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Baroreflex modulation during sleep and in obstructive sleep apnea syndrome
Authors:Cortelli P  Lombardi C  Montagna P  Parati G
Affiliation:IRCSS Istituto delle Scienze Neurologiche di Bologna, Dipartimento di Scienze Neurologiche, Alma Mater Studiorum - Università di Bologna, Italy.
Abstract:
This review focuses on the complex integration between cardiovascular reflexes and central autonomic influences controlling physiological sleep-dependent changes in arterial blood pressure and heart rate. A brief introduction on the anatomic and functional organization of the arterial baroreflex and the methods available to assess its function in humans is followed by an analysis of the functional interaction between autonomic nervous system and sleep mechanisms at the highest levels of brain organization. An insight into these interactions is important to shed light on the physiopathology of the most frequent complications of obstructive sleep apnea syndrome, such as sustained arterial hypertension, and excessive daytime sleepiness.
Keywords:ANS, autonomic nervous system   OSA (OSAS), obstructive sleep apnea (syndrome)   AH, arterial hypertension   EDS, excessive daytime sleepiness   NTS, nucleus of the solitary tract   CVLM, caudal ventrolateral medulla   NA, nucleus ambiguus   SON, supraoptic nuclei of the hypothalamus   PVN, paraventricular nuclei of the hypothalamus   ABP, arterial blood pressure   PAG, periaqueductal gray   BRS, baroreflex sensitivity   NREMS, non-rapid eye movement sleep   REMS, rapid eye movement sleep   EEG, electroencephalogram   CAP, cyclic alternating pattern   HR, heart rate   HIFs, hypoxia-inducible factors   NFAT, nuclear factor of activated T-cells   NF-κB, nuclear factor κB   CPAP, continuous positive airway pressure   RVLM, rostral ventrolateral medulla   SRBD, sleep-related breathing disorders   PSG, polysomnography   MSLT, multiple sleep latency test
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