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Breathing-controlled Electrical Stimulation (BreEStim) for Management of Neuropathic Pain and Spasticity

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State-dependent and reflex drives to the upper airway: basic physiology with clinical implications.

Richard L Horner¹, Stuart W Hughes, Atul Malhotra

¹Department of Medicine, University of Toronto, Toronto, Ontario, Canada;

Journal of Applied Physiology (Bethesda, Md. : 1985)

|August 24, 2013

Summary

Sleep disorders often involve breathing impairment due to upper airway dysfunction. This paper explores common brain pathways affecting breathing and arousal during sleep and sedation.

Keywords:

genioglossus muscle lung obstructive sleep apnea pharyngeal muscles sleep

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Published on: November 19, 2015

Area of Science:

Neuroscience
Sleep Medicine
Respiratory Physiology

Background:

Sleep disorders, particularly hypopneas and apneas, stem from impaired breathing during sleep.
Upper airway dysfunction is a primary cause of sleep-related breathing problems.
The sleeping brain alters respiratory control, reducing responses to distress.

Purpose of the Study:

To identify state-dependent brain pathways and reflex mechanisms affecting the upper airway.
To synthesize established and recent findings on sleep and sedation-induced respiratory and arousal depression.
To investigate common cellular mechanisms underlying these effects.

Main Methods:

Focus on the mechanism of genioglossus muscle inhibition during REM sleep.
Analysis of neurotransmitter convergence onto a root mechanism for pharyngeal motor suppression.
Examination of the lateral reticular formation's role in respiratory and reflex drives.

Main Results:

Genioglossus muscle inhibition in REM sleep is a key focus.
Diverse signaling pathways converge on a common mechanism for pharyngeal motor suppression.
The lateral reticular formation serves as a critical hub for upper airway control.

Conclusions:

Understanding shared brain pathways is crucial for addressing sleep and sedation-induced breathing issues.
Specific mechanisms in REM sleep and drug effects involve common neural pathways.
The lateral reticular formation is a significant target for respiratory and reflex regulation of the upper airway.