Apports de la physiologie des voies aériennes supérieures dans la compréhension des moyens thérapeutiques du syndrome des apnées du sommeil

The understanding of the pathophysiology of the obstruction of the upper airway during sleep enables to have a pragmatic approach of the description of the treatment of the obstructive sleep apnea syndrome. The factors involved in the control of the opening of upper airway can be subdivided into those which determine the pharyngeal transmural gradient and those which modify the mechanic characteristics of upper airway (diameter, form, compliance). However such a subdividion is partially artificial due to the constant interaction between the various factors involved. The effects of sleep and of the specific action of therapeutic strategies, recognized or potential, are detailed. Their place is analyzed within the dynamic equilibrium on which is based the maintenance of the permeability of upper airway and therefore the basis of the obstructive sleep apnea treatment.