Autonomic control of breathing in health and disease

The autonomic nervous system plays a major role in generating the rhythmic activity of breathing, regulating airway smooth muscle tone and pulmonary blood flow through a composite interaction of respiration and circulation, and controlling secretions. Breathing rhythmic activity originates from interactions between three coupled oscillators, in which each phase, inspiration, post-inspiration, and active expiration, is generated within the medulla by its own dedicated microcircuit, referred to as the "triple oscillator hypothesis". This chapter describes the altered autonomic control of breathing in multiple system atrophy, diabetes, epilepsy, chronic obstructive pulmonary disease, asthma, congenital central hypoventilation syndrome, and familial dysautonomia.