Estimating inspiratory neural drive and the wakefulness drive to breathe

Comment on: Compensatory responses to increased mechanical abnormalities in COPD during sleep Eur J Appl Physiol (2022) 122:663–676. https://doi.org/10.1007/s00421-021-04869-0

The neural control of breathing is complex with multiple descending and reflex inputs to many pools of respiratory motoneurones. This complex system provides redundancy to help maintain ventilation in the face of homeostatic challenges. In chronic obstructive pulmonary disease (COPD), diaphragm electromyographic activity (diaEMG) is increased during wakefulness, due to compromised respiratory mechanics and gas exchange. This compensatory increase during resting breathing has been documented for both the crural and costal diaphragm, and the obligatory, ‘extra-diaphragmatic’ inspiratory muscles...