Morris Luc G T, Burschtin Omar, Setlur Jennifer, Bommelje Claire C, Lee Kelvin C, Jacobs Joseph B, Lebowitz Richard A
Department of Otolaryngology, New York University School of Medicine, New York, NY, USA.
Otolaryngol Head Neck Surg. 2008 Nov;139(5):619-23. doi: 10.1016/j.otohns.2008.08.017.
Obstructive sleep apnea events are more common in REM sleep, although there is no relationship between sleep phase and pharyngeal airway status. We studied the patency of the nasal airway during REM and non-REM sleep with the use of acoustic rhinometry.
Serial acoustic rhinometric assessment of nasal cross-sectional area was performed in 10 subjects, before sleep and during REM and non-REM sleep. All measurements were standardized to a decongested baseline with mean congestion factor (MCF).
MCF in the seated position was 10.6% (+/-3.7) and increased with supine positioning to 16.2% (+/-2.3). In REM sleep, MCF was highest, at 22.3% (+/-1.7). In non-REM sleep, MCF was lowest, at 2.3% (+/-3.1). All interstage comparisons were statistically significant on repeated measures ANOVA (P < 0.05).
REM sleep is characterized by significant nasal congestion; non-REM sleep, by profound decongestion. This phenomenon may be attributable to REM-dependent variation in cerebral blood flow that affects nasal congestion via the internal carotid system. REM-induced nasal congestion, an indirect effect of augmented cerebral perfusion, may contribute to the higher frequency of obstructive events in REM sleep.
阻塞性睡眠呼吸暂停事件在快速眼动睡眠期更为常见，尽管睡眠阶段与咽部气道状态之间并无关联。我们运用鼻声反射测量法研究了快速眼动睡眠期和非快速眼动睡眠期鼻腔气道的通畅情况。
对10名受试者在睡眠前、快速眼动睡眠期和非快速眼动睡眠期进行了系列鼻声反射测量，以评估鼻腔横截面积。所有测量均根据平均充血因子（MCF）标准化为去充血基线。
坐位时的MCF为10.6%（±3.7），仰卧位时升高至16.2%（±2.3）。在快速眼动睡眠期，MCF最高，为22.3%（±1.7）。在非快速眼动睡眠期，MCF最低，为2.3%（±3.1）。重复测量方差分析显示，所有阶段间比较均具有统计学意义（P < 0.05）。
快速眼动睡眠期的特征是明显的鼻腔充血；非快速眼动睡眠期则是显著的鼻腔充血减轻。这种现象可能归因于依赖快速眼动睡眠的脑血流变化，其通过颈内动脉系统影响鼻腔充血。快速眼动睡眠诱导的鼻腔充血是脑灌注增加的间接效应，可能导致快速眼动睡眠期阻塞性事件发生率更高。
