Effects of autonomic nervous system on relationships between sleep-disordered breathing and cardiovascular disease

Abstract

There are close relationships between sleep-disordered breathing (SDB) and cardiovascular disease. Mechanisms linking between SDB and cardiovascular disease include a reduction in cardiac output induced by negative inspiratory intrathoracic pressure during obstructive sleep apnea, oxidative stress, enhanced inflammatory reaction caused by repeated intermittent hypoxia, and augmented sympathetic nerve activity. Hypoxia and hypercapnia induced by apnea, reduced cardiac output, diminished stimulations of lung stretch receptor, and arousals enhance sympathetic nerve activity in SDB patients. In addition, such enhanced sympathetic nerve activity is not only observed during sleeping but also during awakening and contribute to pathogenesis of cardiovascular disease through elevated blood pressure, heart rate, and provocation of cardiac arrhythmias.