What are the adverse effects of alveolar hypoventilation due to childhood obstructive sleep apnea (OSA)?

Updated: Feb 13, 2019
  • Author: Mary E Cataletto, MD; Chief Editor: Denise Serebrisky, MD  more...
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Answer

Intermittent hypercapnia frequently occurs among patients with various respiratory disorders, becomes more prominent or sustained during sleep, and is minimal or absent during wakefulness.

Children with obstructive sleep apnea who snore exhibit classic intermittent alveolar hypoventilation, which is elicited by increased upper airway resistance, concurrent with diminished or insufficient compensatory mechanisms developing during sleep.

In adults with obstructive sleep apnea, blunted ventilatory drive to hypercapnia during wakefulness develops and may potentially contribute to the pathophysiology of upper airway obstruction. In contrast, waking and sleeping ventilatory responses to hypercapnia in children with obstructive sleep apnea are similar to those measured in healthy children. However, arousal responses are attenuated during sleep, suggesting that long-standing interactions between sleep and upper airway resistance in these children primarily affect arousal mechanisms during sleep. Another potential contribution of alveolar hypoventilation and hypercapnia during sleep may relate to exacerbation of the effect of intermittent hypoxia on the vasomotor tone of the pulmonary circulation.


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