Upper airway physiology and obstructive sleep-disordered breathing

The quest for better surgical treatment of obstructive sleep-disordered breathing has been hampered by suboptimal airway assessment and inadequate understanding of the mechanism of pharyngeal surgery. Further progress requires improved understanding of various anatomic and physiologic determinates of upper airway competence. The upper air-way cannot be modeled as a simple rigid structure. Dynamic respiratory and sleep physiology has profound effects on maintenance of upper airway competence. Interactions among these factors are complex, and conceptualization and integration can be challenging. The authors present a review of anatomic and physiologic variables and models to help integrate the multitude of various determinants of upper airway competence.