Bonsignore M R, Romano S, Marrone O, Chiodi M, Bonsignore G
Istituto di Fisiopatologia Respiratoria, Italian National Council of Research, Palermo.
Sleep. 1997 Dec;20(12):1167-74.
Both bradycardia and a trend to tachycardia have been reported in obstructive sleep apneas (OSA). Because heart rate (HR) behavior may yield information on parasympathetic activity during OSA, we analyzed HR in samples of consecutive apneic cycles in non-rapid eye movement (NREM) sleep, recorded in normotensive patients breathing room air (n = 7) and supplemental O2 (n = 4). In air, the patients showed different HR trends during apnea, as HR decreased (HR decreased), remained constant (HR=), or increased (HR increased). By multiple regression analysis, development of HR trends correlated with the HR fall in the late interapneic period, HR at first effort, the decrease in esophageal pressure, and the lengthening of inspiration during apnea (R2 = 0.42). O2 abolished HR decreased-OSA, whereas HR= and HR increased-OSA still occurred but at higher HR than in air. In both the air and O2 series, the HR fall preceding apnea correlated significantly with the degree of hypoxia reached in the previous apneic cycle. These data indicate a complex modulation of HR during OSA, with the HR fall in the late interapneic period possibly reflecting the effectiveness of parasympathetic cardiac control in OSA patients during sleep.
阻塞性睡眠呼吸暂停（OSA）患者中既有心动过缓的报道，也有心动过速倾向的报道。由于心率（HR）行为可能提供OSA期间副交感神经活动的信息，我们分析了在呼吸室内空气的血压正常患者（n = 7）和补充氧气的患者（n = 4）中，非快速眼动（NREM）睡眠期间连续呼吸暂停周期样本中的心率。在空气中，患者在呼吸暂停期间表现出不同的心率趋势，心率下降（HR decreased）、保持恒定（HR=）或增加（HR increased）。通过多元回归分析，心率趋势的发展与呼吸暂停后期的心率下降、首次用力时的心率、食管压力的降低以及呼吸暂停期间吸气时间的延长相关（R2 = 0.42）。氧气消除了心率下降型OSA，而心率恒定型和心率增加型OSA仍然发生，但心率高于在空气中。在空气和氧气两组中，呼吸暂停前的心率下降与前一个呼吸暂停周期中达到的低氧程度显著相关。这些数据表明OSA期间心率的复杂调节，呼吸暂停后期的心率下降可能反映了睡眠期间OSA患者副交感神经对心脏控制的有效性。
