Effect of upper airway negative pressure on inspiratory drive during sleep

To determine the effect of upper airway(UA) negative pressure and collapse during inspiration on regulation ofbreathing, we studied four unanesthetized female dogs duringwakefulness and sleep while they breathed via a fenestratedtracheostomy tube, which was sealed around the permanent trachealstoma. The snout was sealed with an airtight mask, thereby isolatingthe UA when the fenestration (Fen) was closed and exposing the UA tointrathoracic pressure changes, but not to flow changes, when Fen wasopen. During tracheal occlusion with Fen closed, inspiratory time(TI) increased duringwakefulness, non-rapid-eye-movement (NREM) sleep and rapid-eye-movement(REM) sleep (155 ± 8, 164 ± 11, and 161 ± 32%,respectively), reflecting the removal of inhibitory lung inflationreflexes. During tracheal occlusion with Fen open (vs. Fen closed):1) the UA remained patent;2)TI further increased duringwakefulness and NREM (215 ± 52 and 197 ± 28%, respectively) but nonsignificantly during REM sleep (196 ± 42%);3) mean rate of rise of diaphragmEMG (EMGdi/TI) and rate offall of tracheal pressure(Ptr/TI) were decreased,reflecting an additional inhibitory input from UA receptors; and4) bothEMGdi/TI andPtr/TI were decreasedproportionately more as inspiration proceeded, suggesting greaterreflex inhibition later in the effort. Similar inhibitory effects ofexposing the UA to negative pressure (via an open tracheal Fen) wereseen when an inspiratory resistive load was applied over severalbreaths during wakefulness and sleep. These inhibitory effectspersisted even in the face of rising chemical stimuli. This inhibitionof inspiratory motor output is alinear within an inspiration andreflects the activation of UA pressure-sensitive receptors by UAdistortion, with greater distortion possibly occurring later in theeffort.