Słomko Joanna, Zawadka-Kunikowska Monika, Kujawski Sławomir, Klawe Jacek J, Tafil-Klawe Małgorzata, Newton Julia L, Zalewski Paweł
Department of Hygiene, Epidemiology and Ergonomics, Faculty of Health Sciences, Nicolaus Copernicus University in Toruń, Toruń, Poland.
Department of Human Physiology, Faculty of Medicine, Nicolaus Copernicus University in Toruń, Toruń, Poland.
Front Physiol. 2018 Sep 28;9:1374. doi: 10.3389/fphys.2018.01374. eCollection 2018.
The main objective of the study was to analyze the impact of sleep deprivation upon hemodynamic and autonomic parameters in subjects with normal blood pressure (BP) compared to prehypertension and hypertension at 24, 28, and 32 h of total sleep deprivation (TSD). Thirty volunteers, healthy men with current medical tests indicating the absence of disease took part in the study. After physical examination (basic neurological, clinical examination, echocardiography and doppler ultrasound of the renal arteries, evaluation of the autonomic nervous system) subjects were divided into three groups: I - normotensive, II - pre-hypertensive, III - hypertensive (age: 31.2 ± 2.1 vs. 33.5 ± 2.7 vs. 36.8 ± 2.7 years, > 0.05; BMI: 25.2 ± 0.8 vs. 29.0 ± 1.5 vs. 26.4 ± 1.0 kg/m, > 0.05). Hemodynamic and autonomic parameters were automatically measured at rest and in a tilted position with a Task Force Monitor. The Task Force Monitor consists of electrocardiography, impedance cardiography, oscillometric, and continuous BP measurement. Mixed models with random effects was applied in order to analyze the parameters' dependence on the time and the group of patients. One-way ANOVA or Kruskal-Wallis test were used to detect differences between normotensive, pre-hypertensive and hypertensive groups in each time point. In the pre-hypertensive group 28-h TSD resulted in increased vagal outflow [changes in high frequency heart rate (HR) variability, = 0.0189], as evidenced by decreased HR ( = 0.0293). Moreover after 24-h TSD and 28-h TSD we observed changes in BP parameters. In hypertensive group, the most important changes in hemodynamic parameters: systolic blood pressure (sBP, = 0.0031), diastolic blood pressure (dBP, = 0.0136), cardiac output (CO, = 0.0439) and changes in HR ( = 0.0063) after tilt test were observed after 32-h TSD. In conclusion, our results show that changes in hemodynamic parameters during sleep deprivation depend on the baseline BP and duration of TSD. What is important, both groups reported a decrease of sBP and dBP during the TSD (pre-hypertensive group after 24, 28-h TSD; hypertensive group after 32-h TSD. In our opinion, this is the first study which considers three homogenous groups in terms of gender: only men, during different points of acute TSD: 24, 28, and 32 h of TSD in laboratory condition.
本研究的主要目的是分析与血压正常（BP）、血压前期和高血压患者相比，在完全睡眠剥夺（TSD）24、28和32小时时，睡眠剥夺对血流动力学和自主神经参数的影响。30名志愿者，即当前医学检查表明无疾病的健康男性参与了该研究。经过体格检查（基本神经学、临床检查、肾动脉超声心动图和多普勒超声、自主神经系统评估）后，受试者被分为三组：I组 - 血压正常组，II组 - 血压前期组，III组 - 高血压组（年龄：31.2±2.1岁 vs. 33.5±2.7岁 vs. 36.8±2.7岁，P>0.05；体重指数：25.2±0.8kg/m² vs. 29.0±1.5kg/m² vs. 26.4±1.0kg/m²，P>0.05）。使用任务力监测仪在静息和倾斜位自动测量血流动力学和自主神经参数。任务力监测仪包括心电图、阻抗心动图、示波法和连续血压测量。应用具有随机效应的混合模型来分析参数对时间和患者组的依赖性。使用单向方差分析或Kruskal-Wallis检验来检测血压正常组、血压前期组和高血压组在每个时间点的差异。在血压前期组中，28小时的TSD导致迷走神经输出增加[高频心率（HR）变异性变化，P = 0.0189]，心率降低（P = 0.0293）证明了这一点。此外，在24小时和28小时TSD后我们观察到血压参数的变化。在高血压组中，在32小时TSD后观察到血流动力学参数的最重要变化：倾斜试验后收缩压（sBP，P = 0.0031）、舒张压（dBP，P = 0.0136）、心输出量（CO，P = 0.0439）和心率变化（P = 0.0063）。总之，我们的结果表明，睡眠剥夺期间血流动力学参数的变化取决于基线血压和TSD的持续时间。重要的是，两组在TSD期间均报告收缩压和舒张压下降（血压前期组在24、28小时TSD后；高血压组在32小时TSD后）。我们认为，这是第一项在性别方面考虑三个同质组的研究：仅男性，在急性TSD的不同时间点：实验室条件下TSD 24、28和32小时。
