Bisogni Valeria, Pengo Martino F, Drakatos Panagis, Maiolino Giuseppe, Kent Brian, Rossitto Giacomo, Steier Joerg, Rossi Gian Paolo
Clinica dell'Ipertensione Arteriosa, Dept. of Medicine-DIMED, University of Padua, Italy.
Clinica dell'Ipertensione Arteriosa, Dept. of Medicine-DIMED, University of Padua, Italy.
Int J Cardiol. 2017 Jun 1;236:458-461. doi: 10.1016/j.ijcard.2017.01.149. Epub 2017 Feb 2.
Increased arterial stiffness and sympathetic nervous system activity, independent markers of cardiovascular risk, are common in patients with severe obstructive sleep apnoea, who have excessive daytime sleepiness. Among patients with mild-to-moderate obstructive sleep apnoea, however, it remains unknown whether arterial stiffness and/or increased sympathetic nervous system activity correlate with excessive daytime sleepiness.
We measured heart rate variability, as an index of autonomic nervous system activity, and arterial stiffness index, as a marker of vascular damage and cardiovascular risk, in 56 men aged 18 to 75years, with mild-to-moderate obstructive sleep apnoea, and matched into two groups, "sleepy" (Epworth Sleepiness Scale≥10) and "non-sleepy" (Epworth Sleepiness Scale<10).
We found no association of excessive daytime sleepiness with sympathetic nervous system activation (very low frequency power 18,947±11,207msvs 15,893±8,272ms, p=0.28; low frequency (LH) power 17,753±8,441msvs 15,414±5,666ms, p=0.26; high frequency (HF) power 7,527±1,979msvs 8,257±3,416ms, p=0.36; LF/HF ratio 3.04±1.37 vs 2.55±1.01, p=0.15) and mean arterial stiffness index (6.97±0.83 vs 7.26±0.66, p=0.18) in mild-to-moderate obstructive sleep apnoea patients.
Symptoms of excessive daytime sleepiness are not associated with sympathetic nervous system activation and arterial stiffness in male subjects with mild-to-moderate obstructive sleep apnoea.
动脉僵硬度增加和交感神经系统活动增强是心血管风险的独立指标，在患有严重阻塞性睡眠呼吸暂停且白天过度嗜睡的患者中很常见。然而，在轻度至中度阻塞性睡眠呼吸暂停患者中，动脉僵硬度和/或交感神经系统活动增加是否与白天过度嗜睡相关尚不清楚。
我们测量了56名年龄在18至75岁、患有轻度至中度阻塞性睡眠呼吸暂停的男性的心率变异性（作为自主神经系统活动的指标）和动脉僵硬度指数（作为血管损伤和心血管风险的标志物），并将其分为两组：“嗜睡组”（爱泼沃斯嗜睡量表≥10）和“非嗜睡组”（爱泼沃斯嗜睡量表<10）。
我们发现，在轻度至中度阻塞性睡眠呼吸暂停患者中，白天过度嗜睡与交感神经系统激活（极低频功率18,947±11,207毫秒对15,893±8,272毫秒，p=0.28；低频（LH）功率17,753±8,441毫秒对15,414±5,666毫秒，p=0.26；高频（HF）功率7,527±1,979毫秒对8,257±3,416毫秒，p=0.36；LF/HF比值3.04±1.37对2.55±1.01，p=0.15）和平均动脉僵硬度指数（6.97±0.83对7.26±0.66，p=0.18）均无关联。
在患有轻度至中度阻塞性睡眠呼吸暂停的男性受试者中，白天过度嗜睡的症状与交感神经系统激活和动脉僵硬度无关。
