Progressive augmentation and long term facilitation of ventilation is enhanced in participants with sleep apnea compared to control and is mitigated by reductions in oxidative stress

Abstract

PurposeTo determine whether progressive augmentation (PA) and long‐term facilitation of minute ventilation (vLTF) is enhanced in participants with obstructive sleep apnea (OSA) compared to control. Moreover, to determine whether treatment with an antioxidant cocktail (AOX) mitigates PA and vLTF in OSA participants.Methods13 OSA and 13 controls completed two trials. During both trials participants were exposed to intermittent hypoxia (IH) which included 12‐4 minute episodes of hypoxia (PETO2 ‐ 50 mmHg, PETCO2 ‐ 4 mmHg above baseline) followed by 30 minutes of recovery. During the trials participants were administered, in a randomized fashion, either an AOX or a PLB before IH.ResultsDuring the PLB trial, baseline minute ventilation was similar between OSA and control (18.8 ± 2.1 vs. 14.8 ± 0.5 L/min). PA was evident in both groups; however it was enhanced in the OSA group compared to control (last hypoxic episode ‐ 36.9 ± 2.8 vs. 27.7 ± 2.2 L/min; p = 0.002). During end‐recovery vLTF was greater in the OSA group compared to control (27.7 ± 2.2 vs. 20.2 ± 1.2 L/min; p = 0.01). PA and vLTF were reduced in the OSA group following AOX compared to PLB (PA ‐ 30.6 ± 2.0 vs. 36.9 ± 2.8 L/min, p = 0.02; vLTF 22.3 ± 1.3 vs. 27.7 ± 2.2 L/min, p = 0.002).ConclusionsPA and vLTF is enhanced in participants with OSA compared to control. PA and vLTF is mitigated after treatment with an antioxidant cocktail.Funding: NIH (HL‐085537)