Launois S H, Abraham J H, Weiss J W, Kirby D A
Charles A. Dana Research Institute and Harvard-Thorndike Laboratory, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston 02215, Massachusetts.
J Appl Physiol (1985). 1998 Oct;85(4):1285-91. doi: 10.1152/jappl.1998.85.4.1285.
Patients with obstructive sleep apnea experience marked cardiovascular changes with apnea termination. Based on this observation, we hypothesized that sudden sleep disruption is accompanied by a specific, patterned hemodynamic response, similar to the cardiovascular defense reaction. To test this hypothesis, we recorded mean arterial blood pressure, heart rate, iliac blood flow and vascular resistance, and renal blood flow and vascular resistance in five pigs instrumented with chronic sleep electrodes. Cardiovascular parameters were recorded during quiet wakefulness, during non-rapid-eye-movement and rapid-eye-movement sleep, and during spontaneous and induced arousals. Iliac vasodilation (iliac vascular resistance decreased by -29.6 +/- 4.1% of baseline) associated with renal vasoconstriction (renal vascular resistance increased by 10.3 +/- 4.0%), tachycardia (heart rate increase: +23.8 +/- 3.1%), and minimal changes in mean arterial blood pressure were the most common pattern of arousal response, but other hemodynamic patterns were observed. Similar findings were obtained in rapid-eye-movement sleep and for acoustic and tactile arousals. In conclusion, spontaneous and induced arousals from sleep may be associated with simultaneous visceral vasoconstriction and hindlimb vasodilation, but the response is variable.
阻塞性睡眠呼吸暂停患者在呼吸暂停终止时会出现明显的心血管变化。基于这一观察结果，我们推测突然的睡眠中断伴随着一种特定的、有规律的血流动力学反应，类似于心血管防御反应。为了验证这一假设，我们记录了五只植入慢性睡眠电极的猪的平均动脉血压、心率、髂血流量和血管阻力以及肾血流量和血管阻力。在安静觉醒期间、非快速眼动和快速眼动睡眠期间以及自发和诱发觉醒期间记录心血管参数。与肾血管收缩（肾血管阻力增加10.3±4.0%）、心动过速（心率增加：+23.8±3.1%）以及平均动脉血压最小变化相关的髂血管舒张（髂血管阻力较基线降低-29.6±4.1%）是最常见的觉醒反应模式，但也观察到了其他血流动力学模式。在快速眼动睡眠以及听觉和触觉诱发觉醒中也获得了类似的发现。总之，睡眠中的自发和诱发觉醒可能与内脏血管收缩和后肢血管舒张同时发生有关，但反应是可变的。
