Autonomic nervous system (ANS) has been extensively explored in obstructive sleep apnea (OSA). Autonomic alterations in these patients have been described by means of several methods, evaluating ANS function both directly with microneurography and indirectly through baroreflex sensitivity (BRS, by the sequence method or the cross-spectral approach), heart rate variability analysis (HRV, both in the time and frequency domain) during sleep and wake, or conventional laboratory tests, including cold pressor test, hand grip test or measurement of urinary cathecolamine excretion. Several studies in OSA patients have shown ANS alterations, in particular sympathetic overactivity, both acutely during apnea events and chronically during the daytime, being both also involved in cardiovascular consequences of sleep disordered breathing. The association between OSA and sympathetic dysregulation suggests a dose response relationship between OSA severity and the degree of sympathetic overactivity and this association seems to be reversible as the treatment of OSA is implemented. Additionally ANS is involved in regulating visceral and humoral functions to maintain the body homeostasis and in reaction and adaptation to external and internal stressor stimuli. However, the vast majority of studies have focussed on cardiovascular alterations, which are easier to measure, somewhat neglecting the other functions regulated by ANS. More evidence is therefore needed to better characterize the impact that sleep disorder breathing may have on ANS both in the short and long term.

中文翻译：

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阻塞性睡眠呼吸暂停综合征和自主神经功能障碍

自主神经系统 (ANS) 已在阻塞性睡眠呼吸暂停 (OSA) 中得到广泛研究。已经通过多种方法描述了这些患者的自主神经改变，通过显微神经造影直接评估 ANS 功能，并通过压力反射敏感性（BRS，通过序列方法或交叉谱方法）、心率变异性分析（HRV，均在时域和频域）在睡眠和觉醒期间，或常规实验室测试，包括冷加压测试、握力测试或尿儿茶酚胺排泄的测量。多项针对 OSA 患者的研究表明，ANS 改变，特别是交感神经过度活跃，无论是在呼吸暂停事件期间还是在白天慢性，都与睡眠呼吸障碍导致的心血管后果有关。OSA 与交感神经失调之间的关联表明 OSA 严重程度与交感神经过度活跃程度之间存在剂量反应关系，并且随着实施 OSA 治疗，这种关联似乎是可逆的。此外，ANS 参与调节内脏和体液功能以维持身体稳态以及对外部和内部压力刺激的反应和适应。然而，绝大多数研究都集中在更容易测量的心血管改变上，而在某种程度上忽略了由 ANS 调节的其他功能。因此，需要更多的证据来更好地描述睡眠呼吸障碍对 ANS 的短期和长期影响。