Nerve and Muscle Changes in the Upper Airways of Subjects with Obstructive Sleep Apnea: Structural Basis for the Neurogenic Theory

Abstract

Obstructive sleep apnea syndrome (OSAS) is a widely diffused disease associated with specific genetics, age, gender, craniofacial and upper airways anatomy, obesity, and endocrine conditions, but not with ethnicity profiles. The so-called neurogenic neurogenic theory of OSAS postulates that the collapse of the upper airways that characterize this disease is due to peripheral nerve degeneration that leads to muscle atrophy and collapse. This review attempts to summarize the structural and functional changes in both the sensory and motor innervation of the walls of the upper air ways in patients suffering from OSAS.

Improving outcomes of hypoglossal nerve stimulation therapy: current practice, future directions, and research gaps. Proceedings of the 2019 International Sleep Surgery Society Research Forum

“…In light of this, assessment of motor or sensory function of the muscles of the upper airway may impact HGNS success 84 and may be useful for preoperative assessment. In addition, Cobo et al 85 reviewed the changes noted in upper airway nerves and muscles in patients with OSA and noted that motor nerve fibers and motor endplates along with the potential role of sensory nerve impairment has not been adequately investigated in OSA, as the current literature regarding this is heterogeneous and contradictory.…”