The influence of sleep fragmentation on arousal and ventilatory responses to respiratory stimuli.

Abstract

The periods of apnea during sleep that characterize the upper-airway obstructive sleep apnea syndromes are usually terminated by electroencephalographic (EEG) and behavioral evidence of brief arousal, followed by an increase in tone of the upper-airway muscles and restoration of airflow (Guilleminault et al., 1976; Remmers et al., 1978). The specific stimuli that lead to arousal probably include hypercapnia and hypoxia, both of which are known to produce reticular stimulation and cortical activation (Bonvallet et al., 1955; Hugelin et al., 1959). However, the degree of asphyxia that develops in such patients during the periods of apnea before producing arousal is often profound; and we have ..