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Articles in PresS, published online ahead of print September 20, 2002
J Appl Physiol, 10.1152/jap.00585.2002
Submitted on July 1, 2002
Accepted on September 19, 2002
1 Division of Sleep Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA
2 Division of Sleep Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
* To whom correspondence should be addressed. E-mail: dpwhite{at}rics.bwh.harvard.edu.
We hypothesized that increased chemical control instability (CCI) in men could partially explain the male predominance in obstructive sleep apnea (OSA). CCI was assessed by sequentially increasing respiratory control system loop gain (LG) with proportional assist ventilation (PAV) in 10 males (age 24-48) and 9 females (age 22-36) until periodic breathing or awakening occurred. Females were studied in both the follicular and luteal phases of the menstrual cycle. The amount by which PAV amplified LG was quantified from the tidal volume amplification factor [(VTAF) assisted tidal volume/unassisted tidal volume]. LG was calculated as the inverse of the VTAF occurring at the assist level immediately preceding the emergence of periodic breathing (when LG x VTAF = 1). Only 1/10 males and 2/9 females developed periodic breathing with PAV. The rest were resistant to periodic breathing despite moderately high levels of PAV amplification. We conclude that LG is low in the majority of normal males and females, and that higher volume amplification factors are needed to determine if gender differences exist in this low range.
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