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Role of Central/Peripheral Chemoreceptors and Their Interdependence in the Pathophysiology of Sleep Apnea

  • Jerome A. DempseyEmail author
  • Curtis A. Smith
  • Gregory M. Blain
  • Ailiang Xie
  • Yuansheng Gong
  • Mihaela Teodorescu
Conference paper
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 758)

Abstract

Unstable periodic breathing with intermittent ventilatory overshoots and undershoots commonly occurs in chronic heart failure, in hypoxia, with chronic opioid use and in certain types of obstructive sleep apnea. Sleep promotes breathing instability because it unmasks a highly sensitive dependence of the respiratory control system on chemoreceptor input, because transient cortical arousals promote ventilatory overshoots and also because upper airway dilator muscle tonicity is reduced and airway collapsibility enhanced. We will present data in support of the premise that carotid chemoreceptors are essential in the pathogenesis of apnea and periodicity; however it is the hyperadditive influence of peripheral chemoreceptor sensory input on central chemosensitivity that accounts for apnea and periodic breathing. This chemoreceptor interdependence also provides a significant portion of the normal drive to breathe in normoxia (i.e. eupnea) and in acute hypoxia. Finally, we discuss the effects of preventing transient hypocapnia (via selective increases in FICO2) on centrally mediated types of periodic breathing and even some varieties of cyclical obstructive sleep apnea.

Keywords

Chemoreceptors Controller/plant gain Apnea treatments 

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Copyright information

© Springer Science+Business Media Dordrecht 2012

Authors and Affiliations

  • Jerome A. Dempsey
    • 1
    Email author
  • Curtis A. Smith
    • 1
  • Gregory M. Blain
    • 1
  • Ailiang Xie
    • 1
  • Yuansheng Gong
    • 1
  • Mihaela Teodorescu
    • 2
  1. 1.Departments of Population Health SciencesUniversity of Wisconsin – MadisonMadisonUSA
  2. 2.Departments of MedicineUniversity of Wisconsin – MadisonMadisonUSA

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