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Dynamic changes in brain bioenergetics during obstructive sleep apnea.
- Source :
-
Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism [J Cereb Blood Flow Metab] 2009 Aug; Vol. 29 (8), pp. 1421-8. Date of Electronic Publication: 2009 May 13. - Publication Year :
- 2009
-
Abstract
- Repetitive collapse of the upper airway during obstructive sleep apnea/hypopnea (OSA) exposes the brain of sufferers to frequent, transient, hypoxic episodes. The loss of cerebrovascular reactivity in sleep, and particularly in OSA, means that physiologic compensatory mechanisms may not ensure adequate brain oxygen levels. This (31)P magnetic resonance spectroscopy study, of 13 males with severe, untreated OSA undertaken after overnight sleep deprivation, represents the first, seconds time-scale analysis of human brain bioenergetics during transient hypoxia and demonstrates that a moderate degree of oxygen desaturation during sleep has significant effects on brain bioenergetic status. Oxygen desaturation >10% of sleeping baseline resulted in decreases in brain adenosine triphosphate levels (P<0.01), and increases in inorganic phosphate (P<0.0001) with no concomitant changes in phosphocreatine or brain pH. This indicates that the mechanism of adenosine triphosphate depletion in these patients is different to that observed in normoxic, awake working brain. These data show that the buffering capacity of phosphocreatine and the creatine kinase system is not active in mild transient hypoxia and that cerebrovascular compensatory mechanisms are not adequate to prevent decrements in brain high-energy phosphates in OSA. Transient hypoxia experienced during sleep may impair brain function more than previously thought.
- Subjects :
- Adenosine Triphosphate metabolism
Adult
Blood Gas Monitoring, Transcutaneous
Brain blood supply
Case-Control Studies
Cerebrovascular Circulation physiology
Humans
Hypoxia, Brain metabolism
Magnetic Resonance Angiography
Magnetic Resonance Spectroscopy
Male
Middle Aged
Oxygen blood
Phosphorus Radioisotopes
Severity of Illness Index
Sleep Apnea Syndromes complications
Sleep Deprivation
Brain metabolism
Energy Metabolism
Hypoxia, Brain etiology
Sleep Apnea Syndromes metabolism
Subjects
Details
- Language :
- English
- ISSN :
- 1559-7016
- Volume :
- 29
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism
- Publication Type :
- Academic Journal
- Accession number :
- 19436316
- Full Text :
- https://doi.org/10.1038/jcbfm.2009.57