Obstructive Sleep Apnea: Anatomical, Neuromuscular and Metabolic Factors

Obstructive sleep apnea (OSA) is one of the most prevalent sleep-related breathing disorders, characterized by recurrent episodes of partial or complete upper airway obstruction during sleep. These events result in intermittent hypoxia, hypercapnia, and sleep fragmentation, contributing to significant cardiovascular and metabolic morbidity.

The pathophysiology of OSA is multifactorial and involves a complex interaction between anatomical susceptibility, impaired neuromuscular control of the upper airway, ventilatory control instability, and metabolic dysfunction. Obesity, insulin resistance, and hormonal alterations play a central role in disease
development and progression.

This review aims to provide a comprehensive overview of the anatomical, neuromuscular, and metabolic mechanisms underlying OSA, with emphasis on their interaction and clinical implications.

Keywords: Obstructive Sleep Apnea, Upper Airway, Obesity, Insulin Resistance, Neuromuscular Control.