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精神应激时阻塞性睡眠呼吸暂停患者静息和运动者的血管反应。

Vascular Response During Mental Stress in Sedentary and Physically Active Patients With Obstructive Sleep Apnea.

机构信息

Universidade de São Paulo, Escola de Artes Ciencias e Humanidades, São Paulo, São Paulo, Brazil.

Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brazil.

出版信息

J Clin Sleep Med. 2018 Sep 15;14(9):1463-1470. doi: 10.5664/jcsm.7314.

Abstract

STUDY OBJECTIVES

To compare vascular function of sedentary (SED) versus physically active (ACTIVE) patients with obstructive sleep apnea (OSA) during rest and mental stress.

METHODS

Patients with untreated OSA without other comorbidities were classified into SED and ACTIVE groups according to the International Physical Activity Questionnaire. Blood pressure (BP), heart rate (HR), forearm blood flow (FBF) (plethysmography), and forearm vascular conductance (FVC = FBF / mean BP × 100) were continuously measured at rest (4 minutes) followed by 3 minutes of mental stress (Stroop Color Word Test).

RESULTS

We studied 40 patients with OSA (men = 24, age = 50 ± 1 years, body mass index = 29.3 ± 0.5 kg/m, apnea-hypopnea index = 39.3 ± 4 events/h). Leisure time physical activity domain in SED (n = 19) and ACTIVE (n = 21) was 20 ± 8 and 239 ± 32 min/wk, ( < .05). Baseline profile and perception of stress were similar in both groups. Baseline FBF (3.5 ± 0.2 mL/min/100 mL versus 2.4 ± 0.14 mL/min/100 mL) and FVC (3.5 ± 0.2 U versus 2.3 ± 0.1 U) were significantly lower in the SED group than in the ACTIVE group, respectively ( < .05). HR and BP increased similarly during mental stress test in both groups. Changes during mental stress in FBF (0.65 ± 0.12 versus 1.04 ± 0.12) and FVC (0.58 ± 0.11 versus 0.99 ± 0.11) were significantly lower in the SED group than in the ACTIVE group, respectively ( < .05). There was a significant correlation between leisure time physical activity and FBF ( = .57, < .05) and FVC ( = .48, < .05) during mental stress.

CONCLUSIONS

The vascular response among patients with OSA is influenced by the level of physical activity. A high level of physical activity may partially protect against the cardiovascular dysfunction associated with OSA.

摘要

研究目的

比较静息和精神应激状态下,阻塞性睡眠呼吸暂停(OSA)伴或不伴躯体活动的患者的血管功能。

方法

根据国际体力活动问卷,将未经治疗且无其他合并症的 OSA 患者分为静息(SED)和活跃(ACTIVE)组。连续测量血压(BP)、心率(HR)、前臂血流(FBF)(容积描记法)和前臂血管传导率(FVC = FBF/平均 BP×100),静息状态下测量 4 分钟,然后进行 3 分钟的精神应激(Stroop 颜色词测试)。

结果

我们研究了 40 例 OSA 患者(男性 24 例,年龄 50±1 岁,体重指数 29.3±0.5kg/m,呼吸暂停低通气指数 39.3±4 次/小时)。SED(n=19)和 ACTIVE(n=21)的闲暇时间体力活动域分别为 20±8 和 239±32 分钟/周,(<0.05)。两组的基线特征和应激感知相似。SED 组的基础 FBF(3.5±0.2mL/min/100mL 对 2.4±0.14mL/min/100mL)和 FVC(3.5±0.2U 对 2.3±0.1U)明显低于 ACTIVE 组,(<0.05)。两组在精神应激试验中心率和血压均有相似增加。SED 组在精神应激时 FBF(0.65±0.12 对 1.04±0.12)和 FVC(0.58±0.11 对 0.99±0.11)的变化明显低于 ACTIVE 组,(<0.05)。在精神应激时,闲暇时间体力活动与 FBF(=0.57,<0.05)和 FVC(=0.48,<0.05)呈显著相关。

结论

OSA 患者的血管反应受体力活动水平的影响。高水平的体力活动可能部分保护与 OSA 相关的心血管功能障碍。

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