Abstract
Trigeminal innervated areas in face, nasolacrimal, and nasal mucosa can produce a wide array of cardiorespiratory manifestations that include apnea, bradypnea, bradycardia, hypotension, and arrhythmias. This reflex is a well-known entity called “trigemino-cardiac reflex” (TCR). The role of TCR is investigated in various pathophysiological conditions especially in neurosurgical, but also skull base surgery procedures. Additionally, its significance in various sleep-related disorders has also been highlighted recently. Though, the role of diving reflex, a subtype of TCR, has been extensively investigated in sudden infant death syndrome. The data related to other sleep disorders including obstructive sleep apnea, bruxism is very limited and thus, this mini review aims to investigate the possible role and correlation of TCR in causing such sleep abnormalities.
Highlights
Sleep disorders are a common increasing health problem in today’s industrialized world and can have a significant impact on quality of life and of working
It is reported that sudden microarousals (MA) occurring in the brain due to airway obstruction during sleep cause tachycardia, which stimulates rhythmic masticatory muscle activity (RMMA) and teeth grinding that activate the trigemino-cardiac reflex” (TCR) resulting in bradycardia
obstructive sleep apnea (OSA), usually occurs due to mild to severe collapse of the airway in up to 9% of women and 24% of men [19, 20]; while the RMMA is much more widespread and occurs in up to 60% of normal population, 80% of these occurring in non-rapid eye movement (NREM) sleep [21]
Summary
Sleep disorders are a common increasing health problem in today’s industrialized world and can have a significant impact on quality of life and of working. Young et al in 1997 reported that 80–90% of adults with clinically significant sleep-disordered breathing remain undiagnosed [2] In this regard, the role of the trigemino-cardiac reflex (TCR) is never extensively explored. It is reported that sudden microarousals (MA) occurring in the brain due to airway obstruction during sleep cause tachycardia, which stimulates RMMA and teeth grinding that activate the TCR resulting in bradycardia. The physiological basis and importance of conditions like sleep bruxism and obstructive sleep apnea (OSA) are still not completely understood. This is a narrative mini review and aims to provide facts and hypotheses that the TCR plays a central role in various sleep disorders
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