Abstract:
Breathing and sleep state are tightly linked. The traditional approach to evaluation of breathing in rapid eye movement sleep has been to focus on apneas and hypopneas, and associated hypoxia or hypercapnia. However, rapid eye movement sleep breathing offers novel insights into sleep physiology and pathology, secondary to complex interactions of rapid eye movement state and cardiorespiratory biology. In this review, morphological analysis of clinical polysomnogram data to assess respiratory patterns and associations across a range of health and disease is presented. There are several relatively unique insights that may be evident by assessment of breathing during rapid eye movement sleep. These include the original discovery of rapid eye movement sleep and scoring of neonatal sleep, control of breathing in rapid eye movement sleep, rapid eye movement sleep homeostasis, sleep apnea endotyping and pharmacotherapy, rapid eye movement sleep stability, non-electroencephalogram sleep staging, influences on cataplexy, mimics of rapid eye movement behaviour disorder, a reflection of autonomic health, and insights into cardiac arrhythmogenesis. In summary, there is rich clinically actionable information beyond sleep apnea encoded in the respiratory patterns of rapid eye movement sleep.
摘要:
睡眠和呼吸是紧密相连的。在快速眼动睡眠中评估呼吸的传统方法是专注于呼吸暂停和呼吸不足,以及相关的缺氧或高碳酸血症。然而,快速眼动睡眠呼吸为睡眠生理学和病理学提供了新的见解,继发于快速眼动状态和心肺生物学的复杂相互作用。在这次审查中,介绍了临床多导睡眠图数据的形态学分析,以评估一系列健康和疾病的呼吸模式和关联。通过评估快速眼动睡眠期间的呼吸,可以明显看出几种相对独特的见解。其中包括最初发现的快速眼动睡眠和新生儿睡眠评分,在快速眼动睡眠中控制呼吸,快速眼动睡眠稳态,睡眠呼吸暂停内分型和药物治疗,快速眼动睡眠稳定,非脑电图睡眠分期,对猝倒的影响,模仿快速眼动行为障碍,自主健康的反映,以及对心律失常发生的见解。总之,在快速眼动睡眠的呼吸模式中编码的睡眠呼吸暂停之外,有丰富的临床可操作信息。