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Daytime sympathetic hyperactivity in OSAS is related to excessive daytime sleepiness.

Journal article
Authors Vincenzo Donadio
Rocco Liguori
Roberto Vetrugno
Manuela Contin
Mikael Elam
Gunnar B Wallin
Tomas Karlsson
Enrico Bugiardini
Agostino Baruzzi
Pasquale Montagna
Published in Journal of sleep research
Volume 16
Issue 3
Pages 327-32
ISSN 0962-1105
Publication year 2007
Published at Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Rehabilitation
Pages 327-32
Language en
Links dx.doi.org/10.1111/j.1365-2869.2007...
Keywords Animals, Continuous Positive Airway Pressure, Disorders of Excessive Somnolence, complications, etiology, physiopathology, Female, Humans, Hyperkinesis, complications, physiopathology, Hypertension, complications, Male, Middle Aged, Muscle, Skeletal, innervation, Polysomnography, Rabbits, Sleep Apnea, Obstructive, complications, physiopathology, Sympathetic Nervous System, physiopathology, Treatment Outcome
Subject categories Medical and Health Sciences

Abstract

The aim of this study was to investigate the relationships among sympathetic hyperactivity, excessive daytime sleepiness (EDS) and hypertension in obstructive sleep apnoea syndrome (OSAS). Ten newly diagnosed OSAS patients with untreated EDS and daytime hypertension underwent polysomnography (PSG) and daytime measurements of plasma noradrenaline (NA), ambulatory blood pressure (BP), muscle sympathetic nerve activity (MSNA) by microneurography and objective assessment of EDS before and during 6 months of compliance-monitored continuous positive airway pressure (CPAP) treatment. One month after the start of CPAP, BP, MSNA and NA were significantly lowered, remaining lower than baseline also after 3 and 6 months of treatment. CPAP use caused a significant improvement of sleep structures, and reduced EDS. A statistical correlation analysis demonstrated that EDS was not correlated with sleep measures obtained from baseline PSG (% sleep stages, apnoea and arousal index, mean oxygen saturation value), whereas daytime sleepiness was significantly correlated with MSNA. Furthermore, MSNA and BP showed no correlation. Our data obtained from selected patients suggest that the mechanisms inducing EDS in OSAS are related to the degree of daytime sympathetic hyperactivity. Additionally, resting MSNA was unrelated to BP suggesting that factors other than adrenergic neural tone make a major contribution to OSAS-related hypertension. The results obtained in this pilot study need, however, to be confirmed in a larger study involving more patients.

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