Background

Obstructive sleep apnea (OSA) is associated with cardiovascular diseases and increased sympathetic tone. We previously demonstrated that patients with OSA have increased skin sympathetic nerve activity (SKNA).

Objective

The purpose of this study was to test the hypothesis that continuous positive airway pressure (CPAP) treatment reduces SKNA.

Methods

The electrocardiogram, SKNA, and polysomnographic recording were recorded simultaneously in 9 patients with OSA. After baseline recording, CPAP titration was performed and the pressure was adjusted gradually for the optimal treatment, defined by reducing the apnea-hypopnea index (AHI) to ≤5/h. Otherwise the treatment was considered suboptimal (AHI > 5/h). Fast Fourier transform analyses were performed to investigate the frequency spectrum of SKNA.

Results

There were very low frequency (VLF), low frequency (LF), and high frequency (HF) oscillations in SKNA. The HF oscillation matched the frequency of respiration. OSA episodes were more frequently associated with the VLF and LF than with the HF oscillations of SKNA. Compared with baseline, CPAP significantly decreased the arousal index and AHI and increased the minimal and mean oxyhemoglobin levels. Optimal treatment significantly increased the dominant frequency and reduced the heart rate, average SKNA (aSKNA), SKNA burst duration, and total burst area. The dominant frequency negatively correlated with aSKNA.

Conclusion

VLF, LF, and HF oscillations are observed in human SKNA recordings. Among them, VLF and LF oscillations are associated with OSA while HF oscillations are associated with normal breathing. CPAP therapy reduces aSKNA and shifts the frequency of SKNA oscillation from VLF or LF to HF.

中文翻译：

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成功的持续气道正压通气治疗可降低阻塞性睡眠呼吸暂停患者的皮肤交感神经活动

背景

阻塞性睡眠呼吸暂停 (OSA) 与心血管疾病和交感神经紧张有关。我们之前证明 OSA 患者的皮肤交感神经活动 (SKNA) 增加。

客观的

本研究的目的是检验持续气道正压通气 (CPAP) 治疗可减少 SKNA 的假设。

方法

同时记录了 9 例 OSA 患者的心电图、SKNA 和多导睡眠图记录。基线记录后，进行 CPAP 滴定并逐渐调整压力以获得最佳治疗，通过将呼吸暂停低通气指数 (AHI) 降低至≤5/h 来定义。否则治疗被认为是次优的 (AHI > 5/h)。进行快速傅立叶变换分析以研究 SKNA 的频谱。

结果

SKNA 中存在极低频 (VLF)、低频 (LF) 和高频 (HF) 振荡。HF 振荡与呼吸频率相匹配。OSA 发作与 VLF 和 LF 相关的频率高于与 SKNA 的 HF 振荡相关的频率。与基线相比，CPAP 显着降低了觉醒指数和 AHI，并增加了最小和平均氧合血红蛋白水平。最佳治疗显着增加了主频率并降低了心率、平均 SKNA (aSKNA)、SKNA 爆发持续时间和总爆发面积。主导频率与 aSKNA 呈负相关。

结论

在人类 SKNA 记录中观察到 VLF、LF 和 HF 振荡。其中，VLF 和 LF 振荡与 OSA 相关，而 HF 振荡与正常呼吸相关。CPAP 治疗减少 aSKNA 并将 SKNA 振荡的频率从 VLF 或 LF 转移到 HF。