Effect of oxygen in obstructive sleep apnea: role of loop gain
- PMID: 18577470
- PMCID: PMC4332598
- DOI: 10.1016/j.resp.2008.05.019
Effect of oxygen in obstructive sleep apnea: role of loop gain
Abstract
We compared the effect of oxygen on the apnea-hypopnea index (AHI) in six obstructive sleep apnea patients with a relatively high loop gain (LG) and six with a low LG. LG is a measure of ventilatory control stability. In the high LG group (unstable ventilatory control system), oxygen reduced the LG from 0.69+/-0.18 to 0.34+/-0.04 (p<0.001) and lowered the AHI by 53+/-33% (p=0.04 compared to the percent reduction in the low LG group). In the low LG group (stable ventilatory control system), oxygen had no effect on LG (0.24+/-0.04 on room air, 0.29+/-0.07 on oxygen, p=0.73) and very little effect on AHI (8+/-27% reduction with oxygen). These data suggest that ventilatory instability is an important mechanism causing obstructive sleep apnea in some patients (those with a relatively high LG), since lowering LG with oxygen in these patients significantly reduces AHI.
Figures
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References
-
- AASM. Sleep-related breathing disorders in adults: Recommendations for syndrome definition and measurement techniques in adults. Sleep. 1999;22:667–689. - PubMed
-
- Appelberg J, Sundstrom G. Ventilatory response to CO2 in patients with snoring, obstructive hypopnoea and obstructive apnoea. Clin Physiol. 1997;17:497–507. - PubMed
-
- Asyali M, Berry R, Khoo M. Assessment of closed-loop ventilatory stability in obstructive sleep apnea. IEEE Trans in Biomed Engineering. 2002;49:206–216. - PubMed
-
- Badr M, Skatrud J, Dempsey J. Effect of chemoreceptor stimulation and inhibition on total pulmonary resistance in humans during NREM sleep. J Appl Physiol. 1994;76:1682–1692. - PubMed
-
- Badr MS, Roiber F, Skatrud JB, Dempsey J. Pharyngeal narrowing/occlusion during central sleep apnea. J Appl Physiol. 1995;78:1806–1815. - PubMed
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