NDLI: Changes in respiration in NREM sleep in hypercapnic chronic obstructive pulmonary disease

Content Provider	PubMed Central
Author	O'donoghue, Fergal J. Catcheside, Peter G. Eckert, Danny J. Mcevoy, R. Doug
Copyright Year	2004
Abstract	Sleep hypoventilation is common in hypercapnic chronic obstructive pulmonary disease (COPD) and may contribute to daytime hypercapnia. The contributions of respiratory drive and respiratory mechanics to alterations in minute ventilation (V̇ I) during sleep in this group have not been assessed. We assessed V̇ I, breathing pattern, upper airway and total lung resistance (UAR, R L), intraoesohageal diaphragmatic EMG (EMGoes), intrinsic positive end-expiratory pressure (PEEPi), dynamic compliance (C dyn), pressure–time product of oesophageal pressure (PTPoes), tension–time index of the diaphragm (TTIdi), end-expiratory lung volume (EELV) and respiratory drive (assessed as the slope of P oes versus time in the isovolumetric interval before PEEPi is overcome). Measurements were made in wakefulness and non-rapid eye movement (NREM) sleep, on 76%N2/24%O2 and on 76%He/24%O2 (heliox). Satisfactory data for analysis were obtained in 10 patients; five had measurements on heliox. V̇ I fell from (mean (s.e.m.)) 8.84(0.46) to 6.64(0.91 l min−1, P = 0.011) between wakefulness and stage II sleep, due to a fall in tidal volume. No changes were seen in PEEPi, C dyn, EELV, PTPoes, TTIdi, EMGoes or respiratory drive. UAR increased (3.11(0.8) to 10.24(2.96) cmH2O l−1 s (P = 0.013) but R L was unchanged. UAR was reduced on heliox (5.20(1.67) to 3.45(1.35) cmH2O l−1 s, P = 0.049) but V̇ I during sleep did not increase. PTPoes (350.2(51.0) to 259.4(46.3) cmH2O s min−1, P = 0.016), TTIdi (0.13(0.02) to 0.10(0.02) P = 0.04), and respiratory drive (20.48(4.69) to 15.02(4.57) cmH2O s−1, P = 0.01) were all reduced. This suggests respiratory drive alters to maintain a preset V̇ I in sleep, irrespective of load, at least while the fatigue threshold of respiratory muscles is not exceeded.
Related Links	http://dx.doi.org/10.1113/jphysiol.2004.066084
Ending Page	673
Page Count	11
Starting Page	663
File Format	PDF
ISSN	00223751
e-ISSN	14697793
Journal	The Journal of Physiology
Issue Number	Pt 2
Volume Number	559
Language	English
Publisher	Blackwell Science Inc
Publisher Date	2004-09-01
Access Restriction	Open
Rights Holder	Blackwell Science Inc
Subject Keyword	Physiology Research in Higher Education
Content Type	Text
Resource Type	Article
Subject	Physiology Sports Science

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