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Contemporary Reviews in Sleep Medicine |

Control of Ventilation in Health and Disease

Susmita Chowdhuri, MD; M. Safwan Badr, MD
Author and Funding Information

aJohn D. Dingell VA Medical Center, Wayne State University, Detroit MI

bDepartment of Medicine, Wayne State University, Detroit MI

CORRESPONDENCE TO: Susmita Chowdhuri, MD, Medical Service (11M), John D. Dingell VA Medical Center, 4646 John R, Detroit, MI 48201


Copyright 2016, . All Rights Reserved.


Chest. 2017;151(4):917-929. doi:10.1016/j.chest.2016.12.002
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Control of ventilation occurs at different levels of the respiratory system through a negative feedback system that allows precise regulation of levels of arterial carbon dioxide and oxygen. Mechanisms for ventilatory instability leading to sleep-disordered breathing include changes in the genesis of respiratory rhythm and chemoresponsiveness to hypoxia and hypercapnia, cerebrovascular reactivity, abnormal chest wall and airway reflexes, and sleep state oscillations. One can potentially stabilize breathing during sleep and treat sleep-disordered breathing by identifying one or more of these pathophysiological mechanisms. This review describes the current concepts in ventilatory control that pertain to breathing instability during wakefulness and sleep, delineates potential avenues for alternative therapies to stabilize breathing during sleep, and proposes recommendations for future research.

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