Tongue and Upper Airway Muscles

The tongue and upper airway muscles, most notably the genioglossus, are skeletal muscles that play a vital role in maintaining pharyngeal patency during the respiratory cycle (StatPearls, 2023). In healthy individuals, these muscles contract during inspiration to oppose the negative pressure generated by the diaphragm; however, in patients with obstructive sleep apnea (OSA), this neuromuscular compensation is insufficient, leading to repetitive airway collapse and intermittent hypoxia (Nature and Science of Sleep, 2018). While these muscles are anatomical structures rather than single molecular targets, they represent the functional focus of emerging phenotype-targeted therapies in sleep medicine. Current pharmacological research focuses on using combinations of noradrenergic agents, such as atomoxetine, and antimuscarinic agents, such as oxybutynin, to increase the firing rate of the hypoglossal nerve and enhance muscle responsiveness during both REM and non-REM sleep (AJRCCM, 2019). These interventions aim to stabilize the airway by addressing the underlying physiological deficit in muscle tone, providing a potential alternative to mechanical treatments like continuous positive airway pressure (CPAP) (Journal of Clinical Sleep Medicine, 2021).

Other names

Upper airway dilator musclesPharyngeal dilatorsGenioglossus muscleOropharyngeal musclesHypopharyngeal muscles

Pharmacological stimulation of upper airway dilator muscles via noradrenergic and antimuscarinic pathways to increase muscle tone and prevent pharyngeal collapse during sleep (AJRCCM, 2019; PubMed, 2020).