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Sympathetic Nervous System Alterations in Sleep Apnea : The Relative Importance of Respiratory Disturbance, Hypoxia, and Sleep Quality

Joel E. Dimsdale; Timothy Coy; Sonia Ancoli-Israel; Paul Mills; Jack Clausen; Michael G. Ziegler
Author and Funding Information

Affiliations: From the Department of Psychiatry, University of California, San Diego,  From the San Diego State University/UCSD Joint Doctoral Program in Clinical Psychology, San Diego,  From the Department of Psychiatry, University of California, San Diego; and the Veterans Affairs Medical Center, San Diego,  From the Department of Medicine, University of California, San Diego

Affiliations: From the Department of Psychiatry, University of California, San Diego,  From the San Diego State University/UCSD Joint Doctoral Program in Clinical Psychology, San Diego,  From the Department of Psychiatry, University of California, San Diego; and the Veterans Affairs Medical Center, San Diego,  From the Department of Medicine, University of California, San Diego

Affiliations: From the Department of Psychiatry, University of California, San Diego,  From the San Diego State University/UCSD Joint Doctoral Program in Clinical Psychology, San Diego,  From the Department of Psychiatry, University of California, San Diego; and the Veterans Affairs Medical Center, San Diego,  From the Department of Medicine, University of California, San Diego

Affiliations: From the Department of Psychiatry, University of California, San Diego,  From the San Diego State University/UCSD Joint Doctoral Program in Clinical Psychology, San Diego,  From the Department of Psychiatry, University of California, San Diego; and the Veterans Affairs Medical Center, San Diego,  From the Department of Medicine, University of California, San Diego


1997 by the American College of Chest Physicians


Chest. 1997;111(3):639-642. doi:10.1378/chest.111.3.639
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Published online

Abstract

Numerous alterations in the sympathetic nervous system have been reported in patients with obstructive sleep apnea. It is unclear whether such alterations can be attributed to the respiratory disturbance itself, the resulting hypoxia, or disruption of sleep. We examined urinary norepinephrine levels in 45 individuals with varying amounts of respiratory disturbance and sleep disruption. All were of similar age (40 to 60 years) and body weight (100 to 160% ideal body weight), and all were free from antihypertensive medications that could influence norepinephrine levels. Twenty-four-hour urinary norepinephrine levels were correlated with respiratory disturbance index (r=0.39, p<0.01) and mean oxygen saturation (r=−0.36, p<0.05). These variables, together with the time in slow-wave sleep, accounted for a statistically significant but modest percentage of the variance in urinary norepinephrine (R2=0.19, p<0.05). However, the variables were so tightly intercorrelated that no single variable independently predicted norepinephrine levels in multiple regression analysis.


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