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Sleep Breath 2000; 04(1): 0031-0042
DOI: 10.1055/s-2000-11528
Copyright © 2000 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

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
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Publication History

Publication Date:
31 December 2000 (online)

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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

REFERENCES

  • 1 Phillipson E A. Sleep apnea-a major public health problem.  N Engl J Med . 1993;  328 1271-1273
    CrossrefPubMedGoogle Scholar
  • 2 Holden C. Wake-up call for sleep research.  Science . 1993;  259 305
    PubMedGoogle Scholar
  • 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
    Google Scholar
  • 4 Bradley T D, Phillipson E. Central sleep apnea.  Clin Chest Med . 1992;  13 493-506
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 6 Douglas N J, Polo O. Pathogenesis of obstructive sleep apnea/hypopnoea syndrome.  Lancet . 1994;  344 653-655
    CrossrefPubMedGoogle Scholar
  • 7 Berry R B, Gleeson K. Respiratory arousal from sleep: Mechanisms and significance.  Sleep . 1997;  20 654-675
    PubMedGoogle Scholar
  • 8 Shepard J W. Excessive daytime sleepiness, upper airway resistance, and nocturnal arousals.  Chest . 1993;  104 665-666
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 10 Butler P J, Jones D R. Physiology of diving of birds and mammals.  Physiol Rev . 1997;  77 837-899
    CrossrefPubMedGoogle Scholar
  • 11 Andersen H T. Physiological adaptations of diving vertebrates.  Physiol Rev . 1966;  46 213-243
    PubMedGoogle Scholar
  • 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
    Google Scholar
  • 13 Kooyman G L, Ponganis P J. The physiological basis of diving to deep: Birds and mammals.  Annu Rev Physiol . 1998;  60 19-32
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 15 Schumacher U, Welsch U. Histological, histochemical and fine structure observations on the spleen of seals.  Am J Anat . 1987;  179 357-368
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 17 Maillard D, Fleury B, Housset B. Decreased oxyhemoglobin affinity in patients with sleep apnea syndrome.  Am Rev Respir Dis . 1991;  143 486-489
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 19 Eliassen E. Cardiovascular responses to submersion asphyxia in avian divers.  Arbok Univ Bergen Mat.-Naturvitensk Ser . 1960;  2 1-76
    PubMedGoogle Scholar
  • 20 Stephenson R. Respiratory and plumage gas volumes in unrestrained diving ducks (Aythya affinis).  Respir Physiol . 1995;  100 129-137
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 22 Schaefer K E. Effects of prolonged diving training.  Nat Acad Sci National Research Council Publication . 1963;  1181 271-278
    PubMedGoogle Scholar
  • 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
    Google Scholar
  • 24 Irving L, Scholander P F, Grinnel S W. The respiration of the porpoise Tursiops truncatus J Comp Physiol .  1941;  17 145-168
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    Google Scholar
  • 27 Snyder G K. Respiratory adaptations in diving mammals.  Respir Physiol . 1983;  54 269-294
    CrossrefPubMedGoogle Scholar
  • 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
    Google Scholar
  • 29 Butler P J. Respiratory and cardiovascular control during diving in birds and mammals.  J Exp Biol . 1982;  100 195-221
    PubMedGoogle Scholar
  • 30 Houston A L, Carbone C. The optimal allocation of time during the diving cycle.  Behav Ecol . 1992;  3 255-265
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 32 Andersen H T. Hyperpotaseima and electrocardiographic changes in the duck during prolonged diving.  Acta Physiol Scand . 1965;  63 292-295
    PubMedGoogle Scholar
  • 33 Scholander P F. The masterswitch of life.  Sci Am . 1963;  209 92-106
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 35 Hong S K, Rahn H. The diving women of Korea and Japan.  Sci Am . 1967;  216 34-43
    PubMedGoogle Scholar
  • 36 Refsum H E. Severe arterial hypoxemia and liver cell necrosis in patients with pulmonary insufficiency.  Acta Med Scand . 1964;  176 473-478
    PubMedGoogle Scholar
  • 37 Leivestad H, Andersen H, Scholander P F. Physiological response to air exposure in fish.  Science . 1957;  126 505
    PubMedGoogle Scholar
  • 38 Berg T, Steen J B. Physiological mechanisms for aerial respiration in the eel.  Comp Biochem Physiol . 1965;  5 469-484
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 43 Gilbert F F, Gofton N. Heart rates in mink muskrat and beaver.  Comp Biochem Physiol . 1982;  73 249-251
    CrossrefPubMedGoogle Scholar
  • 44 Thompson D, Fedak M A. Cardiac responses in grey seals during diving at sea.  J Exp Biol . 1993;  174 139-164
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 46 Murdraugh H V, Seabury J C, Mitchell. Electrocardiogram of the diving seal.  Circ Res . 1961;  9 358-361
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 50 Guilleminault C, Connolly S, Winkle R, Melvin K. Cyclical variation of the heart rate in sleep apnea syndrome.  Lancet . 1984;  21 126-131
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    Google Scholar
  • 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
    PubMedGoogle Scholar
  • 54 Hajak G, Klingelhöfer J, Schulz-Varszegi M, Sander D, Rüther E. Sleep apnea syndrome and cerebral hemodynamics.  Chest . 1996;  110 670-679
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    Google Scholar
  • 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
    Google Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 60 Schmidt-Nielsen K. Animal Physiology. Adaptation and Environment, 3rd ed. Cambridge: Cambridge University Press, 1983: 192
    Google Scholar