Chemoreflex physiology and implications for sleep apnoea: Insights from studies in humans

Research output: Contribution to journalArticle

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Abstract

New Findings: What is the topic of this review? This review summarizes chemoreflex physiology in health and disease, with specific focus on chemoreflex-mediated pathophysiology in obstructive and central sleep apnoea. What advances does it highlight? Chemoreflex mechanisms are thought to contribute significantly to the pathophysiology and adverse outcomes seen in sleep apnoea. Clinical implications of altered chemoreflex function in sleep apnoea from recent studies in humans, including cardiac arrhythmias, coronary artery disease, systolic/diastolic heart failure and sudden cardiac death are highlighted. Activation of the chemoreflex in response to hypoxaemia results in an increase in sympathetic neural outflow. This process is predominantly mediated by the peripheral chemoreceptors in the carotid bodies and is potentiated by the absence of the sympatho-inhibitory influence of ventilation during apnoea, as is seen in patients with sleep apnoea. In these patients, repetitive nocturnal hypoxaemia and apnoea elicit sympathetic activation, which may persist into wakefulness and is thought to contribute to the development of systemic hypertension and cardiac and vascular dysfunction. Chemoreflex activation could possibly lead to adverse cardiovascular outcomes, such as nocturnal myocardial infarction, systolic and/or diastolic heart failure, cardiac arrhythmias and sudden death in patients with sleep apnoea. This review summarizes chemoreflex physiology in health and disease, with specific focus on chemoreflex-mediated pathophysiology in obstructive and central sleep apnoea. Measurement of the chemoreflex response may serve as a potential avenue for individualized screening for cardiovascular disease. Whether modulation of this response in sleep apnoea may aid in the prevention and treatment of adverse cardiovascular consequences will require further study.

Original languageEnglish (US)
Pages (from-to)130-135
Number of pages6
JournalExperimental Physiology
Volume100
Issue number2
DOIs
StatePublished - Feb 1 2015

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Sleep Apnea Syndromes
Diastolic Heart Failure
Central Sleep Apnea
Systolic Heart Failure
Obstructive Sleep Apnea
Apnea
Cardiac Arrhythmias
Carotid Body
Wakefulness
Sudden Cardiac Death
Health
Sudden Death
Blood Vessels
Ventilation
Coronary Artery Disease
Cardiovascular Diseases
Myocardial Infarction
Hypertension
Hypoxia

ASJC Scopus subject areas

  • Physiology

Cite this

Chemoreflex physiology and implications for sleep apnoea : Insights from studies in humans. / Mansukhani, Meghna; Wang, Shihan; Somers, Virend.

In: Experimental Physiology, Vol. 100, No. 2, 01.02.2015, p. 130-135.

Research output: Contribution to journalArticle

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