This paper presents a series of experiments, both in patients and computer models, investigating the transition from acute to chronic hypercapnia in OSA. The data demonstrate that acute hypercapnia during periodic breathing occurs due to either reduction in magnitude of inter-event ventilation and/or reduction in interevent ventilatory duration relative to duration of the preceding event. The transition between acute hypercapnia during sleep and chronic sustained hypercapnia during wakefulness may be determined by an interaction between respiratory control and renal handling of HCO3 ‒
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Berger, K.I., Norman, R.G., Ayappa, I., Oppenheimer, B.W., Rapoport, D.M., Goldring, R.M. (2008). Potential Mechanism for Transition Between Acute Hypercapnia During Sleep to Chronic Hypercapnia During Wakefulness in Obstructive Sleep Apnea. In: Poulin, M.J., Wilson, R.J.A. (eds) Integration in Respiratory Control. Advances in Experimental Medicine and Biology, vol 605. Springer, New York, NY. https://doi.org/10.1007/978-0-387-73693-8_75
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