Evaluation of Autonomic Dysfunction in Obstructive Sleep Apnea Syndrome

Yıl 2012, Cilt: 21 Sayı: 2, 109 - 121, 01.06.2012

Ahmet Turan Evlice

Öz

The nervous system, which controls the body's internal organs is called Autonomic Nervous System. Parkinson's disease, vascular diseases, diabetes mellitus and Guilllain-Barre syndrome cause to disotonomia. Recent studies has been shown, obstructive sleep apnea syndrome cause to disotonomia too. To investigate disotonomia in in obstructive sleep apnea syndrome , should be preferred the methods like analysis of heart rate variability and sympathetic skin response which have low cost and easy applicability. Thus, it will be possible to prevent morbidity and mortality due to autonomic dysfuncion.

Anahtar Kelimeler

Autonomic nervous system , obstructive sleep apnea syndrome, heart rate variability, sympathetic skin response

Obstruktif Uyku Apne Sendromunda Otonomik Disfonksiyonun Değerlendirilmesi

Öz

Sinir sisteminin, vücudun iç organlarını kontrol eden bölümüne Otonom Sinir Sistemi denmektedir. Disotonomiye neden olan nedenler arasında Parkinson hastalığı, vasküler hastalıklar, diabetes mellitus, Guilllain-Barre sendromu sayılabilir. Son dönemde yapılan çalışmalarda obstrüktif uyku apne sendromunun da disotonomiye neden olduğu gösterilmiştir. Obstrüktif uyku apne sendromunda disotonomiyi araştırmak için kalp hız değişkenliği ve sempatik deri yanıtı incelemesi, düşük maliyet ve kolay uygulanabilirliği ile tercih edilmesi gereken yöntemlerdir. Böylece otonomik disfonksiyonun neden olduğu morbidite ve mortalitenin önüne geçmek mümkün olacaktır.

Anahtar Kelimeler

Otonom sinir sistemi, obstrüktif uyku apne sendromu, kalp hız değişkenliği, sempatik deri yanıtı

Kaynakça

• Ravits JM. AAEM minimonograph #48: autonomic nervous system testing. Muscle Nerve. 1997; 20: 919-37.
• Low PA. Clinical Autonomic Disorders: Evaluation and Management. 1993;169-197.
• Toyokura M. Sympathetic skin responses: the influence of electrical stimulus intensity and habituation on the waveform. Clin Auton Res. 2006; 16: 130-5.
• Akyüz G. Türkdoğan Sözüer D, Turan B, Canbolat N, Yilmaz I, Us O, Kayhan O. Normative data of sympathetic skin response and RR interval variation in Turkish children. Brain Dev. 1999; 21: 99-102.
• Hedner J, Ejnell H, Sellgren J, Hedner T, Wallin G. Is high and fluctuating muscle nerve sympathetic activity in the sleep apnoea syndrome of pathogenetic importance for the development of hypertension? J Hypertens Suppl. 1988; 6: 529-31.
• Carlson JT, Hedner J, Elam M, Ejnell H, Sellgren J, Wallin BG. Augmented resting sympathetic activity in awake patients with obstructive sleep apnea. Chest. 1993; 103: 1763- 8.
• Narkiewicz K, van de Borne PJ, Cooley RL, Dyken ME, Somers VK. Sympathetic activity in obese subjects with and without obstructive sleep apnea. Circulation. 1998; 98: 772-6.
• Peled N, Greenberg A, Pillar G, Zinder O, Levi N, Lavie P. Contributions of hypoxia and respiratory disturbance index to sympathetic activation and blood pressure in obstructive sleep apnea syndrome. Am J Hypertens. 1998; 11: 1284-9.
• Morgan BJ, Crabtree DC, Palta M, Skatrud JB. Combined hypoxia and hypercapnia evokes long-lasting sympathetic activation in humans. J Appl Physiol. 1995; 79: 205-13.
• Xie A, Skatrud JB, Crabtree DC, Puleo DS, Goodman BM, Morgan BJ. Neurocirculatory consequences of intermittent asphyxia in humans. J Appl Physiol. 2000; 89: 1333-9.
• Heart rate variability. Standards of measurement, physiological interpretation, and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Eur Heart J. 1996; 17: 354-81.
• Kucera P,Goldenberg Z, Kurca E. Sympathetic skin response: review of the method and its clinical use. Bratisl Lek Listy. 2004; 105:108-16.
• Miller WP. Cardiac arrhythmias and conduction disturbances in the sleep apnea syndrome. Prevalence and significance. Am J Med. 1982; 73: 317-21.
• Guilleminault C, Connolly SJ, Winkle RA. Cardiac arrhythmia and conduction disturbances during sleep in 400 patients with sleep apnea syndrome. Am J Cardiol. 1983; 52: 490-4.
• Stoohs R, Guilleminault C. Cardiovascular changes associated with obstructive sleep apnea syndrome. J Appl Physiol. 1992; 72: 583-9.
• Guilleminault C, Connolly S, Winkle R, Melvin K, Tilkian A. Cyclical variation of the heart rate in sleep apnoea syndrome. Mechanisms, and usefulness of 24 h electrocardiography as a screening technique. Lancet. 1984; 1: 126-31.
• Roche F, Gaspoz JM, Court-Fortune I, Minini P, Pichot V, Duverney D, Costes F, Lacour JR, Barthélémy JC. Screening of obstructive sleep apnea syndrome by heart rate variability analysis. Circulation. 1999; 100: 1411-5.
• Hilton MF, Bates RA, Godfrey KR, Chappell MJ, Cayton RM. Evaluation of frequency and time-frequency spectral analysis of heart rate variability as a diagnostic marker of the sleep apnoea syndrome. Med Biol Eng Comput. 1999; 37: 760-9.
• Dingli K, Assimakopoulos T, Wraith PK, Fietze I, Witt C, Douglas NJ. Spectral oscillations of RR intervals in sleep apnoea/hypopnoea syndrome patients. Eur Respir J. 2003; 22: 943-50.
• Roche F, Pichot V, Sforza E, Court-Fortune I, Duverney D, Costes F, Garet M, Barthélémy JC. Predicting sleep apnoea syndrome from heart period: a time-frequency wavelet analysis. Eur Respir J. 2003; 22: 937-42.
• Bixler EO, Vgontzas AN, Ten Have T, Tyson K, Kales A. Effects of age on sleep apnea in men: I. Prevalence and severity. Am J Respir Crit Care Med. 1998; 157: 144-8.
• Versace F, Mozzato M, De Min Tona G, Cavallero C, Stegagno L. Heart rate variability during sleep as a function of the sleep cycle. Biol Psychol. 2003; 63: 149-62.
• Vanoli E, Adamson PB, Ba-Lin, Pinna GD, Lazzara R, Orr WC. Heart rate variability during specific sleep stages. A comparison of healthy subjects with patients after myocardial infarction. Circulation. 1995; 91: 1918-22.
• Ertekin C. Sentral ve periferik EM. 2006; 195-211, 883-911.
• Bennett T, Farquhar IK, Hosking DJ, Hampton JR. Assessment of methods for estimating autonomic nervous control of the heart in patients with diabetes mellitus. Diabetes. 1978; 27: 1167-74.
• Bennett T, Fentem PH, Fitton D, Hampton JR, Hosking DJ, Riggott PA. Assessment of vagal control of the heart in diabetes. Measures of R-R interval variation under different conditions. Br Heart J. 1977; 39: 25-8.
• Ewing DJ, Borsey DQ, Bellavere F, Clarke BF. Cardiac autonomic neuropathy in diabetes: comparison of measures of R-R interval variation. Diabetologia. 1981; 21: 18-24.
• Low PA, Opfer-Gehrking TL, Proper CJ, Zimmerman I. The effect of aging on cardiac autonomic and postganglionic sudomotor function. Muscle Nerve. 1990; 13: 152-7.
• Pfeifer MA, Cook D, Brodsky J, Tice D, Reenan A, Swedine S, Halter JB, Porte D Jr. Quantitative evaluation of cardiac parasympathetic activity in normal and diabetic man. Diabetes. 1982; 31: 339-45.
• Wieling W, van Brederode JF, de Rijk LG, Borst C, Dunning AJ. Reflex control of heart rate in normal subjects in relation to age: a data base for cardiac vagal neuropathy. Diabetologia. 1982; 22: 163-6.
• Eckberg DL. Parasympathetic cardiovascular control in human disease: a critical review of methods and results. Am J Physiol. 1980; 239: 581-93.
• Benarroch EE, Opfer-Gehrking TL, Low PA. Use of the photoplethysmographic technique to analyze the Valsalva maneuver in normal man. Muscle Nerve. 1991; 14: 1165-72.
• Benarroch EE, Chang FL. Central autonomic disorders. J Clin Neurophysiol. 1993; 10: 39- 50.
• Nishimura RA, Tajik AJ. The Valsalva maneuver and response revisited. Mayo Clin Proc. 1986; 61: 211-7.
• Smith SA. Reduced sinus arrhythmia in diabetic autonomic neuropathy: diagnostic value of an age-related normal range. Br Med J (Clin Res Ed). 1982; 285: 1599-601.
• Low PA, Zimmerman BR, Dyck PJ. Comparison of distal sympathetic with vagal function in diabetic neuropathy. Muscle Nerve. 1986; 9: 592-6.
• Wheeler T, Watkins PJ. Cardiac denervation in diabetes. Br Med J. 1973; 4: 584-6.
• Malik M, Farrell T, Cripps T, Camm AJ. Heart rate variability in relation to prognosis after myocardial infarction: selection of optimal processing techniques. Eur Heart J. 1989; 10: 1060-74.
• Narkiewicz K, Somers VK. Sympathetic nerve activity in obstructive sleep apnoea. Acta Physiol Scand. 2003; 177: 385-90.
• Smith RP. Obstructive sleep apnoea and the autonomic nervous system. Sleep Medicine Reviews. 1998; 2: 69-92.
• Zakrzewska-Pniewska B, Nojszewska M, Przybylowski T, Byśkiniewicz K. Clinical versus electrophysiological assessment of dysautonomia in obstructive sleep apnea syndrome. J Clin Neurophysiol. 2004; 21: 435-9.
• Wang GH. The galvanic skin reflex; a review of old and recent works from a physiologic point of view. II. Am J Phys Med. 1958; 37: 35-57.
• Knezevic W, Bajada S. Peripheral autonomic surface potential. A quantitative technique for recording sympathetic conduction in man. J Neurol Sci. 1985; 67: 239-51.
• Flanigan, WF, Wilcox RH, Rechtschaffen A. The EEG and behavioral continuum of the crocodilian, Caiman sclerops. Electroencephalogr Clin Neurophysiol. 1973; 34: 521-38.
• Shahani BT, Halperin JJ, Boulu P, Cohen J. Sympathetic skin response--a method of assessing unmyelinated axon dysfunction in peripheral neuropathies. J Neurol Neurosurg Psychiatry. 1984; 47: 536-42.
• Vinik AI, Maser RE, Mitchell BD, Freeman R. Diabetic autonomic neuropathy. Diabetes Care. 2003; 26: 1553-79.
• Schondorf R. New investigations of autonomic nervous system function. J Clin Neurophysiol. 1993; 10: 28-38.
• Redline S, Tishler PV, Hans MG, Tosteson TD, Strohl KP, Spry K. Racial differences in sleep-disordered breathing in African-Americans and Caucasians. Am J Respir Crit Care Med. 1997; 155: 186-92.
• Strobel RJ, Rosen RC. Obesity and weight loss in obstructive sleep apnea: a critical review. Sleep. 1996; 19: 104-15.
• Kucera P, Goldenberg Z, Kurca E. Sympathetic skin response: review of the method and its clinical use. Bratisl Lek Listy. 2004; 105: 108-16.
• Cohen AM, Vig PS. A serial growth study of the tongue and intermaxillary space. Angle Orthod. 1976; 46: 332-7.
• Braune HJ. Early detection of diabetic neuropathy: a neurophysiological study on 100 patients. Electromyogr Clin Neurophysiol. 1997; 37: 399-407.
• Levy DM, Reid G, Rowley DA, Abraham RR. Quantitative measures of sympathetic skin response in diabetes: relation to sudomotor and neurological function. J Neurol Neurosurg Psychiatry. 1992; 55: 902-8.
• Soliven B, Maselli R, Jaspan J, Green A, Graziano H, Petersen M, Spire JP. Sympathetic skin response in diabetic neuropathy. Muscle Nerve. 1987; 10: 711-6.
• Solders G. Autonomic function tests in healthy controls and in terminal uraemia. Acta Neurol Scand. 1986; 73: 638-9.
• Argani H, Ayromlou H, Raisii M. Sympathetic skin response in hemodialysis and renal transplantation. Transplant Proc. 2002; 34: 2128.
• Montagna P, Salv Fi, Liguor R. Sympathetic skin response in familial amyloid polyneuropathy. Muscle Nerve. 1988; 11: 183-4.
• Tugnoli V, Eleopra R, De Grandis D. Hyperhidrosis and sympathetic skin response in chronic alcoholic patients. Clin Auton Res. 1999; 9: 17-22.
• Ulvi H, Yoldaş T, Yiğiter R, Müngen B. R-R interval variation and the sympathetic skin response in the assessment of the autonomic nervous system in leprosy patients. Acta Neurol Scand. 2003; 107: 42-9.
• Solder G, Andersson T, Persson A. Central conduction and autonomic nervous function in HMSN I. Muscle Nerve. 1991; 14: 1074-9.
• Taly, AB, Arunodaya GR, Rao S, Sympathetic skin response in Guillain-Barre syndrome. Clin Auton Res. 1995. 5: 215-9.
• Malessa R, Ohrmann P, Agelink MW, Brockmeyer NH, Diener HC. [HIV-1 associated autonomic dysfunction (HIVAD)]. Nervenarzt. 1996; 67: 147-54.