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1 Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan
2 Department of Population Health Sciences, University of Wisconsin, Madison, Wisconsin, United States
* To whom correspondence should be addressed. E-mail: casmith4{at}wisc.edu.
We hypothesized that chronic intermittent hypoxia (CIH) would induce a predisposition to apnea in response to induced hypocapnia. To test this, we used pressure support ventilation to quantify the difference in end-tidal partial pressure of CO2 (PETCO2) between eupnea and the apneic threshold ("CO2 reserve"), as an index of the propensity for apnea and unstable breathing during sleep, both before and following up to 3 weeks' exposure to chronic intermittent hypoxia in dogs. CIH consisted of 25 seconds of PETO2 = 35-40 Torr followed by 35 seconds of normoxia, and this pattern was repeated 60 times/hour, 7-8 hours/day for 3 weeks. The CO2 reserve was determined during NREM sleep in normoxia 14-16 hours after the most recent hypoxic exposure. Contrary to our hypothesis, the slope of the ventilatory response to CO2 below eupnea progressively decreased during CIH (control, 1.36±0.18; week 2, 0.94±0.12; week 3, 0.73±0.05 l·min-1·Torr-1, P<0.05). This resulted in a significant increase in the CO2 reserve relative to control (P<0.05) following both 2 and 3 weeks of CIH (control, 2.6±0.6; week 2, 3.7±0.8; week 3, 4.5±0.9 Torr). CIH also: a) caused no change in eupneic, air breathing PaCO2; b) increased the slope of the ventilatory response to hypercapnia after 2 weeks but not after 3 weeks compared to control; and c) had no effect on the ventilatory response to hypoxia. We conclude that 3 weeks' CIH reduced the sensitivity of the ventilatory response to transient hypocapnia and thereby increased the CO2 reserve, i.e., the propensity for apnea was reduced.
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