However, NIPPV in the pressure support, bi-level mode augments tidal volume; the ensuing hyperventilation results in hypocapnia and possible worsening of central apnoea and periodic breathing during sleep (115).
Changes in inspiratory muscle electrical activity and upper airway resistance during periodic breathing induced by hypoxia during sleep.
Effect of hypoxia-induced periodic breathing on upper airway obstruction during sleep.
Periodic breathing is an abnormal oscillatory ventilation pattern consisting of cyclic hyperpnea and hypopnea, which can occur in heart failure (HF) patients during sleep or on exertion.
Corra and associates assessed the prognostic value of sleep periodic breathing and exertional periodic breathing in a prospective study of 133 patients with stable, moderate to severe HF as a result of ischemic or idiopathic dilated cardiomyopathy (Circulation 2006;113:44-50).
A total of 67 patients (50%) had some form of periodic breathing: 39 patients (29%) had severe sleep periodic breathing alone, 6 (4%) had exertional periodic breathing alone, and 22 (16%) had both.