Central and peripheral factors contributing to obstructive sleep apneas.

Area of Science:

• * Physiology
• * Pathophysiology
• * Neurology

Background:

• * Apnea, the cessation of breathing, is a common physiological and pathophysiological event.
• * Obstructive sleep apnea (OSA) is a prominent form, characterized by repetitive airway occlusions.
• * Current understanding often oversimplifies OSA as solely due to peripheral obstructions.

Purpose of the Study:

• * To review the complex interplay of peripheral and central nervous system components in apnea.
• * To elucidate the multifactorial mechanisms underlying obstructive and central apneas.
• * To highlight the neuronal and cardiovascular consequences of these breathing disorders.

Main Methods:

• * Literature review of physiological and pathophysiological mechanisms of apnea.
• * Analysis of the interplay between chemosensory reflexes, neuromodulation, and respiratory networks.
• * Discussion of central and peripheral nervous system contributions to breathing cessation.

Main Results:

• * Obstructive sleep apnea (OSA) results from a dynamic interplay of reflexes, neuromodulation, and respiratory network activation.
• * Both OSA and central apneas (CA) involve multiple, partly overlapping mechanisms.
• * The origins of OSA and CA are neither exclusively peripheral nor exclusively central.

Conclusions:

• * Apnea mechanisms are complex, involving a dynamic interplay of peripheral and central nervous system components.
• * Oversimplification of OSA as solely peripheral is inaccurate.
• * Understanding these interactions is crucial for addressing the morbidity and mortality associated with apnea.