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Vol. 84, Issue 1, 269-276, January 1998
Departments of 1 Preventive Medicine and of 2 Medicine, University of Wisconsin-Madison, Madison, Wisconsin 53705
Wilson, Christine R., Shalini Manchanda, David Crabtree,
James B. Skatrud, and Jerome A. Dempsey. An induced blood pressure
rise does not alter upper airway resistance in sleeping humans.
J. Appl. Physiol. 84(1): 269-276, 1998.
Sleep apnea is associated with episodic increases in systemic
blood pressure. We investigated whether transient increases in arterial
pressure altered upper airway resistance and/or breathing
pattern in nine sleeping humans (snorers and nonsnorers). A
pressure-tipped catheter was placed below the base of the tongue, and
flow was measured from a nose or face mask. During
non-rapid-eye-movement sleep, we injected 40- to 200-µg iv boluses of
phenylephrine. Parasympathetic blockade was used if bradycardia was
excessive. Mean arterial pressure (MAP) rose by 20 ± 5 (mean ± SD) mmHg (range 12-37 mmHg) within 12 s and remained elevated for
105 s. There were no significant changes in inspiratory or expiratory
pharyngeal resistance (measured at peak flow, peak pressure, 0.2 l/s or
by evaluating the dynamic pressure-flow relationship). At
peak MAP, end-tidal CO2 pressure fell by 1.5 Torr and remained low for 20-25 s. At 26 s after peak MAP, tidal volume fell by 19%, consistent with hypocapnic ventilatory inhibition. We conclude that transient increases in MAP of a magnitude commonly observed during non-rapid-eye-movement sleep-disordered breathing do not increase upper airway resistance and, therefore, will
not perpetuate subsequent obstructive events.
baroreceptor; phenylephrine; respiration; sleep apnea
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