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This Article Full Text Full Text (PDF) All Versions of this Article: 91/2/295    most recent expphysiol.2005.032268v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Cherniack, N. S. Articles by Longobardo, G. S. Search for Related Content PubMed PubMed Citation Articles by Cherniack, N. S. Articles by Longobardo, G. S. Related Collections Respiratory

¹ New Jersey Medical School, University of Medicine and Dentistry of New Jersey, NJ, USA

Periodic breathing is an unusual form of breathing with oscillations in minute ventilations and with repetitive apnoeas or near apnoeas. Reported initially in patients with heart failure or stroke, it was later recognized to occur especially during sleep. The recurrent hypoxia and surges of sympathetic activity that often occur during the apnoeas have serious health consequences. Mathematical models have helped greatly in the understanding of the causes of recurrent apnoeas. It is unlikely that every instance of periodic breathing has the same cause, but many result from instability in the feedback control involved in the chemical regulation of breathing caused by increased controller and plant gains and delays in information transfer. Even when it is not the main cause of the periodic breathing, unstable control modifies the ventilatory pattern and sometimes intensifies the recurrent apnoeas. The characteristics of disturbances to breathing and their interaction with the control system can be critical in determining ventilation responses and the occurrence of periodic breathing. Large abrupt changes in ventilation produced, for example, in the transition from waking to sleep and vice versa, or in the transition from breathing to apnoea, are potent factors causing periodic breathing. Mathematical models show that periodic breathing is a ‘systems disorder’ produced by the interplay of multiple factors. Multiple factors contribute to the occurrence of periodic breathing in congestive heart failure and cerebrovascular disease, increasing treatment options.

(Received 14 September 2005; accepted after revision 7 November 2005; first published online 10 November 2005)
Corresponding author N. S. Cherniack: New Jersey Medical School UMDNJ, 185 South Orange Avenue, PO Box 1709, Newark NJ07101-1709 USA. Email: cherniac{at}umdnj.edu

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