Autonomic markers of arousal during sleep in patients undergoing investigation for obstructive sleep apnoea, their relationship to EEG arousals, respiratory events and subjective sleepiness
Autonomic markers of arousal during sleep in patients undergoing investigation for obstructive sleep apnoea, their relationship to EEG arousals, respiratory events and subjective sleepiness
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DOI：
10.1046/j.1365-2869.1998.00092.x
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发表时间：
1998-03-01
影响因子：
4.4
通讯作者：
Stradling, JR
中科院分区：
文献类型：
--
作者：
Pitson, DJ;Stradling, JR
估计睡眠碎片化程度是呼吸睡眠研究的重要组成部分，通常使用EEG微觉醒进行测量，或者从呼吸暂停和去饱和等呼吸异常间接推断。有必要减少劳动密集型的睡眠片段的措施，血压和心率的短暂上升可能会履行这一作用。对40例因可能的阻塞性睡眠呼吸暂停（OSA）而接受调查的睡眠门诊转诊患者进行了一晚的多导睡眠图研究。比较了三个常规的睡眠片段化指标（EEG微觉醒、呼吸暂停/呼吸不足指数（AHI）和氧饱和度下降率（SaO（2）dips））和两个自主神经指标（心率和血压升高）。这五个指数之间的相关性范围从r = 0.38到r = 0.73。在这两个自主神经指标中，血压升高与SaO（2）下降和EEG微觉醒的相关性（分别为r = 0.71和r = 0.65）强于心率升高（分别为0.55和0.51）。除心率上升外，所有睡眠碎片指数与主观嗜睡的相关性相似（r值为0.21-0.36）。由血压升高（使用脉搏传导时间）暗示的觉醒可以很容易地测量，是客观的，并且在预测主观嗜睡方面并不比EEG微觉醒或AHI差。因此，他们可以提供一个有用的替代手动评分的微觉醒从脑电图作为睡眠片段的指数在睡眠诊所的患者接受调查可能的OSA。
Estimating the degree of sleep fragmentation is an important part of a respiratory sleep study and is conventionally measured using EEG micro arousals or is inferred indirectly from respiratory abnormalities such as apnoeas and desaturations. There is a need for less labour-intensive measures of sleep fragmentation, and transient rises in blood pressure and heart rate may fulfil this role. Forty unselected sleep clinic referrals undergoing investigation for possible obstructive sleep apnoea (OSA) were studied with one night of polysomnography. Three conventional indices of sleep fragmentation (EEG micro arousals, apnoea/hypopnoea index (AHI) and oxygen saturation dip rate (SaO(2) dips)) and two autonomic indices (heart rate and blood pressure rises) have been compared. Correlations between these five indices ranged from r = 0.38 to r = 0.73. Of the two autonomic indices, the correlations for blood pressure rises with SaO(2) dips and EEG micro arousals were stronger (r = 0.71 and r = 0.65, respectively) than those for heart rate rises (0.55 and 0.51). All indices of sleep fragmentation, apart from heart rate rises, were similar in their correlation with subjective sleepiness (r-values 0.21-0.36). Arousals implied from blood pressure rises (using pulse transit time) can be measured easily, are objective, and appear no worse at predicting subjective sleepiness than either EEG micro arousals or AHI. They may therefore provide a useful alternative to manual scoring of micro arousals from the EEG as an index of sleep fragmentation in sleep clinic patients undergoing investigation for possible OSA.