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Sleep and Breathing

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01.09.2020 | Sleep Breathing Physiology and Disorders • Review

Obstructive sleep apnea and respiratory center regulation abnormality

verfasst von: Liang Si, Jing Zhang, Yan Wang, Jie Cao, Bao-yuan Chen, Heng-juan Guo

Erschienen in: Sleep and Breathing | Ausgabe 2/2021

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Abstract

Purpose

Obstructive sleep apnea (OSA) is a complex disease in which phenotypic analysis and understanding pathological mechanisms facilitate personalized treatment and outcomes. However, the pathophysiology responsible for this robust observation is incompletely understood. The objective of the present work was to review how respiratory center regulation varies during sleep and wakeness in patients with OSA.

Data sources

We searched for relevant articles up to December 31, 2019 in PubMed database.

Methods

This review examines the current literature on the characteristics of respiratory center regulation during wakefulness and sleep in OSA, detection method, and phenotypic treatment for respiratory center regulation.

Results

Mechanisms for ventilatory control system instability leading to OSA include different sleep stages in chemoresponsiveness to hypoxia and hypercapnia and different chemosensitivity at different time. One can potentially stabilize the breathing center in sleep-related breathing disorders by identifying one or more of these pathophysiological mechanisms.

Conclusions

Advancing mechanism research in OSA will guide symptom research and provide alternate and novel opportunities for effective treatment for patients with OSA.

Moss IR (2005) A respiratory control and behavior in humans: lessons from imaging and experiments of nature. Can J Neurol Sci 32:287–297PubMed

Villablanca JR (2004) Counterpointing the functional role of the forebrain and of the brainstem in the control of the sleep-waking system. J Sleep Res 13:179–208PubMed

Norman RG, Goldring RM, Clain JM et al (2006) Transition from acute to chronic hypercapnia in patients with periodic breathing: predictions from a computer model. J Appl Physiol (1985) 100(5):1733–1741

Guyenet PG, Bayliss DA (2015) Neural Control of Breathing and CO2 Homeostasis. Neuron J 9:946–961

Williams RH, Jensen LT, Verkhratsky A, Fugger L, Burdakov D (2007) Control of hypothalamic orexin neurons by acid and CO2. Proc Natl Acad Sci U S A 104(25):10685–10690PubMedPubMedCentral

Landry SA, Andara C, Terrill PI, Joosten SA, Leong P, Mann DL et al (2018) Ventilatory control sensitivity in patients with obstructive sleep apnea is sleep stage dependent. Sleep J:1–10

Koo BB, Patel SR, Strohlet K, Hoffstein V (2008) Rapid eye movement-related sleep-disordered breathing: influence of age and gender. Chest. 134(6):1156–1161PubMedPubMedCentral

Joosten SA, Hamza K, Sands S, Turton A, Berger P, Hamilton G (2012) Phenotypes of patients with mild to moderate obstructive sleep apnoea as confirmed by cluster analysis. Respirology. 17(1):99–107PubMed

Carberry JC, Jordan AS, White DP, Wellman A, Eckert DJ (2016) Upper airway collapsibility (Pcrit) and pharyngeal dilator muscle activity are sleep stage dependent. Sleep. 39(3):511–521PubMedPubMedCentral

10.

Zhou Y, Di Zhao GY, Li J, Cao X, Zhang Y et al (2019) Analysis of the myoelectric characteristics of genioglossus in REM sleep and its improvement by CPAP treatment in OSA patients. Sleep Breath 6(11). https://doi.org/10.1007/s11325-019-01875-7

11.

Mano M, Hoshino T, Sasanabe R, Murotani K, Nomura A, Hori R et al (2019) Impact of gender and age on rapid eye movement-related obstructive sleep apnea: a clinical study of 3234 Japanese OSA patients. Int J Environ Res Public Health 16:1068. https://doi.org/10.3390/ijerph16061068CrossRefPubMedCentral

12.

Jeremy EORR, Malhotr A, Sands SA (2017) Pathogenesis of central and complex sleep apnoea. Respirology. 22(1):43–52

13.

Thomas RJ, Terzano MG, Parrino L, Weiss JW (2004) Obstructive sleep-disordered breathing with a dominant cyclic alternating pattern–a recognizable polysomnographic variant with practical clinical implications. Sleep. 27(2):229–234PubMed

14.

Yumino D, Bradley TD (2008) Central sleep apnea and Cheyne-Stokes respiration. Proc Am Thorac Soc 5(2):226–236PubMed

15.

Mahamed S, Hanly PJ, Gabor J, Beecroft J, Duffin J (2005) Overnight changes of chemoreflex control in obstructive sleep apnoea patients. Respiratory Physiology & Neurobiology 146:279–290

16.

Mateika JH, Narwani G (2009) Intermittent hypoxia and respiratory plasticity in humans and other animals: does exposure to intermittent hypoxia promote or mitigate sleep apnoea? Exp Physiol 94:279–296PubMed

17.

Mateika JH, Syed Z (2013) Intermittent hypoxia, respiratory plasticity and sleep apnea in humans: present knowledge and future investigations. Respir Physiol Neurobiol 188:289–300PubMedPubMedCentral

18.

Griffin HS, Pugh K, Kumar P, Balanos GM (2012) Long-term facilitation of ventilation following acute continuous hypoxia in awake humans during sustained hypercapnia. Aust J Phys 590:5151–5165

19.

Mateika JH, Mendello C, Obeid D, Badr MS (2004) Peripheral chemoreflex responsiveness is increased at elevated levels of carbon dioxide after episodic hypoxia in awake humans. J Appl Physiol 96:1197–1205PubMed

20.

Morelli C, Badr MS, Mateika JH (2004) Ventilatory responses to carbon dioxide at low and high levels of oxygen are elevated after episodic hypoxia in men compared with women. J Appl Physiol 97:1673–1680PubMed

21.

Wadhwa H, Gradinaru C, Gates GJ, Badr MS, Mateika JH (2008) Impact of intermittent hypoxia on long-term facilitation of minute ventilation and heart rate variability in men and women: do sex differences exist? J Appl Physiol 104:1625–1633PubMedPubMedCentral

22.

Spengler CM, Czeisler CA, Shea SA (2000) An endogenous circadian rhythm of respiratory control in humans. Aust J Phys 526:683–694

23.

Stephenson R, Mohan RM, Duffin J, Jarsky TM (2000) Circadian rhythms in the chemoreflex control of breathing. Am J Physiol Regul Integr Comp Physiol 278:R282–R286PubMed

24.

El-Chami M, Shaheen D, Ivers B, Syed Z, Badr MS, Lin H-S, Mateika JH (2014) Time of day affects chemoreflex sensitivity and the carbon dioxide reserve during NREM sleep in participants with sleep apnea. J Appl Physiol 117:1149–1156PubMed

25.

Takakura AC, Moreira TS, Colombari E, West GH, Stornetta RL, Guyenet PG (2006) Peripheral chemoreceptor inputs to retrotrapezoid nucleus (RTN) CO 2 -sensitive neurons in rats. Aust J Phys 572:503–523

26.

Peng YJ, Overholt JL, Kline D, Kumar GK, Prabhakar NR (2003) Induction of sensory long-term facilitation in the carotid body by intermittent hypoxia: implications for recurrent apneas. Proc Natl Acad Sci U S A 100:10073–10078PubMedPubMedCentral

27.

Folgering H (1988) Studying the control of breathing in man. Eur Respir J 1:651–660PubMed

28.

Edelman NH, Epstein PE, Lahiri S, Cherniak NS (1973) Ventilatory responses to transient hypoxia and hypercapnia in man. Respir Physiol 17:302–314PubMed

29.

Rebuck AS, Campbell JM (1974) A clinical method for assessing the ventilatory response to hypoxia. Am Rev Respir Dis 109:345–350PubMed

30.

Domnik NJ, Turcotte SE, Yuen NY, Iscoe S, Fisher JT (2013) CO2 rebreathing: an undergraduate laboratory to study the chemical control of breathing. Adv Physiol Educ 37:361–369. https://doi.org/10.1152/advan.00075CrossRefPubMed

31.

Duffin J, McAvoy GV (1988) The peripheral-chemoreceptor threshold to carbon dioxide in man. Aust J Phys 406:15–26

32.

Duffin J (2011) Measuring the respiratory chemoreflexes in humans. Respiratory Physiology & Neurobiology 177:71–79

33.

Wellman A, Edwards BA, Sands SA, Owens RL, Nemati S, Butler J, Passaglia CL, Jackson AC, Malhotra A, White DP (2013) A simplified method for determining phenotypic traits in patients with obstructive sleep apnea. J Appl Physiol 114:911–922PubMed

34.

Messi L, Taranto-Montemurro L, Azarbarzin A, Oliveira Marques MD, Calianese N, White DP et al Breath-holding as a means to estimate the loop gain contribution to obstructive sleep apnea, This is an Accepted Article that has been peer-reviewed and approved for publication in the The Journal of Physiology, but has yet to undergo copy-editing and proof correction. Please cite this article as an ‘Accepted Article’;2019. Aust J Phys. https://doi.org/10.1113/JP276206

35.

Trembach NV, Zabolotskikh IB (2018) Voluntary breath-holding duration in healthy subjects with obesity: role of peripheral chemosensitivity to carbon dioxide. Respir Physiol Neurobiol 249:7–10PubMed

36.

Jordan AS, O’Donoghue FJ, Cori JM, Trinder J (2017) Physiology of arousal in obstructive sleep apnea and potential impacts for sedative treatment. Am J Respir Crit Care Med 196(7):814–821PubMed

37.

Eckert DJ, Owens RL, Kehlmann GB, Wellman A, Rahangdale S, Susie YIM-YEH et al (2011) Eszopiclone increases the respiratory arousal threshold and lowers the apnoea/hypopnoea index in obstructive sleep apnoea patients with a low arousal threshold. Clin Sci (Lond) 120(12):505–514

38.

Wellman A, Malhotra A, Jordan AS, Stevenson KE, Gautam S, White DP (2008) Effect of oxygen in obstructive sleep apnea: role of loop gain. Respir Physiol Neurobiol 162(2):144–151PubMedPubMedCentral

39.

Edwards BA, Sands SA, Eckert DJ, White DP, Butler JP, Robert L. Owens, et al. (2012) Acetazolamide improves loop gain but not the other physiological traits causing obstructive sleep apnoea. Aust J Phys 590(5):1199–1211

40.

Choi JH, Lee JY, Cha J, Kim K, Hong SN, Lee SH (2017) Predictive models of objective oropharyngeal OSA surgery outcomes: success rate and AHI reduction ratio. PLoS One 12(9):e0185201PubMedPubMedCentral

41.

Eckert DJ (2018) Phenotypic approaches to obstructive sleep apnoea – new pathways for targeted therapy. Sleep Med Rev 37:45–59PubMed

42.

Eckert DJ, White DP, Jordan AS, Malhotra A, Wellman A (2013) Defining phenotypic causes of obstructive sleep apnea. Identification of novel therapeutic targets. Am J Respir Crit Care Med 188(8):996–1004PubMedPubMedCentral

43.

Neelapu BC, Kharbanda OP, Sardana HK, Balachandran R, Sardana V, Kapoor P, Gupta A, Vasamsetti S (2017) Craniofacial and upper airway morphology in adult obstructive sleep apnea patients: a systematic review and meta-analysis of cephalometric studies. Sleep Med Rev 31:79–90PubMed

44.

Heinzer R, Vat S, Marques-Vidal P, Marti-Soler H, Andries D, Tobback N, Mooser V, Preisig M, Malhotra A, Waeber G, Vollenweider P, Tafti M, Haba-Rubio J (2015) Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study. Lancet Respir Med 3(4):310–318PubMedPubMedCentral

45.

Simpson R, Oyekan AA, Ehsan Z, Ingram DG (2018) Obstructive sleep apnea: current perspectives. Nat Sci Sleep 10:21–34

46.

Cairns A, Poulos G, Bogan R (2014) Who is getting tested for obstructive sleep apnea using a portable recording system? Test results from 193,221 patients. J Clin Sleep Med 10(11):1193–1198PubMedPubMedCentral

47.

Mateika JH, El-Chami M, Shaheen D, Ivers B (2015) Intermittent hypoxia: a low-risk research tool with therapeutic value in humans. J Appl Physiol (1985) 118(5):520–532

48.

Mateika JH, Komnenov D (2017) Intermittent hypoxia initiated plasticity in humans: a multipronged therapeutic approach to treat sleep apnea and overlapping comorbidities. Exp Neurol 287(Pt2):113–129PubMed

49.

Kirkness JP, Madronio M, Stavrinou R, Wheatley JR, Amis TC (2003) Relationship between surface tension of upper airway lining liquid and upper airway collapsibility during sleep in obstructive sleep apnea hypopnea syndrome. J Appl Physiol 95:1761–1766PubMed

50.

Stadler DL, McEvoy RD, Sprecher KE, Thomson KJ, Ryan MK, Thompson CC, Catcheside PG (2009) Abdominal compression increases upper airway collapsibility during sleep in obese male obstructive sleep apnea patients. Sleep 32:1579–1587PubMedPubMedCentral

51.

Redolfi S, Arnulf I, Pottier M, Lajou J, Koskas I, Bradley TD, Similowski T (2011) Attenuation of obstructive sleep apnea by compression stockings in subjects with venous insufficiency. Am J Respir Crit Care Med 184:1062–1066PubMed

52.

Redolfi S, Yumino D, Ruttanaumpawan P, Yau B, Su MC, Lam J, Bradley TD (2009) Relationship between overnight rostral fluid shift and obstructive sleep apnea in nonobese men. Am J Respir Crit Care Med 179:241–246PubMed

53.

Jordan AS, Eckert DJ, Catcheside PG, McEvoy RD (2003) Ventilatory response to brief arousal from non-rapid eye movement sleep is greater in men than in women. Am J Respir Crit Care Med 168:1512–1519PubMed

54.

Walsh JH, Maddison KJ, Platt PR, Hillman DR, Eastwood PR (2008) Influence of head extension, flexion, and rotation on collapsibility of the passive upper airway. Sleep 31:1440–1447PubMedPubMedCentral

Titel: Obstructive sleep apnea and respiratory center regulation abnormality
verfasst von: Liang Si
Jing Zhang
Yan Wang
Jie Cao
Bao-yuan Chen
Heng-juan Guo
Publikationsdatum: 01.09.2020
Verlag: Springer International Publishing
Erschienen in: Sleep and Breathing / Ausgabe 2/2021
Print ISSN: 1520-9512
Elektronische ISSN: 1522-1709
DOI: https://doi.org/10.1007/s11325-020-02175-1

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Obstructive sleep apnea and respiratory center regulation abnormality

Abstract

Purpose

Data sources

Methods

Results

Conclusions

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Abstract

Purpose

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Conclusions

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