Myopathy of the upper airway in snoring and obstructive sleep apnea
Objective Previous reports of muscle changes in the upper airways of obstructive sleep apnea (OSA) patients have primarily been attributed to acquired nerve lesions due to snoring vibrations. The aim of this study was to investigate whether alterations reflecting muscle fiber injuries also occur in...
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Published in | Laryngoscope investigative otolaryngology Vol. 7; no. 2; pp. 636 - 645 |
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Main Authors | , |
Format | Journal Article |
Language | English |
Published |
Hoboken, USA
John Wiley & Sons, Inc
01.04.2022
Wiley |
Subjects | |
Online Access | Get full text |
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Summary: | Objective
Previous reports of muscle changes in the upper airways of obstructive sleep apnea (OSA) patients have primarily been attributed to acquired nerve lesions due to snoring vibrations. The aim of this study was to investigate whether alterations reflecting muscle fiber injuries also occur in the upper respiratory tract of snoring and OSA patients and if these changes relate to upper airway dysfunction.
Methods
Muscle changes in biopsies from the soft palate of 20 patients suffering from snoring and OSA were investigated with enzyme, immunohistochemical, and morphometric techniques. Biopsies from eight healthy non‐snoring subjects were used as controls. Swallowing dysfunction was assessed with videoradiography.
Results
Fourteen patients had various degrees of swallowing dysfunction. The muscle samples from all the patients showed changes typical for both motor‐nerve lesions and muscle fiber injuries. The most common alterations reflecting myopathy were fibers having aggregates and disorganization of cytoskeletal proteins (15.5 ± 10.7%). Other changes were fibers with vacuole‐like structures (5.0 ± 4.4%), centrally positioned myonuclei (7.9 ± 4.8%), subsarcolemmal accumulations of nuclei, and various forms and sizes of ring fibers, that is, fibers where the myofilaments were disorganized peripherally (2.8 ± 2.8%).
Conclusion
The results show that muscle changes mirroring both myopathy and neuropathy co‐exist in the upper airway of snoring OSA patients. These findings suggest muscle weakness as a contributing factor to the upper airway dysfunction in OSA patients. |
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Bibliography: | Funding information Insamlingsstiftelsen Umeå University, Grant/Award Number: Dnr 223‐1881‐13; Swedish Research Council, Grant/Award Number: Dnr 2018‐02574 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Funding information Insamlingsstiftelsen Umeå University, Grant/Award Number: Dnr 223‐1881‐13; Swedish Research Council, Grant/Award Number: Dnr 2018‐02574 |
ISSN: | 2378-8038 2378-8038 |
DOI: | 10.1002/lio2.782 |