Gaultier C
Laboratoire de physiologie, INSERM CJF 8909, Hôpital Antoine-Béclère, Faculté de Médecine Paris XI, Clamart, France.
Neurophysiol Clin. 1994 Jun;24(3):195-206. doi: 10.1016/s0987-7053(05)80184-4.
Upper airway dilator muscle generate inspiratory pressure that balances subatmospheric pharyngeal pressure gene-rated by diaphragmatic contraction leading to reduce upper airway patency. Neural control of upper airway dilator muscles involve several categories of receptors such as vagal pulmonary receptors, upper airway mecanoreceptors, baroreceptors, chemoreceptors. Upper airway resistances increase during sleep and upper airway inspiratory muscle activity decrease especially during bursts of rapid eye movements in REM sleep. Sleep-related upper airway obstruction occurs when upper airway dilator pressure does not balance subatmospheric pharyngeal pressure. Several variables are involved in the pathophysiology of obstructive apneas such as upper airway anatomical factors, structural muscular dysfunction, changes in neural drive.
上气道扩张肌产生吸气压力，该压力可平衡因膈肌收缩产生的低于大气压的咽部压力，从而导致上气道通畅性降低。上气道扩张肌的神经控制涉及几类感受器，如迷走神经肺部感受器、上气道机械感受器、压力感受器、化学感受器。睡眠期间上气道阻力增加，尤其是在快速眼动睡眠期的阵发性快速眼球运动期间，上气道吸气肌活动减少。当上气道扩张肌压力无法平衡低于大气压的咽部压力时，就会发生与睡眠相关的上气道阻塞。阻塞性呼吸暂停的病理生理学涉及多个变量，如气道解剖因素、结构性肌肉功能障碍、神经驱动变化。
