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Semin Neurol 2009; 29(4): 368-371
DOI: 10.1055/s-0029-1237122
© Thieme Medical Publishers

Neurologic Aspects of Sleep Apnea: Is Obstructive Sleep Apnea a Neurologic Disorder?

Christian Guilleminault1 , Kannan Ramar1
  • 1Stanford Sleep Disorders Center of Excellence, Stanford University School of Medicine, Stanford, California
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Publication History

Publication Date:
09 September 2009 (online)

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ABSTRACT

The upper airway caliber is determined by afferent sensory input to the brainstem respiratory centers and efferent motor neural output to the upper airway structures. Upper airway caliber is altered in obstructive sleep apnea. The mechanosensory receptors of the upper airway are capable of responding to changes in airway pressure, airflow, temperature, and to the upper airway muscle tone itself. Application of topical anesthesia change chronic snorers in apneic patients during sleep and prolong sleep apnea in obstructive sleep apnea (OSA) patients. Respiratory-related evoked potential are significantly reduced in OSA patients during non-rapid eye movement sleep indicating a sleep-related blunted cortical response to inspiratory occlusion. Histologic investigations of palatopharyngeal muscles from OSA patients show evidence of motor neuron lesions and actual damage to the muscles. Currently demonstrated local neurologic impairment and lesions can explain the development of sleep apneas and hypopneas.

KEYWORDS

Obstructive sleep apnea - chronic snoring - upper airway - sensory input - motor deficit - central integration during sleep

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Christian GuilleminaultM.D. 

Professor of Psychiatry and Behavioral Sciences, Stanford Sleep Disorders Center of Excellence

Stanford University School of Medicine, 401 Quarry Road, Suite 3301, Stanford, CA 94305

Email: cguil@stanford.edu