Riedl Maik, Müller Andreas, Kraemer Jan F, Penzel Thomas, Kurths Juergen, Wessel Niels
Cardiovascular Physics, Department of Physics, Humboldt-Universität zu Berlin, Berlin, Germany.
Department for Cardiology, Sleep Medicine Centre, Charité Universitätsmedizin Berlin, Berlin, Germany.
PLoS One. 2014 Apr 9;9(4):e93866. doi: 10.1371/journal.pone.0093866. eCollection 2014.
Cardiovascular diseases are the main source of morbidity and mortality in the United States with costs of more than $170 billion. Repetitive respiratory disorders during sleep are assumed to be a major cause of these diseases. Therefore, the understanding of the cardio-respiratory regulation during these events is of high public interest. One of the governing mechanisms is the mutual influence of the cardiac and respiratory oscillations on their respective onsets, the cardio-respiratory coordination (CRC). We analyze this mechanism based on nocturnal measurements of 27 males suffering from obstructive sleep apnea syndrome. Here we find, by using an advanced analysis technique, the cardiogram, not only that the occurrence of CRC is significantly more frequent during respiratory sleep disturbances than in normal respiration (p-value<10(-51)) but also more frequent after these events (p-value<10(-15)). Especially, the latter finding contradicts the common assumption that spontaneous CRC can only be observed in epochs of relaxed conditions, while our newly discovered epochs of CRC after disturbances are characterized by high autonomic stress. Our findings on the connection between CRC and the appearance of sleep-disordered events require a substantial extension of the current understanding of obstructive sleep apneas and hypopneas.
心血管疾病是美国发病和死亡的主要原因，花费超过1700亿美元。睡眠期间反复出现的呼吸紊乱被认为是这些疾病的主要原因。因此，了解这些事件期间的心肺调节具有很高的公众关注度。其中一个控制机制是心脏和呼吸振荡对其各自起始的相互影响，即心肺协调（CRC）。我们基于对27名患有阻塞性睡眠呼吸暂停综合征男性的夜间测量来分析这一机制。在此我们发现，通过使用先进的分析技术心电图，不仅CRC的发生在呼吸睡眠障碍期间比正常呼吸时显著更频繁（p值<10^(-51)），而且在这些事件之后也更频繁（p值<10^(-15)）。特别是，后一个发现与普遍假设相矛盾，即自发性CRC只能在放松状态的时段观察到，而我们新发现的干扰后CRC时段的特征是高自主神经应激。我们关于CRC与睡眠障碍事件出现之间联系的发现需要大幅扩展目前对阻塞性睡眠呼吸暂停和呼吸不足的理解。
