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Heart rate changes in sleep apnea syndrome Akiko Noda 1 , Tamotsu Okada 2 , Fumihiko Yasuma 3 , Hiroshi Hayashi 3 , Ryujiro Suzuki 1 , Mitsuhiro Yokota 1 , Tatsuro Ohta 2 , Jun Takeuchi 1 1Department of Clinical Laboratory, Nagoya University Hospital 2Department of Psychiatry, Nagoya University Hospital 3The First Department of Internal Medicine, Nagoya University Hospital Keyword: 睡眠時無呼吸(sleep apnea) , 心拍数変動(heart rate changes) , 動脈血酸素飽和度低下(arterial oxygen desaturation) pp.1097-1105
Published Date 1990/11/15
DOI https://doi.org/10.11477/mf.1404910043
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Sleep apnea syndrome (SAS) is often associated with arrhythmias. The study was performed to clarify the characteristics and mechanisms of the heart rate (HR) changes during and after sleep induced apneas. Thirty-one patients with SAS with-out definitive heart disease, aged 17-78 years (mean 54. 2 years), were examined by electoencephalograms, electrocardiograms, electrooculograms, nasal and oral breathing, thoracic and abdominal respiratory move-ments and arterial oxygen saturation (SaO2).

<Results and Discussion> At the onset of sleep apnea, some showed progressive reductions in HR, followed by abrupt tachycardia on the resumption of breathing. Thirty-one patients with SAS were classified into three Groups (A, B, C). Group Ademonstrated that HR changes occurred associated with apnea both in stage REM and in stage non-REM. Group B demonstrated that HR changes occurred associated with apnea only in stage REM. Group C demonstrated that HR changes did not occur associated with apnea. In Group A, apnea frequency and apnea index were higher than those of Group C. In Group A, the lowest SaO2, was lower than that of Group C, total time under 90% of arterial oxygen saturation (SaO2) was longer than that of Group C. There was a good negative correlation between oxygen saturation and HR changes.

Further, HR changes were augmented by arousal response. This might be related to the arousal response as well as to the cardiostimulatory effects of hypoxia associated with increased ventilation. The arousability in response to apneas might be important in HR changes.

In SAS, the degree of HR changes was related to apnea frequency, apnea index, apnea length and sleep stage. We suggest that both oxygen desatu-ration and arousal response may be important stimuli rhat contribute to HR changes associated with apnea. These observations indicated that HR changes might provide useful information on the pathophy-siology SAS.


Copyright © 1990, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1200 印刷版ISSN 0452-3458 医学書院

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