TY - JOUR
T1 - Obstructive sleep apnoea and hypertension : the role of the central nervous system
AU - Henderson, Luke A.
AU - Macefield, Vaughan G.
PY - 2016
Y1 - 2016
N2 - Purpose of review Obstructive sleep apnoea (OSA) is associated with both nocturnal and daytime hypertensions which increase cardiovascular morbidity and mortality. It is thought that the repeated episodes of hypoxia and hypercapnia during nocturnal airway obstructions that characterise OSA result in increased sympathetic drive that persists during wakefulness. Although the underlying mechanisms responsible for this hypertension remain to be elucidated, several neural and humoral mechanisms have been proposed and recent evidence suggesting changes in the central nervous system may play a significant role. The purpose of this review is to explore recent evidence of central changes associated with elevated sympathetic drive in individuals with OSA. Recent findings Recent human brain imaging investigations and, in particular, combined microneurography recording of resting sympathetic activity with high-resolution functional magnetic resonance imaging have provided some important insights into changes in brain function and anatomy associated with resting sympathetic activity. Functional and anatomical changes occur in OSA, including in regions of the brainstem circuitry known to be responsible for setting resting sympathetic activity. Furthermore, these changes are reversed following continuous positive airway treatment in concert with reductions in resting sympathetic drive. Summary These resent findings suggest that the central changes may contribute significantly to the hypertension associated with OSA.
AB - Purpose of review Obstructive sleep apnoea (OSA) is associated with both nocturnal and daytime hypertensions which increase cardiovascular morbidity and mortality. It is thought that the repeated episodes of hypoxia and hypercapnia during nocturnal airway obstructions that characterise OSA result in increased sympathetic drive that persists during wakefulness. Although the underlying mechanisms responsible for this hypertension remain to be elucidated, several neural and humoral mechanisms have been proposed and recent evidence suggesting changes in the central nervous system may play a significant role. The purpose of this review is to explore recent evidence of central changes associated with elevated sympathetic drive in individuals with OSA. Recent findings Recent human brain imaging investigations and, in particular, combined microneurography recording of resting sympathetic activity with high-resolution functional magnetic resonance imaging have provided some important insights into changes in brain function and anatomy associated with resting sympathetic activity. Functional and anatomical changes occur in OSA, including in regions of the brainstem circuitry known to be responsible for setting resting sympathetic activity. Furthermore, these changes are reversed following continuous positive airway treatment in concert with reductions in resting sympathetic drive. Summary These resent findings suggest that the central changes may contribute significantly to the hypertension associated with OSA.
KW - brainstems
KW - magnetic resonance imagin
KW - muscles
UR - http://handle.uws.edu.au:8081/1959.7/uws:35705
U2 - 10.1007/s11906-016-0665-2
DO - 10.1007/s11906-016-0665-2
M3 - Article
SN - 1522-6417
VL - 18
JO - Current Hypertension Reports
JF - Current Hypertension Reports
M1 - 59
ER -