The essential role of peripheral respiratory chemoreceptor inputs in maintaining breathing revealed when CO2stimulation of central chemoreceptors is diminished

Key points • Central sleep apnoea is a condition characterized by oscillations between apnoea and hyperpnoea during sleep, which can have many serous health implications. • Each ventilatory overshoot following an apnoea attenuates peripheral chemoreceptor input which, in turn, has the potential to cause a further apnoea. • In a decerebrate, vagotomized, in situ rat preparation, we show that central apnoeas can be overcome both physiologically (with high peripheral CO 2) and pharmacologically (with peripheral pituitary adenylate cyclase-activating peptide). • We also show that the central apnoeic threshold, i.e. the CO 2 level at which the animal stops breathing, can be lowered by increasing peripheral chemoreceptor stimulation. • These data suggest that stimulation of peripheral chemoreceptors may prevent central apnoeas, reaffirming the peripheral chemoreceptors as possible therapeutic targets for some sleep apnea phenotypes.