Obstructive apnea during sleep is associated with peripheral vasoconstriction

被引:84
作者
Imadojemu, VA
Gleeson, K
Gray, KS
Sinoway, LI
Leuenberger, UA
机构
[1] Penn State Univ, Milton S Hershey Med Ctr, Coll Med, Div Pulm Allergy & Crit Care, Hershey, PA 17033 USA
[2] Penn State Univ, Milton S Hershey Med Ctr, Coll Med, Div Cardiol, Hershey, PA 17033 USA
[3] Vet Affairs Med Ctr, Lebanon, PA USA
关键词
blood flow; blood pressure; Doppler; muscle sympathetic nervous system; obstructive sleep apnea; vasoconstriction;
D O I
10.1164/ajrccm.165.1.2009062
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Obstructive apnea during sleep is associated with a substantial transient blood pressure elevation. The mechanism of this pressor response is unclear. In this study we measured muscle sympathetic nerve activity (MSNA), mean arterial pressure ((Psa) over bar), and mean limb blood velocity as an index of blood flow (MBV, Doppler) and calculated changes in limb vascular resistance during and after apneas during both wakefulness and sleep in patients with the obstructive sleep apnea syndrome. Immediately postapnea during sleep (Psa) over bar increased significantly compared with the earlier stages of apnea and this was preceded by a rise of MSNA (n = 5). In contrast to blood pressure, MBV remained unchanged. Because resistance = blood pressure/blood flow, limb vascular resistance increased by 29 +/- 8% from late apnea to postapnea (n = 7, p < 0.002). Voluntary breathhold maneuvers during room air exposure evoked similar responses (n = 10). Supplemental oxygen administered via nonrebreather face mask attenuated the MSNA and vasoconstrictor responses to obstructive (n = 2) and voluntary apneas (n = 10). Our data suggest that obstructive apneas in patients with the obstructive apnea syndrome are accompanied by transient limb vasoconstriction. This vasoconstrictor response appears to be, at least in part, mediated by the sympathetic nervous system and may be linked to hypoxia.
引用
收藏
页码:61 / 66
页数:6
相关论文
共 35 条
[1]  
[Anonymous], 1989, AM REV RESPIR DIS, V139, P559
[2]   Comparative hemodynamic effects of periodic obstructive and simulated central apneas in sedated pigs [J].
Chen, L ;
Scharf, SM .
JOURNAL OF APPLIED PHYSIOLOGY, 1997, 83 (02) :485-494
[3]  
de Wit C, 1998, KIDNEY INT, V54, pS122
[4]   STROKE VOLUME AND CARDIAC-OUTPUT DECREASE AT TERMINATION OF OBSTRUCTIVE APNEAS [J].
GARPESTAD, E ;
KATAYAMA, H ;
PARKER, JA ;
RINGLER, J ;
LILLY, J ;
YASUDA, T ;
MOORE, RH ;
STRAUSS, HW ;
WEISS, JW .
JOURNAL OF APPLIED PHYSIOLOGY, 1992, 73 (05) :1743-1748
[5]   OBSTRUCTIVE SLEEP-APNEA AND CARDIAC INDEX [J].
GUILLEMINAULT, C ;
MOTTA, J ;
MIHM, F ;
MELVIN, K .
CHEST, 1986, 89 (03) :331-334
[6]   SLEEP APNEA SYNDROMES [J].
GUILLEMINAULT, C ;
TILKIAN, A ;
DEMENT, WC .
ANNUAL REVIEW OF MEDICINE, 1976, 27 :465-484
[7]   SYMPATHETIC AND BLOOD-PRESSURE RESPONSES TO VOLUNTARY APNEA ARE AUGMENTED BY HYPOXEMIA [J].
HARDY, JC ;
GRAY, K ;
WHISLER, S ;
LEUENBERGER, U .
JOURNAL OF APPLIED PHYSIOLOGY, 1994, 77 (05) :2360-2365
[8]   IS HIGH AND FLUCTUATING MUSCLE NERVE SYMPATHETIC ACTIVITY IN THE SLEEP-APNEA SYNDROME OF PATHOGENETIC IMPORTANCE FOR THE DEVELOPMENT OF HYPERTENSION [J].
HEDNER, J ;
EJNELL, H ;
SELLGREN, J ;
HEDNER, T ;
WALLIN, G .
JOURNAL OF HYPERTENSION, 1988, 6 :S529-S531
[9]   A SPECIFIC AND POTENT PRESSOR EFFECT OF HYPOXIA IN PATIENTS WITH SLEEP-APNEA [J].
HEDNER, JA ;
WILCOX, I ;
LAKS, L ;
GRUNSTEIN, RR ;
SULLIVAN, CE .
AMERICAN REVIEW OF RESPIRATORY DISEASE, 1992, 146 (05) :1240-1245
[10]   SYMPATHETIC MUSCLE NERVE ACTIVITY DURING SLEEP IN MAN [J].
HORNYAK, M ;
CEJNAR, M ;
ELAM, M ;
MATOUSEK, M ;
WALLIN, BG .
BRAIN, 1991, 114 :1281-1295