Horner Richard L
Department of Medicine, University of Toronto, 1 Kings College Circle, Toronto, ON M5S 1A8, Canada.
Can J Physiol Pharmacol. 2007 Jan;85(1):155-65. doi: 10.1139/y06-089.
Sleep, especially rapid-eye-movement sleep, causes fundamental modifications of respiratory muscle activity and control mechanisms, modifications that can predispose individuals to sleep-related breathing disorders. One of the most common of these disorders is obstructive sleep apnea (OSA) that affects approximately 4% of adults. OSA is caused by repeated episodes of pharyngeal airway obstruction that can occur hundreds of times per night, leading to recurrent asphyxia, arousals from sleep, daytime sleepiness, and adverse cardiovascular and cerebrovascular consequences. OSA is caused by the effects of sleep on pharyngeal muscle tone in individuals with already narrow upper airways. Moreover, since OSA occurs only in sleep, this disorder by definition is a state-dependent process ultimately caused by the influence of sleep neural mechanisms on the activity of pharyngeal motoneurons. This review synthesizes recent findings relating to control of pharyngeal muscle activity across sleep-wake states, with special emphasis on the influence of neuromodulators acting at the hypoglossal motor nucleus that inervates the genioglossus muscle of the tongue. The results of such basic physiological studies may be relevant to identifying and developing new pharmacological strategies to augment pharyngeal muscle activity in sleep, especially rapid-eye-movement sleep, as potential treatments for OSA.
睡眠，尤其是快速眼动睡眠，会引起呼吸肌活动和控制机制的根本性改变，这些改变会使个体易患与睡眠相关的呼吸障碍。其中最常见的一种障碍是阻塞性睡眠呼吸暂停（OSA），约4%的成年人受其影响。OSA是由咽部气道反复阻塞发作引起的，每晚可能发生数百次，导致反复窒息、睡眠中觉醒、白天嗜睡以及不良的心血管和脑血管后果。OSA是由睡眠对已经狭窄的上气道个体咽部肌肉张力的影响所致。此外，由于OSA仅在睡眠中发生，根据定义，这种障碍是一种状态依赖性过程，最终是由睡眠神经机制对咽部运动神经元活动的影响引起的。本综述综合了有关睡眠-觉醒状态下咽部肌肉活动控制的最新研究结果，特别强调了作用于舌下运动核的神经调节剂的影响，该运动核支配舌的颏舌肌。此类基础生理学研究的结果可能与识别和开发新的药理学策略有关，以增强睡眠尤其是快速眼动睡眠中的咽部肌肉活动，作为OSA的潜在治疗方法。
