{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T08:02:03Z","timestamp":1785830523760,"version":"3.56.0"},"reference-count":25,"publisher":"American Physiological Society","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Applied Physiology"],"published-print":{"date-parts":[[2000,1,1]]},"abstract":"<jats:p> The contribution of apnea to chronic hypercapnia in obstructive sleep apnea (OSA) has not been clarified. Using a model (D. M. Rapoport, R. G. Norman, and R. M. Goldring. J. Appl. Physiol. 75: 2302\u20132309, 1993), we previously illustrated failure of CO<jats:sub>2<\/jats:sub> homeostasis during periodic breathing resulting from temporal dissociation between ventilation and perfusion (\u201ctemporal V\u02d9\/Q\u02d9mismatch\u201d). This study measures acute kinetics of CO<jats:sub>2<\/jats:sub> during periodic breathing and addresses interapnea ventilatory compensation for maintenance of CO<jats:sub>2<\/jats:sub> homeostasis in 11 patients with OSA during daytime sleep (37\u2013171 min). Ventilation and expiratory CO<jats:sub>2<\/jats:sub> and O<jats:sub>2<\/jats:sub> fractions were measured on a breath-by-breath basis by means of a tight-fitting full facemask. Calculations included CO<jats:sub>2<\/jats:sub>excretion, metabolic CO<jats:sub>2<\/jats:sub>production, and CO<jats:sub>2<\/jats:sub> balance (metabolic CO<jats:sub>2<\/jats:sub> production \u2212 exhaled CO<jats:sub>2<\/jats:sub>). CO<jats:sub>2<\/jats:sub> balance was tabulated for each apnea\/hypopnea event-interevent cycle and as a cumulative value during sleep. Cumulative CO<jats:sub>2<\/jats:sub> balance varied (\u22123,570 to +1,388 ml). Positive cumulative CO<jats:sub>2<\/jats:sub> balance occurred in the absence of overall hypoventilation during sleep. For each cycle, positive CO<jats:sub>2<\/jats:sub> balance occurred despite increased interevent ventilation to rates as high as 45 l\/min. This failure of CO<jats:sub>2<\/jats:sub> homeostasis was dependent on the event-to-interevent duration ratio. The results demonstrate that 1) periodic breathing provides a mechanism for acute hypercapnia in OSA, 2) acute hypercapnia during periodic breathing may occur without a decrease in average minute ventilation, supporting the presence of temporalV\u02d9\/Q\u02d9 mismatch, as predicted from our model, and 3) compensation for CO<jats:sub>2<\/jats:sub> accumulation during apnea\/hypopnea may be limited by the duration of the interevent interval. The relationship of this acute hypercapnia to sustained chronic hypercapnia in OSA remains to be further explored. <\/jats:p>","DOI":"10.1152\/jappl.2000.88.1.257","type":"journal-article","created":{"date-parts":[[2017,12,22]],"date-time":"2017-12-22T16:26:03Z","timestamp":1513959963000},"page":"257-264","source":"Crossref","is-referenced-by-count":81,"title":["CO<sub>2<\/sub> homeostasis during periodic breathing  in obstructive sleep apnea"],"prefix":"10.1152","volume":"88","author":[{"given":"Kenneth I.","family":"Berger","sequence":"first","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine and Bellevue Hospital Chest Service, Department of Medicine, New York University School of Medicine, New York, New York 10016"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Indu","family":"Ayappa","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine and Bellevue Hospital Chest Service, Department of Medicine, New York University School of Medicine, New York, New York 10016"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I. Barry","family":"Sorkin","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine and Bellevue Hospital Chest Service, Department of Medicine, New York University School of Medicine, New York, New York 10016"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert G.","family":"Norman","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine and Bellevue Hospital Chest Service, Department of Medicine, New York University School of Medicine, New York, New York 10016"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David M.","family":"Rapoport","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine and Bellevue Hospital Chest Service, Department of Medicine, New York University School of Medicine, New York, New York 10016"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta M.","family":"Goldring","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine and Bellevue Hospital Chest Service, Department of Medicine, New York University School of Medicine, New York, New York 10016"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"24","reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/0034-5687(85)90140-9"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI103206"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/18.7.581"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1991.71.3.1112"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1164\/arrd.1986.134.5.920"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(56)90094-8"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1152\/ajpendo.1994.267.5.E732"},{"key":"B8","first-page":"451","volume":"124","author":"Garay S. 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