title: Physiology in medicine: obstructive sleep apnea pathogenesis and treatment--considerations beyond airway anatomy.
abstract: We review evidence in support of significant contributions to the pathogenesis of obstructive sleep apnea (OSA) from pathophysiological factors beyond the well-accepted importance of airway anatomy. Emphasis is placed on contributions from neurochemical control of central respiratory motor output through its effects on output stability, upper airway dilator muscle activation, and arousability. In turn, we consider the evidence demonstrating effective treatment of OSA via approaches that address each of these pathophysiologic risk factors. Finally, a case is made for combining treatments aimed at both anatomical and ventilatory control system deficiencies and for individualizing treatment to address a patient's own specific risk factors.
authors.affiliation: James B. Skatrud Laboratory of Pulmonary & Sleep Medicine, Middleton Veterans Administration Hospital and Department of Population Health Sciences, University of Wisconsin-Madison, Madison Wisconsin;
authors.forename: Jerome A
authors.initials: JA
authors.lastname: Dempsey
authors.forename: Ailiang
authors.initials: A
authors.lastname: Xie
authors.forename: David S
authors.initials: DS
authors.lastname: Patz
authors.forename: David
authors.initials: D
authors.lastname: Wang
mesh_terms: D000818:Animals; D006801:Humans; D010827:Physiology; D012137:Respiratory System / Q000473:pathology* / Q000503:physiopathology*; D020181:Sleep Apnea, Obstructive / Q000473:pathology* / Q000503:physiopathology*
keywords: chemosensitivity; collapsible airway; sleep apnea