The determinants of the apnea threshold during NREM sleep in normal subjects

James A. Rowley, Xusong S. Zhou, Michael Peter Diamond, M. Safwan Badr

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

Study Objective: To determine whether (1) postmenopausal women have a higher apnea threshold than premenopausal women and men and (2) hormone replacement therapy would decrease the apnea threshold in postmenopausal women. Design: Protocol #1: Analysis of a prospectively collected database of 55 subjects who had undergone an apnea-threshold protocol. Protocol #2: Intervention study: apnea threshold compared in 6 postmenopausal women before and after 30 days of replacement therapy with progestin and estrogen. Setting: Research sleep laboratory. Participants: Healthy volunteers aged 18 to 65 years without evidence of sleep-disordered breathing. Interventions: Hypocapnia was induced via nasal mechanical ventilation for 3 minutes during stable non-rapid eye movement sleep. Cessation of mechanical ventilation resulted in hypocapnic central apnea or hypopnea, depending upon the magnitude of the hypocapnia. The change in end-tidal CO2 at the apnea threshold was defined as the change in end-tidal CO2 associated with the apnea closest to the last hypopnea. Measurements and Results: The change in the end-tidal CO2 at the apnea threshold was highest in the premenopausal women (4.6±0.6 mm Hg), with no difference between the postmenopausal women (3.1±0.5 mm Hg) and men (3.4±0.7 mm Hg). Determinants of the change in end-tidal CO 2 at the apnea threshold included sex and menopause status. Hormone replacement therapy increased the change in end-tidal CO2 at the apnea threshold from 2.9±0.4 mm Hg to 4.8±0.4 mm Hg (P<.001). Conclusions: These data support the hypothesis that estrogens and progestins positively influence the apnea threshold and control of breathing during non-rapid eye movement sleep.

Original languageEnglish (US)
Pages (from-to)95-103
Number of pages9
JournalSleep
Volume29
Issue number1
DOIs
StatePublished - Jan 1 2006
Externally publishedYes

Fingerprint

Apnea
Sleep
Hypocapnia
Hormone Replacement Therapy
Eye Movements
Artificial Respiration
Central Sleep Apnea
Estrogen Replacement Therapy
Sleep Apnea Syndromes
Progestins
Carbon Monoxide
Menopause
Nose
Healthy Volunteers
Respiration
Estrogens
Databases

Keywords

  • Aging
  • Body mass index
  • Control of breathing
  • Hypocapnia
  • Upper airway resistance

ASJC Scopus subject areas

  • Clinical Neurology
  • Physiology (medical)

Cite this

The determinants of the apnea threshold during NREM sleep in normal subjects. / Rowley, James A.; Zhou, Xusong S.; Diamond, Michael Peter; Badr, M. Safwan.

In: Sleep, Vol. 29, No. 1, 01.01.2006, p. 95-103.

Research output: Contribution to journalArticle

Rowley, James A. ; Zhou, Xusong S. ; Diamond, Michael Peter ; Badr, M. Safwan. / The determinants of the apnea threshold during NREM sleep in normal subjects. In: Sleep. 2006 ; Vol. 29, No. 1. pp. 95-103.
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