Human Sleep Apneas and Animal Diving Reflexes: The Comparative Link

Ruben V. Rial; Ferràn Barbal; Francesca Cañellas; Antoni Gamundi; Mourad Akaârir; Maria C. Nicolau

doi:10.1055/s-2000-11528

Sleep and Breathing, Inhaltsverzeichnis

Sleep Breath 2000; 04(1): 0031-0042
DOI: 10.1055/s-2000-11528

Human Sleep Apneas and Animal Diving Reflexes: The Comparative Link

Ruben V. Rial¹ , Ferràn Barbal² , Francesca Cañellas³ , Antoni Gamundi¹ , Mourad Akaârir¹ , Maria C. Nicolau¹

¹Departmento de Biologia F. i C.S., Universitat de les Illes Balears, Palma de Mallorca, Spain
²Pneumology Services, Hospital Universitat Son Dureta, Palma de Mallorca, Spain and
³Psychiatry Services, Hospital Universitat Son Dureta, Palma de Mallorca, Spain

Abstract

ABSTRACT

Adaptations to survive periods of limited access to oxygen should have been favored along the evolution of vertebrates. Paradigmatic examples of this adaptation are the diving animals, which can sustain prolonged and repetitive periods of anoxia. These animals support what would be considered a severe gas imbalance in their internal environment thanks to three main strategies: increased oxygen stores, resistance to asphyxia, and reduced metabolic expenditure during the apneic intervals. However, diving animals developed their abilities from very old life-sustaining responses that should have been used on many other occasions. Humans with sleep apneas perhaps share many physiological adaptations with diving animals. We review here the extent of such similarities and offer clear evidence of its existence and suggest possible research lines that could improve the clinical knowledge about this condition.

KEYWORD

:sleep apnea - diving apnea - diving reflexes

Volltext

Referenzen

REFERENCES

1 Phillipson E A. Sleep apnea-a major public health problem. N Engl J Med . 1993; 328 1271-1273
2 Holden C. Wake-up call for sleep research. Science . 1993; 259 305
3 Thorpy M J. Classification of sleep disorders. In: Kryger MH, Roth T, Dement WC, eds. Principles and Practice of Sleep Medicine Philadelphi: W.B. Saunders 1994: 426-435
4 Bradley T D, Phillipson E. Central sleep apnea. Clin Chest Med . 1992; 13 493-506
5 Wilcox P G, Paré P D, Road J D, Fleetham J A. Respiratory muscle function during obstructive sleep apnea. Am Rev Respir Dis . 1990; 142 533-539
6 Douglas N J, Polo O. Pathogenesis of obstructive sleep apnea/hypopnoea syndrome. Lancet . 1994; 344 653-655
7 Berry R B, Gleeson K. Respiratory arousal from sleep: Mechanisms and significance. Sleep . 1997; 20 654-675
8 Shepard J W. Excessive daytime sleepiness, upper airway resistance, and nocturnal arousals. Chest . 1993; 104 665-666
9 Wright J, Johns R, Watt I, Melville A, Sheldon T. Health effects of obstructive sleep apnea and the effectiveness of continuous positive airways pressure. A systematic review of the research evidence. BMJ . 1997; 314 851-860
10 Butler P J, Jones D R. Physiology of diving of birds and mammals. Physiol Rev . 1997; 77 837-899
11 Andersen H T. Physiological adaptations of diving vertebrates. Physiol Rev . 1966; 46 213-243
12 Scholander P F. Animals in aquatic environments: Diving mammals and birds. In: Dill ED, Adolph EF, Wilber CG, eds. Adaptation to the Environment, section 4 of the Handbook of Physiology, Washington, DC: American Physiology Society, 1964: 729-740
13 Kooyman G L, Ponganis P J. The physiological basis of diving to deep: Birds and mammals. Annu Rev Physiol . 1998; 60 19-32
14 Castellini J M, Castellini M A. Estimation of splenic volume and its relationship to long duration apnea in seals. Physiol Zool . 1993; 66 619-627
15 Schumacher U, Welsch U. Histological, histochemical and fine structure observations on the spleen of seals. Am J Anat . 1987; 179 357-368
16 Brix O, Ekker M, Condo S G. Lactate does facilitate oxygen uploading from the hemoglobin of the whale Balaenoptera acutorostrataafter diving. Arctic Med Res . 1990; 49 39-42
17 Maillard D, Fleury B, Housset B. Decreased oxyhemoglobin affinity in patients with sleep apnea syndrome. Am Rev Respir Dis . 1991; 143 486-489
18 Farmery A D, Roe P G. A model to describe the rate of oxyhaemoglobin desaturation during apnea. Br J Anaesth . 1996; 76 284-291
19 Eliassen E. Cardiovascular responses to submersion asphyxia in avian divers. Arbok Univ Bergen Mat.-Naturvitensk Ser . 1960; 2 1-76
20 Stephenson R. Respiratory and plumage gas volumes in unrestrained diving ducks (Aythya affinis). Respir Physiol . 1995; 100 129-137
21 Robin E D, Murdaugh Jr V H, Pyron W, Weiss E, Soteres P. Adaptation to diving in the harbor seal. Gas exchange and ventilatory response to CO₂ . Am J Physiol . 1963; 205 1175-1177
22 Schaefer K E. Effects of prolonged diving training. Nat Acad Sci National Research Council Publication . 1963; 1181 271-278
23 Lilly J C. Animals in aquatic environments: Adaptation of mammals to the ocean. In: Dill ED, Adolph EF, Wilber CG, eds. Adaptation to the Environment, section 4 of the Handbook of Physiology Washington, DC: American Physiology Society 1964: 741-747
24 Irving L, Scholander P F, Grinnel S W. The respiration of the porpoise Tursiops truncatus J Comp Physiol . 1941; 17 145-168
25 Kooyman G L, Castellini M A, Davis R V, Maue R A. Aerobic dive limits of immature Weddell seals. J Comp Physiol . 1983; 151 171-174
26 Hochachka P W, Guppy M. Diving mammals and birds. In: Metabolic Arrest and the Control of Biological time Cambridge: Harvard University Press, 1987: 36-56
27 Snyder G K. Respiratory adaptations in diving mammals. Respir Physiol . 1983; 54 269-294
28 Butler P J, Jones D R. The comparative physiology of diving in vertebrates. In: Lowenstein OE, ed. Advances in Comparative Physiology and Biochemistry Vol. 8. New York: Academic Press, 1982: 179-364
29 Butler P J. Respiratory and cardiovascular control during diving in birds and mammals. J Exp Biol . 1982; 100 195-221
30 Houston A L, Carbone C. The optimal allocation of time during the diving cycle. Behav Ecol . 1992; 3 255-265
31 Angell James E J, de Burg Daly M. Reflex respiratory and cardiovascular effects of stimulation of receptors in the nose of the dog. J Physiol Lond . 1969; 220 673-696
32 Andersen H T. Hyperpotaseima and electrocardiographic changes in the duck during prolonged diving. Acta Physiol Scand . 1965; 63 292-295
33 Scholander P F. The masterswitch of life. Sci Am . 1963; 209 92-106
34 Scholander P F, Hammel H T, LeMessurier E, Hemmingsen E, Garey W. Circulation adjustments in pearl divers. J Appl Physiol . 1962; 17 184-190
35 Hong S K, Rahn H. The diving women of Korea and Japan. Sci Am . 1967; 216 34-43
36 Refsum H E. Severe arterial hypoxemia and liver cell necrosis in patients with pulmonary insufficiency. Acta Med Scand . 1964; 176 473-478
37 Leivestad H, Andersen H, Scholander P F. Physiological response to air exposure in fish. Science . 1957; 126 505
38 Berg T, Steen J B. Physiological mechanisms for aerial respiration in the eel. Comp Biochem Physiol . 1965; 5 469-484
39 Angell James J E, de Burg Daly M. Some mechanisms involved in the cardiovascular adaptations to diving. Symp Soc Exp Biol . 1972; 26 313-341
40 Harding R, Jhonson P, McClelland M E. Liquid sensitive laryngeal receptors in the developing sheep, cat, and monkey. J Physiol (Lond) . 1978; 277 409-422
41 Butler P J, Woakes A J. Control of heart rate by carotid chemoreceptors during diving in tufted ducks. J Appl Physiol . 1982; 53 1405-1410
42 Parkos C A, Wahrenbrock E A. Acute effects of hypercapnia and hyperoxia on minute ventilation of unrestrained Weddel seals. Respir Physiol . 1987; 67 197-207
43 Gilbert F F, Gofton N. Heart rates in mink muskrat and beaver. Comp Biochem Physiol . 1982; 73 249-251
44 Thompson D, Fedak M A. Cardiac responses in grey seals during diving at sea. J Exp Biol . 1993; 174 139-164
45 Macartur R A, Karpan C M. Heart rates of muskrats diving during simulated field conditions: Persistence of the bradycardia response and factors modifying its expression. Can J Zool . 1989; 67 1783-1792
46 Murdraugh H V, Seabury J C, Mitchell. Electrocardiogram of the diving seal. Circ Res . 1961; 9 358-361
47 Furilla R A, Jones D R. The relationship between dive and pre-dive heart rates in restrained and free dives by diving ducks. J Exp Biol . 1987; 127 333-348
48 Signore P E, Jones D R. Effect of pharmacological blocking on cardiovascular responses to voluntary and forced diving in muskrats. J Exp Biol . 1995; 198 2307-2315
49 Garay S M, Rapoport D, Sorkin B. Regulation of ventilation in the obstructive sleep apnea syndrome. Am J Respir Crit Care Med . 1981; 149 715-721
50 Guilleminault C, Connolly S, Winkle R, Melvin K. Cyclical variation of the heart rate in sleep apnea syndrome. Lancet . 1984; 21 126-131
51 Brooks D, Horner R L, Kozar L F, Render-Teixeira C L, Phillipson E A. Obstructive sleep apnea as a cause of systemic hypertension-evidence from a canine model. J Clin Invest . 1997; 99 106-109
52 Stoohs R, Suh B, Nouriani B, Guilleminault C. Obstructive sleep apnea related cardiac changes during NREM and REM sleep. In: Horne J ed. Sleep 90. Bochum: Pontenagel Press 1990
53 Hayakawa T, Terashima M, Kayukawa Y, Ohta T, Okada T. Changes in cerebral oxygenation and hemodynamics during obstructive sleep apneas. Chest . 1996; 109 916-921
54 Hajak G, Klingelhöfer J, Schulz-Varszegi M, Sander D, Rüther E. Sleep apnea syndrome and cerebral hemodynamics. Chest . 1996; 110 670-679
55 Krieger J, Schmidt M, Kurtz D. Renal function in patients with obstructive sleep apnea. Effects of nasal continuous positive airway pressure. Arch Intern Med . 1988; 1337-1340
56 Krieger J. Breathing during sleep in normal subjects. In: Kryger MH, Roth T, Dement WC, eds. Principles and Practice of Sleep Medicine Philadelphia: W.B. Saunders, 1994: 212-223
57 Douglas N J. Control of ventilation during sleep. In: Kryger M, Roth T, Dement WC, eds. Principles and Practice of Sleep Medicine Philadelphia: W.B. Saunders, 1994: 201-211
58 Gleeson K, Zwillich C W, White D P. The influence of increasing ventilatory effort on arousal from sleep. Am Rev Respir Dis . 1990; 142 295-300
59 Butler P J, Woakes A J, Boyd I L, Kanatous S. Relations between heart rate and oxygen consumption during steady-state swimming in California seal lions. J Exp Biol . 1992; 170 35-42
60 Schmidt-Nielsen K. Animal Physiology. Adaptation and Environment, 3rd ed. Cambridge: Cambridge University Press, 1983: 192