Jain Vivek, Marbach Joseph, Kimbro Shawn, Andrade David C, Jain Arad, Capozzi Eleanor, Mele Kyle, Del Rio Rodrigo, Kay Matthew W, Mendelowitz David
Department of Medicine, The George Washington University, Washington, District of Columbia.
Department of Biomedical Engineering, The George Washington University, Washington, District of Columbia.
Am J Physiol Lung Cell Mol Physiol. 2017 Nov 1;313(5):L825-L833. doi: 10.1152/ajplung.00206.2017. Epub 2017 Aug 10.
Activation of oxytocin receptors has shown benefits in animal models of obstructive sleep apnea (OSA). We tested if nocturnal oxytocin administration could have beneficial effects in OSA patients. Eight patients diagnosed with OSA were administered intranasal oxytocin (40 IU). Changes in cardiorespiratory events during sleep, including apnea and hypopnea durations and frequency, risk of event-associated arousals, and heart rate variability, were assessed. Oxytocin significantly increased indexes of parasympathetic activity, including heart rate variability, total sleep time, and the postpolysommogram sleep assessment score, an index of self-reported sleep satisfaction. Although the apnea-hypopnea index was not significantly changed with oxytocin administration, when apnea and hypopnea events were compared independently, the frequency of hypopneas, but not apneas, was significantly ( ≤ 0.005) decreased with oxytocin treatment. Both apneas and hypopneas were significantly shortened in duration with oxytocin treatment. Oxytocin treatment significantly decreased the percent of apnea and hypopnea events that were accompanied with an arousal. Oxytocin administration has the potential to restore cardiorespiratory homeostasis and reduce some clinically important (objective and patient-reported) adverse events that occur with OSA. Additional studies are needed to further understand the mechanisms by which oxytocin promotes these changes in cardiorespiratory and autonomic function in OSA patients.
在阻塞性睡眠呼吸暂停（OSA）动物模型中，催产素受体激活已显示出有益效果。我们测试了夜间给予催产素对OSA患者是否有有益作用。八名被诊断为OSA的患者接受了鼻内催产素（40 IU）治疗。评估了睡眠期间心肺事件的变化，包括呼吸暂停和呼吸浅慢的持续时间和频率、事件相关觉醒的风险以及心率变异性。催产素显著增加了副交感神经活动指标，包括心率变异性、总睡眠时间以及多导睡眠图后睡眠评估分数，后者是自我报告睡眠满意度的指标。尽管给予催产素后呼吸暂停低通气指数没有显著变化，但当独立比较呼吸暂停和呼吸浅慢事件时，催产素治疗使呼吸浅慢的频率显著（≤0.005）降低，而呼吸暂停频率未降低。催产素治疗使呼吸暂停和呼吸浅慢的持续时间均显著缩短。催产素治疗显著降低了伴有觉醒的呼吸暂停和呼吸浅慢事件的百分比。给予催产素有可能恢复心肺稳态，并减少OSA患者出现的一些临床上重要的（客观和患者报告的）不良事件。需要进一步研究以深入了解催产素促进OSA患者心肺和自主神经功能发生这些变化的机制。
