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Neural Circuitry Underlying Waking Up to Hypercapnia.

Satvinder Kaur1, Clifford B Saper1

  • 1Department of Neurology, Program in Neuroscience, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States.

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|May 14, 2019
PubMed
Summary

Obstructive sleep apnea causes sleep disruption and health issues due to airway collapse. This review explores how the parabrachial nucleus regulates waking responses to breathing changes during sleep apnea.

Keywords:
arousalcalcitonin gene related peptidehypercapniaobstructive sleep apneaparabrachial nucleus

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Area of Science:

  • Neuroscience
  • Sleep Medicine
  • Respiratory Physiology

Background:

  • Obstructive sleep apnea (OSA) involves airway collapse during sleep, leading to repetitive arousals.
  • These arousals disrupt sleep, causing cognitive, cardiovascular, and metabolic problems.
  • Understanding neural circuits controlling arousal and respiration is key to preventing OSA complications.

Purpose of the Study:

  • To review the neural circuits regulating cortical arousal and respiratory responses to apnea.
  • To focus on the role of the parabrachial nucleus (PB) in hypercapnia-induced arousal from sleep.

Main Methods:

  • Review of existing literature on neural circuits involved in sleep apnea.
  • Focus on studies utilizing genetic tools to dissect neuronal subtypes in the parabrachial nucleus.
  • Analysis of chemosensory and mechanosensory inputs to the PB.

Main Results:

  • The parabrachial nucleus (PB) integrates chemosensory (hypercapnia, hypoxia) and mechanosensory information.
  • PB exerts control over cortical arousal and respiration, mediating EEG arousal and airway restoration during apneas.
  • Specific neuronal subtypes within the PB relay arousal stimuli to forebrain circuits.

Conclusions:

  • The parabrachial nucleus is a critical hub for regulating arousal and respiratory responses during sleep apnea.
  • Targeting PB circuitries may offer novel therapeutic strategies for OSA.
  • Further research into PB neuronal subtypes is needed to understand and treat sleep-disordered breathing.