Sex differences in the effect of acute intermittent hypoxia on respiratory modulation of sympathetic activity

Jane S. Edmunds, Clayton L. Ivie, Elizabeth P. Ott, Dain W. Jacob, Sarah E. Baker, Jennifer L. Harper, Camila M. Manrique-Acevedo, Jacqueline K. Limberg

Research output: Contribution to journalArticlepeer-review


Sex-related differences in respiratory modulation of sympathetic activity have been observed in rodent models of sleep apnea [intermittent hypoxia (IH)]. In light of sex disparities in the respiratory response to acute IH in humans as well as changes in respiratory modulation of muscle sympathetic nerve activity (MSNA) in clinical sleep apnea, we examined sex-related differences in respiratory modulation of MSNA following acute IH. We hypothesized that respiratory modulation of MSNA would be altered in both male and female participants after IH; however, the respiratory patterning of MSNA following IH would be sex specific. Heart rate, MSNA, and respiration were evaluated in healthy male (n = 21, 30 ± 5 yr) and female (n = 10, 28 ± 5 yr) participants during normoxic rest before and after 30 min of IH. Respiratory modulation of MSNA was assessed by fitting polynomials to cross-correlation histograms constructed between sympathetic spikes and respiration. MSNA was elevated after IH in male (20 ± 6 to 24 ± 8 bursts/min) and female (19 ± 8 to 22 ± 10 bursts/min) participants (P < 0.01). Both male and female participants exhibited respiratory modulation of MSNA (P < 0.01); however, the pattern differed by sex. After IH, modulation of MSNA within the breath was reduced in male participants (P = 0.03) but increased in female participants (P = 0.02). Both male and female adults exhibit changes in respiratory patterning of MSNA after acute IH; however, this pattern differs by sex. These data support sex disparities in respiratory modulation of MSNA and may have implications for conditions such as sleep apnea.

Original languageEnglish (US)
Pages (from-to)R903-R911
JournalAmerican Journal of Physiology - Regulatory Integrative and Comparative Physiology
Issue number6
StatePublished - Dec 2021


  • Intermittent hypoxia
  • Muscle sympathetic nerve activity
  • Women

ASJC Scopus subject areas

  • Physiology
  • Physiology (medical)


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