Vom Vibrationstrauma zur pharyngealen Muskelinstabilität – Ein sich selbst unterhaltender pathophysiologischer Prozess (Circulus vitiosus) bei obstruktiver Schlafapnoe (OSA)

Zusammenfassung

Die Pharynxstabilität wird sowohl durch anatomische als auch nicht-anatomische Faktoren gewährleistet. Neben der anatomischen Weite sind auch funktionelle Faktoren für den Obstruktionsgrad des oberen Atemwegs bedeutsam. Die Funktionsfähigkeit der pharyngealen Muskeln ist von einer ungestörten Sensomotorik abhängig. Bei Patienten mit Rhonchopathie bzw. obstruktiver Schlafapnoe (OSA) verändern sich Sensomotorik und Muskelmorphologie in zunehmendem Ausmaß. Es ist zu mutmaßen, dass langjähriges Schnarchen zu einer vibrationsbedingten sensomotorischen Neuropathie mit Verlust der Funktion und Struktur der pharyngealen Muskulatur führt. Pharyngeale Mechanorezeptoren verlieren ihre Empfindlichkeit und die Informationen können aufgrund eines neuronalen Schadens nicht mehr adäquat motorisch umgesetzt werden. Es stellt sich die Frage, nach welchem Zeitraum es zu einem irreversiblen vibrationsbedingten Rezeptorschaden durch Schnarchen kommt.

Abstract

Pharyngeal stability is ensured by both anatomical and non-anatomical factors. In addition to the anatomical width, functional factors are also significant in determining the degree of obstruction of the upper airway. The functionality of the pharyngeal muscles depends on an undisturbed sensorimotor system. In patients with rhonchopathy or obstructive sleep apnea (OSA), sensorimotor function and muscle morphology change progressively. It is hypothesised that long-term snoring leads to vibration-induced sensorimotor neuropathy, resulting in the loss of function and structure of the pharyngeal muscles. Pharyngeal mechanoreceptors lose their sensitivity, and due to neural damage, information can no longer be adequately translated into motor responses. This raises the question of the timeframe within which irreversible vibration-induced receptor damage occurs due to snoring.

Schlüsselwörter

Schnarchen - obstruktive Schlafapnoe - pharyngeale Mechanorezeptoren - Vibrationsschaden - Sensomotorik

Keywords

snoring - obstructive sleep apnea - pharyngeal mechanoreceptors - vibration damage - sensorimotor function

Publication History

Received: 05 September 2024

Accepted after revision: 08 October 2024

Article published online:
04 December 2024

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