Baroreflex modulation during sleep and in obstructive sleep apnea syndrome |
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Authors: | Cortelli P Lombardi C Montagna P Parati G |
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Affiliation: | IRCSS Istituto delle Scienze Neurologiche di Bologna, Dipartimento di Scienze Neurologiche, Alma Mater Studiorum - Università di Bologna, Italy. |
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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. |
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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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