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Sleep State and Periodic Respiration

  • Allan I. Pack
  • Allan Gottschalk
  • Michael Cola
  • Adrian Goldszmidt

Abstract

Periodic breathing occurs commonly in stage 1–2 non-rapid-eye-movement (NREM) sleep.1–4 When pronounced, apnea may occur at the nadir of ventilation. Thus, sleep apnea may be considered as a severe form of periodic breathing (see discussion, ref. 5). The degree of periodic breathing, however, varies with sleep stage. This was recognized in early, relatively qualitative studies.1,2 Recent quantitative studies in our laboratory have both confirmed and extended such earlier observations.4 The results of these studies led us to the hypothesis that oscillations in ventilation were secondary to oscillations in sleep state. Thus, in addition to the experimental studies, we have performed a theoretical study to determine the implications of the coupling between sleep state and ventilatory drive.

Keywords

Sleep Apnea Sleep Stage Sleep Onset Ventilatory Response Sleep State 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    K. Bulow, Respiration and wakefulness in man, Acta Physiol. Scand. Suppl. 209:5–110 (1963).Google Scholar
  2. 2.
    P. Webb, Periodic breathing during sleep, J. Appl. Physiol. 37:899–903 (1974).PubMedGoogle Scholar
  3. 3.
    E.T. Shore, R.P. Millman, D.A. Silage, D.C. Chung, and A.I. Pack, Ventilatory and arousal patterns during sleep in normal young and elderly subjects. J. Appl. Physiol. 59:1607x2013;1615 (1985).PubMedGoogle Scholar
  4. 4.
    A.I. Pack, D.A. Silage, R.P. Millman, H. Knight, E.T. Shore, and D-C.C. Chung, Spectral analysis of ventilation in elderly subjects awake and asleep. J. Appl. Physiol. 64:1257–1267 (1988).PubMedGoogle Scholar
  5. 5.
    G.S. Longobardo. B. Gothe, M.D. Goldman, and N.S. Cherniack, Sleep apnea considered as a control system instability, Respir. Physiol. 50:311–333 (1982).PubMedCrossRefGoogle Scholar
  6. 6.
    M.A. Carskadon and W.C. Dement, Respiration during sleep in the aged human, J. Gerontol. 36:420–423 (1981).PubMedGoogle Scholar
  7. 7.
    P.J. Brusil, T.B. Waggener, and R.E. Kronauer, Using a comb filter to describe time- varying biological rhythmicities, J. Appl. Physiol. 48:557–561 (1980).PubMedGoogle Scholar
  8. 8.
    T.B. Waggener, I.D. Frantz III, A.R. Stark, and R.E. Kronauer, Oscillatory breathing patterns leading to apneic spells in infants, J. Appl. Physiol. 52:1288–1295(1882).Google Scholar
  9. 9.
    T.B. Waggener, A.R. Stark, B.A. Cohlan, and I.D. Frantz III, Apnea duration is related to ventilatory oscillation characteristics in newborn infants, J. Appl. Physiol. 57:536–544 (1984).PubMedGoogle Scholar
  10. 10.
    M.C. Khoo, R.E. Kronauer, K.P. Strohl, and A.S. Slutsky, Factors inducing periodic breathing in humans: a general model, J. Appl. Physiol. 53:644–659 (1982).PubMedGoogle Scholar
  11. 11.
    S. Lahiri, K. Maret, and M.G. Sherpa, Evidence of high altitude sleep apnea on ventilatory sensitivity to hypoxia, Respir. Physiol. 52:281–301 (1983).PubMedCrossRefGoogle Scholar
  12. 12.
    D.P. White, K. Gleeson, C.K. Pickett, A.M. Rannels, A. Cymerman, and J.V. Weil, Altitude acclimatization: influence on periodic breathing and chemoresponsiveness during sleep, J. Appl. Physiol. 63:401x2013;412 (1987).Google Scholar
  13. 13.
    A. Berssenbrugge, J. Dempsey, C. Iber, J. Skatrud, and P. Wilson, Mechanisms of hypoxia-induced periodic breathing during sleep in human, J. Physiol. (Lond.) 343: 507–526(1983).Google Scholar
  14. 14.
    T.B. Waggener, P.J. Brusil, R.E. Kronauer, R.A. Gabel, and G.F. Inbar, Strength and cycle time of high-altitude ventilatory patterns in unacclimatized humans.Appl. Physiol. 56:576–581 (1984).Google Scholar
  15. 15.
    G.R. Kelman, Digital computer subroutine for the conversion of oxygen tension into saturation.J. Appl. Physiol. 21:1375–1376 (1966)PubMedGoogle Scholar
  16. 16.
    G.R. Kelman, Digital computer procedure for the conversion of PC02 into blood C02 content, Respir. Physio. 3:111–115 (1967).CrossRefGoogle Scholar
  17. 17.
    S. Lahiri and R.G. DeLaney, Stimulus interaction in the responses of carotid body chemoreceptor single afferent fibers, Respir Physiol. 24: 249–266 (1975).Google Scholar
  18. 18.
    A. Berkenbosch, J.H. van Beek, C.N. Olievier, J. De Goede, and P.H. Quanjer, Central respiratory CO sensitivity at extreme hypocapnia, Respir. Physiol. 55:95–102 (1984).PubMedCrossRefGoogle Scholar
  19. 19.
    M. Berthon-Jones and C.E. Sullivan, Ventilatory and arousal responses to hypoxia in sleeping humans, Am. Rev. Respir. Pis. 125:632–639 (1982).Google Scholar
  20. 20.
    M. Berthon-Jones and C.E. Sullivan, Ventilation and arousal responses to hypercapnia in normal sleeping humans, J. Appl. Physiol. 57:59–67 (1984).PubMedGoogle Scholar
  21. 21.
    K. Gleeson, C.W. Zwillich, and D.P. White, Arousal from sleep in response to ventilator stimuli occurs at a similar degree of ventilatory effort irrespective of the stimulus, Am. Rev. Respir. Pis. 139:A82 (1989).Google Scholar
  22. 22.
    G. Bowes and E.A. Phillipson, Control of breathing during sleep in: “Handbook of Physiology, Section 3, Volume II, Part 2”, 1986, p. 647–689.Google Scholar
  23. 23.
    B. Gothe, M.P. Altose, M.P. Goldman, and N.S. Cherniack, Effect of quiet sleep on resting and C02 -stimulated breathing in humans, J. Appl. Physiol. 50:724–730 (1981).PubMedGoogle Scholar
  24. 24.
    K.R. Rajagopal, P.H. Abbrecht, S.S. Perderian, C. Pickett, F. Hofeldt, C.J. Tellis, and C.W. Zwillich, Obstructive sleep apnea in hypothyroidism, Ann. Intern. Med. 101: 491–494 (1984).PubMedGoogle Scholar
  25. 25.
    R.P. Millman, J. Bevilacqua, P.P. Peterson, and A.I. Pack, Central sleep apnea in hypothyroidism, Am. Rev. Respir. Pis. 127:504–507 (1983).Google Scholar
  26. 26.
    C.W. Zwillich, P.J. Pierson, F.P. Hofeldt, E.G. Lufkin, and J.V. Weil, Ventilatory control in myxedema and hypothyroidism, N. Engl. J. Med. 292:662–665 (1975).PubMedCrossRefGoogle Scholar
  27. 27.
    R.S. Kronenberg and C.W. Drage, Attenuation of the ventilatory and heart rate responses to hypoxia and hypercapnia with aging in normal men, J. Clin. Invest. 52:1812–1819 (1973).PubMedCrossRefGoogle Scholar
  28. 28.
    D.D. Peterson, A.I. Pack, D.A. Silage, and A.P. Fishman, Effects of aging on ventilator and occlusion pressure responses to hypoxia and hypercapnia, Am. Rev. Respir. Pis. 124:387–391 (1981).Google Scholar
  29. 29.
    J. Orem, I. Osorio, E. Brooks, and T. Dick, Activity of respiratory neurons during NREM sleep, J. Neurophysiol. 54:1144–1156, 1985.PubMedGoogle Scholar
  30. 30.
    A. Rechtschaffen and A. Kales (editors), “A Manual of Standardized Techniques and Scoring System for Sleep Stages of Human Subjects”, Brain Information Service, Brain Research Institute, Los Angeles, CA (1968).Google Scholar
  31. 31.
    I. Gath and E. Bar-On, Classical sleep stages and the spectral content of the EEG signal, .Int. J. Neurosci. 22:147–155, 1983.PubMedCrossRefGoogle Scholar
  32. 32.
    Hasan, J., Differentiation of normal and disturbed sleep by automatic analysis, .Acta Physiol. Scand. (Suppl.). 526:1–103. 1983.Google Scholar

Copyright information

© Plenum Press, New York 1989

Authors and Affiliations

  • Allan I. Pack
    • 1
  • Allan Gottschalk
    • 2
  • Michael Cola
    • 1
  • Adrian Goldszmidt
    • 1
  1. 1.Pulmonary Section, Department of MedicineUniversity of PennsylvaniaPhiladelphiaUSA
  2. 2.Department of AnesthesiaUniversity of PennsylvaniaPhiladelphiaUSA

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