Successful continuous positive airway pressure treatment reduces skin sympathetic nerve activity in patients with obstructive sleep apnea.
Successful continuous positive airway pressure treatment reduces skin sympathetic nerve activity in patients with obstructive sleep apnea.
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DOI：
10.1016/j.hrthm.2021.09.018
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发表时间：
2022-01
期刊：
影响因子：
5.5
通讯作者：
Tang Y
中科院分区：
文献类型：
--
作者：
Meng G;He W;Wong J;Li X;Mitscher GA;Straka S;Adams D;Everett TH 4th;Manchanda S;Liu X;Chen PS;Tang Y
阻塞性睡眠呼吸暂停(OSA)与心血管疾病和交感神经张力增加有关。我们先前证明OSA患者的皮肤交感神经活动(SKNA)增加。验证持续气道正压(CPAP)治疗可降低SKNA的假设。对9例阻塞性睡眠呼吸暂停综合征患者同时进行心电图、睡眠脑干诱发电位和多导睡眠图检查。基线记录后，进行CPAP滴定，并逐渐调整压力，以确定最佳治疗方案，即将呼吸暂停低通气指数降至≤5/h。否则，该方案被认为是次优方案(AHI和Gt；5/h)。用快速傅立叶变换(FFT)分析了SKNA的频谱。SKNA有极低频(VLF)、低频(LF)和高频(HF)振荡。高频振荡与呼吸频率相匹配。OSA事件更多地与SKNA的VLF和LF有关，而不是高频振荡。与基线相比，CPAP显著降低觉醒指数、AHI，升高最低氧饱和度和平均氧饱和度。优化治疗可显著增加心电主频(DF)，降低心率、平均心电节律(ASKNA)、心电节律持续时间和总心搏面积。Df与aSKNA呈负相关。在人类SKNA记录中观察到甚低频、低频和高频振荡。其中，甚低频和低频与阻塞性睡眠呼吸暂停有关，而高频与正常呼吸有关。CPAP治疗降低了aSKNA，并将SKNA振荡的频率从VLF或LF移至HF。
Obstructive sleep apnea (OSA) is associated with cardiovascular diseases and increased sympathetic tone. We previously demonstrated that OSA patients have increased skin sympathetic nerve activity (SKNA). To test the hypothesis that continuous positive airway pressure (CPAP) treatment reduces SKNA. The ECG, SKNA, and polysomnography were recorded simultaneously in 9 OSA patients. After baseline recording, CPAP titration was performed and the pressure was adjusted gradually for the optimal treatment, defined by reducing the apnea-hypopnea index (AHI) to ≤ 5/h. Otherwise the treatment was considered suboptimal (AHI > 5/h). Fast Fourier transform (FFT) analyses were conducted to investigate the frequency spectrum of SKNA. There were very low frequency (VLF), low frequency (LF) and high frequency (HF) oscillations in the SKNA. The HF oscillation matched the frequency of respiration. OSA episodes were more frequently associated with the VLF and LF than HF oscillations of the SKNA. Compared with baseline, CPAP significantly decreased the arousal index, AHI, and increased the minimal and average O2 saturation. Optimal treatment significantly increased the dominant frequency (DF), and reduced the heart rate, average SKNA (aSKNA), SKNA burst duration and total burst area. The DF negatively correlated with aSKNA. VLF, LF and HF oscillations are observed in human SKNA recordings. Among them, VLF and LF are associated with OSA while HF is associated with normal breathing. CPAP therapy reduces the aSKNA and shifts the frequency of SKNA oscillation from VLF or LF to HF.
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