Influence of Sleep and Sleep Apnea on Autonomic Control of the Cardiovascular System

Krzysztof Narkiewicz, Virend K. Somers, Bradley G. Phillips

Research output: Chapter in Book/Report/Conference proceedingChapter


Normal sleep is accompanied by distinct alterations in blood pressure and heart rate. These alterations are dependent upon sleep stage and appear to be mediated primarily by changes in autonomic circulatory control. It has become increasingly clear that sleep does not consist of a homogenous autonomic cardiovascular pro?le but rather represents a dynamic and organized modulation of neural circulatory control. The spectrum of autonomic regulation during normal sleep includes sympathetic inhibition, bradycardia, and lower blood pressures during synchronized non-rapid-eye-movement (NREM) sleep, and sympathetic activation with intermittent surges in blood pressure and heart rate during REM sleep. In patients with obstructive sleep apnea, the normal sleep stage-related changes in sympathetic activity and blood pressure are opposed by chemore?ex-mediated responses to hypoxemia and hypercapnia. These chemore?ex-mediated responses frequently overwhelm the modulatory effects of normal sleep on neural circulatory control.

Original languageEnglish (US)
Title of host publicationSleep Apnea
Subtitle of host publicationImplications in Cardiovascular and Cerebrovascular Disease: Volume 146
PublisherCRC Press
Number of pages24
ISBN (Electronic)9780824741884
ISBN (Print)9781498743341
StatePublished - Jan 1 2000

ASJC Scopus subject areas

  • Medicine(all)


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