Otsuka K, Yanaga T, Ichimaru Y, Seto K
Jpn Heart J. 1982 Jul;23(4):479-86. doi: 10.1536/ihj.23.479.
The relationship between arrhythmias and sleep states was investigated in patients with night-type arrhythmias, which were detected by 24-hour electrocardiogram recordings using the Holter Avionics system. These patients were examined using all-night polygraphic recordings and sleep states were divided in to 5 groups according to the standard sleep stage scoring manual as stage I, II, III, IV, and REM sleep. Patients were divided into 5 groups: (1) grade 2 ventricular premature contractions (VPCs), (2) grade 4a VPCs, (3) grade 4b VPCs, (4) supraventricular premature contractions, and (5) paroxysmal tachyarrhythmias such as paroxysmal atrial fibrillation or paroxysmal supraventricular tachycardia. The paroxysmal tachyarrhythmia group showed a significant increase in arrhythmia incidence during REM sleep (p less than 0.05). However, the subjects with other arrhythmias showed no significant increase during REM sleep, but grade 2 VPCs showed a tendency to increase in sleep stage IV (0.05 less than p less than 0.1). These results suggest that there are 2 types of arrhythmias influenced by sleep. The first type is affected by a phasic increase in sympathetic nervous tone during REM sleep and the second type is related to an increase in vagal tone during the night.
采用霍尔特航空电子系统进行24小时心电图记录，对夜间型心律失常患者的心律失常与睡眠状态之间的关系进行了研究。使用通宵多导睡眠图记录对这些患者进行检查，并根据标准睡眠阶段评分手册将睡眠状态分为5组，即I期、II期、III期、IV期和快速眼动（REM）睡眠。患者被分为5组：（1）2级室性早搏（VPCs）；（2）4a级VPCs；（3）4b级VPCs；（4）室上性早搏；（5）阵发性快速心律失常，如阵发性心房颤动或阵发性室上性心动过速。阵发性快速心律失常组在快速眼动睡眠期间心律失常发生率显著增加（p<0.05）。然而，其他心律失常患者在快速眼动睡眠期间无显著增加，但2级室性早搏在IV期睡眠时有增加趋势（0.05<p<0.1）。这些结果表明，有两种类型的心律失常受睡眠影响。第一种类型受快速眼动睡眠期间交感神经张力阶段性增加的影响，第二种类型与夜间迷走神经张力增加有关。
