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

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Arterial Chemoreception

Part of the book series: Advances in Experimental Medicine and Biology ((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.

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Notes

  1. 1.

    Another explanation for this lack of effectiveness of carotid body hypocapnia, per se, in eliciting apnea may be that afferent feedback from lung stretch interacts with carotid body inhibition (perhaps at the level of the NTS (Bajic et al. 1994) to produce sufficient inhibition at the medullary level to cause apnea. This possibility has not yet been tested under physiological conditions.

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Author information

Authors and Affiliations

  1. Departments of Population Health Sciences, University of Wisconsin – Madison, 1300 University Ave., Room 4245 MSC, Madison, 53706, WI, USA

    Jerome A. Dempsey, Curtis A. Smith, Gregory M. Blain, Ailiang Xie & Yuansheng Gong

  2. Departments of Medicine, University of Wisconsin – Madison, 1300 University Ave., Room 4245 MSC, Madison, 53706, WI, USA

    Mihaela Teodorescu

Authors
  1. Jerome A. Dempsey
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  2. Curtis A. Smith
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  3. Gregory M. Blain
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  4. Ailiang Xie
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  5. Yuansheng Gong
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  6. Mihaela Teodorescu
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Corresponding author

Correspondence to Jerome A. Dempsey .

Editor information

Editors and Affiliations

  1. Dept. Biology, McMaster University, Main St. W. 1280, Hamilton, L8S 4K1, Ontario, Canada

    Colin A. Nurse

  2. Facultad de Medicina, Depto. Bioquímica y Biología, Universidad de Valladolid, C\ Ramón y Cajal 7, Valladolid, 47005, Spain

    Constancio Gonzalez

  3. Fac. Medicine & Health, Division of Cardiovascular &, University of Leeds, Clarendon Way, Leeds, LS2 9JT, United Kingdom

    Chris Peers

  4. , Biological Sciences Div &, University of Chicago, South Maryland Avenue 5841, Chicago, 60637, Illinois, USA

    Nanduri Prabhakar

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© 2012 Springer Science+Business Media Dordrecht

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Dempsey, J.A., Smith, C.A., Blain, G.M., Xie, A., Gong, Y., Teodorescu, M. (2012). Role of Central/Peripheral Chemoreceptors and Their Interdependence in the Pathophysiology of Sleep Apnea. In: Nurse, C., Gonzalez, C., Peers, C., Prabhakar, N. (eds) Arterial Chemoreception. Advances in Experimental Medicine and Biology, vol 758. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-4584-1_46

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