{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T01:36:31Z","timestamp":1775784991257,"version":"3.50.1"},"reference-count":35,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pneumologie"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Die obstruktive Schlafapnoe (OSA) ist charakterisiert durch eine partielle bzw. komplette Obstruktion des pharyngealen Atemwegs. Prinzipiell kann man anatomische von nicht-anatomischen Faktoren unterscheiden. Alter und Adipositas stellen die Hauptrisikofaktoren f\u00fcr OSA dar, dennoch sind etwa 50% der Patienten nicht adip\u00f6s. Im h\u00f6heren Alter (&gt;60 Jahre) nimmt der Stellenwert der Adipositas ab, es werden vermehrt normgewichtige Patienten mit OSA gefunden. Durch Effekte der chronisch intermittierenden Hypox\u00e4mie, der Low-grade-Inflammation, des erh\u00f6hten Sympathikotonus sowie der mechanischen Beanspruchung kommt es zu einer Muskelfasertransformation im oberen Atemweg mit verminderter Muskelmasse und -kraft. Seltener auftretende nicht-anatomische Faktoren sind ein reduzierter muskul\u00e4rer Tonus, eine erh\u00f6hte Arousalschwelle sowie eine ver\u00e4nderte Sensibilit\u00e4t der Chemorezeptoren auf CO2.<\/jats:p>","DOI":"10.1055\/a-2142-7701","type":"journal-article","created":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T22:50:26Z","timestamp":1693435826000},"page":"191-198","source":"Crossref","is-referenced-by-count":2,"title":["Der obere Atemweg bei OSA-Patienten ist auch im Wachzustand pathologisch"],"prefix":"10.1055","volume":"78","author":[{"given":"Mikail Aykut","family":"Degerli","sequence":"additional","affiliation":[{"name":"Pneumologie, Philipps-Universit\u00e4t Marburg, Marburg, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4680-3282","authenticated-orcid":false,"given":"Ulrich","family":"Koehler","sequence":"additional","affiliation":[{"name":"Pneumologie, Philipps-Universit\u00e4t Marburg, Marburg, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karl","family":"Kesper","sequence":"additional","affiliation":[{"name":"Pneumologie, Philipps-Universit\u00e4t Marburg, Marburg, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olaf","family":"Hildebrandt","sequence":"additional","affiliation":[{"name":"Pneumologie, Philipps-Universit\u00e4t Marburg, Marburg, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Regina","family":"Conradt","sequence":"additional","affiliation":[{"name":"Fachbereich Gesundheit, Technische Hochschule Mittelhessen, Gie\u00dfen, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niklas","family":"Koehler","sequence":"additional","affiliation":[{"name":"Regulatory Affairs, ThoraTech GmbH, Gie\u00dfen, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuel","family":"Stenger","sequence":"additional","affiliation":[{"name":"Fachbereich Gesundheit, Technische Hochschule Mittelhessen, Gie\u00dfen, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wulf","family":"Hildebrandt","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Anatomie und Zellbiologie, Philipps-Universit\u00e4t Marburg, Marburg, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janine","family":"Sambale","sequence":"additional","affiliation":[{"name":"Kieferorthop\u00e4die, Philipps-Universitat Marburg, Marburg, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,8,30]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1227","DOI":"10.5665\/sleep.3844","article-title":"Obstructive Sleep Apnea in Older Adults is a Distinctly Different Physiological Phenotype","volume":"37","author":"BA Edwards","year":"2014","journal-title":"Sleep"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"1673","DOI":"10.5665\/sleep.4078","article-title":"Upper airway collapsibility is associated with obesity and hyoid position","volume":"37","author":"PR Genta","year":"2014","journal-title":"Sleep"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1531","DOI":"10.5664\/jcsm.8600","article-title":"Discriminating the severity of pharyngeal collapsibility in men using anthropometric and polysomnographic indices","volume":"16","author":"PR Genta","year":"2020","journal-title":"J Clin Sleep Med"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"72.e9","DOI":"10.1016\/j.amjmed.2005.01.077","article-title":"Age influences on pharyngeal anatomy and physiology: the predisposition to pharyngeal collapse","volume":"119","author":"A Malhotra","year":"2006","journal-title":"Am J Med"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"1618","DOI":"10.1152\/japplphysiol.00045.2008","article-title":"Contribution of male sex, and obesity to mechanical instability of the upper airway during sleep","volume":"104","author":"JP Kirkness","year":"2008","journal-title":"J Appl Physiol"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1177\/0194599815577598","article-title":"Systematic Evaluation of the Upper Airway in a Sample Population: Factors Associated with Obstructive Sleep Apnea Syndrome","volume":"153","author":"MC Oliveira","year":"2015","journal-title":"Otolaryngol Head Neck Surg"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"1098","DOI":"10.4187\/respcare.00929","article-title":"Upper Airway Fat Tissue Distribution in Subjects With Obstructive Sleep Apnea and Its Effect on Retropalatal Mechanical Loads","volume":"57","author":"Y Li","year":"2012","journal-title":"Respir Care"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1295","DOI":"10.1164\/rccm.201501-0169OC","article-title":"Understanding the Anatomic Basis for Obstructive Sleep Apnea syndrome in Adolescents","volume":"191","author":"RJ Schwab","year":"2015","journal-title":"Am J Respir Crit Care Med"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"21","DOI":"10.2147\/NSS.S124657","article-title":"Obstructive sleep apnea: current perspectives","volume":"10","author":"AM Osman","year":"2018","journal-title":"Nature and Science of Sleep"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1016\/j.smrv.2016.10.002","article-title":"Phenotypes in obstructive sleep apnea: a definition, examples and evolution of approaches","volume":"35","author":"A Zinchuk","year":"2017","journal-title":"Sleep Med Rev"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"1746","DOI":"10.1152\/jappl.1994.76.4.1746","article-title":"Pharyngeal myopathy of loaded upper airways in dogs with sleep apnea","volume":"76","author":"BJ Petrof","year":"1994","journal-title":"J Appl Physiol"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1055\/s-2006-925105","article-title":"Pathophysiologie der Atmung unter besonderer Ber\u00fccksichtigung schlafbezogener Atmungst\u00f6rungen","volume":"85","author":"T Sch\u00e4fer","year":"2006","journal-title":"Laryngo-Rhino-Otol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1164\/ajrccm.164.2.2010012","article-title":"Upper airway sensation in snoring and obstructive sleep apnea","volume":"164","author":"J Kimoff","year":"2001","journal-title":"Am J of Respir Crit Care Med"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.sleep.2023.02.011","article-title":"Muscle and visceral fat infiltration: A potential mechanism to explain the worsening of obstructive sleep apnea with age","volume":"104","author":"GF D\u2019Angelo","year":"2023","journal-title":"Sleep Medicine"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1007\/s11357-016-9921-2","article-title":"Effects of age and sex on neuromuscular-mechanical determinants of muscle strength","volume":"38","author":"R Wu","year":"2016","journal-title":"AGE"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.maturitas.2022.06.009","article-title":"Associations of indicators of sleep impairment and disorders with low muscle strength in middle-aged and older adults: The Hypno Laus cohort study","volume":"164","author":"RD Piovezan","year":"2022","journal-title":"Maturitas"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1152\/japplphysiol.01067.2016","article-title":"Alteration in upper airway dilator muscle coactivation during sleep: comparison of patients with obstructive sleep aonea and healthy subjects","volume":"124","author":"R Oliven","year":"2018","journal-title":"J Appl Physiol"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1093\/bmb\/ldq008","article-title":"Sarcopenia: characteristics, mechanisms and functional significance","volume":"95","author":"MV Narici","year":"2010","journal-title":"British Medical Bulletin"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"608","DOI":"10.1164\/ajrccm.163.3.9911064","article-title":"Prevalence of Sleep-disordered Breathing in Women. Effects of Gender","volume":"163","author":"Eo Bixler","year":"2001","journal-title":"Am J Respir Crit Care Med"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"1286","DOI":"10.1164\/rccm.201602-0265OC","article-title":"Continuous Positive Airway Pressure Improves Quality of Life in Women with Obstructive Sleep Apnea","volume":"194","author":"F Campos-Rodriguez","year":"2016","journal-title":"Am J Respir Crit Care Med"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"483","DOI":"10.5665\/sleep.1730","article-title":"The Extracellular Matrix of the Lateral Pharyngeal Wall in Obstructice Sleep Apnea","volume":"35","author":"DA Silva Dantas","year":"2012","journal-title":"Sleep"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1164\/rccm.200308-1100OC","article-title":"Upper Airway Muscle Inflammation and Denervation Changes in Obstructive Sleep Apnea","volume":"170","author":"JH Boyd","year":"2004","journal-title":"Am J Respir Crit Care Med"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1111\/j.1748-1716.2010.02130.x","article-title":"Fibre types in skeletal muscle: a personal account","volume":"199","author":"S Schiaffino","year":"2010","journal-title":"Acta physiologica"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"1447","DOI":"10.1152\/physrev.00031.2010","article-title":"Fiber types in mammalian skeletal muscles","volume":"91","author":"S Schiaffino","year":"2011","journal-title":"Physiological Reviews"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.hrtlng.2023.03.009","article-title":"High- and low-intensity expiratory musle strength training in patients with severe obstructive sleep apnea syndrome using non-invasive mechanical ventilation: A double-blinded, randomized controlled trial","volume":"61","author":"N Erturk","year":"2023","journal-title":"Heart and Lung"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"940","DOI":"10.1016\/j.hrtlng.2020.07.014","article-title":"The effectiveness of oropharyngeal exercises compared to inspiratory muscle training in obstructive sleep apnea: A randomized controlled trial","volume":"49","author":"N Erturk","year":"2020","journal-title":"Heart and Lung"},{"key":"ref27","first-page":"1","article-title":"Respiratory muscle training for obstructive sleep apnea: Systematic review and meta-analysis","volume":"e13941","author":"AS Sousa","year":"2023","journal-title":"J Sleep Res"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"889","DOI":"10.1152\/japplphysiol.00978.2004","article-title":"Geniohyoid muscle properties and myosin heavy chain composition are altered after short-term intermittent hypoxic exposure","volume":"98","author":"EK Pae","year":"2005","journal-title":"J Appl Physiol"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1183\/09031936.00048610","article-title":"Increased upper airway cytokines and oxidative stress in severe obstructive sleep apnoea","volume":"38","author":"RJ Kimoff","year":"2011","journal-title":"Eur Respir J"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1016\/S0954-6111(03)00034-9","article-title":"Skeletal muscle changes in patients with obstructive sleep apnoea","volume":"97","author":"J Sauleda","year":"2003","journal-title":"Respiratory Medicine"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"1870","DOI":"10.1164\/ajrccm.153.6.8665048","article-title":"Characteristics in the genioglossus and musculus uvulae in sleep apnea hypopnea syndrome and in snorers","volume":"153","author":"FJ Series","year":"1996","journal-title":"Am J Respir Crit Care Med"},{"key":"ref32","doi-asserted-by":"crossref","first-page":"1960","DOI":"10.1164\/ajrccm.159.6.9809052","article-title":"Patients with obstructive sleep apnea exhibit genioglossus dysfunction that is normalized after treatment with CPAP","volume":"159","author":"M Carrera","year":"1999","journal-title":"Am J Respir Crit Care Med"},{"key":"ref33","first-page":"463","article-title":"Obstruktive Schlafapnoe \u2013 ein perioperativer Risikofaktor","volume":"113","author":"P Fassbender","year":"2016","journal-title":"Dtsch \u00c4rztebl Int"},{"key":"ref34","first-page":"1","article-title":"Upper airway collapsibility measured using a simple wakefulness test closely relates to the pharyngeal critical closure pressure during sleep in obstructice sleep apnea","volume":"42","author":"AM Osman","year":"2019","journal-title":"Sleep J"},{"key":"ref35","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.5664\/jcsm.6184","article-title":"Upper Airwa Collapsibility Assessed by Negative Expiratory Pressure while Awake is Associated with Upper Airway Anatomy","volume":"12","author":"RP Hirata","year":"2016","journal-title":"J Clin Sleep Med"}],"container-title":["Pneumologie"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2142-7701.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T12:51:49Z","timestamp":1730811109000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2142-7701"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,30]]},"references-count":35,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2024,2,28]]},"published-print":{"date-parts":[[2024,3]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2142-7701","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0934-8387","1438-8790"],"issn-type":[{"value":"0934-8387","type":"print"},{"value":"1438-8790","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,30]]}}}