Cincin Altug, Sari Ibrahim, Oğuz Mustafa, Sert Sena, Bozbay Mehmet, Ataş Halil, Ozben Beste, Tigen Kursat, Basaran Yelda
Department of Cardiology, Marmara University Faculty of Medicine, Pendik, Istanbul, Turkey,
Sleep Breath. 2015 May;19(2):631-6. doi: 10.1007/s11325-014-1066-x. Epub 2014 Oct 16.
Sleep deprivation (SD) is known to be associated with increased incidence of adverse cardiovascular events, but underlying pathophysiological mechanism has not been clearly demonstrated. Autonomic nervous system plays an important role in the regulation of cardiovascular function, and impairment in this system is associated with increased cardiovascular mortality. The aim of the current study was to investigate the effect of acute SD on autonomic regulation of cardiac function by determining heart rate recovery (HRR).
Twenty-one healthy security officers and nine nurses (mean age 33.25 ± 8.18) were evaluated. Treadmill exercise test was applied once after a night with regular sleep and once after a night shift in hospital. The HRR was calculated as the reduction in heart rate from peak exercise to the 30th second (HRR30), 1st minute (HRR1), 2nd minute (HRR2), 3rd minute (HRR3), and 5th minute (HRR5). The change in blood pressure (BP) measurements was also determined.
Exercise capacity of individuals with SD was significantly lower (10.96 ± 1.01 vs. 11.71 ± 1.30 metabolic equivalent task (MET)s; p = 0.002), and peak systolic BP was significantly higher (173.8 ± 16.3 vs. 166.2 ± 9.9; p = 0.019). There was a signicant difference in HRR30 (12.74 ± 6.19 vs. 17.66 ± 5.46; p = 0.003) and HRR1 (31 ± 6.49 vs. 36.10 ± 7.78; p = 0.004). The ratio of these indices to peak HR was also significantly lower with SD (HRR%30 8.04 ± 4.26 vs. 10.19 ± 3.21; p = 0.025 and HRR%1: 18.66 ± 4.43 vs. 20.98 ± 4.72; p = 0.013). The difference in other indices of HRR was not significant.
Our findings suggest that SD blunts cardiovascular autonomic response, and consequences of this relation might be more pronounced in subjects who are exposed to sleeplessness regularly or in subjects with baseline cardiovascular disease.
已知睡眠剥夺(SD)与不良心血管事件发生率增加有关,但其潜在的病理生理机制尚未得到明确证实。自主神经系统在心血管功能调节中起重要作用,该系统受损与心血管死亡率增加有关。本研究的目的是通过测定心率恢复(HRR)来研究急性睡眠剥夺对心脏功能自主调节的影响。
对21名健康保安人员和9名护士(平均年龄33.25±8.18)进行评估。在正常睡眠一晚后和医院值夜班一晚后分别进行一次跑步机运动试验。HRR计算为运动峰值至第30秒(HRR30)、第1分钟(HRR1)、第2分钟(HRR2)、第3分钟(HRR3)和第5分钟(HRR5)时心率的下降值。还测定了血压(BP)测量值的变化。
睡眠剥夺个体的运动能力显著降低(10.96±1.01与11.71±1.30代谢当量任务(MET);p = 0.002),收缩压峰值显著升高(173.8±16.3与166.2±9.9;p = 0.019)。HRR30(12.74±6.19与17.66±5.46;p = 0.003)和HRR1(31±6.49与36.10±7.78;p = 0.004)存在显著差异。睡眠剥夺时这些指标与心率峰值的比值也显著降低(HRR%30 8.04±4.26与10.19±3.21;p = 0.025和HRR%1:18.66±4.43与20.98±4.72;p = 0.013)。HRR的其他指标差异不显著。
我们的研究结果表明,睡眠剥夺会削弱心血管自主反应,这种关系的后果在经常失眠的受试者或患有基线心血管疾病的受试者中可能更为明显。