The connection between sleep apnea, neurotransmitter deficiency, and a dysfunctional swallow is discussed in some depth by Andrisani et al., who explore how orofacial muscle dysfunction, particularly involving the swallowing mechanism, can impact neurological regulation of the upper airway. Here’s a breakdown of the concept based on their work:
Swallowing is a highly coordinated neuromuscular activity controlled by brainstem centers that also regulate breathing. Andrisani et al. emphasize that a dysfunctional swallow—often caused by poor tongue posture, weak or poorly coordinated orofacial muscles, or abnormal swallowing patterns (e.g., tongue thrust)—disrupts normal sensorimotor feedback to the brainstem.
Proper swallowing stimulates neurotransmitter release—especially acetylcholine, dopamine, and other modulators involved in motor control and autonomic function. These neurotransmitters help regulate tone in the upper airway dilator muscles, such as the genioglossus, during sleep. When the swallowing mechanism is dysfunctional, it leads to:
During sleep, especially REM, muscle tone naturally decreases. If neurotransmitter activity is already diminished due to lack of proper oropharyngeal stimulation, this can exacerbate upper airway collapse, leading to obstructive sleep apnea (OSA). Andrisani et al. propose that this cycle originates early in life, possibly due to:
These interfere with normal neuromuscular development and swallow reflexes, setting the stage for long-term breathing and sleep disorders.
To read the full article, click here: https://doi.org/10.1007/s11325-023-02783-7
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