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J Appl Physiol (1985). 2020 Sep 24;:
Authors: Rastogi R, Badr MS, Ahmed A, Chowdhuri S
Abstract
Elderly adults demonstrate increased propensity for breathing instability during sleep compared with younger adults and this may contribute to increased prevalence of sleep disordered breathing (SDB) in this population. Hence, in older adults with SDB, we examined whether addition of supplemental oxygen (O2) will stabilize breathing during sleep and alleviate SDB. We hypothesized that exposure to supplemental O2 during non-rapid eye movement (NREM) sleep will stabilize breathing and alleviate SDB by reducing ventilatory chemoresponsiveness and widening the carbon dioxide (CO2) reserve. We studied 10 older adults with mild-moderate SDB who were randomized to undergo noninvasive bilevel mechanical with exposure to room air or supplemental O2 (Oxy) to determine the CO2 reserve, apneic threshold(AT) and controller and plant gains. Supplemental O2 was introduced during sleep to achieve a steady state O2 saturation ≥95% and fraction of inspired O2 at 40-50%. The CO2 reserve increased significantly during Oxy vs. room air (-4.2 ± 0.5 mmHg vs -3.2 ± 0.5 mmHg, p=0.03). Compared with room air, Oxy was associated with a significant decline in the controller gain (1.9 ± 0.4 L/min/mmHg vs. 2.5 ± 0.5 L/min/mmHg, p=0.04), with reductions in the apnea hypopnea index (11.8 ± 2.0/hour vs. 24.4 ± 5.6/hour, p=0.006) and central-apnea-hypopnea index (1.7 ± 0.6/hour vs. 6.9 ± 3.9/hour, p=0.03). The AT and plant gain were unchanged. Thus, a reduced slope of CO2 response resulted in an increased CO2 reserve. In conclusion, supplemental O2 reduced SDB in older adults during NREM sleep via reduction in chemoresponsiveness and central respiratory events.
PMID: 32969781 [PubMed - as supplied by publisher]
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