Aldrich M, Eiser A, Lee M, Shipley J E
Department of Neurology, University of Michigan Medical Center, Ann Arbor 48109-0316.
Sleep. 1989 Oct;12(5):413-9. doi: 10.1093/sleep/12.5.413.
In patients with obstructive sleep apnea and associated rapid-eye-movement (REM) sleep deprivation and disruption, the first night of nasal continuous positive airway pressure (CPAP) is often associated with increases in REM sleep time and REM density (REM rebound). The amount of REM rebound, however, varies considerably. We sought to characterize the magnitude of REM rebound and to determine what factors determine individual differences in REM rebound with initial CPAP treatment. Twenty-six patients with sleep apnea had a baseline nocturnal polysomnogram and a second night with a trial of CPAP. REM sleep time increased by 69% with CPAP, REM density increased by 73%, and REM activity by 169%. REM density was highest in the second REM period. Improvement in respiratory disturbance index with CPAP correlated significantly with increased minutes of REM sleep with CPAP. Of polysomnographic measures on the baseline night, change in minutes of REM sleep with CPAP correlated best with minimum oxygen saturation and to a lesser degree with respiratory disturbance index, and minutes of Stage 1 sleep. One possible explanation for the effect of hypoxemia on subsequent REM rebound is that some physiological functions of REM sleep may fail when oxygen saturation falls below a certain level.
在患有阻塞性睡眠呼吸暂停以及相关快速眼动（REM）睡眠剥夺和紊乱的患者中，鼻持续气道正压通气（CPAP）治疗的第一晚通常与REM睡眠时间增加和REM密度增加（REM反弹）相关。然而，REM反弹的程度差异很大。我们试图描述REM反弹的幅度，并确定在初始CPAP治疗中，哪些因素决定了REM反弹的个体差异。26名睡眠呼吸暂停患者进行了基线夜间多导睡眠图检查，并在第二晚进行了CPAP试验。使用CPAP后，REM睡眠时间增加了69%，REM密度增加了73%，REM活动增加了169%。REM密度在第二个REM期最高。CPAP治疗后呼吸紊乱指数的改善与使用CPAP时REM睡眠时间增加显著相关。在基线夜间的多导睡眠图测量中，使用CPAP时REM睡眠时间的变化与最低血氧饱和度相关性最好，与呼吸紊乱指数以及1期睡眠时间的相关性较小。低氧血症对随后REM反弹产生影响的一种可能解释是，当血氧饱和度低于一定水平时，REM睡眠的某些生理功能可能会失效。
