Dawson A, Lehr P, Bigby B G, Mitler M M
Division of Sleep Disorders, Scripps Clinic and Research Foundation, La Jolla, CA 92037.
Alcohol Clin Exp Res. 1993 Apr;17(2):256-62. doi: 10.1111/j.1530-0277.1993.tb00759.x.
We have previously reported that bedtime ethanol (2.0 ml/kg of 100 proof vodka) increases upper airway closing pressure in males who habitually snored but were otherwise healthy. We also observed that some of these snorers developed obstructive apneas. To explore this phenomenon in more detail, we measured the inspiratory resistance (RI) and respiratory drive after bedtime ethanol in 10 nonobese men (ages 23 to 33) with no history of snoring. Subjects went to bed wearing a tightly fitting valved mask over the nose and mouth that allowed measurement of inspiratory and expiratory flow, pressure in the mask, and endtidal CO2. We measured RI by calculating the pressure difference between the mouth and a balloon positioned in the midesophagus. Respiratory drive was quantified by the inspiratory occlusion pressure (P0.1), the ventilatory response to hyperoxic hypercapnia (delta VE/delta PETCO2), and the ventilatory response to isocapnic hypoxia (delta VE/delta SaO2). Measurements were made during waking and during stage 2 NREM sleep on two nights: (1) when the subjects drank 1.5 ml/kg of 100 proof vodka in orange juice over a 30-min period 15-45 min before lights out and (2) when the orange juice contained less than 0.1 ml of vodka floating on the top. Eight of the nine men in whom we had technically adequate measurements showed a rise in RI during NREM sleep above the waking level on both control and ethanol nights and the sleeping RI was greater on the ethanol than on the control night.(ABSTRACT TRUNCATED AT 250 WORDS)
我们之前曾报道,睡前饮用乙醇(2.0毫升/千克100标准酒精度的伏特加)会使习惯性打鼾但其他方面健康的男性上气道闭合压升高。我们还观察到,其中一些打鼾者会出现阻塞性呼吸暂停。为了更详细地探究这一现象,我们测量了10名无打鼾史的非肥胖男性(年龄23至33岁)睡前饮用乙醇后的吸气阻力(RI)和呼吸驱动力。受试者上床睡觉时,口鼻佩戴紧密贴合的带阀面罩,该面罩可测量吸气和呼气流量、面罩内压力以及呼气末二氧化碳。我们通过计算口腔与置于食管中段的气球之间的压力差来测量RI。呼吸驱动力通过吸气阻断压(P0.1)、对高氧高碳酸血症的通气反应(δVE/δPETCO2)以及对等碳酸性低氧血症的通气反应(δVE/δSaO2)来量化。在两个晚上的清醒期和NREM睡眠第2阶段进行测量:(1)受试者在熄灯前15至45分钟内的30分钟内饮用1.5毫升/千克100标准酒精度的橙汁伏特加;(2)橙汁中伏特加含量少于0.1毫升且浮于表面。在我们进行了技术上足够测量的9名男性中,有8名在NREM睡眠期间的RI在对照夜和乙醇夜均高于清醒水平,且乙醇夜的睡眠RI高于对照夜。(摘要截选于250字)