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Factors affecting respiratory system stability

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Abstract

Periodic breathing (recurrent central apneas) occurs frequently during sleep. Periodic breathing can arise as a result of unstable behavior of the respiratory control system. A mathematical model of the respiratory control system was used to investigate, systematically, the effect of severity of disturbances to respiration and certain system parameters on periodic breathing occurring during sleep. The model consisted of multi-compartment representation of O2 and CO2 stores, a peripheral controller sensitive to O2 and CO2, and a central controller sensitive to CO2. The effects of hypoxia and hypercapnia on the upper airway muscles were not considered in the model. Episodes of hyperventilation or asphyxia were used to disturb the control system and explore the boundaries of stable breathing. Circulation time and metabolic rate were also varied. Simulations with the model produced the following findings: The number of central apneas associated with periodic breathing were greater as circulation time increased; controller gain increases also made the number of apneas greater, although periodic breathing occurs with lower controller gains as circulation time increases. At each level of circulation time there was a range of controller gain changes which caused little change in the number of apneas. There were more apneas with hypoxia; also the number of apneas increased with sleep-associated reductions in metabolic rate. The more rapidly resting PCO2 rose at sleep onset, the greater the likelihood of recurrent apneas. Finally, the more intense the disturbance, the more apneas there were.

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References

  1. Berssenbrugger, A.; Dempsey, J.; Iber, C.; Skatrud, J.; Wilson, P. Mechanisms of hypoxia-induced periodic breathing during sleep in humans. J. Physiol. Lond. 343:507–524; 1983.

    Google Scholar 

  2. Bulow, K. Respiration and wakefulness in man. Acta Physiol. Scand. Suppl. 209:5–110; 1963.

    Google Scholar 

  3. Chapman, K.R.; Bruce, E.N.; Gothe, B.; Cherniack, N.S. Possible mechanisms of periodic breathing during sleep. J. Appl. Physiol. 64:1000–1008; 1988.

    CAS  PubMed  Google Scholar 

  4. Cherniack, N.S. Sleep apnea and its causes. J. Clin. Invest. 73:1501–1506; 1984.

    CAS  PubMed  Google Scholar 

  5. Cherniack, N.S.; Euler, C. von; Homma, I.; Kao, F.F. Experimentally induced Cheyne-Stokes breathing. Respir. Physiol. 37:185–200; 1979.

    Article  CAS  PubMed  Google Scholar 

  6. Cherniack, N.S.; Longobardo, G.S. CO2 and O2 gas stores of the body. Physiol. Rev. 50:196–243; 1970.

    CAS  PubMed  Google Scholar 

  7. Cherniack, N.S.; Longobardo, G.S.; Gothe, B.; Weiner, D. Interactive effects of central and obstructive apneas. In: Hutas, I.; Debreczeni, L.A., eds. Advances in Physiological Science: Respiration, Vol. 10. New York: Pergamon; 1981; pp. 553–560.

    Google Scholar 

  8. Cherniack, N.S.; Longobardo, G.S.; Levine, O.R.; Mellins, R.; Fishman, A.P. Periodic breathing in dogs. J. Appl. Physiol. 21:1847–1854; 1966.

    CAS  PubMed  Google Scholar 

  9. Damokosh-Giordano, A.; Longobardo, G.S.; Cherniack, N.S. The effect of controlled system (plant) dynamics on ventilatory response to disturbances in CO2 balance. In: Iberall, A.S.; Guyton, A.C., eds. Regulation and Control in Physiological Systems. Pittsburgh: Instrument Society of America; 1973; pp. 291–299.

    Google Scholar 

  10. Eldridge, F.L. Central neural respiratory stimulating effect of active respiration. J. Appl. Physiol. 37:723–735; 1974.

    CAS  PubMed  Google Scholar 

  11. Grodins, F.S.; Buell, J.; Bart, A.J. Mathematical analysis and digital simulation of the respiratory control system. J. Appl. Physiol. 22:260–276; 1967.

    CAS  PubMed  Google Scholar 

  12. Guilleminault, C.; Van Den Hold, J.; Mitler, M.M. Clinical overview of sleep apnea syndrome. In: Guilleminault, C.; Dement, W.C., eds. Sleep Apnea Syndromes. New York: Liss; 1978; pp. 1–12.

    Google Scholar 

  13. Guyton, A.C.; Crowell, J.W.; Moore, J.W. Basic oscillating mechanism in Cheyne-Stokes breathing. Am. J. Physiol. 187:395–398; 1956.

    PubMed  Google Scholar 

  14. Khoo, M.C.K.; Kronauer, R.E.; Strohl, K.P.; Slutsky, A.S. Factors inducing periodic breathing in humans: a general model. J. Appl. Physiol. 53:644–659; 1982.

    CAS  PubMed  Google Scholar 

  15. Kreiger, J.; Turlot, J.-C.; Mangin, P.; Kurtz, D. Breathing during sleep in normal young and elderly subjects: hypoapneas, apneas, and correlated factors. Sleep Basel 6:108–120; 1983.

    Google Scholar 

  16. Lahiri, S.; Moret, K.; Sheipa, M.G. Dependence of high altitude sleep apnea on ventilatory sensitivity to hypoxia. Respir. Physiol. 52:281–301; 1983.

    Article  CAS  PubMed  Google Scholar 

  17. Longobardo, G.S.; Cherniack, N.S. Abnormalities in respiratory rhythm. In: Cherniack, N.S.; Widdicombe, J.G., eds. Handbook of Physiology, Section 3, The Respiratory System, Part II. Bethesda, MD: American Physiological Society; 1986; pp. 729–749.

    Google Scholar 

  18. Longobardo, G.S.; Cherniack, N.S.; Fishman, A.P. Cheyne-Stokes breathing produced by a model of the human respiratory system. J. Appl. Physiol. 21:1839–1846; 1966.

    CAS  PubMed  Google Scholar 

  19. Longobardo, G.S.; Gothe, B.; Goldman, M.D.; Cherniack, N.S. Sleep apnea as a control system instability. Respir. Physiol. 50:311–333; 1982.

    Article  CAS  PubMed  Google Scholar 

  20. Mackey, M.C.; Glass, L. Oscillations and chaos in physiological control of systems. Science 197: 287–289; 1977.

    CAS  PubMed  Google Scholar 

  21. McDowell, A.R.; Buckley, C.E., III; Cohen, R.; Whalen, R.E.; Sieker, H.O. Cheyne-Stokes respiration: a review of clinical manifestations and critique of physiological mechanisms. Arch. Intern. Med. 127:712–726; 1971.

    Google Scholar 

  22. Onal, E.; Lopata, M.; O'Connor, T. Pathogenesis of apneas in hypersomnia—sleep apnea syndrome. Am. Rev. Respir. Dis. 125:167–174; 1982.

    CAS  PubMed  Google Scholar 

  23. Pack, A.I.; Silage, D.A.; Millman, R.P.; Knight, H.; Shore, E.T.; Chung, D.C. Spectral analysis of ventilation in elderly subjects awake and asleep. J. Appl. Physiol. 64:1257–1267; 1988.

    CAS  PubMed  Google Scholar 

  24. Phillipson, E.A. Regulation of breathing during sleep. Am. Rev. Respir. Dis. 115, Suppl. 6:217–224; 1977.

    CAS  PubMed  Google Scholar 

  25. Phillipson, E.A.; Bowes, G. Control of breathing during sleep. In: Cherniack, N.S.; Widdicombe, J.G., eds. Handbook of Physiology, Section 3, The Respiratory System, Part II. Bethesda, MD: American Physiological Society; 1986; pp. 649–689.

    Google Scholar 

  26. Reynolds, W.J.; Milhorn, H.T., Jr.; Holloman, G.H., Jr. Transient ventilatory response to graded hypercapnia in man. J. Appl. Physiol. 33:47–54; 1972.

    CAS  PubMed  Google Scholar 

  27. Santiago, T.V.; Guerra, E.; Neubauer, J.A.; Edelman, N.H. Correlation between ventilation and brain blood flow during sleep. J. Clin. Invest. 73:497–506; 1984.

    CAS  PubMed  Google Scholar 

  28. Waggener, T.B.; Frantz, I.D., III; Stark, A.R.; Kronauer, R.E. Oscillatory breathing patterns leading to apneic spells in infants. J. Appl. Physiol. 52:1288–1295; 1982.

    CAS  PubMed  Google Scholar 

  29. Webb, P. Periodic breathing during sleep. J. Appl. Physiol. 37:899–903; 1974.

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Case Western Reserve University, 44106, Cleveland, Ohio

    Guy S. Longobardo,  Neil S. Cherniack & Barbara Gothe

Authors
  1. Guy S. Longobardo
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  2. Neil S. Cherniack
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  3. Barbara Gothe
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Longobardo, G.S., Cherniack, N.S. & Gothe, B. Factors affecting respiratory system stability. Ann Biomed Eng 17, 377–396 (1989). https://doi.org/10.1007/BF02368057

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  • DOI: https://doi.org/10.1007/BF02368057

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