McGinty D, Littner M, Beahm E, Ruiz-Primo E, Young E, Sowers J
Neurobiol Aging. 1982 Winter;3(4):337-50. doi: 10.1016/0197-4580(82)90022-7.
The incidence of sleep-related breathing disorders (SRBDs) associated with hemoglobin desaturation was determined by nocturnal polygraphic evaluations in 26 healthy men, aged 55-70 years. Sixteen subjects (62%) had abnormal rates of at least 12 episodes per hour of sleep: 8 had occlusive, and 8 had central apnea or hypopnea. During waking ten of 16 SRBD subjects and only one subject without SRBDs exhibited either an elevated nasopharyngeal airway resistance (n = 4) or a reduced ventilatory response to hypercapnia (n = 4) and/or hypoxia (n = 3). However, these abnormalities were not related to the type or severity of SRBDs, and 6 subjects with SRBDs demonstrated no respiratory defect. We conclude that SRBDs have a very high incidence in older males and are not usually secondary to pulmonary cardiac, neurological, or behavioral disorders. Additionally, we hypothesize that abnormalities in ventilatory control or upper airway resistance contribute to SRBDs, but depression of brain stem reticular formation activity during sleep plays a primary role in these disorders. Factors related to both aging and SRBDs are reviewed. These include reduced chemoreceptor responses, altered steroid hormone metabolism, and use and metabolism of hypnotic drugs and alcohol.
通过夜间多导睡眠图评估，确定了26名年龄在55至70岁之间的健康男性中与血红蛋白去饱和相关的睡眠呼吸障碍（SRBDs）的发生率。16名受试者（62%）每小时睡眠中至少有12次发作的异常率：8名有阻塞性呼吸暂停，8名有中枢性呼吸暂停或呼吸不足。在清醒状态下，16名SRBD受试者中的10名以及只有1名无SRBD的受试者表现出要么鼻咽气道阻力升高（n = 4），要么对高碳酸血症（n = 4）和/或低氧血症（n = 3）的通气反应降低。然而，这些异常与SRBD的类型或严重程度无关，并且6名SRBD受试者未表现出呼吸缺陷。我们得出结论，SRBD在老年男性中发生率非常高，且通常并非继发于肺部、心脏、神经或行为障碍。此外，我们推测通气控制或上气道阻力异常促成了SRBD，但睡眠期间脑干网状结构活动的抑制在这些障碍中起主要作用。对与衰老和SRBD相关的因素进行了综述。这些因素包括化学感受器反应降低、类固醇激素代谢改变以及催眠药物和酒精的使用与代谢。
