CARDIORESPIRATORY TRANSFER IN OBSTRUCTIVE SLEEP APNEA

描述(改编自申请人的摘要)：主要目标 提出的项目有三个方面。第一个是量化动态 呼吸对梗阻性心脏病患者心率控制的影响 睡眠呼吸暂停综合征(OSAS)在清醒和睡眠期间。第二大调 目的：评价持续正压气道治疗的远期疗效。 压力(CPAP)疗法对阻塞性睡眠呼吸暂停低通气综合征患者心肺转流的影响 阐明这些变化背后可能存在的机制。第三个目标是 开发一个能够表征该复合体的功能定量模型 呼吸和心率控制之间的动态耦合和增强我们的 对潜在的生理机制的理解。动态模型 将心率波动与以下方面的变化联系起来：(A)瞬时 肺容量，(B)呼吸动力，和(C)动脉血压。正常 不打鼾者、高血压非打鼾者和OSAS患者6前后 持续数月的CPAP治疗将在4个系列的实验中进行研究。变化 阻塞性睡眠呼吸暂停综合征心肺转移术与持续正压治疗的疗效 在减少这些变化方面将通过比较估计的模型进行评估 所有受试者组的参数和导出的传递函数。在……里面 系列1a，心肺传递函数(CTF)将在#年估计 在自主呼吸和控制呼吸条件下的清醒状态。在……里面 系列lb、ctf将在觉醒和睡眠中以及在 以下干预措施在睡眠中的应用：高氧血症， 常氧CPAP和CPAP过程中周期性的声音诱导唤醒。在……里面 系列2和3计算机控制的呼吸机将提供随机 呼吸辅助水平和随机发生的闭塞 不同的睡眠阶段。这些扰动将提高模型参数 通过降低输入变量之间的相关性来估计过程。在……里面 系列3：自主神经对睡眠中听觉唤醒的反应 对OSAS患者CPAP治疗前后6个月进行比较。 本研究中验证的方法可能提供一种客观的手段。 预测阻塞性睡眠呼吸暂停综合征患者发生潜在致命心脏病的风险 心律不齐。

DESCRIPTION (Adapted from the applicant's abstract): The major goals of the proposed project are threefold. The first is to quantify the dynamic effects of respiration on heart rate control in subjects with obstructive sleep apnea syndrome (OSAS) during wakefulness and sleep. The second major objective is to assess the long-term effects of continuous positive airway pressure (CPAP) therapy on cardiorespiratory transfer in OSAS and to elucidate the mechanisms that may underlie these changes. The third goal is to develop a functional quantitative model that can characterize the complex dynamic coupling between respiration and heart rate control and enhance our understanding of the underlying physiological mechanisms. The dynamic model will relate fluctuations in heart rate to changes in: (a) instantaneous lung volume, (b) respiratory drive, and (c) arterial blood pressure. Normal non-snorers, hypertensive non-snorers, and OSAS patients before and after 6 months of CPAP therapy will be studied in 4 series of experiments. Changes in cardiorespiratory transfer due to OSAS and the efficacy of CPAP therapy in reducing these changes will be assessed by comparing the estimated model parameters and derived transfer functions across the subject groups. In Series 1a, cardiorespiratory transfer functions (CTF) will be estimated in wakefulness under spontaneous and controlled breathing conditions. In Series lb, CTF will be estimated in wakefulness and sleep, as well as during the application of the following interventions in sleep: hyperoxia, normoxic CPAP, and periodic acoustically-induced arousals during CPAP. In Series 2 and 3 a computer-controlled ventilator will provide randomized levels of respiratory assistance and randomly-occurring occlusions during various sleep stages. These perturbations will enhance the model-parameter estimation process by reducing correlation among the input variables. In Series 3 the autonomic responses to acoustically-induced arousals from sleep in OSAS subjects before and after 6 months of CPAP therapy will be compared. The methods validated in this study may provide an objective means of predicting in OSAS patients the risk of developing potentially fatal cardiac arrhythmias.