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OSA has many neurological and systemic comorbidities, including dysphagia, or disordered swallow, and discoordination with breathing. However, the mechanism in which chronic intermittent hypoxia (CIH) causes dysphagia is unknown. Recently, we showed the postinspiratory complex (PiCo) acts as an interface between the swallow pattern generator (SPG) and the inspiratory rhythm generator, the preB\u00f6tzinger complex, to regulate proper swallow-breathing coordination (Huff et al., 2023). PiCo is characterized by interneurons co-expressing transporters for glutamate (Vglut2) and acetylcholine (ChAT). Here we show that optogenetic stimulation of ChATcre:Ai32, Vglut2cre:Ai32, and ChATcre:Vglut2FlpO:ChR2 mice exposed to CIH does not alter swallow-breathing coordination, but unexpectedly disrupts swallow behavior via triggering variable swallow motor patterns. This suggests that glutamatergic\u2013cholinergic neurons in PiCo are not only critical for the regulation of swallow-breathing coordination, but also play an important role in the modulation of swallow motor patterning. Our study also suggests that swallow disruption, as seen in OSA, involves central nervous mechanisms interfering with swallow motor patterning and laryngeal activation. These findings are crucial for understanding the mechanisms underlying dysphagia, both in OSA and other breathing and neurological disorders.<\/jats:p>","DOI":"10.7554\/elife.92175","type":"journal-article","created":{"date-parts":[[2023,11,9]],"date-time":"2023-11-09T08:20:15Z","timestamp":1699518015000},"update-policy":"https:\/\/doi.org\/10.7554\/elife.92175","source":"Crossref","is-referenced-by-count":9,"title":["Chronic intermittent hypoxia reveals role of the Postinspiratory Complex in the mediation of normal swallow production"],"prefix":"10.7554","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2817-251X","authenticated-orcid":true,"given":"Alyssa D","family":"Huff","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01njes783","id-type":"ROR","asserted-by":"publisher"}],"name":"Center for Integrative Brain Research, Seattle Children\u2019s Research Institute","place":["Seattle, United 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