Al Ashry Haitham S, Ni Yuenan, Thomas Robert J
Division of Pulmonary and Sleep Medicine, Elliot Health System, Manchester, NH, United States.
Division of Pulmonary, Critical Care and Sleep Medicine, West China Hospital, Sichuan University, Chengdu, China.
Front Neurosci. 2021 Nov 12;15:755464. doi: 10.3389/fnins.2021.755464. eCollection 2021.
The interactions of heart rate variability and respiratory rate and tidal volume fluctuations provide key information about normal and abnormal sleep. A set of metrics can be computed by analysis of coupling and coherence of these signals, cardiopulmonary coupling (CPC). There are several forms of CPC, which may provide information about normal sleep physiology, and pathological sleep states ranging from insomnia to sleep apnea and hypertension. As CPC may be computed from reduced or limited signals such as the electrocardiogram or photoplethysmogram (PPG) vs. full polysomnography, wide application including in wearable and non-contact devices is possible. When computed from PPG, which may be acquired from oximetry alone, an automated apnea hypopnea index derived from CPC-oximetry can be calculated. Sleep profiling using CPC demonstrates the impact of stable and unstable sleep on insomnia (exaggerated variability), hypertension (unstable sleep as risk factor), improved glucose handling (associated with stable sleep), drug effects (benzodiazepines increase sleep stability), sleep apnea phenotypes (obstructive vs. central sleep apnea), sleep fragmentations due to psychiatric disorders (increased unstable sleep in depression).
心率变异性与呼吸频率及潮气量波动之间的相互作用提供了有关正常和异常睡眠的关键信息。通过分析这些信号的耦合和相干性，可以计算出一组指标，即心肺耦合（CPC）。CPC有几种形式，它们可能提供有关正常睡眠生理以及从失眠到睡眠呼吸暂停和高血压等病理睡眠状态的信息。由于CPC可以从诸如心电图或光电容积脉搏波描记图（PPG）等简化或有限的信号与全夜多导睡眠图进行计算，因此包括可穿戴设备和非接触式设备在内的广泛应用成为可能。当从仅通过血氧测定法获取的PPG进行计算时，可以计算出源自CPC-血氧测定法的自动呼吸暂停低通气指数。使用CPC进行睡眠分析可证明稳定和不稳定睡眠对失眠（变异性过大）、高血压（不稳定睡眠作为危险因素）、改善葡萄糖处理（与稳定睡眠相关）、药物作用（苯二氮䓬类药物增加睡眠稳定性）、睡眠呼吸暂停表型（阻塞性与中枢性睡眠呼吸暂停）、精神疾病导致的睡眠片段化（抑郁症中不稳定睡眠增加）的影响。
