Ventilatory responses to hypercapnia during wakefulness and sleep in obese adolescents with and without obstructive sleep apnea syndrome
| Autor: | Ruth Bradford, Eliot S. Katz, Michelle B Ward, Joseph M. McDonough, Jingtao Huang, Yin N Lee, Sophia Konstantinopoulou, Swaroop J. Pinto, Carole L. Marcus, John Samuel, Ignacio E. Tapia, Justine Shults, Shucheng Hua, Haibo Yuan, Paul R. Gallagher |
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| Rok vydání: | 2012 |
| Předmět: |
Male
Adolescent Polysomnography Sleep REM Non-rapid eye movement sleep Hypercapnia Physiology (medical) medicine Humans Obesity Wakefulness Child Tidal volume Monitoring Physiologic Analysis of Variance Sleep Apnea Obstructive Genioglossus medicine.diagnostic_test business.industry Carbon Dioxide medicine.disease respiratory tract diseases Respiratory Function Tests Obstructive sleep apnea Anesthesia Female Neurology (clinical) medicine.symptom business Sleep Ventilatory Responses to Hypercapnia in Obese Adolescents Respiratory minute volume |
| Zdroj: | Sleep. 35(9) |
| ISSN: | 1550-9109 |
| Popis: | Study objectives Abnormal ventilatory drive may contribute to the pathophysiology of the childhood obstructive sleep apnea syndrome (OSAS). Concomitant with the obesity epidemic, more adolescents are developing OSAS. However, few studies have specifically evaluated the obese adolescent group. The authors hypothesized that obese adolescents with OSAS would have a blunted hypercapnic ventilatory response (HCVR) while awake and blunted ventilatory responses to carbon dioxide (CO(2)) during sleep compared with obese and lean adolescents without OSAS. Design CVR was measured during wakefulness. During nonrapid eye movement (NREM) and rapid eye movement (REM) sleep, respiratory parameters and genioglossal electromyogram were measured during CO(2) administration in comparison with room air in obese adolescents with OSAS, obese control study participants, and lean control study participants. Setting Sleep laboratory. Participants Twenty-eight obese patients with OSAS, 21 obese control study participants, and 37 lean control study participants. Results The obese OSAS and obese control groups had a higher HCVR compared with the lean control group during wakefulness. During both sleep states, all 3 groups had a response to CO(2); however, the obese OSAS group had lower percentage changes in minute ventilation, inspiratory flow, inspiratory time, and tidal volume compared with the 2 control groups. There were no significance differences in genioglossal activity between groups. Conclusions HCVR during wakefulness is increased in obese adolescents. Obese adolescents with OSAS have blunted ventilatory responses to CO(2) during sleep and do not have a compensatory prolongation of inspiratory time, despite having normal CO(2) responsivity during wakefulness. Central drive may play a greater role than upper airway neuromotor tone in adapting to hypercapnia. |
| Databáze: | OpenAIRE |
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