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阻塞性睡眠呼吸暂停对累积副交感神经系统活动影响的初步研究。

A preliminary study on the influence of obstructive sleep apnea upon cumulative parasympathetic system activity.

作者信息

Tabata Ryoko, Yin Min, Nakayama Meiho, Ikeda Maiko, Hata Tomoko, Shibata Yutaka, Itasaka Yoshiaki, Ishikawa Kazuo, Okawa Masako, Miyazaki Soichiro

机构信息

Division of Adult Nursing, Department of Clinical Nursing, Shiga University of Medical Science, Seta, Otsu 520-2192, Japan.

出版信息

Auris Nasus Larynx. 2008 Jun;35(2):242-6. doi: 10.1016/j.anl.2007.11.001. Epub 2008 Jan 31.

Abstract

OBJECTIVE

Although the autonomic nervous system plays a key role in mediating cardiovascular changes during obstructive sleep apnea (OSA), parasympathetic nervous system (PNS) activity during sleep apnea has not yet been sufficiently investigated. This study is to discuss the relationship between PNS activity and OSA.

METHODS

Polysomnography recording was carried out in 76 patients (71 male and 5 female) with OSA. Cumulative PNS activity during sleep for each patient was derived from time series data of electrocardiogram (ECG) and analyzed by coarse graining spectral analysis of heart rate variability. The correlation between cumulative PNS activity and apnea-hypopnea index (AHI) was then discussed.

RESULTS

Cumulative PNS activity and PNS peaks during sleep were lowly but significantly correlated with OSA severity (r=-0.344, p<0.005; and r=-0.266, p<0.05 respectively), and a linear regression equation could be established. Furthermore, significant correlation was also observed in the adult groups and in the moderate and severe groups, but not in the juvenile and the elderly and mild groups.

CONCLUSION

These findings indicated that PNS function was obviously influenced by OSA during sleep. Cumulative PNS activity level might also serve as a useful parameter for the evaluation of OSA.

摘要

目的

尽管自主神经系统在阻塞性睡眠呼吸暂停(OSA)期间介导心血管变化中起关键作用,但睡眠呼吸暂停期间副交感神经系统(PNS)的活动尚未得到充分研究。本研究旨在探讨PNS活动与OSA之间的关系。

方法

对76例OSA患者(71例男性,5例女性)进行多导睡眠图记录。每位患者睡眠期间的累积PNS活动来自心电图(ECG)的时间序列数据,并通过心率变异性的粗粒化频谱分析进行分析。然后讨论累积PNS活动与呼吸暂停低通气指数(AHI)之间的相关性。

结果

睡眠期间的累积PNS活动和PNS峰值与OSA严重程度呈低度但显著相关(分别为r = -0.344,p < 0.005;r = -0.266,p < 0.05),并且可以建立线性回归方程。此外,在成年组以及中度和重度组中也观察到显著相关性,但在青少年、老年人和轻度组中未观察到。

结论

这些发现表明睡眠期间PNS功能明显受OSA影响。累积PNS活动水平也可能作为评估OSA的有用参数。

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