Upper airway muscle dysfunction is implicated inthe pathophysiology of sleep disorderedbreathing.
Sleep disordered breathing (SDB) describes a group of disorders that arecharacterised by abnormalities in respiration during sleep. In this review Iwill focus on the most common SBD disorder obstructive sleep apnea(OSA). Patients with OSA develop repetitive collapse of the upper airwayduring sleep and it takes arousal from sleep and sudden bursts of activityto terminate the occlusive event. The causes of OSA are multi-factorialhowever it is generally thought to occur as result of a normal statedependent decrease in upper airway muscle activity in individuals with anabnormal airway anatomy. In this review I will discuss the anatomicalabnormalities that are thought to predispose individuals to OSA. OSApatients do not experience these collapses in the upper airway duringwakefulness due to compensatory reflex responses of the upper airway. Therefore, as a result of OSA the upper airway muscles experiencemechanical trauma including increased muscle load, altered muscleactivity and hypoxia. Pathophysiology is the study of disturbances innormal function caused by a disease. In this review I will discuss howthese mechanical traumas induced by OSA affect the upper airway musclestructure and function and how it may be able to cause muscle injury.
The upper airway is surrounded by a complex anatomical arrangement of skeletal muscles and soft tissues that supports the upper airways differentfunctions, such as speech, swallowing and respiration. The nonrespiratoryfunctions require the airway to be dynamic to accommodate for thechange in airway size which allows for the movement of air, liquid andsolids. Therefore the human pharynx can be considered as a collapsibletube that compromises the essential respiratory function of the upperairway, which requires the airway to be stiff. Consequently the humanpharyngeal airway is largely dependent on the upper airway muscleactivity to maintain its patency. These muscles can actively dilate andopen the airway, or may just stiffen the soft tissue structures so they areless prone to deformation by negative pharyngeal pressure, generatedduring inspiration. The principal muscles of the pharyngeal airway that are