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J Appl Physiol 89: 947-955, 2000;
8750-7587/00 $5.00
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Vol. 89, Issue 3, 947-955, September 2000

Blood pressure and heart rate during periodic breathing while asleep at high altitude

Giuseppe Insalaco1, Salvatore Romano1, Adriana Salvaggio1, Alberto Braghiroli2, Paola Lanfranchi2, Vincenzo Patruno3, Oreste Marrone1, Maria R. Bonsignore1, Claudio F. Donner2, and Giovanni Bonsignore1

1 Institute of Respiratory Pathophysiology of the Italian National Research Council, 90146 Palermo; Salvatore Maugeri Foundation, IRCCS, 2 Divisions of Pulmonary Disease and Cardiology, Medical Center of Rehabilitation, 28010 Veruno (NO); and 3 Division of Pneumology, Medical Center of Rehabilitation, 27040 Montescano (PV), Italy

The ventilatory and arterial blood pressure (ABP) responses to isocapnic hypoxia during wakefulness progressively increased in normal subjects staying 4 wk at 5,050 m (Insalaco G, Romano S, Salvaggio A, Braghiroli A, Lanfranchi P, Patruno V, Donner CF, and Bonsignore G; J Appl Physiol 80: 1724-1730, 1996). In the same subjects (n = 5, age 28-34 yr) and expedition, nocturnal polysomnography with ABP and heart rate (HR) recordings were obtained during the 1st and 4th week to study the cardiovascular effects of phasic (i.e., periodic breathing-dependent) vs. tonic (i.e., acclimatization-dependent) hypoxia during sleep. Both ABP and HR fluctuated during non-rapid eye movement sleep periodic breathing. None of the subjects exhibited an ABP increase during the ventilatory phases that correlated with the lowest arterial oxygen saturation of the preceding pauses. Despite attenuation of hypoxemia, ABP and HR behaviors during sleep in the 4th wk were similar to those in the 1st wk. Because ABP during periodic breathing in the ventilatory phase increased similarly to the ABP response to progressive hypoxia during wakefulness, ABP variations during ventilatory phases may reflect ABP responsiveness to peripheral chemoreflex sensitivity rather than the absolute value of hypoxemia, suggesting a major tonic effect of hypoxia on cardiorespiratory control at high altitude.

hypobaric hypoxia; cardiovascular system; hyperventilation; respiratory pause


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