Daytime loop gain is elevated in obstructive sleep apnea but not reduced by CPAP treatment

Journal of Applied Physiology
Naomi Louise Deacon-DiazPeter G Catcheside

Abstract

Reduced ventilatory control stability (elevated loop gain) is a key nonanatomical, pathological trait contributing to obstructive sleep apnea (OSA), yet the mechanisms responsible remain unclear. We sought to identify the key factors contributing to elevated loop gain in OSA (controller vs. plant contributions) and to examine whether abnormalities in these factors persist after OSA treatment. In 15 males (8 OSA, 7 height, weight- and age -matched controls), we measured loop gain, controller gain, and plant gain using a pseudorandom binary CO2 stimulation method during wakefulness. Factors potentially influencing plant gain were also assessed (supine lung volume via helium dilution and spirometry). Measures were repeated 2 and 6 wk after initiating continuous positive airway pressure treatment. Loop gain (LG) was higher in OSA versus controls (LG at 1 cycle/min 0.28 ± 0.04 vs. 0.16 ± 0.04, P = 0.046, respectively), and the controller exhibited a greater peak response to CO2 and faster roll-off in OSA. OSA patients also exhibited reduced forced expiratory volume in the first second and forced vital capacity compared with controls (92.2 ± 1.7 vs. 102.9 ± 3.5% predicted, P = 0.021; 93.4 ± 3.1 vs. 106.6 ± 3.6% predicted, P = 0.015, ...Continue Reading

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Citations

Jun 19, 2019·Respirology : Official Journal of the Asian Pacific Society of Respirology·Ludovico MessineoScott A Sands
Jan 16, 2020·Sleep & Breathing = Schlaf & Atmung·Rosalba Courtney
Feb 23, 2020·Journal of Applied Physiology·Geoffrey GinterM Safwan Badr
Jul 13, 2019·F1000Research·Jerome A Dempsey
Jul 17, 2020·Journal of Applied Physiology·Tiffany W DongRichard E Moon
Nov 20, 2018·Frontiers in Neurology·Naomi Deacon-Diaz, Atul Malhotra
Apr 26, 2019·American Journal of Respiratory and Critical Care Medicine·Bradley A EdwardsRobert L Owens
Nov 27, 2019·Journal of Clinical Medicine·Lenise Jihe KimVsevolod Y Polotsky
Feb 4, 2021·Journal of Clinical Medicine·Patrick McKeownGuillermo Plaza
Apr 30, 2021·Nature and Science of Sleep·Hong Peng LiQing Yun Li

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