Upper airway physiology and obstructive sleep-disordered breathing.

Upper airway competence involves complex interactions between anatomy and physiology. The common final denominator of OSDB is a structurally small and abnormally collapsible upper airway. The mechanisms contributing are often an accumulation of many skeletal or soft tissue abnormalities and respiratory physiology that individually may or may not be pathologic. So far, simplistic models have hampered progress in this field. Successful medical and surgical treatment of OSDB continues to be elusive for too many patients. Great strides remain to be taken, but the possibility seems within reach.