Jurysta F, Lanquart J-P, van de Borne P, Migeotte P-F, Dumont M, Degaute J-P, Linkowski P
Sleep Laboratory, Department of Psychiatry, Erasmus Academic Hospital, Free University of Brussels, 1070 Brussels, Belgium.
Am J Physiol Regul Integr Comp Physiol. 2006 Oct;291(4):R1165-71. doi: 10.1152/ajpregu.00787.2005. Epub 2006 May 4.
We hypothesize that sleep apnea-hypopnea alters interaction between cardiac vagal modulation and sleep delta EEG. Sleep apnea-hypopnea syndrome (SAHS) is related to cardiovascular complications in men. SAHS patients show higher sympathetic activity than normal subjects. In healthy men, non-rapid eye movement (NREM) sleep is associated with cardiac vagal influence, whereas rapid eye movement (REM) sleep is linked to cardiac sympathetic activity. Interaction between cardiac autonomic modulation and delta sleep EEG is not altered across a life span nor is the delay between appearances of modifications in both signals. Healthy controls, moderate SAHS, and severe SAHS patients were compared across the first three NREM-REM cycles. Spectral analysis was applied to ECG and EEG signals. High frequency (HF) and low frequency (LF) of heart rate variability (HRV), ratio of LF/HF, and normalized (nu) delta power were obtained. A coherency analysis between HF(nu) and delta was performed, as well as a correlation analysis between obstructive apnea index (AI) or hypopnea index (HI) and gain, coherence, or phase shift. HRV components were similar between groups. In each group, HF(nu) was larger during NREM, while LF(nu) predominated across REM and wake stages. Coherence and gain between HF(nu) and delta decreased from controls to severe SAHS patients. In SAHS patients, the delay between modifications in HF(nu) and delta did not differ from zero. AI and HI correlated negatively with coherence, while HI correlated negatively with gain only. Apneas-hypopneas affect the link between cardiac sympathetic and vagal modulation and delta EEG demonstrated by the loss of cardiac autonomic activity fluctuations across shifts in sleep stages. Obstructive apneas and hypopneas alter the interaction between both signals differently.
我们推测睡眠呼吸暂停低通气会改变心脏迷走神经调制与睡眠δ波脑电图之间的相互作用。睡眠呼吸暂停低通气综合征（SAHS）与男性心血管并发症有关。SAHS患者的交感神经活动高于正常受试者。在健康男性中，非快速眼动（NREM）睡眠与心脏迷走神经影响有关，而快速眼动（REM）睡眠与心脏交感神经活动有关。心脏自主神经调制与δ波睡眠脑电图之间的相互作用在整个生命周期中不会改变，两个信号变化出现的延迟也不会改变。在前三个NREM - REM周期中对健康对照者、中度SAHS患者和重度SAHS患者进行了比较。对心电图和脑电图信号进行了频谱分析。获得了心率变异性（HRV）的高频（HF）和低频（LF）、LF/HF比值以及标准化（nu）δ波功率。进行了HF（nu）与δ波之间的相干性分析，以及阻塞性呼吸暂停指数（AI）或呼吸浅慢指数（HI）与增益、相干性或相移之间的相关性分析。各组之间的HRV成分相似。在每组中，HF（nu）在NREM期间较大，而LF（nu）在REM和清醒阶段占主导。从对照组到重度SAHS患者，HF（nu）与δ波之间的相干性和增益降低。在SAHS患者中，HF（nu）和δ波变化之间的延迟与零无差异。AI和HI与相干性呈负相关，而HI仅与增益呈负相关。呼吸暂停 - 低通气通过睡眠阶段转换时心脏自主神经活动波动的丧失影响心脏交感神经和迷走神经调制与δ波脑电图之间的联系。阻塞性呼吸暂停和低通气对两个信号之间相互作用的改变有所不同。
