Obesity and upper airway control during sleep

Alan R. Schwartz, Susheel P. Patil, Samuel Squier, Hartmut Schneider, Jason P. Kirkness, Philip L. Smith

Research output: Contribution to journalReview articlepeer-review

Abstract

Mechanisms linking obesity with upper airway dysfunction in obstructive sleep apnea are reviewed. Obstructive sleep apnea is due to alterations in upper airway anatomy and neuromuscular control. Upper airway structural alterations in obesity are related to adipose deposition around the pharynx, which can increase its collapsibility or critical pressure (Pcrit). In addition, obesity and, particularly, central adiposity lead to reductions in resting lung volume, resulting in loss of caudal traction on upper airway structures and parallel, increases in pharyngeal collapsibility. Metabolic and humoral factors that promote central adiposity may contribute to these alterations in upper airway mechanical function and increase sleep apnea susceptibility. In contrast, neural responses to upper airway obstruction can mitigate these mechanical loads and restore pharyngeal patency during sleep. Current evidence suggests that these responses can improve with weight loss. Improvements in these neural responses with weight loss may be related to a decline in systemic and local pharyngeal concentrations of specific inflammatory mediators with somnogenic effects.

Original languageEnglish (US)
Pages (from-to)430-435
Number of pages6
JournalJournal of applied physiology
Volume108
Issue number2
DOIs
StatePublished - Feb 2010

Keywords

  • Neuromuscular control
  • Obstructive sleep apnea
  • Pharyngeal neuromechanical function
  • Upper airway obstruction

ASJC Scopus subject areas

  • Physiology
  • Physiology (medical)

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