Hemodynamic consequences of obstructive sleep apnea

被引:108
作者
Weiss, JW
Remsburg, S
Garpestad, E
Ringler, J
Sparrow, D
Parker, JA
机构
[1] BETH ISRAEL HOSP, HARVARD THORNDIKE LAB, BOSTON, MA 02215 USA
[2] BETH ISRAEL HOSP, SLEEP DISORDERS CTR, BOSTON, MA 02215 USA
[3] BETH ISRAEL HOSP, NORMAT AGING STUDY, BOSTON, MA 02215 USA
[4] BETH ISRAEL HOSP, DEPT MED, BOSTON, MA 02215 USA
[5] BETH ISRAEL HOSP, DEPT RADIOL, BOSTON, MA 02215 USA
[6] BRIGHAM & WOMENS HOSP, BOSTON, MA 02115 USA
[7] HARVARD UNIV, SCH MED, BOSTON, MA USA
关键词
sleep; obstructive sleep apnea; arterial pressure; hypertension; hemodynamic;
D O I
10.1093/sleep/19.5.388
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Patients with obstructive sleep apnea demonstrate both acute and chronic hemodynamic changes attributable to their disease. Acutely, these patients experience repetitive nocturnal hemodynamic oscillations. Sudden increases in heart rate and arterial pressure occur in association with decreases in left ventricular stroke volume immediately following apnea termination. These hemodynamic changes are likely attributable primarily to the effects of oxygen desaturation and arousal, an abrupt change in state. These acute changes occur against a background of altered cardiovascular control. Patients with sleep apnea, even when sleeping without obstructions, fail to display the normal nocturnal decline in arterial pressure of 10-15% from the waking value. The absence of a nocturnal decline may have chronic consequences, such as development of left ventricular hypertrophy. Another chronic hemodynamic consequence of sleep apnea may be sustained diurnal hypertension. Epidemiologic studies suggest individuals with sleep disordered breathing are at greater risk of daytime hypertension, even after controlling for other risk factors. Although sleep apnea may contribute to pulmonary, as well as systemic hypertension, sleep apnea alone does not appear to be a cause of decompensated right heart failure. Although knowledge of the hemodynamic consequences of sleep apnea has grown in recent years, much remains to be learned.
引用
收藏
页码:388 / 397
页数:10
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