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阻塞性睡眠呼吸暂停相关的睡眠出汗:与睡眠阶段和血压的关系。

Sleep-related sweating in obstructive sleep apnoea: association with sleep stages and blood pressure.

机构信息

Department of Respiratory Medicine and Sleep, Landspitali University Hospital, Reykjavik, Iceland.

出版信息

J Sleep Res. 2010 Mar;19(1 Pt 2):122-30. doi: 10.1111/j.1365-2869.2009.00743.x. Epub 2009 Jul 22.

DOI:10.1111/j.1365-2869.2009.00743.x
PMID:19635063
Abstract

The aim of this study was to investigate sleep-related sweating as a symptom of obstructive sleep apnoea (OSA). Fifteen otherwise healthy male non-smoking patients with untreated moderate-to-severe OSA underwent polysomnography, including measurements of skin and core body temperature and electrodermal activity (EDA) as an objective indicator of sweating. Evening and morning blood pressure was measured as well as catecholamines in nocturnal urine. All measurements were repeated after 3 months on successful continuous positive airway pressure (CPAP) treatment. The untreated OSA subjects had a mean (+/-SD) apnoea-hypopnoea index of 45.3 +/- 3.9 and a mean EDA index during sleep of 131.9 +/- 22.4 events per hour. Patients with higher EDA indices had higher systolic blood pressure in the evening and morning (P = 0.001 and 0.006) and lower rapid eye movement (REM) sleep percentage (P = 0.003). The EDA index decreased significantly to 78.5 +/- 17.7 in the patients on CPAP treatment (P = 0.04). The decrease correlated with lower evening systolic and diastolic blood pressure (P = 0.05 and 0.006) and an increase in REM% (P = 0.02). No relationship was observed between EDA and skin or core body temperature, or to catecholamine levels in urine. OSA patients who experience sleep-related sweating may have increased blood pressure and decreased REM sleep compared with other OSA patients. CPAP treatment appears to lower blood pressure and increase REM sleep to a higher extent in these patients compared with other OSA patients.

摘要

本研究旨在探讨睡眠相关出汗作为阻塞性睡眠呼吸暂停(OSA)的症状。15 名未经治疗的中重度 OSA 且无吸烟史的健康男性非吸烟者接受了多导睡眠图检查,包括皮肤和核心体温以及皮肤电活动(EDA)的测量,后者作为出汗的客观指标。还测量了夜间和清晨血压以及夜间尿中的儿茶酚胺。所有测量均在成功接受持续气道正压通气(CPAP)治疗 3 个月后重复进行。未经治疗的 OSA 患者的呼吸暂停低通气指数平均(+/-SD)为 45.3 +/- 3.9,睡眠期间 EDA 指数平均为 131.9 +/- 22.4 次/小时。EDA 指数较高的患者在傍晚和清晨的收缩压较高(P = 0.001 和 0.006),快速眼动(REM)睡眠百分比较低(P = 0.003)。CPAP 治疗后患者的 EDA 指数显著下降至 78.5 +/- 17.7(P = 0.04)。下降与傍晚收缩压和舒张压降低(P = 0.05 和 0.006)以及 REM%增加相关(P = 0.02)。未观察到 EDA 与皮肤或核心体温或尿液中儿茶酚胺水平之间存在关系。与其他 OSA 患者相比,经历睡眠相关出汗的 OSA 患者可能存在血压升高和 REM 睡眠减少。与其他 OSA 患者相比,CPAP 治疗似乎可以在这些患者中更有效地降低血压并增加 REM 睡眠。

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