Stenlöf K, Grunstein R, Hedner J, Sjöström L
Department of Medicine, Sahlgrenska University Hospital, Göteborg, Sweden.
Am J Physiol. 1996 Dec;271(6 Pt 1):E1036-43. doi: 10.1152/ajpendo.1996.271.6.E1036.
We examined 24-h energy expenditure (EE) in a chamber for indirect calorimetry in five male patients with obstructive sleep apnea (OSA) and six snoring control subjects (snorers). The 24-h EE was remeasured in patients with OSA after 3-mo treatment with nasal continuous positive airway pressure (CPAP). Patients with OSA had a greater degree of severe sleep-breathing disturbance than snorers. Patients with OSA had higher 24-h EE [39.2 +/- 3.0 vs. 33.9 +/- 2.7 kcal.24 h-1.kg fat-free mass (FFM)-1, P < 0.05], daytime urinary norepinephrine and vanillylmandelic acid (VMA), and aminoterminal procollagen III peptide (PIIIp) levels, and they tended to have higher sleeping EE (32.4 +/- 4.1 vs. 26.3 +/- 1.9 kcal.24 h-1.kg FFM-1, P < 0.1) than snorers. CPAP treatment normalized sleep architecture and breathing. CPAP treatment also decreased sleep EE (from 32.4 +/- 4.1 to 27.2 +/- 1.4 kcal.24 h-1.kg FFM-1, P < 0.05) and EE variability during sleep (from 1.6 +/- 0.5 to 1.0 +/- 0.5 kcal.24 h-1.kg FFM-1, P < 0.05) and increased the basal metabolic rate-to-sleep EE ratio in all subjects. Serum PIIIp and plasma norepinephrine decreased after CPAP in all patients. We conclude that OSA is associated with an increased sleep EE, which is normalized by treatment with CPAP.
我们在一个用于间接量热法的舱室内，对5名阻塞性睡眠呼吸暂停（OSA）男性患者和6名打鼾对照受试者（打鼾者）的24小时能量消耗（EE）进行了检测。对OSA患者进行3个月的鼻持续气道正压通气（CPAP）治疗后，重新测量其24小时EE。OSA患者的严重睡眠呼吸紊乱程度比打鼾者更高。OSA患者的24小时EE更高[39.2±3.0 vs. 33.9±2.7千卡·24小时-1·千克去脂体重（FFM）-1，P<0.05]，日间尿去甲肾上腺素和香草扁桃酸（VMA）以及氨基末端前胶原III肽（PIIIp）水平更高，并且他们的睡眠EE往往也比打鼾者更高（32.4±4.1 vs. 26.3±1.9千卡·24小时-1·千克FFM-1，P<（此处原文有误，应改为P<0.1））。CPAP治疗使睡眠结构和呼吸正常化。CPAP治疗还降低了睡眠EE（从32.4±4.1降至27.2±1.4千卡·24小时-1·千克FFM-1，P<0.05）以及睡眠期间的EE变异性（从1.6±0.5降至1.0±0.5千卡·24小时-1·千克FFM-1，P<0.05），并提高了所有受试者的基础代谢率与睡眠EE的比值。所有患者在CPAP治疗后血清PIIIp和血浆去甲肾上腺素均下降。我们得出结论，OSA与睡眠EE增加有关，CPAP治疗可使其恢复正常。
