Effects of sleep-disordered breathing on cerebrovascular regulation: A population-based study.

American Journal of Respiratory and Critical Care Medicine
Barbara J MorganF J Nieto

Abstract

Cerebrovascular regulation is impaired in patients with moderate to severe obstructive sleep apnea; however, it is unknown whether this impairment exists in individuals with less severe sleep-disordered breathing. To test the hypothesis that cerebrovascular responses to hypercapnia are attenuated in a nonclinical population-based cohort. A rebreathing test that raised end-tidal CO₂ tension by 10 mm Hg was performed during wakefulness in 373 participants of the Wisconsin Sleep Cohort. We measured cerebral flow velocity (transcranial Doppler ultrasound); heart rate (electrocardiogram); blood pressure (photoplethysmograph); ventilation (pneumotachograph); and end-tidal CO₂ (expired gas analysis). Cerebrovascular CO₂ responsiveness was quantified as the slope of the linear relationship between flow velocity and end-tidal CO₂ during rebreathing. Linear regression analysis was performed using cerebrovascular CO₂ responsiveness as the outcome variable. Main independent variables were the apnea-hypopnea index and the mean level of arterial oxygen saturation during sleep. We observed a positive correlation between cerebrovascular CO₂ responsiveness and the mean level of oxygen saturation during sleep that was statistically significant i...Continue Reading

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