PDF(Pubmed)
Abstract：
Background and Objectives: The mechanisms connecting obstructive sleep apnea (OSA) and cardiovascular disease are multifactorial, involving intermittent hypoxia, hypercapnia, and sympathetic activation. The aim of this study was to explore the oscillations of sympathetic activity during the sleep apnea episodes throughout the entire night in patients with OSA. Materials and Methods: The participants received whole-night polysomnography (PSG), and electrocardiogram (EKG) data from the PSG were collected for heart rate variability (HRV) analysis. HRV measurements were conducted in the time and frequency domains. The root mean square of successive differences between normal heartbeats (RMSSD), which reflects parasympathetic activity, and the ratio of the absolute power of the low-frequency band (0.04-0.15 Hz) to the absolute power of the high-frequency band (0.015-0.4 Hz) (LF/HF ratio), which indicates sympathetic activity, were computed. Results: A total of 43 participants (35 men and 8 women) were included in the analysis. The mean age of the participants was 44.1 ± 11.3 years old, and the mean BMI was 28.6 ± 5.4 kg/m2. The sleep apnea episodes throughout the entire night in patients with OSA were selected randomly and occurred most frequently during the non-REM stages (39, 90.7%). The selected sleep apnea episodes typically exhibited multiple apneas, often interrupted by snoring respiration and followed by hyperventilation at the end of the episode (HE). Our findings indicate that the centers of the 5 min HRV window for the lowest and highest LF/HF ratios, at 111.8 ± 88.2 and 117.4 ± 88.6 min after sleep onset, respectively, showed a statistically significant difference (p < 0.001). Similarly, the ratios of the lowest and highest LF/HF, at 0.82 ± 0.56 and 3.53 ± 2.94, respectively, exhibited a statistically significant difference (p < 0.001). Conclusions: In the current study, the selected sleep apnea episodes throughout the entire night in patients with OSA occurred primarily during the non-REM stages. Additionally, we observed that sympathetic activity reached its peak in the window that includes hyperventilation at the end stage of apnea, potentially posing a cardiovascular risk. However, additional studies are needed to validate these results.
摘要：
背景和目的:阻塞性睡眠呼吸暂停(OSA)与心血管疾病的相关机制是多因素的,涉及间歇性缺氧，高碳酸血症,和同情的激活。这项研究的目的是探索OSA患者在整个晚上的睡眠呼吸暂停发作期间交感神经活动的振荡。材料和方法：参与者接受了通宵多导睡眠图（PSG），收集PSG的心电图（EKG）数据进行心率变异性（HRV）分析。在时域和频域中进行HRV测量。正常心跳（RMSSD）之间的连续差异的均方根，反映了副交感神经活动，以及低频带的绝对功率（0.04-0.15Hz）与高频带的绝对功率（0.015-0.4Hz）之比（LF/HF比），这表明交感神经活动，是计算的。结果：共有43名参与者（35名男性和8名女性）被纳入分析。参与者的平均年龄为44.1±11.3岁，平均BMI为28.6±5.4kg/m2。OSA患者整晚的睡眠呼吸暂停发作是随机选择的，在非REM阶段最常见（39，90.7％）。选定的睡眠呼吸暂停发作通常表现出多个呼吸暂停，通常被打鼾呼吸打断，然后在发作结束时换气过度（HE）。我们的研究结果表明，5分钟HRV窗口的中心为最低和最高的LF/HF比率，在睡眠开始后111.8±88.2和117.4±88.6分钟，分别,差异有统计学意义(p<0.001)。同样，最低和最高的LF/HF的比率，分别为0.82±0.56和3.53±2.94，表现出统计学上的显著差异(p<0.001)。结论：在当前的研究中，OSA患者整晚选定的睡眠呼吸暂停发作主要发生在非REM阶段.此外,我们观察到交感神经活动在包括呼吸暂停末期过度通气的窗口中达到峰值，潜在的心血管风险。然而,需要更多的研究来验证这些结果.
