Noradrenergic Control of Trigeminal Motoneurons in Sleep: Relevance to Sleep Apnea

Schwarz, Peter B.; Peever, John H.

doi:10.1007/978-1-4419-5692-7_57

Cited by 7 publications

(7 citation statements)

References 11 publications

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“…Other muscles are likely important, for example, the tensor palatini which receives its output from the mandibular branch of the trigeminal nerve 406–409 . Of note, the neurobiology and control of different motor nuclei differ substantially from the standpoint of premotor inputs and neuropharmacology.…”

Section: Pathogenesis Of Osamentioning

confidence: 99%

“…375,[403][404][405] Other muscles are likely important, for example, the tensor palatini which receives its output from the mandibular branch of the trigeminal nerve. [406][407][408][409] Of note, the neurobiology and control of different motor nuclei differ substantially from the standpoint of premotor inputs and neuropharmacology. The tensor palatini has primarily tonic activity (i.e., constant activity throughout the respiratory cycle) and thus has less in the way of respiratory modulation than the genioglossus or other phasic muscles.…”

Section: Vb2 Neuromuscular Controlmentioning

confidence: 99%

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International Consensus Statement on Obstructive Sleep Apnea

Chang

Goldberg

Alt

et al. 2023

Int Forum Allergy Rhinol

119

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Background: Evaluation and interpretation of the literature on obstructive sleep apnea (OSA) allows for consolidation and determination of the key factors important for clinical management of the adult OSA patient. Toward this goal, an international collaborative of multidisciplinary experts in sleep apnea evaluation and treatment have produced the International Consensus statement on Obstructive Sleep Apnea (ICS:OSA). Methods: Using previously defined methodology, focal topics in OSA were assigned as literature review (LR), evidence-based review (EBR), or evidencebased review with recommendations (EBR-R) formats. Each topic incorporated the available and relevant evidence which was summarized and graded on study quality. Each topic and section underwent iterative review and the ICS:OSA was created and reviewed by all authors for consensus. Results: The ICS:OSA addresses OSA syndrome definitions, pathophysiology, epidemiology, risk factors for disease, screening methods, diagnostic testing types, multiple treatment modalities, and effects of OSA treatment on multiple OSA-associated comorbidities. Specific focus on outcomes with positive airway pressure (PAP) and surgical treatments were evaluated. Conclusion:This review of the literature consolidates the available knowledge and identifies the limitations of the current evidence on OSA. This effort aims to create a resource for OSA evidence-based practice and identify future research needs. Knowledge gaps and research opportunities include improving the metrics of OSA disease, determining the optimal OSA screening paradigms, developing strategies for PAP adherence and longitudinal care, enhancing selection of PAP alternatives and surgery, understanding health risk outcomes, and translating evidence into individualized approaches to therapy.

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Section: Pathogenesis Of Osamentioning

confidence: 99%

Section: Vb2 Neuromuscular Controlmentioning

confidence: 99%

International Consensus Statement on Obstructive Sleep Apnea

Chang

Goldberg

Alt

et al. 2023

Int Forum Allergy Rhinol

119

View full text Add to dashboard Cite

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“…We speculate that this arrangement provides flexibility in the muscle's activity while preserving its respiratory role of stiffening the palatal region of the airway throughout the respiratory cycle. Given recent insights into neurochemical control of the trigeminal motor system, 28 pharmacological targets for OSA are likely to emerge once the critical units to target have been defined.…”

Section: Ep Unitsmentioning

confidence: 99%

Discharge Patterns of Human Tensor Palatini Motor Units During Sleep Onset

Nicholas

Jordan

Heckel

et al. 2012

Sleep

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“…Thus, the sleep-wake cycle variations in the release of 5-HT and NE may affect upper airway motor tone in a state-dependent manner by acting on motoneurons, as well as at different premotor sites. It is, however, of note that the net effects of NE or 5-HT applied onto orofacial motoneurons are uniformly excitatory (6, 244, 276, 285, 293, 331, 436, 473), whereas, as discussed earlier, the effects of these amines at other respiratory sites are less uniform. This justifies particular interest in the magnitude and pattern of state-dependent effects exerted by 5-HT and NE at the motoneuronal level.…”

Section: Neurochemically Distinct Central Neuronal Systems With Statementioning

confidence: 74%

Neural Control of the Upper Airway: Respiratory and State‐Dependent Mechanisms

Kubin

2016

Comprehensive Physiology

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Upper airway muscles subserve many essential for survival orofacial behaviors, including their important role as accessory respiratory muscles. In the face of certain predisposition of craniofacial anatomy, both tonic and phasic inspiratory activation of upper airway muscles is necessary to protect the upper airway against collapse. This protective action is adequate during wakefulness, but fails during sleep which results in recurrent episodes of hypopneas and apneas, a condition known as the obstructive sleep apnea syndrome (OSA). Although OSA is almost exclusively a human disorder, animal models help unveil the basic principles governing the impact of sleep on breathing and upper airway muscle activity. This article discusses the neuroanatomy, neurochemistry, and neurophysiology of the different neuronal systems whose activity changes with sleep-wake states, such as the noradrenergic, serotonergic, cholinergic, orexinergic, histaminergic, GABAergic and glycinergic, and their impact on central respiratory neurons and upper airway motoneurons. Observations of the interactions between sleep-wake states and upper airway muscles in healthy humans and OSA patients are related to findings from animal models with normal upper airway, and various animal models of OSA, including the chronic-intermittent hypoxia model. Using a framework of upper airway motoneurons being under concurrent influence of central respiratory, reflex and state-dependent inputs, different neurotransmitters, and neuropeptides are considered as either causing a sleep-dependent withdrawal of excitation from motoneurons or mediating an active, sleep-related inhibition of motoneurons. Information about the neurochemistry of state-dependent control of upper airway muscles accumulated to date reveals fundamental principles and may help understand and treat OSA.

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Noradrenergic Control of Trigeminal Motoneurons in Sleep: Relevance to Sleep Apnea

Cited by 7 publications

References 11 publications

International Consensus Statement on Obstructive Sleep Apnea

International Consensus Statement on Obstructive Sleep Apnea

Discharge Patterns of Human Tensor Palatini Motor Units During Sleep Onset

Neural Control of the Upper Airway: Respiratory and State‐Dependent Mechanisms

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