SYMPATHETIC NEURAL MECHANISMS IN OBSTRUCTIVE SLEEP-APNEA
SYMPATHETIC NEURAL MECHANISMS IN OBSTRUCTIVE SLEEP-APNEA
复制标题
DOI：
10.1172/jci118235
复制
发表时间：
1995-10-01
影响因子：
15.9
通讯作者：
ABBOUD, FM
中科院分区：
文献类型：
--
作者：
SOMERS, VK;DYKEN, ME;ABBOUD, FM
对10例阻塞性睡眠呼吸暂停患者在清醒和睡眠时的血压、心率、交感神经活动和多导睡眠图进行了记录。对4名患者进行持续气道正压通气（CPAP）治疗后，还测量了10名年龄和性别匹配的对照组和5名无睡眠呼吸暂停病史的肥胖组的清醒交感神经活动。睡眠呼吸暂停患者即使在清醒时也有高水平的神经活动（P < 0.001），血压和交感神经活动在睡眠的任何阶段都没有下降，清醒时的平均血压为92 ± 4.5 mmHg，在II期睡眠（n = 10）和快速眼动（REM）睡眠（n = 10）期间达到峰值水平，分别为116 ± 5和127 ± 7 mmHg。5），差异有显著性（P < 0.001）。睡眠时交感神经活动增加（P = 0.01）尤其是在II期（133+/-9%高于清醒; P = 0.006）和REM（141+/-13%; P = 0.007），交感神经活性峰值（在每次呼吸暂停事件的最后10秒内测量）在第二阶段睡眠期间增加到299+/-96%，在REM睡眠期间增加到246+/-36结果表明，阻塞性睡眠呼吸暂停患者在清醒时交感神经活性增高，睡眠时血压和交感神经活性进一步增高，经CPAP治疗后，交感神经活性和血压的增高幅度均减小（P < 0.03）。
Blood pressure, heart rate, sympathetic nerve activity, and polysomnography were recorded during wakefulness and sleep in 10 patients with obstructive sleep apnea. Measurements were also obtained after treatment with continuous positive airway pressure (CPAP) in four patients, Awake sympathetic activity was also measured in 10 age- and sex-matched control subjects and in 5 obese subjects without a history of sleep apnea.Patients with sleep apnea had high levels of nerve activity even when awake (P < 0.001), Blood pressure and sympathetic nerve activity did not fall during any stage of sleep, Mean blood pressure was 92+/-4.5 mmHg when awake and reached peak levels of 116+/-5 and 127+/-7 mmHg during stage II sleep (n = 10) and rapid eye movement (REM) sleep (n = 5), respectively (P < 0.001). Sympathetic activity increased during sleep (P = 0.01) especially during stage II (133+/-9% above wakefulness; P = 0.006) and REM (141+/-13%; P = 0.007), Peak sympathetic activity (measured over the last 10 s of each apneic event) increased to 299+/-96% during stage II sleep and to 246+/-36% during REM sleep (both P < 0.001), CPAP decreased sympathetic activity and blood pressure during sleep (P < 0.03).We conclude that patients with obstructive sleep apnea have high sympathetic activity when awake, with further increases in blood pressure and sympathetic activity during sleep, These increases are attenuated by treatment with CPAP.