Semin Respir Crit Care Med 1998; 19(2): 99-112
DOI: 10.1055/s-2007-1009387
Copyright © 1998 by Thieme Medical Publishers, Inc.

Pathophysiology and Risk Factors for Obstructive Sleep Apnea

Shannon J. Winakur, Philip L. Smith, Alan R. Schwartz
  • The Johns Hopkins University Sleep Disorders Center, Division of Pulmonary and Critical Care Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland
Further Information

Publication History

Publication Date:
20 March 2008 (online)

Abstract

This chapter reviews the pathophysiology and risk factors for obstructive sleep apnea (OSA). Important risk factors for this disorder include obesity, male gender, and postmenopausal state. There is also an association between OSA and certain heritable factors, along with the endocrine disorders, acromegaly, and hypothyroidism. The pathogenesis of OSA is related to upper airway obstruction. Both neural and structural mechanisms may account for the development of pharyngeal obstruction during sleep. Neural factors influencing upper airway patency include neuromuscular reflexes, central nervous system (CNS) depressants, and neuromodulators; airway structures that both elongate and dilate the pharynx influence pharyngeal collapsibility. Based on our current understanding of the pathogenic mechanisms of upper airway obstruction, we outline the major principles for therapy of this disorder.

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