Ventilatory Responsiveness to CO2 Above & Below Eupnea: Relative Importance of Peripheral Chemoreception
Sleep apnea is a highly prevalent problem occurring in the general working population at rates of 2–3% in children, 3–7% in middle-aged adults and 10–15% in the healthy elderly (>65 years old).1,2 While anatomical dimensions or mechanical properties of the upper airway are an important risk factor for sleep apnea, neural control over the magnitude and stability of respiratory motor output to both the upper airway and chest wall pump muscles has also emerged as a major contributor to all types of sleep apnea.3, 4, 5, 6, 7 Chemoreflexes are the most important determinant of respiratory drive during sleep. Given the rapidity with which hypopneas/apneas develop in a typical central and/or “mixed” apnea episode, our recent work has addressed the general hypothesis that carotid chemoreceptors have a dominant role in mediating ventilatory responses to transient increases and decreases in CO2 as commonly occurs in sleep-disordered breathing.
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