Castiglione F, Emde C, Armstrong D, Schneider C, Bauerfeind P, Stacher G, Blum A L
Division of Gastroenterology, CHUV/PMU, Lausanne, Switzerland.
Gut. 1993 Dec;34(12):1653-9. doi: 10.1136/gut.34.12.1653.
Simultaneous overnight oesophageal pH and manometric and sleep electroencephalographic recordings were performed in eight healthy subjects, aged 20-38 years, to test the hypothesis that the frequency of primary, swallow related contractions decreases progressively with deeper sleep stages whereas the frequency of secondary contractions remains constant throughout the night. During the nocturnal period (2300 to 0700), periods of oesophageal motor quiescence were interspersed by clusters of contractions detected 5 and 15 cm above the lower oesophageal sphincter. Primary contractions decreased in frequency from 1.42/min (median) during arousal periods to 0.22/min during stage 1 sleep, 0.05/min during stages 2 to 4 combined, and 0.03/min during rapid eye movement (REM) sleep. Secondary contractions were also most frequent during arousal periods (0.51/min) and they, too, decreased in frequency during stage 1 (0.35/min) and stages 2 to 4 combined (0.08/min). During REM sleep, however, the frequency of secondary contractions increased (0.50/min) to levels noted during arousal and stage 1 sleep. Compared with primary contractions, secondary contractions had a lower amplitude (51.9 hPa v 76.0 hPa; p = 0.0078) and a shorter duration (3.08 v 4.06 s; p = 0.0078). The results of this study suggest that there is no intrinsic oesophageal motor activity in the absence of a stimulatory input from the central nervous system and that the increased number of secondary contractions during REM sleep may be a result of an REM related increase in autonomic nervous system activity although a temporary decrease of efferent inhibitory influences cannot be ruled out. Nocturnal contraction clusters comprise both primary contractions during arousals and stage 1 sleep and secondary contractions during REM sleep.
对8名年龄在20至38岁的健康受试者进行了夜间同步食管pH值、测压及睡眠脑电图记录，以检验以下假设：与吞咽相关的原发性收缩频率会随着睡眠深度的增加而逐渐降低，而继发性收缩的频率在整个夜间保持恒定。在夜间时段（23:00至07:00），食管运动静止期被在下食管括约肌上方5厘米和15厘米处检测到的收缩簇穿插。原发性收缩频率从觉醒期的1.42次/分钟（中位数）降至1期睡眠时的0.22次/分钟、2至4期合并时的0.05次/分钟以及快速眼动（REM）睡眠时的0.03次/分钟。继发性收缩在觉醒期也最为频繁（0.51次/分钟），并且在1期（0.35次/分钟）和2至4期合并时（0.08次/分钟）频率也降低。然而，在REM睡眠期间，继发性收缩的频率增加（0.50次/分钟）至觉醒期和1期睡眠时的水平。与原发性收缩相比，继发性收缩的幅度较低（51.9百帕对76.0百帕；p = 0.0078）且持续时间较短（3.08对4.06秒；p = 0.0078）。本研究结果表明，在没有来自中枢神经系统的刺激输入时不存在内在的食管运动活动，并且REM睡眠期间继发性收缩数量的增加可能是自主神经系统活动与REM相关增加的结果，尽管不能排除传出抑制影响的暂时降低。夜间收缩簇包括觉醒期和1期睡眠时的原发性收缩以及REM睡眠时的继发性收缩。
