Sleep apnea, norepinephrine-release rate, and daytime hypertension

Sleep
M G ZieglerJ E Dimsdale

Abstract

Patients with obstructive sleep apnea (OSA) are often hypertensive, and both apneics and hypertensives are reported to have increased sympathetic nerve activity. We measured plasma norepinephrine (NE) levels, clearance, and release rate among 65 subjects who breathed room air, a hypoxic gas mixture, and the hypoxic mixture combined with intermittent breath holding. Apneics' plasma NE across all three breathing conditions was 307 pg/ml compared with the non-apneics' level of 248 pg/ml (p = 0.017). NE clearance increased from 3.2 l/minute to 3.9 l/minute when subjects breathed a hypoxic gas mixture (p < 0.001). NE clearance was similar among normal controls, apneics, and hypertensives. The rate at which NE was released from sympathetic nerves into the bloodstream was higher among hypertensives but not among apneics while subjects breathed room air. Hypoxia increased the NE-release rate from 892 ng/minute to 1,042 ng/minute (p < 0.001) and increased the NE-release rate more among apneics than non-apneics (p < 0.001). The NE-release rate response to hypoxia and breath holding differed between hypertensives and normotensives (p < 0.001) and between apneics and non-apneics (p < 0.001). Normotensive apneics had the largest increase in...Continue Reading

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