Tulen J H, Man in 't Veld A J, van Steenis H G, Mechelse K
Department of Psychiatry, University Hospital Dijkzigt, Rotterdam, The Netherlands.
Clin Auton Res. 1991 Dec;1(4):309-15. doi: 10.1007/BF01819837.
Sleep patterns and 24-h blood pressure variability were studied in four female patients (age range: 56-82 years) with pure autonomic failure. All patients had severe symptomatic postural hypotension, without neurological deficits. In these patients the following patterns were observed: (i) a reversed diurnal blood pressure pattern, with the highest values observed at sleep onset; (ii) a prolonged sleep latency and increased amount of stage 3 sleep; (iii) difficulty with getting up after awakening in the morning, due to severe postural hypotension; (iv) an absence of prominent respiratory abnormalities during sleep; and (v) a dissociation between respiratory and haemodynamic findings. It is concluded that isolated deficiency of presumed postganglionic autonomic function influences sleep architecture, probably through absence of buffering of diurnal haemodynamic alterations, such as by postural hypotension and its consequences for body fluid volume regulation. This may be of relevance when sleep patterns are studied in other types of autonomic failure with postural hypotension involving central or preganglionic lesions, as in patients with the Shy-Drager syndrome or multiple system atrophy.
对4名患有单纯自主神经功能衰竭的女性患者（年龄范围：56 - 82岁）的睡眠模式和24小时血压变异性进行了研究。所有患者均有严重的症状性体位性低血压，无神经功能缺损。在这些患者中观察到以下模式：（i）昼夜血压模式颠倒，睡眠开始时血压值最高；（ii）睡眠潜伏期延长，3期睡眠时间增加；（iii）由于严重的体位性低血压，早晨醒来后起床困难；（iv）睡眠期间无明显呼吸异常；（v）呼吸和血流动力学结果之间无相关性。得出的结论是，推测的节后自主神经功能的孤立缺陷可能通过缺乏对昼夜血流动力学改变的缓冲作用（如体位性低血压及其对体液容量调节的影响）来影响睡眠结构。当在其他类型的伴有体位性低血压的自主神经功能衰竭（如夏伊-德雷格综合征或多系统萎缩患者）中研究睡眠模式时，这可能具有相关性。
