Sympathetic nerve activity in obstructive sleep apnoea

Krzysztof Narkiewicz, Virend Somers

Research output: Contribution to journalArticle

239 Citations (Scopus)

Abstract

The mechanisms underlying the link between obstructive sleep apnoea (OSA) and cardiovascular disease are not completely established. However, there is increasing evidence that autonomic mechanisms are implicated. A number of studies have consistently shown that patients with OSA have high levels of sympathetic nerve traffic. During sleep, repetitive episodes of hypoxia, hypercapnia and obstructive apnoea act through chemoreceptor reflexes and other mechanisms to increase sympathetic drive. Remarkably, the high sympathetic drive is present even during daytime wakefulness when subjects are breathing normally and no evidence of hypoxia or chemoreflex activation is apparent. Several neural and humoral mechanisms may contribute to maintenance of higher sympathetic activity and blood pressure. These mechanisms include chemoreflex and baroreflex dysfunction, altered cardiovascular variability, vasoconstrictor effects of nocturnal endothelin release and endothelial dysfunction. Long-term continuous positive airway pressure treatment decreases muscle sympathetic nerve activity in OSA patients. The vast majority of OSA patients remain undiagnosed. Unrecognized OSA may contribute, in part, to the metabolic and cardiovascular derangements that are thought to be linked to obesity, and to the association between obesity and cardiovascular risk. Furthermore, acting through sympathetic neural mechanisms, OSA may contribute to or augment elevated levels of blood pressure in a large proportion of the hypertensive patient population.

Original languageEnglish (US)
Pages (from-to)385-390
Number of pages6
JournalActa Physiologica Scandinavica
Volume177
Issue number3
DOIs
StatePublished - Mar 1 2003

Fingerprint

Obstructive Sleep Apnea
Obesity
Blood Pressure
Continuous Positive Airway Pressure
Hypercapnia
Baroreflex
Wakefulness
Endothelins
Vasoconstrictor Agents
Apnea
Reflex
Sleep
Respiration
Cardiovascular Diseases
Muscles
Population

Keywords

  • Autonomic nervous system
  • Blood pressure
  • Heart rate
  • Sleep apnoea
  • Sympathetic nervous system

ASJC Scopus subject areas

  • Physiology

Cite this

Sympathetic nerve activity in obstructive sleep apnoea. / Narkiewicz, Krzysztof; Somers, Virend.

In: Acta Physiologica Scandinavica, Vol. 177, No. 3, 01.03.2003, p. 385-390.

Research output: Contribution to journalArticle

Narkiewicz, Krzysztof ; Somers, Virend. / Sympathetic nerve activity in obstructive sleep apnoea. In: Acta Physiologica Scandinavica. 2003 ; Vol. 177, No. 3. pp. 385-390.
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