Regulation of ventilation in the obstructive sleep apnea syndrome.

The recent recognition of the sleep apnea syndrome has forced a re-evaluation of the mechanism of hypercapnia and disordered respiratory control in obese patients. Thirteen obese patients with sleep apnea were studied in an attempt to relate the pattern of sleep abnormality and awake ventilatory control to the presence of chronic hypercapnia. Patients with hypercapnia and/or hypoxemia had reduced ventilatory responses to hypercapnic and hypoxic stimulation, respectively. The presence of hypercapnia, however, did not separate the patients with respect to type, duration, or frequency of apneas. The degree of awake chemical drives could not be related to the severity of the sleep apnea phenomenon. However, patients with intact ventilatory control demonstrated augmented ventilation after apneas, which may explain their eucapnic state.