Carbon dioxide in sleep medicine: The next frontier for measurement, manipulation, and research

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All Volumes10 (2014)09 (2013)08 (2012)07 (2011)06 (2010)05 (2009)04 (2008)03 (2007)02 (2006)01 (2005) 010203040506070809101112All Issues All WordsAny Words Search ADVERTISEMENT Current Issue: Volume: 10 Number: 09 View Current Issue Login Issue Navigator Volume 10 No. 05 Editorial Analysis and Perspectives Scientific Investigations New Research Commentary New Research From Couch Potato to Gym Junkie—CPAP May Not Be the Answer Carbon Dioxide in Sleep Medicine: The Next Frontier for Measurement, Manipulation, and Research Case Reports New Research Special Articles Sleep Medicine Pearls Departments Earn CME Accepted Papers Classifieds View my search results in Volume 10, Issue 05 Share PDF Print Commentary Carbon Dioxide in Sleep Medicine: The Next Frontier for Measurement, Manipulation, and Research http://dx.doi.org/10.5664/jcsm.3702 Robert Joseph Thomas, M.D., M.M.Sc., F.A.A.S.M. Beth Israel Deaconess Medical Center, Boston, MA Carbon dioxide (CO2) is the most important regulator of respiration and blood pH. Papers are published with scant new information every so often that largely focus on clinical descriptions of hypercapnic individuals, often obese. While there is intense basic science interest in CO2 sensitive neurons in the brainstem, including the Phox2beurokinin-1 receptor (NK1R)-expressing neurons in the pre-B?tzinger complex (pre-B?tzC),1 and exposing the carotid bodies to hypocapnia induces periodic breathing,2,3 the science and industry of sleep-breathing medicine has generally neglected CO2. Much of the information on chronic exposure to elevated but low levels of CO2 comes from submarine research, targeting sustained ambient concentrations in the low single digits.4–8 Acute exposure to high concentrations of CO2 results in extreme dyspnea and death; the gas has anesthetic properties and can induce a reversible isoelectric EEG.9