Age-related changes in cardiac autonomic control during sleep
Age-related changes in cardiac autonomic control during sleep
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DOI：
10.1046/j.1365-2869.2003.00353.x
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发表时间：
2003-09-01
影响因子：
4.4
通讯作者：
Simon, C
中科院分区：
文献类型：
--
作者：
Brandenberger, G;Viola, AU;Simon, C
衰老通常与睡眠质量下降和周期性呼吸（PB）增加有关，这会影响心率变异性（HRV）。考虑到睡眠质量和呼吸模式，根据HRV分析推断，确定了心脏自主控制。两组12名年轻志愿者（21.1 +/- 0.8岁）和12名年长志愿者（64.9 +/- 1.9岁）在一个实验晚上接受了脑电图、心脏和呼吸记录。计算5 min段HRV的时间和频域指标，并结合脑电图和呼吸功率谱。在老年人中，在甚低频（VLF）范围内出现了较大的R-R振荡，这反映了在18%的睡眠时间内观察到的PB频率。PB在快速眼动睡眠（REM）时发生频率更高，导致正常R-R间隔（SDNN）标准差和绝对低频功率（LF）显著升高（P < 0.02）。在正常呼吸模式下，SDNN、绝对VLF、LF和高频（HF）功率在每个睡眠阶段均较年轻受试者下降（P < 0.01），且无明显的睡眠阶段依赖性变化。老年人正常HF/(LF + HF)总体下降（P < 0.01），提示副交感神经活动主要丧失，这可能与慢波睡眠时间减少有关。这些结果表明，两种截然不同的呼吸特征，意味着不同程度的自主驱动到心脏，影响老年人睡眠时的心率波动。必须考虑呼吸模式来正确解释老年人的HRV。
Aging is commonly associated with decreased sleep quality and increased periodic breathing (PB) that can influence heart rate variability (HRV). Cardiac autonomic control, as inferred from HRV analysis, was determined, taking into account the sleep quality and breathing patterns. Two groups of 12 young (21.1 +/- 0.8 years) and 12 older (64.9 +/- 1.9 years) volunteers underwent electroencephalographic, cardiac, and respiratory recordings during one experimental night. Time and frequency domain indices of HRV were calculated in 5-min segments, together with electroencephalographic and respiratory power spectra. In the elderly, large R-R oscillations in the very-low frequency (VLF) range emerged, that reflected the frequency of PB observed in 18% of the sleep time. PB occurred more frequently during rapid eye movement sleep ( REM) sleep and caused a significant (P < 0.02) increase in the standard deviation of normal R-R intervals (SDNN) and absolute low-frequency (LF) power. With normal respiratory patterns, SDNN, absolute VLF, LF, and high frequency (HF) power fell during each sleep stage ( P < 0.01) compared with young subjects, with no significant sleep-stage dependent variations. An overall decrease ( P < 0.01) in normalized HF/(LF + HF) was observed in the elderly, suggesting a predominant loss of parasympathetic activity which may be related to decreased slow-wave sleep duration. These results indicate that two distinct breathing features, implying different levels of autonomic drive to the heart, influence HRV in the elderly during sleep. The breathing pattern must be considered to correctly interpret HRV in the elderly.