Transcutaneous CO₂ plateau as set-point for respiratory drive during upper airway flow-limitation

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• 作者：Ville Rimpil盲 ; Tarja Saaresranta ; Heini Huhtala ; Arho Virkki ; Aaro V. Salminen ; Olli Polo
• 关键词：Sleep apnea ; Sleep-disordered breathing ; Carbon dioxide ; Snoring
• 刊名：Respiratory Physiology & Neurobiology
• 出版年：15 January, 2014
• 年：2014
• 卷：191
• 期：Complete
• 页码：44-51
• 全文大小：1462 K

文摘

Upper airway flow-limitation is often but not always associated with prolonged gradually increasing respiratory effort. We investigated the changes in transcutaneous carbon dioxide tension (tcCO₂) during episodes of upper airway flow limitation during sleep with or without respiratory effort response.

Seventy-seven episodes of progressive flow-limitation were analyzed in 36 patients with sleep-disordered breathing. TcCO₂ and arterial oxyhaemoglobin saturation (SaO₂) were measured during steady breathing and during episodes of flow-limitation with and without effort response.

After lights-off tcCO₂ increased and leveled-off at plateau, when breathing stabilized. During flow-limitation tcCO₂ increased at rate of 4.0 kPa/h. Flow-limitation with increasing respiratory effort associated with tcCO₂ increase above the plateau (terminating at 105.2%, p < 0.001), whereas flow-limitation without effort response associated with tcCO₂ increase starting below the plateau (95.8%, p < 0.001).

We conclude that the nocturnal tcCO₂ plateau indicates the level above which the increasing respiratory effort is triggered as response to upper airway flow-limitation. We propose that flow-limitation below the tcCO₂ plateau is an event related to stabilization of sleep and breathing.