Multiple Modes of Periodic Breathing during Sleep

Abstract

Periodic breathing (PB) during sleep is commonly observed and may be accompanied by frequent arousals. The full extent of the associated public health issues and the roles of medical and surgical treatment have yet to be fully elucidated. An appreciation of the underlying mechanism(s) would aid the discussion by focusing on specific physiological differences which could predict and discriminate clinically significant PB. One means of clarifying the mechanism(s) of PB is through the formulation of quantitative models of respiratory control during wakefulness and sleep which also consider the transitions between these states. We recently demonstrated that a model with otherwise normal parameters which also incorporated a wakefulness drive and the capacity to arouse from sleep could produce PB if the wakefulness drive is of sufficient magnitude and is withdrawn sufficiently rapidly with sleep onset (5). We now examine such a model in greater detail to reveal the multiple modes by which PB can emerge during sleep.