夜间打鼾会降低白天压力感受器的敏感性。

Nocturnal snoring decreases daytime baroreceptor sensitivity.

作者信息

Schöbel Christoph, Fietze Ingo, Glos Martin, Schary Inett, Blau Alexander, Baumann Gert, Penzel Thomas

机构信息

Sleep Medicine Center, Charité Universitätsmedizin Berlin, Berlin, Germany; Center for Cardiology and Angiology, Charité Universitätsmedizin Berlin, Berlin, Germany.

Sleep Medicine Center, Charité Universitätsmedizin Berlin, Berlin, Germany.

出版信息

Respir Med. 2014 Jul;108(7):1049-55. doi: 10.1016/j.rmed.2014.03.012. Epub 2014 Apr 2.

DOI:10.1016/j.rmed.2014.03.012

PMID:24735916

Abstract

BACKGROUND

In patients with obstructive sleep apnea heart rate variability and baroreceptor sensitivity during night and daytime are impaired. Snoring without obstructive sleep apnea may already influence heart rate variability and baroreceptor sensitivity during daytime.

METHODS

Cardiovascular daytime testing was performed in 11 snorers and age, BMI, and gender matched controls. Sleep apnea and snoring were quantified by sleep recordings. Paced breathing was performed during daytime with ECG, non-invasive blood pressure, and respiration recorded. Heart rate variability and blood pressure variability were analyzed in the time and frequency domain. Baroreceptor sensitivity (alpha gain) was calculated.

RESULTS

In snorers a significant increase in high frequency systolic blood pressure variability (SBPV-HF) compared to control group (0.37 mm Hg(2) vs. 0.11 mm Hg(2) for 12 breaths and 0.35 mm Hg(2) vs. 0.10 mm Hg(2) for 15 breaths) was demonstrated. Furthermore a lower baroreceptor sensitivity was found in snorers compared to controls (9.2 ms/mm Hg vs. 16.2 ms/mm Hg for 12 breaths and 8.5 ms/mm Hg vs. 17.4 ms/mm Hg for 15 breaths per minute) using the paced breathing protocol. Mean heart rate was elevated in snorers as well.

CONCLUSIONS

Snorers may have a reduced parasympathetic tone during daytime rather than an increased sympathetic tone.

摘要

背景

阻塞性睡眠呼吸暂停患者夜间和白天的心率变异性及压力感受器敏感性受损。无阻塞性睡眠呼吸暂停的打鼾可能已影响白天的心率变异性和压力感受器敏感性。

方法

对11名打鼾者及年龄、BMI和性别匹配的对照组进行心血管日间测试。通过睡眠记录对睡眠呼吸暂停和打鼾进行量化。日间进行定频呼吸，同时记录心电图、无创血压和呼吸情况。在时域和频域分析心率变异性和血压变异性。计算压力感受器敏感性（α增益）。

结果

与对照组相比，打鼾者高频收缩压变异性（SBPV-HF）显著增加（12次呼吸时为0.37mmHg² 对0.11mmHg²，15次呼吸时为0.35mmHg² 对0.10mmHg²）。此外，使用定频呼吸方案时，与对照组相比，打鼾者的压力感受器敏感性较低（12次呼吸时为9.2ms/mm Hg对16.2ms/mm Hg，每分钟15次呼吸时为8.5ms/mm Hg对17.4ms/mm Hg）。打鼾者的平均心率也升高。