What is the clinical evidence from this study?

Study design: Other. Population: Healthy (n=7). Intervention: Periodic breathing vs. Regular breathing. Primary outcome: Magnitudes of systolic blood pressure and heart rate oscillations (p=<0.005).

What does this research mean for the field?

Periodic breathing significantly increases the magnitude of systolic blood pressure and heart rate oscillations compared to regular breathing, demonstrating that ventilation alterations alone can entrain these oscillations in the absence of hypoxia or sleep arousals. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.CHALLENGES_CONSENSUS.

April 1, 1999

Entrainment of Blood Pressure and Heart Rate Oscillations by Periodic Breathing

Q: What are the key findings of this study?

Periodic breathing significantly increased the magnitude of systolic blood pressure oscillations (up to 25±7 vs 14±5 mm Hg; p<0.005) and heart rate oscillations compared to regular breathing.

Q: What does this research mean for the field?

Periodic breathing significantly increases the magnitude of systolic blood pressure and heart rate oscillations compared to regular breathing, demonstrating that ventilation alterations alone can entrain these oscillations in the absence of hypoxia or sleep arousals. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.CHALLENGES_CONSENSUS.

Key Result

Periodic breathing significantly increased the magnitude of systolic blood pressure oscillations (up to 25±7 vs 14±5 mm Hg; p<0.005) and heart rate oscillations compared to regular breathing.

Structured PICO

Do periodic alterations in ventilation alone promote oscillations in blood pressure and heart rate in healthy subjects?

Population

7 healthy, wakeful subjects

Intervention

Periodic breathing with three (PB3: cycle frequency = 0.035 Hz) or five (PB5: cycle frequency = 0.030 Hz) augmented breaths alternating with 20-s apneas

Comparator

Regular breathing (RB)

Outcome

Magnitudes of systolic blood pressure and heart rate oscillationssurrogate

Periodic alterations in ventilation alone can amplify and entrain oscillations in blood pressure and heart rate, independent of hypoxia or sleep arousals.

Main Result

p-value: p=<0.005

Abstract

Cheyne-Stokes respiration (CSR) is a form of periodic breathing associated with periodic oscillations in blood pressure (BP) and heart rate (HR), which have been attributed to hypoxia and arousals from sleep. We hypothesized that periodic alterations in ventilation alone would promote oscillations in BP and HR. Seven healthy, wakeful subjects breathed in three patterns, as follows: (1) regular breathing (RB); (2) periodic breathing with three (PB3: cycle frequency = 0.035 Hz) augmented breaths alternating with 20-s apneas; and (3) periodic breathing with five (PB5: cycle frequency = 0.030 Hz) augmented breaths alternating with 20-s apneas. SaO2 remained above 95% throughout. During periodic breathing, peaks in BP and HR occurred during the ventilatory period and troughs occurred during apnea. The magnitudes of systolic BP oscillations increased significantly from RB (14 +/- 5 mm Hg) to PB3 (20 +/- 4 mm Hg) and PB5 (25 +/- 7 mm Hg; p < 0.005). HR oscillations also increased from regular breathing (13 +/- 6.0 beats/min) to PB3 (20.2 +/- 2.3 beats/min) and PB5 (20.2 +/- 4.7 beats/ min; p < 0.01). Spectral analysis showed that during periodic breathing there were discrete peaks in the spectral power of ventilation, BP, and R-wave-to-R-wave interval at the periodic breathing cycle frequencies. We conclude that oscillations in ventilation occurring during periodic breathing can amplify and entrain oscillations in BP and HR in the absence of hypoxia or arousals from sleep.

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