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Ereignisbasierte Charakterisierung kardiovaskulärer Interaktionen während des Schlafs

Kardiorespiratorische Koordination und Ensemble-Kopplungsspuren

Event-based characterization of cardiovascular interactions during sleep

Cardiorespiratory coordination and ensemble coupling traces

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Somnologie - Schlafforschung und Schlafmedizin Aims and scope Submit manuscript

Zusammenfassung

Die Untersuchung verschiedener Ereignisse wie Apnoen, Hypopnoen und diverser Arousals während des Schlafs spielt eine zentrale Rolle in der Diagnostik und im Verstehen von Schlafstörungen und evtl. Folgeerkrankungen. Häufig wird nur das Auftreten dieser Ereignisse betrachtet, statt diese im Zusammenhang mit anderen kardiovaskulären Größen zu untersuchen und die jeweiligen Interaktionen dieser Größen untereinander zu charakterisieren. Mit dem Koordigramm und den Ensemble-Kopplungsspuren werden 2 neue Methoden vorgestellt, die genau das ermöglichen sollen. Anhand einer Fallstudie eines Probanden mit häufig auftretenden Arousals werden die Möglichkeiten der neuen Werkzeuge zur Quantifizierung der autonomen Reaktion auf Störungen des Schlafs demonstriert. In einer Reanalyse von Patienten mit obstrukiver Schlafapnoe wird weiterhin die diagnostische Relevanz der kardiorespiratorischen Koordination zur Risikoabschätzung einer entstehenden Hypertonie gezeigt.

Abstract

The analysis of events such as apneas, hypopneas, and various types of arousals during sleep plays a central role when diagnosing and trying to understand sleep-related disorders and possible sequelae. Often, only the occurrence of these events is regarded instead of putting them into context with other cardiovascular variables and characterizing their mutual interactions. In this article, we present two new methods that allow for such an analysis: the coordigram and the ensemble symbolic-coupling traces. Through a case study of a subject with frequent arousals, the potential of the new tools for quantifying the autonomic response to sleep disturbances is shown. Furthermore, in a reanalysis of patients suffering from obstructive sleep apnea, the diagnostic relevance of cardiorespiratory coordination for risk stratification of an emerging hypertension is demonstrated.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. A. Müller und M. Riedl wurden finanziert durch DFG WE 2834/5-1 und DFG RI 2016/2-1. T. Penzel, J Kurths und N. Wessel geben an, dass kein Interessenkonflikt besteht. Alle im vorliegenden Manuskript beschriebenen Untersuchungen am Menschen wurden mit Zustimmung der zuständigen Ethik-Kommission, im Einklang mit nationalem Recht sowie gemäß der Deklaration von Helsinki von 1975 (in der aktuellen, überarbeiteten Fassung) durchgeführt. Von allen beteiligten Patienten liegt eine Einverständniserklärung vor.

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Authors and Affiliations

  1. Institut für Physik, Kardiovaskuläre Physik, Humboldt-Universität zu Berlin, Robert-Koch-Platz 4, 10115, Berlin, Deutschland

    A. Müller, M. Riedl, J. Kurths & N. Wessel

  2. Interdisziplinäres Schlafmedizinisches Zentrum, Charité Berlin, Berlin, Deutschland

    T. Penzel

  3. Potsdam-Institut für Klimafolgenforschung, Potsdam, Deutschland

    J. Kurths

  4. Institute for Complex Systems and Mathematical Biology, University of Aberdeen, Aberdeen, UK

    J. Kurths

Authors
  1. A. Müller
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  2. M. Riedl
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  3. T. Penzel
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  4. J. Kurths
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  5. N. Wessel
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Correspondence to A. Müller.

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Müller, A., Riedl, M., Penzel, T. et al. Ereignisbasierte Charakterisierung kardiovaskulärer Interaktionen während des Schlafs. Somnologie 18, 243–251 (2014). https://doi.org/10.1007/s11818-014-0688-3

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  • DOI: https://doi.org/10.1007/s11818-014-0688-3

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