Biomedical Engineering Department, University of Southern California, Los Angeles, CA 90089-1111, USA.
Respir Physiol Neurobiol. 2010 Nov 30;174(1-2):4-28. doi: 10.1016/j.resp.2010.06.001. Epub 2010 Jun 11.
While many physiological control models exist in the literature, none thus far has focused on characterizing the interactions among the respiratory, cardiovascular and sleep-wake regulation systems that occur in sleep-disordered breathing. The model introduced in this study integrates the autonomic control of the cardiovascular system, chemoreflex and state-related control of respiration, including respiratory and upper airway mechanics, along with a model of circadian and sleep-wake regulation. The integrative model provides realistic predictions of the physiological responses under a variety of conditions including: the sleep-wake cycle, hypoxia-induced periodic breathing, Cheyne-Stokes respiration in chronic heart failure, and obstructive sleep apnoea (OSA). It can be used to investigate the effects of a variety of interventions, such as isocapnic and hypercapnic and/or hypoxic gas administration, the Valsalva and Mueller maneuvers, and the application of continuous positive airway pressure on OSA subjects. By being able to delineate the influences of the various interacting physiological mechanisms, the model is useful in providing a more lucid understanding of the complex dynamics that characterize state-cardiorespiratory control in the different forms of sleep-disordered breathing.
虽然文献中有许多生理控制模型，但迄今为止，还没有一个模型专门针对睡眠呼吸障碍中发生的呼吸、心血管和睡眠-觉醒调节系统之间的相互作用进行特征描述。本研究引入的模型整合了心血管系统的自主控制、化学反射和与状态相关的呼吸控制，包括呼吸和上呼吸道力学，以及昼夜节律和睡眠-觉醒调节模型。该综合模型可以对各种情况下的生理反应进行现实预测，包括：睡眠-觉醒周期、缺氧诱导的周期性呼吸、慢性心力衰竭中的 Cheyne-Stokes 呼吸以及阻塞性睡眠呼吸暂停（OSA）。它可以用于研究各种干预措施的影响，例如等碳酸和高碳酸和/或低氧气体给药、瓦尔萨尔瓦和穆勒动作以及持续气道正压通气在 OSA 患者中的应用。通过能够描绘出各种相互作用的生理机制的影响，该模型有助于更清晰地理解不同形式的睡眠呼吸障碍中特征性的状态-心肺控制的复杂动力学。
