Abstract
Unstable (cyclical alternating pattern, or CAP) sleep is associated with surges of sympathetic nervous system activity, increased blood pressure and vasoconstriction, heightened baroreflex sensitivity, and unstable heart rhythm and breathing. In susceptible persons, CAP sleep provokes clinically significant events, including hypertensive crises, sleep-disordered breathing, and cardiac arrhythmias. Here we explore the neurophysiology of CAP sleep and its impact on cardiovascular and respiratory functions. We show that: (i) an increase in neurophysiological recovery rate can explain the emergence of slow, self-sustained, hypersynchronized A1 CAP-sleep pattern and its transition to the faster A2-A3 CAP-sleep patterns; (ii) in a two-dimensional, continuous model of cardiac tissue with heterogeneous action potential duration (APD) distribution, heart rate accelerations during CAP sleep may encounter incompletely recovered electrical excitability in cell clusters with longer APD. If the interaction between short cycle length and incomplete, spatially heterogeneous repolarization persists over multiple cycles, irregularities and asymmetry of depolarization front may accumulate and ultimately lead to a conduction block, retrograde cond...Continue Reading
References
Jan 1, 1972·Biophysical Journal·H R Wilson, J D Cowan
Aug 1, 1995·Journal of the American College of Cardiology·K P AndersonM Mori
May 1, 1995·Circulation·B S KollerM R Franz
Jan 1, 1994·Journal of the American College of Cardiology·M RoelkeJ N Ruskin
Feb 1, 1996·Cardiovascular Research·R L VerrierJ A Hobson
Jun 15, 2000·Computers and Biomedical Research, an International Journal·V ShustermanK P Anderson
Jan 18, 2002·Journal of Applied Physiology·Bruce D Nearing, Richard L Verrier
Oct 3, 2002·Circulation·Rachel LampertDiwakar Jain
Jan 18, 2003·Sleep Medicine Reviews·Mario Giovanni Terzano, Liborio Parrino
Apr 23, 2003·Circulation·Martyn P NashDavid J Paterson
Jan 13, 2004·Journal of Electrocardiology·Vladimir ShustermanDavid Schwartzman
Nov 10, 2004·Journal of Electrocardiology·Vladimir Shusterman, Anna Goldberg
Jun 21, 2006·Circulation·Vladimir ShustermanBarry London
Jul 1, 2006·Sleep Medicine Reviews·Liborio ParrinoMario Giovanni Terzano
Jul 23, 2008·Physical Review. E, Statistical, Nonlinear, and Soft Matter Physics·Vladimir Shusterman, William C Troy
Feb 28, 2009·Journal of the American College of Cardiology·Rachel LampertRobert Soufer
Apr 19, 2011·Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc·Eathar RazakJan Němec
Mar 21, 2012·Journal of Cardiovascular Electrophysiology·Vladimir ShustermanDavid Schwartzman
Oct 9, 2012·International Journal of Cardiology·Taner UlusBulent Gorenek