Sleep Medicine Center, Department for Cardiology, Charité Universitätsmedizin Berlin, Charitéplatz 1, D-10117, Berlin, Germany.
Comput Biol Med. 2012 Mar;42(3):328-34. doi: 10.1016/j.compbiomed.2011.09.001. Epub 2011 Sep 21.
Obstructive sleep apnea (OSA) is a sleep disorder with a high prevalence that causes pathological changes in cardiovascular regulation during the night and also during daytime. We investigated whether the treatment of OSA at night by means of continuous positive airway pressure (CPAP) improves the daytime consequences. Twenty-eight patients with OSA, 18 with arterial hypertension, 10 with normal blood pressure, were investigated at baseline and with three months of CPAP treatment. Ten age and sex matched healthy control subjects were investigated for comparisons. We recorded a resting period with 20min quiet breathing and an exercise stress test during daytime with ECG and blood pressure (Portapres). The bicycle ergometry showed a significant reduction of the diastolic blood pressure at a work load of 50W and 100W (p<0.05 and p<0.01, respectively) and a decrease of the heart rate recovery time after the stress test (p<0.05). These results indicate a reduction of vascular resistance and sympathetic activity during daytime. The coupling analysis of the resting periods by means of symbolic coupling traces approach indicated an effect of the CPAP therapy on the baroreflex reaction in hypertensive patients where influences of the systolic blood pressure on the heart rate changed from pathological patterns to adaptive mechanisms of the normotensive patients (p<0.05).
阻塞性睡眠呼吸暂停（OSA）是一种高患病率的睡眠障碍，它会导致心血管调节在夜间和白天发生病理性变化。我们研究了通过持续气道正压通气（CPAP）治疗夜间 OSA 是否能改善白天的后果。我们在基线和 CPAP 治疗三个月时对 28 例 OSA 患者、18 例高血压患者和 10 例血压正常患者进行了研究。还对 10 名年龄和性别匹配的健康对照者进行了调查，以进行比较。我们记录了白天静息期的 20 分钟安静呼吸和心电图及血压（Portapres）的运动应激测试。在 50W 和 100W 的工作负荷下，自行车测力计显示舒张压显著降低（分别为 p<0.05 和 p<0.01），应激试验后心率恢复时间缩短（p<0.05）。这些结果表明白天血管阻力和交感神经活动减少。通过符号耦合迹线方法对静息期的耦合分析表明，CPAP 治疗对高血压患者的压力反射反应有影响，其中收缩压对心率的影响从病理性模式转变为正常血压患者的适应性机制（p<0.05）。
