整夜完全睡眠剥夺对心血管自主神经活动的影响

The effects of overnight sleep deprivation on cardiovascular autonomic modulation

目的为研究整夜完全睡眠剥夺对人心血管自主神经活动的影响。方法对18例健康青年男性进行了整夜完全睡眠剥夺。在睡眠剥夺前后采集心电图及桡动脉连续血压波形。并进行频谱分析和对各频谱成分进行标准化。心率变异(HRV)的高频(HF)代表心脏副交感神经调制,低频(LF)代表交感神经调制而低频与高频的比率(LF/HF)代表交感神经与副交感神经的平衡,血压变异(BPV)的LF代表血管交感神经调制。结果睡眠剥夺前后心率与血压无显著变化。与基础值相比,整夜睡眠剥夺后HRVLF显著增加[(67·0±13·9)%vs(59·4±15·7)%,P=0·039],HRVLF/HF也显著增加(3·8±2·3比2·7±1·7,P=0·032),HRVHF有显著降低[(22·8±10·4)%比(29·0±11·6)%,P=0·030];BPVLF有显著增加[(72·4±13·2)%比(63·2±16·5)%,P<0·001]。结论整夜完全睡眠剥夺可导致健康青年男性心血管交感神经调制增加以及心脏副交感神经调制降低。

Objective This study aimed to delineate cardiovascular autonomic modulation associated with overnight total sleep deprivation （TSD） in humans. Methods Cardiovascular autonomic modulation during overnight total sleep deprivation was assessed in 18 normal male subjects [age：（26.2±4.2）years, BMI（23.9±1.7）kg/m^2 ]. ECG and continuous blood pressure from radial artery tonometry were obtained in seated position before TSD （baseline） and after overnight TSD. Spectral analysis of heart rate variability （HRV） and BP variability （BPV） were computed for cardiac parasympathetic modulation （high frequency power, HF） ; sympathetic modulation （low frequency power, LF） , sympatho-vagal balance （ LF/HF power of R-R variability, LF/HF） and BPV sympathetic modulation （ low frequency power, BPV LF） in normalized（N） units [（total power of the components）/（ total power-very low frequency power）×100]. Results No significant changes were found in BP and heart rate. HRV LF was increased significantly from baseline （59.4±15.7）% to overnight SD （67.0±13.9）%. HRV LF/HF was increased significantly from baseline （2. 7±1.7） to overnight SD （3.8±2.3） , HRV HFN was decreased from baseline （29. 0±11.6）% to overnight SD （22.8±10.4）%, BPV LF was significantly increased from baseline（63.2±16.5）% to overnight SD （72.4±13.2）%. Conclusion Acute SD was associated with increased sympathetic and decreased parasympathetic cardiovascular modulation.