Abstract
Differences in upper airway collapsibility are thought to underlie the observations that obstructive sleep apnea (OSA) is more common in men and in older individuals. Baseline neuromuscular activity and upper airway reflexes are two of the determinants of upper airway size and collapsibility and gender and aging differences in these determinants could explain, in part, differences in OSA prevalence. The purpose of this review is to review the influence of gender and age on upper airway reflexes. Most recent findings indicate that aging is associated with both changes in baseline neuromuscular activity of the genioglossus muscle (when studied as muscle unit potentials) and is associated with impairment in upper airway reflexes, particularly the perception response to inspiratory loading. The limited data on gender differences in upper airway reflexes shows no difference in the negative pressure reflex or relationship between epiglottic pressure and genioglossus activity. Thus, gender differences in upper airway collapsibility are probably not explained by differences in upper airway reflexes. In contrast, there is evidence that upper airway reflexes are impaired with aging and these impairments might contribute to the increased collapsibility of the upper airway observed in some, though not all, studies of older subjects.
Published Version
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