose of review Obstructive sleep apnea is an increasingly prevalent disease, with a considerable societal burden. The disease is defined by recurrent intermittent collapse of the upper airway. Understanding of and treatment for the disease is largely confined to relief of the mechanical obstruction of the upper airway by application of continuous positive airway pressure, and less commonly weight loss or surgery. However, recent work has focused on the function, rather than structure alone, of the upper airway. Recent findings The following contributors to upper airway structure and function have been studied: traditional fixed anatomical abnormalities, dynamic anatomical changes, upper airway dilator muscle dysfunction, lung volumes, and instability in control of breathing. In each patient with obstructive sleep apnea, the relative contribution of each of these components may be quite variable. The studies reviewed here describe methods to evaluate these factors, and some attempts at treatment. Summary Ongoing studies are attempting to classify patients on the basis of the underlying pathophysiology. This work suggests that obstructive sleep apnea is a heterogeneous disease with multiple root causes. Ultimately, such a classification may allow more individualized treatment, not only relying on mechanical relief of the upper airway obstruction.
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