Arterial blood pressure responses to graded transient arousal from sleep in normal humans

Davies, Robert J. O.; Belt, P. J.; Roberts, S. J.; Ali, Noorjahan; Stradling, John

doi:10.1152/jappl.1993.74.3.1123

Cited by 274 publications

(201 citation statements)

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“…In addition, we found significant cardiovascular changes at event termination despite few CAs, regardless of type, being terminated by arousal. This is consistent with previous studies in adults that have demonstrated that arousals not meeting the ASDA criteria are also associated with significant autonomic changes, albeit smaller than those associated with EEG desynchronization (Davies et al, 1993).…”

Section: Discussionsupporting

confidence: 93%

Central apnoeas have significant effects on blood pressure and heart rate in children

O'Driscoll

Foster

et al. 2009

Journal of Sleep Research

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Summary Brief central apnoeas (CAs) during sleep are common in children and are not usually considered clinically significant unless associated with oxygen desaturation. CAs can occur spontaneously or following a movement or sigh. The aim of this study was to investigate acute cardiovascular changes associated with CAs in children. Beat‐by‐beat mean arterial pressure (MAP) and heart rate (HR) were analysed across CAs, and spontaneous and movement‐induced events were compared using two‐way analysis of variance with post hoc analyses. Fifty‐three children (28 male/25 female) aged 7–12 years referred for investigation of sleep‐disordered breathing (SDB) and 21 age‐matched healthy controls (8 male/13 female) were studied. Children underwent routine clinical polysomnography with continuous blood pressure (BP) recordings. Movement‐induced, but not spontaneous, CAs were more frequent in children with mild or moderate/severe obstructive sleep apnoea (OSA) compared with healthy controls (P < 0.05 for both). Movement‐induced CAs were associated with significantly larger MAP and HR changes across the event compared with spontaneous CAs. The percentage changes in MAP and HR between late‐event and post‐event were significantly greater for movement‐induced compared with spontaneous CAs (MAP 20.6 ± 2.3 versus 12.2 ± 1.8%, P < 0.01; HR 28.2 ± 2.6 versus 14.7 ± 2.5%, P < 0.001). This study demonstrates that movement‐induced CAs are more common in children with OSA, and are associated with significantly greater changes in HR and BP compared with spontaneous CAs. These data suggest that movement‐induced CAs should be considered when assessing the cardiovascular impact of SDB.

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Section: Discussionsupporting

confidence: 93%

Central apnoeas have significant effects on blood pressure and heart rate in children

O'Driscoll

Foster

et al. 2009

Journal of Sleep Research

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“…The higher night-time risks may also be explained by acute physiologic responses induced by night-time noise events that might affect restoration during sleep. Noise-induced instantaneous autonomic responses during sleep do not only occur in waking hours but also in sleeping subjects even when no (electroencephalogram recorded) awakening occurs (Davies et al 1993). Subjects do not adapt on a long-term basis although a clear subjective habituation occurs after a few nights (Muzet 2002).…”

Section: Discussionmentioning

confidence: 99%

Hypertension and Exposure to Noise Near Airports—The Hyena Study

et al. 2007

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BACKGROUND: An increasing number of people are exposed to aircraft and road traffic noise. Hypertension is an important risk factor for cardiovascular disease, and even a small contribution in risk from environmental factors may have a major impact on public health. OBJECTIVES: The HYENA (Hypertension and Exposure to Noise near Airports) study aimed to assess the relations between noise from aircraft or road traffic near airports and the risk of hypertension. METHODS:We measured blood pressure and collected data on health, socioeconomic, and lifestyle factors, including diet and physical activity, via questionnaire at home visits for 4,861 persons 45-70 years of age, who had lived at least 5 years near any of six major European airports. We assessed noise exposure using detailed models with a resolution of 1 dB (5 dB for United Kingdom road traffic noise), and a spatial resolution of 250 × 250 m for aircraft and 10 × 10 m for road traffic noise. RESULTS: We found significant exposure-response relationships between night-time aircraft as well as average daily road traffic noise exposure and risk of hypertension after adjustment for major confounders. For night-time aircraft noise, a 10-dB increase in exposure was associated with an odds ratio (OR) of 1.14 [95% confidence interval (CI), 1.01-1.29]. The exposure-response relationships were similar for road traffic noise and stronger for men with an OR of 1.54 (95% CI, 0.99-2.40) in the highest exposure category (> 65 dB; p trend = 0.008). CONCLUSIONS: Our results indicate excess risks of hypertension related to long-term noise exposure, primarily for night-time aircraft noise and daily average road traffic noise.

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“…Another possible explanation could be that we observed that the mean duration of the respiratory events preceding longer arousals showed a trend to be higher than the duration of events preceding shorter arousals. Davies et al [7] showed that apnea length was an independent predictor of blood pressure rise. They suggested that because the stimulus required for causing arousal increases with the depth of NREM sleep, longer apneas (during which sleep has had longer to become established) may require a more intense arousal response for their termination and, thus, lead to larger peripheral autonomic effects.…”

Section: Discussionmentioning

confidence: 99%

“…The arousal response is important for survival of the affected patient; however, the sleep fragmentation induced by repetitive arousals and the physiological events that surround the arousal response also have adverse consequences which contribute to the pathophysiology and clinical manifestations of SDB [5]. Arousals are characterized by abrupt changes in central nervous system activity that produce electroencephalogram (EEG) activation and marked changes in a wide range of autonomic nervous system parameters such as heart rate (HR), blood pressure (BP), ventilation and peripheral vascular resistance [6][7][8][9][10]. Arousals are typically evident and conventionally detected as changes in cortical EEG activity, a labor-intensive approach associated with high interscorer variability [11].…”

Section: Introductionmentioning

confidence: 99%

Obstructive sleep apnea syndrome: effect of respiratory events and arousal on pulse wave amplitude measured by photoplethysmography in NREM sleep

et al. 2005

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Obstructive sleep apnea syndrome: effect of respiratory events and arousal on pulse wave amplitude measured by photoplethysmography in NREM sleep Abstract The objective of the study is to evaluate changes in finger pulse wave amplitude (PWA), as measured by photoplethysmography, and heart rate (HR), related to obstructive respiratory events and associated arousals during sleep. We analyzed 1,431 respiratory events in NREM sleep from 12 patients according to (1) the type of event (apnea, hypopnea, upper airway resistance episode) and (2) the duration of the associated EEG arousal (>10, 3-10, <3 s). Obstructive respiratory events provoked a relative bradycardia and vasodilation followed by HR increase and vasoconstriction. Relative PWA changes were significantly greater than HR changes. These responses differed significantly according to EEG-arousal grades (time×arousal interaction, p<0.0001), with longer arousals producing greater responses, but not to the type of respiratory event (time×event interaction, p = ns). Obstructive respiratory events provoke HR and PWA changes, the magnitude seemingly related to the intensity of central nervous activation, with PWA changes greater than HR. PWA obtained from a simple pulse oxymeter might be a valuable method to evaluate sleep fragmentation in sleep breathing disorders.

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Arterial blood pressure responses to graded transient arousal from sleep in normal humans

Cited by 274 publications

References 0 publications

Central apnoeas have significant effects on blood pressure and heart rate in children

Central apnoeas have significant effects on blood pressure and heart rate in children

Hypertension and Exposure to Noise Near Airports—The Hyena Study

Obstructive sleep apnea syndrome: effect of respiratory events and arousal on pulse wave amplitude measured by photoplethysmography in NREM sleep

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