Robert J. Thomas, M.D. Strong Chemoreflex Modulation of Sleep-Breathing: Some Answers but Even More Questions. Commentary on Javaheri S, et al. The prevalence and natural history of complex sleep apnea. J Clin Sleep Med 2009; 5(3):205-211. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2699163/ PMCID: PMC2699163 PMID: 19960639
The polysomnographic characterization of chemoreflex influences on sleep-breathing has remained essentially stuck with the “straight line in everything for 10-seconds” central apnea or 10 continuous minutes of concordant waxing and waning effort and airflow. Flow-limitation has become the accepted practical biomarker of upper airway obstruction-thus the vast majority of scored events in clinical sleep medicine or research are categorized as obstructive.
The ECG-derived sleep spectrogram can detect low frequency coupled oscillations with two primary patterns: broad band and narrow band. Narrow band coupling detects sequences of central apneas and periodic breathing at altitude, but also tags segments of polysomnograms traditionally scored with obstructive respiratory events.
The technique detects periodic breathing.