TY - JOUR
T1 - Systolic pressure response to voluntary apnea predicts sympathetic tone in obstructive sleep apnea as a clinically useful index
AU - Jouett, Noah P.
AU - Hardisty, Janelle M.
AU - Mason, J. Ryan
AU - Niv, Dorene
AU - Romano, James J.
AU - Watenpaugh, Donald E.
AU - Burk, John R.
AU - Smith, Michael L.
N1 - Publisher Copyright:
© 2015 Elsevier B.V.
PY - 2016/1/1
Y1 - 2016/1/1
N2 - The present investigation tested the hypotheses that systolic arterial pressure (SAP) responses to voluntary apnea (a) serve as a surrogate of sympathetic nerve activity (SNA), (b) can distinguish Obstructive Sleep Apnea (OSA) patients from control subjects and (c) can document autonomic effects of treatment. 9 OSA and 10 control subjects were recruited in a laboratory study; 44 OSA subjects and 78 control subjects were recruited in a clinical study; and 21 untreated OSA subjects and 14 well-treated OSA subjects were recruited into a treatment study. Each subject performed hypoxic and room air voluntary apneas in triplicate. Muscle SNA (MSNA) and continuous AP were measured during each apnea in the laboratory study, while systolic arterial pressure (SAP) responses were measured continuously and by standard auscultation in the clinical and treatment studies. OSA subjects exhibited increased mean arterial pressure (MAP), SAP and MSNA responses to hypoxic apnea (all P < 0.01) and the SAP response highly correlated with the MSNA response (R2 = 0.72, P < 0.001). Clinical assessment confirmed that OSA subjects exhibited markedly elevated SAP responses (P < 0.01), while treated OSA subjects had a decreased SAP response to apnea (P < 0.04) compared to poorly treated subjects. These data indicate that (a) OSA subjects exhibit increased pressor and MSNA responses to apnea, and that (b) voluntary apnea may be a clinically useful assessment tool of autonomic dysregulation and treatment efficacy in OSA.
AB - The present investigation tested the hypotheses that systolic arterial pressure (SAP) responses to voluntary apnea (a) serve as a surrogate of sympathetic nerve activity (SNA), (b) can distinguish Obstructive Sleep Apnea (OSA) patients from control subjects and (c) can document autonomic effects of treatment. 9 OSA and 10 control subjects were recruited in a laboratory study; 44 OSA subjects and 78 control subjects were recruited in a clinical study; and 21 untreated OSA subjects and 14 well-treated OSA subjects were recruited into a treatment study. Each subject performed hypoxic and room air voluntary apneas in triplicate. Muscle SNA (MSNA) and continuous AP were measured during each apnea in the laboratory study, while systolic arterial pressure (SAP) responses were measured continuously and by standard auscultation in the clinical and treatment studies. OSA subjects exhibited increased mean arterial pressure (MAP), SAP and MSNA responses to hypoxic apnea (all P < 0.01) and the SAP response highly correlated with the MSNA response (R2 = 0.72, P < 0.001). Clinical assessment confirmed that OSA subjects exhibited markedly elevated SAP responses (P < 0.01), while treated OSA subjects had a decreased SAP response to apnea (P < 0.04) compared to poorly treated subjects. These data indicate that (a) OSA subjects exhibit increased pressor and MSNA responses to apnea, and that (b) voluntary apnea may be a clinically useful assessment tool of autonomic dysregulation and treatment efficacy in OSA.
KW - Arterial pressure response
KW - Obstructive sleep apnea
KW - Sympathetic
UR - http://www.scopus.com/inward/record.url?scp=84983095800&partnerID=8YFLogxK
U2 - 10.1016/j.autneu.2015.12.003
DO - 10.1016/j.autneu.2015.12.003
M3 - Article
C2 - 26774324
AN - SCOPUS:84983095800
SN - 1566-0702
VL - 194
SP - 38
EP - 45
JO - Autonomic Neuroscience: Basic and Clinical
JF - Autonomic Neuroscience: Basic and Clinical
ER -