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《2015年全国睡眠呼吸学术年会论文汇编》2015年
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Cardiovascular Consequences of Repetitive Arousals over the Entire Sleep Duration

Xu Zhong  Yanyan Wu  Yi Xiao  Rong Huang  
【摘要】:Study Objectives:To explore the cardiovascular effects of nightlong repetitive arousals(RA)induced by auditory stimuli.Design:Each subject participated in two consecutive sleep studies with the first as a selfcontrol and the second one disturbed by experimental arousals.Blood pressure,heart rate variability(HRV)indices and stiffness index(SI)were measured before and after sleep,and compared between and within the two nights.Nitric oxide(NO),endothelin-1(ET-1),C reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and vascular endothelial growth factor(VEGF)in serum were measured and compared.Setting:Sleep-disordered breathing laboratory in a hospital setting.Participants:Twenty healthy young men with an average age of 25.0±2.1y and mean bodymass index(BMI)of 22.9±1.9 kg·m-2.Interventions:The first night was free of any intervention.During the second night,subjects were aroused repetitively by acoustical stimuli over the entire sleep duration,with the expected arousal index(ArI)as 60 hr-1.Measurements and Results:Experimental RA led to overnight elevation in diastolic blood pressure(DBP)but not in systolic blood pressure(SBP).Regarding to HRV analysis,overnight increase in low frequency power(LF)and low frequency to high frequency ratio(LHR)and decrease in high frequency power(HF)were all evident.The relative overnight differences of both HF and LHR were correlated with the amount of rapid-eye movement(REM)sleep.The change in DBP was not significantly correlated with alterations in HRV indices.RA did not cause detectable change in either SI or serum markers of interest.Conclusions:Nightlong RA alters the sympatho-vagal modulation significantly and this effect seemed to be associated with the amount of REM sleep.Exposure to RA also caused an elevation in post-sleep DBP.Disturbance to autonomic nervoussystem may occur prior to endothelial dysfunction and increase of arterial stiffness as cardiovascular consequences of RA.

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