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Aging is associated with increased propensity for central apnea during NREM sleep
Susmita Chowdhuri1,2, Sukanya Pranathiageswaran2, Hillary Loomis-King2
1Medical Service, Sleep Medicine Section, John D. Dingell Veterans Affairs Medical Center , Detroit, Michigan.
Journal of Applied Physiology (Bethesda, Md. : 1985)
|October 14, 2017
Summary
Elderly adults have a higher risk of central sleep apnea due to reduced carbon dioxide reserve and increased breathing instability during sleep. This heightened chemoresponsiveness makes them more prone to breathing cessations.
Area of Science:
- Sleep Medicine
- Respiratory Physiology
- Gerontology
Background:
- Sleep-disordered breathing, particularly central apneas, is more prevalent in the elderly.
- The underlying physiological mechanisms contributing to this increased propensity remain unclear.
Purpose of the Study:
- To investigate whether older adults exhibit a reduced carbon dioxide (CO2) reserve during non-rapid eye movement (NREM) sleep compared to younger adults.
- To determine if this reduced CO2 reserve is associated with increased hypocapnic chemoresponsiveness, potentially explaining the higher incidence of central apneas in the elderly.
Main Methods:
- Ten elderly and 15 young healthy adults participated in the study.
- Nasal noninvasive positive pressure ventilation was applied during stable NREM sleep, followed by brief cessations of mechanical ventilation (MV).
- Carbon dioxide (CO2) reserve and hypocapnic ventilatory response (controller gain) were measured by analyzing end-tidal CO2 and minute ventilation changes.
Main Results:
- Elderly adults demonstrated a significantly lower eupneic end-tidal CO2 compared to young adults.
- A significantly reduced CO2 reserve was observed in the elderly (-2.6 mmHg) versus young adults (-4.1 mmHg).
- Elderly participants exhibited a higher controller gain (2.3 l·min-1·mmHg-1) compared to young adults (1.4 l·min-1·mmHg-1), indicating increased chemoresponsiveness.
Conclusions:
- Healthy older adults possess a reduced CO2 reserve and heightened chemoresponsiveness during NREM sleep.
- These physiological changes increase their susceptibility to hypocapnic central apneas.
- The findings provide a potential explanation for the increased prevalence of central sleep apnea in the elderly population.
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