阻塞性睡眠呼吸暂停引起觉醒的通路研究进展

Advance of pathways mediating arousal from obstructive sleep apnea

阻塞性睡眠呼吸暂停(OSA)患者睡眠过程中反复发作的上呼吸道部分或完全塌陷会诱发频繁睡眠微觉醒。觉醒是一种保护性反射,可通过增强通气驱动力恢复正常呼吸,缓解气道阻塞,但频繁睡眠微觉醒会破坏呼吸代偿和睡眠结构。研究觉醒的皮质脑电图和呼吸反应的神经回路,有助于提高对OSA多种病理生理的理解,探索新的OSA相关药物治疗。本文综述了介导OSA觉醒的相关通路,及臂旁核在反射中的整合功能。

Obstructive sleep apnea(OSA)is characterized by recurrent partial or complete collapse of the upper airway during patients sleep,which induces more frequently sleep micro-arousal.Arousal is a protective reflex that contributes to recovery of effective breathing and relief of airway obstruction by enhancing ventilation drive force.However,frequent micro-arousal might damage respiratory compensation and sleep structure.The neural circuits regarding arousal electrocorticography and respiratory reflex will assist the knowledge of OSA pathophysiology for exploring novel treatments option for OSA.This paper reviewes the relevant pathways mediating arousal from OSA and the integrated function of parabrachial nucleus in this process.