Regulation of ventilation before and after sleep in patients with obstructive sleep apnoea.
Regulation of ventilation before and after sleep in patients with obstructive sleep apnoea.
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DOI：
10.1046/j.1440-1843.1999.00163.x
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发表时间：
1999-06-01
期刊：
影响因子：
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通讯作者：
Arakawa, M
中科院分区：
文献类型：
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作者：
Fuse, K;Satoh, M;Arakawa, M
本研究的目的是检测阻塞性睡眠呼吸暂停(OSAS)患者睡眠时异常呼吸是否会影响觉醒后的换气调节。对19例阻塞性睡眠呼吸暂停综合征(OSA)患者和12例正常人进行了睡眠前、后对低氧(HVR)和高碳酸血症(HCVR)的呼吸反应(BS和AS)的检测，并将其与睡眠中呼吸事件的变化进行了比较。在OSA组，AS组的静息通气值明显小于BS组，动脉血二氧化碳分压(PETCO2)显著升高。BS和AS的HVR或HCVR的斜率无差异。然而，两组反应线均下移，每分钟通气量(VE)80(动脉血氧饱和度(SaO2)为80%时的VE)和VE60(PETCO2为60 mm Hg时的VE)从BS到AS均显著降低。VE80和VE60的百分比变化与平均SaO2、总睡眠时间<90%SaO2和睡眠中最低SaO2显著相关。然而，在正常受试者中，我们没有观察到他们的呼吸反应的昼夜变化。这些数据支持一种假设，即反复出现夜间低氧和高二氧化碳可能会改变阻塞性睡眠呼吸暂停患者觉醒后的呼吸调节。
The objective was to examine whether abnormal breathing during sleep may affect regulation of ventilation after awakening in patients with obstructive sleep apnoea (OSAS). In 19 patients with OSA and 12 normal subjects we examined ventilatory responses to hypoxia (HVR) and to hypercapnia (HCVR) before and after sleep (BS and AS), and compared the changes in ventilatory responses with respiratory events during sleep. In the OSA group, the values of resting ventilation were significantly smaller in AS than those in BS and end-tidal partial pressure of CO2 in arterial blood (Pco2) (PETCO2) rose significantly from BS to AS. The slopes of the HVR or HCVR did not differ between BS and AS. However, both the response lines shifted downward and minute ventilation (VE)80 (VE at arterial oxygen saturation (Sao2) of 80%) in HVR and VE60 (VE at PETCO2 of 60 mmHg) in HCVR decreased significantly from BS to AS. The percentage changes of VE80 and VE60 were significantly correlated with mean Sao2, total sleep time below Sao2 of 90% and lowest Sao2 during sleep. However, in normal subjects we observed no circadian variation in their ventilatory responses. These data support the hypothesis that repeated episodes of nocturnal hypoxia and hypercapnia may modify the regulation of ventilation after awakening in patients with OSA.