Blood pressure increase detected by ambulatory monitoring correlates with hypoxemia reflecting sleep apnea severity

Abstract

<jats:title>Abstract</jats:title><jats:p>Ambulatory blood pressure monitoring and parallel polysomnographic study were performed in 116 adult males divided into 6 groups. Thirty blood-pressure (BP) and polysomnographic variables were measured to test their usefulness for screening for both arterial hypertension and sleep apnea-hypopnea syndrome (SAHS). The development of severe breathing disorders and hypoxemia during sleep was attributed to SAHS, when compared with measurements in healthy controls and in patients with arterial hypertension. Such disorders manifested as an increased apnea-hypopnea index, apnea index, duration of arterial oxygen saturation of less than 85%, and decrease of average arterial oxygen saturation that correlated with nocturnal average diastolic BP (p=0.0049, p=0.0027, p=0.049 and p=0.0457, respectively). These respiratory disorders resulted in various nocturnal, rather than diurnal, and diastolic and systolic BP variables. The acute antihypertensive effect of continuous positive airway pressure therapy for SAHS significantly reduced the episodes of apnea and hypopnea and the secondary component of hypertension caused by excessive sympathetic stimulation. For the SAHS-induced, dose-dependent component of hypertension that responded to continuous positive airway pressure, the following variables, in decreasing significance, were useful: nocturnal average systolic and diastolic BP and 24-hour average systolic and diastolic BP, as well as percent time elevation and mean blood pressure load. The monitoring of these variables could contribute to early diagnostic and prognostic stratification of complications and adequate therapy of the secondary component of hypertension caused by SAHS.</jats:p>

Resuscitation and auto resuscitation by airway reflexes in animals

“…The resuscitation potential of AspR was proved by termination of progressive hypotension and atrio-ventricular (A-V) blockade in a cat, during gasping stage caused by severe asphyxia, indicated on Figure 3 , analyzed later more in detail. Similar gasp-like inspirations were elicited by mechanical stimulation of NPh also in adult rats [ 36 ], dogs [ 37 ] and premature infants [ 38 ], as well as by inflation of the whole respiratory system also in newborn babies [ 39 ]. Such approved similarity of gasp-like AspR in cats and other animals, with the gasping in infants suggests also similar resuscitation potential for AspR in cats and other animals, than gasping in human infants.…”

“…They were characterized by increase in tidal volume, airflow and minute volume, compared to control breaths. Such AspR-es provoked by mechanical stimulations, repeated in cycles of 16 s, significantly decreased the higher HR and the number of extrasystoles, caused by intraperitoneal application of aconitin [ 36 ]. AspR has various powerful normalization and restorative effects , which can inhibit different spastic events, such as bronchoconstriction and laryngospasm, as well as interrupts hypoxic apnoea, and inhibits the number and intensity of the cough efforts, at least in cats.…”

Light-dark dependence of electrocardiographic changes during asphyxia and reoxygenation in a rat model

“…Apnoeic episodes, obstructive or central and often in connection with the sleep apnea syndrome, are linked with cardiac arrhythmias [45][46][47][48][49][50].…”