ABSTRACT
The following book chapter considers the therapeutic benefit of treating sleep apnea with mild intermittent hypoxia or hyperoxia. Initially, two forms of respiratory plasticity initiated by mild intermittent hypoxia are defined. Thereafter, the potential effect that these two forms of plasticity have on breathing stability is considered. Following this consideration, the beneficial effect of mild intermittent hypoxia on mitigating airway collapsibility and the role that this outcome measure has on improving adherence to continuous positive airway pressure is addressed. The direct benefit of mild intermittent hypoxia, coupled with the indirect benefit of increasing adherence to continuous positive airway pressure, on cardiovascular outcomes is subsequently outlined.
The effect of supplemental oxygen on treating sleep apnea is also studied. The effect that supplemental oxygen has on the arousal threshold, loop gain, and upper airway collapsibility is explored. The likelihood that hyperoxia is most effective in mitigating sleep apnea in those individuals with a high loop gain, less collapsible airway, and high arousal threshold (i.e. more difficult to arouse) is described. Thereafter, the impact of treatment duration with hyperoxia on sleep apnea is specified. Finally, the influence of hyperoxia on autonomic and cardiovascular outcome measures in individuals with sleep apnea is summarized.
