Effect of CPAP therapy on daytime cardiovascular regulations in patients with obstructive sleep apnea
Effect of CPAP therapy on daytime cardiovascular regulations in patients with obstructive sleep apnea
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DOI：
10.1016/j.compbiomed.2011.09.001
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发表时间：
2012-03-01
影响因子：
7.7
通讯作者：
Wessel, N.
中科院分区：
文献类型：
--
作者：
Penzel, T.;Riedl, M.;Wessel, N.
阻塞性睡眠呼吸暂停（OSA）是一种高患病率的睡眠障碍，其导致夜间和白天心血管调节的病理变化。我们研究了通过持续气道正压通气（CPAP）在夜间治疗OSA是否改善了白天的结果。28例OSA患者，18例动脉高压，10例血压正常，在基线和CPAP治疗3个月时进行了研究。研究了10名年龄和性别匹配的健康对照受试者进行比较。我们记录了20分钟安静呼吸的休息期，并在白天进行了心电图和血压的运动负荷试验（Portapres）。踏车测功试验显示，负荷50W和100W时舒张压明显降低（P < 0.05和P < 0.01），负荷后心率恢复时间明显缩短（P < 0.05）。这些结果表明白天血管阻力和交感神经活动减少。用符号耦合迹线法对静息期的耦合分析表明，CPAP治疗对高血压患者的压力感受性反射反应有影响，收缩压对心率的影响由正常血压患者的病理性改变为适应性改变（p < 0.05）。(C)2011爱思唯尔有限公司保留所有权利。
Obstructive sleep apnea (OSA) is a sleep disorder with a high prevalence that causes pathological changes in cardiovascular regulation during the night and also during daytime. We investigated whether the treatment of OSA at night by means of continuous positive airway pressure (CPAP) improves the daytime consequences. Twenty-eight patients with OSA, 18 with arterial hypertension, 10 with normal blood pressure, were investigated at baseline and with three months of CPAP treatment. Ten age and sex matched healthy control subjects were investigated for comparisons. We recorded a resting period with 20 min quiet breathing and an exercise stress test during daytime with ECG and blood pressure (Portapres). The bicycle ergometry showed a significant reduction of the diastolic blood pressure at a work load of 50W and 100W (p < 0.05 and p < 0.01, respectively) and a decrease of the heart rate recovery time after the stress test (p < 0.05). These results indicate a reduction of vascular resistance and sympathetic activity during daytime. The coupling analysis of the resting periods by means of symbolic coupling traces approach indicated an effect of the CPAP therapy on the baroreflex reaction in hypertensive patients where influences of the systolic blood pressure on the heart rate changed from pathological patterns to adaptive mechanisms of the normotensive patients (p < 0.05). (C) 2011 Elsevier Ltd. All rights reserved.