Sunbul Murat, Kanar Batur Gonenc, Durmus Erdal, Kivrak Tarik, Sari Ibrahim
Faculty of Medicine, Department of Cardiology, Marmara University, Fevzi Cakmak Mahallesi, Mimar Sinan Caddesi, No. 41, Pendik, Istanbul, Turkey,
Sleep Breath. 2014 Mar;18(1):215-20. doi: 10.1007/s11325-013-0873-9. Epub 2013 Jul 14.
Arterial stiffness and its hemodynamic consequences are known to be associated with increased cardiovascular morbidity and mortality. Pulse wave velocity (PWV) and augmentation index (AIx) are noninvasive indicators of the arterial stiffness and wave reflection. Sleep deprivation (SD) is known to be associated with increased incidence of adverse cardiovascular events. The aim of this study was to investigate whether there is an association between acute SD and arterial stiffness parameters in healthy adults, which has not been studied previously.
The study population consisted of 42 healthy volunteers (18 males, mean age 30.0 ± 4.5 years). Measurements of arterial stiffness were carried out by using a Mobil-O-Graph arteriograph system. Arterial stiffness measurements were obtained both after a night with regular sleep (RS) and after a night with SD.
Mean sleep time was significantly lower after the night of SD when compared after RS (0.73 ± 1.39 versus 7.33 ± 0.52 h, p<0.001). Peripheral systolic blood pressure, peripheral pulse pressure, and cardiac output were significantly higher after SD when compared after RS (p=0.032, 0.007, and 0.003, respectively). PWV was significantly higher (5.33 ± 0.46 versus 5.15 ± 0.26 m/s, p=0.001), and AIx was significantly lower (20.5 ± 11.9 versus 26.0 ± 8.4 %, p=0.008) after the night of SD when compared after the RS. While PWV was significantly higher (p=0.008), and AIx was significantly lower (p=0.039) in male subjects, only PWV was significantly higher (p=0.009) in female subjects. Sleep time correlated with AIx (p=0.034; r=0.233) and inversely correlated with PWV (p=0.044; r=-0.222).
In the present study, we demonstrated that even one night of SD is associated with increased arterial stiffness in healthy adults. The present findings suggest that adverse effects of SD on cardiovascular system might be at least in part due to increased arterial stiffness which needs to be tested with large-scale studies and in the chronic SD setting.
动脉僵硬度及其血流动力学后果与心血管疾病发病率和死亡率的增加有关。脉搏波速度（PWV）和增强指数（AIx）是动脉僵硬度和波反射的无创指标。已知睡眠剥夺（SD）与不良心血管事件的发生率增加有关。本研究的目的是调查健康成年人中急性睡眠剥夺与动脉僵硬度参数之间是否存在关联，此前尚未对此进行过研究。
研究人群包括42名健康志愿者（18名男性，平均年龄30.0±4.5岁）。使用Mobil-O-Graph动脉造影系统进行动脉僵硬度测量。在正常睡眠（RS）一晚后和睡眠剥夺一晚后均进行动脉僵硬度测量。
与正常睡眠后相比，睡眠剥夺一晚后的平均睡眠时间显著降低（0.73±1.39小时对7.33±0.52小时，p<0.001）。与正常睡眠后相比，睡眠剥夺后外周收缩压、外周脉压和心输出量显著升高（分别为p=0.032、0.007和0.003）。与正常睡眠后相比，睡眠剥夺一晚后PWV显著升高（5.33±0.46对5.15±0.26米/秒，p=0.001），AIx显著降低（20.5±11.9对26.0±8.4%，p=0.008）。男性受试者中PWV显著更高（p=0.008），AIx显著更低（p=0.039），而女性受试者中只有PWV显著更高（p=0.009）。睡眠时间与AIx相关（p=0.034；r=0.233），与PWV呈负相关（p=0.044；r=-0.222）。
在本研究中，我们证明即使一晚的睡眠剥夺也与健康成年人动脉僵硬度增加有关。目前的研究结果表明，睡眠剥夺对心血管系统的不良影响可能至少部分归因于动脉僵硬度增加，这需要在大规模研究和慢性睡眠剥夺环境中进行验证。
