Narrative review reveals neural chemoreceptor pathways regulating arousal reflexes during sleep, highlighting parabrachial convergence as a key driver of disruption in sleep apnoea.
Arousal from sleep in response to CO 2 is a life‐preserving reflex that enhances ventilatory drive and facilitates behavioural adaptations to restore eupnoeic breathing. Recurrent activation of the CO 2 ‐arousal reflex is associated with sleep disruption in obstructive sleep apnoea. In this review we examine the role of chemoreceptors in the carotid bodies, the retrotrapezoid nucleus and serotonergic neurons in the dorsal raphe in the CO 2 ‐arousal reflex. We also provide an overview of the supra‐medullary structures that mediate CO 2 ‐induced arousal. We propose a framework for the CO 2 ‐arousal reflex in which the activity of the chemoreceptors converges in the parabrachial nucleus to trigger cortical arousal.
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Abbott et al. (2021) studied this question.
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