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Erschienen in: Sleep and Breathing 4/2018

10.05.2018 | Sleep Breathing Physiology and Disorders • Original Article

The independent and combined effects of respiratory events and cortical arousals on the autonomic nervous system across sleep stages

verfasst von: Jiuxing Liang, Xiangmin Zhang, Xiaomin He, Li Ling, Chunyao Zeng, Yuxi Luo

Erschienen in: Sleep and Breathing | Ausgabe 4/2018

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Abstract

Purpose

During sleep, respiratory events readily modulate the autonomic nervous system (ANS). Whether such modulation is caused by the respiratory event itself or the cortical arousal that follows and whether these influences differ across sleep stages are not clear. Thus, we aimed to study the independent and combined effects of respiratory events and cortical arousals on the ANS across sleep stages.

Methods

We recruited 22 male patients with sleep apnea-hypopnea syndrome (SAHS) and analyzed the differences in the indices of heart rate variability among normal respiration (NR), pathological respiratory events without cortical arousals (PR), cortical arousals without respiratory events (CA), and the coexistence of PR and CA (PR&CA), by sleep stage.

Results

Compared with NR, four indices of variation of the beat-to-beat interval demonstrated consistent results in all sleep stages generally: PR&CA showed the biggest difference, followed by PR and followed by CA, which exhibited the least difference. Thus, the respiratory event itself affects ANS modulation, but the cortical arousal that follows generally enhances this effect. For low-frequency power and low-frequency/high-frequency power ratio (LF/HF), PR&CA had the greatest impact. For mean beat-to-beat interval and high-frequency power (HFP), the influence of PR, CA, and PR&CA depended on sleep depth. However, PR&CA had a different influence on HFP in N2 stage vs. REM stage.

Conclusions

Sleep stage also has an effect on this neuromodulatory mechanism. These findings may help clarify the relationship between SAHS and cardiovascular disease.
Glossar
N1
light sleep occurs mostly in the beginning of sleep, with slow eye movement
N2
no eye movement occurs, and dreaming is very rare
N3
deep sleep, slow-wave sleep
QRS
a voltage waveform due to ventricular contraction
R Peak
a summation wave generated by the depolarization front as it transits the atria
REM
desynchronized sleep similarities to waking states, including rapid, low-voltage desynchronized brain waves
RR
the beat-to-beat interval of the heart
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Metadaten
Titel
The independent and combined effects of respiratory events and cortical arousals on the autonomic nervous system across sleep stages
verfasst von
Jiuxing Liang
Xiangmin Zhang
Xiaomin He
Li Ling
Chunyao Zeng
Yuxi Luo
Publikationsdatum
10.05.2018
Verlag
Springer International Publishing
Erschienen in
Sleep and Breathing / Ausgabe 4/2018
Print ISSN: 1520-9512
Elektronische ISSN: 1522-1709
DOI
https://doi.org/10.1007/s11325-018-1669-8

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