Stoohs R, Guilleminault C
Sleep Disorders Clinic and Research Center, Stanford University School of Medicine, California 94305.
J Appl Physiol (1985). 1992 Feb;72(2):583-9. doi: 10.1152/jappl.1992.72.2.583.
Five men free of lung or cardiovascular diseases and with severe obstructive sleep apnea participated in a study on the impact of sleep states on cardiovascular variables during sleep apneas. A total of 128 obstructive apneas [72 from stage 2 non-rapid-eye-movement (NREM) sleep and 56 from rapid-eye-movement (REM) sleep] were analyzed. Each apnea was comprised of an obstructive period (OP) followed by a hyperventilation period, which was normally associated with an arousal. Heart rate (HR), stroke volume (SV), cardiac output (CO) (determined with an electrical impedance system), radial artery blood pressures (BP), esophageal pressure nadir, and arterial O2 saturation during each OP and hyperventilation period were calculated for NREM and REM sleep. During stage 2 NREM sleep, the lowest HR always occurred during the first third of the OP, and the highest was always seen during the last third. In contrast, during REM sleep the lowest HR was always noted during the last third of the OP. There was an inverse correlation when the percentage of change in HR over the percentage of change in SV during an OP was considered. The HR and SV changes during NREM sleep allowed maintenance of a near-stable CO during OPs. During REM sleep, absence of a compensatory change in SV led to a significant drop in CO. Systolic, diastolic, and mean BP always increased during the studied OPs.(ABSTRACT TRUNCATED AT 250 WORDS)
五名无肺部或心血管疾病且患有严重阻塞性睡眠呼吸暂停的男性参与了一项关于睡眠呼吸暂停期间睡眠状态对心血管变量影响的研究。共分析了128次阻塞性呼吸暂停[72次来自非快速眼动（NREM）睡眠第2阶段，56次来自快速眼动（REM）睡眠]。每次呼吸暂停均由一个阻塞期（OP）和随后的过度通气期组成，过度通气期通常与一次觉醒相关。计算了NREM和REM睡眠期间每次OP和过度通气期的心率（HR）、每搏输出量（SV）、心输出量（CO）（通过电阻抗系统测定）、桡动脉血压（BP）、食管压力最低点和动脉血氧饱和度。在NREM睡眠第2阶段，最低心率总是出现在OP的前三分之一期间，最高心率总是出现在最后三分之一期间。相比之下，在REM睡眠期间，最低心率总是在OP的最后三分之一期间出现。当考虑OP期间HR变化百分比与SV变化百分比的相关性时，两者呈负相关。NREM睡眠期间HR和SV的变化使得在OP期间CO维持在接近稳定的水平。在REM睡眠期间，SV缺乏代偿性变化导致CO显著下降。在所研究的OP期间，收缩压、舒张压和平均血压总是升高。（摘要截断于250字）
