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1 Charles A. Dana Institute and
the Harvard-Thorndike Laboratory of Beth Israel Deaconess Medical
Center,
Patients with obstructive sleep apnea (OSA) have
been reported to have an augmented pressor response to hypoxic
rebreathing. To assess the contribution of the peripheral vasculature
to this hemodynamic response, we measured heart rate, mean arterial
pressure (MAP), and forearm blood flow by venous occlusion
plethysmography in 13 patients with OSA and in 6 nonapneic control
subjects at arterial oxygen saturations
(SaO2) of 90, 85, and 80% during
progressive isocapnic hypoxia. Measurements were also performed during
recovery from 5 min of forearm ischemia induced with cuff
occlusion. MAP increased similarly in both groups during hypoxia (mean
increase at 80% SaO2: OSA patients, 9 ± 11 mmHg; controls, 12 ± 7 mmHg). Forearm vascular resistance,
calculated from forearm blood flow and MAP, decreased in controls (mean
change 
37 ± 19% at SaO2 80%) but not in patients (mean change 4 ± 16% at 80%
SaO2). Both groups decreased forearm
vascular resistance similarly after forearm ischemia (maximum
change from baseline 85%). We conclude that OSA patients have
an abnormal peripheral vascular response to isocapnic hypoxia.
sleep apnea; blood pressure; vascular resistance
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