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[Autonomic nervous system and obstructive sleep apneas].

R Smith1, D Veale, J L Pépin

  • 1Service de Pneumologie, CHU de Grenoble.

Revue Des Maladies Respiratoires
|September 3, 1999
PubMed
Summary

Obstructive sleep apnoea causes significant autonomic nervous system changes, impacting cardiovascular health. Continuous positive airway pressure (CPAP) therapy can mitigate these effects, though long-term cardiovascular benefits require further study.

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Area of Science:

  • Physiology
  • Cardiovascular Medicine
  • Sleep Medicine

Context:

  • Obstructive sleep apnoea (OSA) is a common condition with significant cardiovascular implications.
  • Recent research has rapidly advanced the understanding of OSA's pathophysiology.
  • Cardiovascular changes and morbidity are linked to OSA, with the autonomic nervous system playing a key role.

Purpose:

  • To investigate the role of the autonomic nervous system in mediating cardiovascular changes associated with obstructive sleep apnoea.
  • To explore the acute and chronic autonomic alterations in OSA patients.
  • To assess the impact of CPAP therapy on these autonomic and cardiovascular changes.

Summary:

  • Acute hemodynamic changes in OSA are linked to high sympathetic discharge and fluctuating parasympathetic activity.

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  • Chronic changes include altered baroreceptor/chemoreceptor reflexes, increased daytime sympathetic activity, and abnormal vagal responses.
  • These autonomic changes are triggered by hypoxemia, upper airway responses, ventilatory changes, and arousal.

    • Impact:

    • Continuous positive airway pressure (CPAP) therapy normalizes respiration, preventing acute cardiovascular changes and reducing sympathetic over-activity.
    • CPAP therapy can restore abnormal vagal responses and decrease chronic sympathetic activity in compliant patients.
    • The long-term reduction in cardiovascular morbidity with CPAP therapy in OSA patients remains to be definitively established.