[Obstructive-sleep apnea syndrome: brain oxygenation measured with near-infrared spectroscopy. Preliminary results]

The Effects of Fast and Slow Yoga Breathing on Cerebral and Central Hemodynamics

BACKGROUND

Yoga breathing has shown to impose significant cardiovascular and psychological health benefits.

OBJECTIVE

The mechanism (s) responsible for these health benefits remain unclear. The aim of the present study was to assess the differences in cerebral and central hemodynamic responses following fast breathing (FB) and slow breathing (SB) protocols compared to breathing awareness (BA) as a control.

METHODS

Twenty healthy participants (10 males and 10 females) volunteered to take part in the study. Participants were between ages 18-55 years (group mean: 24 ± 5 years), with a height of 168.7 ± 9.8 cm and a weight of 70.16 ± 10.9 kg. A familiarization trial including FB and SB protocols were performed by each participant at least 24 h before the testing day. The breathing protocols were designed to achieve 6 breath/min for SB and ~ 120 breaths/min for FB.

RESULTS

FB resulted in an increase in both right prefrontal cortex (RPFC) and left prefrontal cortex (LPFC) hemoglobin difference (Hbdiff) (brain oxygenation) compared to BA (P < 0.05). FB resulted in an increased Hbdiff in LPFC compared to RPFC SB (P < 0.05). FB resulted in an increased Hbdiff in LPFC compared to SB (P < 0.05).

CONCLUSION

FB may be an effective yoga breathing technique for eliciting cerebral brain oxygenation indicated by increased Hbdiff. These results may be applicable to both healthy and clinical populations.

Obstructive sleep apnea-hypopnea results in significant variations in cerebral hemodynamics detected by diffuse optical spectroscopies

The objective of this study was to adapt a novel near-infrared diffuse correlation spectroscopy (DCS) flow-oximeter for simultaneous and continuous monitoring of relative changes in cerebral blood flow (rCBF) and cerebral oxygenation (i.e. oxygenated/deoxygenated/total hemoglobin concentration: Δ[HbO2]/Δ[Hb]/ΔTHC) during overnight nocturnal polysomnography (NPSG) diagnostic test for obstructive sleep apnea-hypopnea (OSAH). A fiber-optic probe was fixed on subject's frontal head and connected to the DCS flow-oximeter through a custom-designed fiber-optic connector, which allowed us to easily connect/detach the optical probe from the device when the subject went to bathroom. To minimize the disturbance to the subject, the DCS flow-oximeter was remotely operated by a desktop located in the control room. The results showed that apneic events caused significant variations in rCBF and ΔTHC. Moreover, the degrees of variations in all measured cerebral variables were significantly correlated with the severity of OSAH as determined by the apnea-hypopnea index (AHI), demonstrating the OSAH influence on both CBF and cerebral oxygenation. Large variations in arterial blood oxygen saturation (SaO2) were also found during OSAH. Since frequent variations/disturbances in cerebral hemodynamics may adversely impact brain function, future study will investigate the correlations between these cerebral variations and functional impairments for better understanding of OSAH pathophysiology.

Physiological functions of the effects of the different bathing method on recovery from local muscle fatigue

BACKGROUND

Recently, mist saunas have been used in the home as a new bathing style in Japan. However, there are still few reports on the effects of bathing methods on recovery from muscle fatigue. Furthermore, the effect of mist sauna bathing on human physiological function has not yet been revealed. Therefore, we measured the physiological effects of bathing methods including the mist sauna on recovery from muscle fatigue.

METHODS

The bathing methods studied included four conditions: full immersion bath, shower, mist sauna, and no bathing as a control. Ten men participated in this study. The participants completed four consecutive sessions: a 30-min rest period, a 10-min all out elbow flexion task period, a 10-min bathing period, and a 10-min recovery period. We evaluated the mean power frequency (MNF) of the electromyogram (EMG), rectal temperature (Tre), skin temperature (Tsk), skin blood flow (SBF), concentration of oxygenated hemoglobin (O2Hb), and subjective evaluation.

RESULTS

We found that the MNF under the full immersion bath condition was significantly higher than those under the other conditions. Furthermore, Tre, SBF, and O2Hb under the full immersion bath condition were significantly higher than under the other conditions.

CONCLUSIONS

Following the results for the full immersion bath condition, the SBF and O2Hb of the mist sauna condition were significantly higher than those for the shower and no bathing conditions. These results suggest that full immersion bath and mist sauna are effective in facilitating recovery from muscle fatigue.

Phase-amplitude investigation of spontaneous low-frequency oscillations of cerebral hemodynamics with near-infrared spectroscopy: a sleep study in human subjects

We have investigated the amplitude and phase of spontaneous low-frequency oscillations (LFOs) of the cerebral deoxy- and oxy-hemoglobin concentrations ([Hb] and [HbO]) in a human sleep study using near-infrared spectroscopy (NIRS). Amplitude and phase analysis was based on the analytic signal method, and phasor algebra was used to decompose measured [Hb] and [HbO] oscillations into cerebral blood volume (CBV) and flow velocity (CBFV) oscillations. We have found a greater phase lead of [Hb] vs. [HbO] LFOs during non-REM sleep with respect to the awake and REM sleep states (maximum increase in [Hb] phase lead: ~π/2). Furthermore, during non-REM sleep, the amplitudes of [Hb] and [HbO] LFOs are suppressed with respect to the awake and REM sleep states (maximum amplitude decrease: 87%). The associated cerebral blood volume and flow velocity oscillations are found to maintain their relative phase difference during sleep, whereas their amplitudes are attenuated during non-REM sleep. These results show the potential of phase-amplitude analysis of [Hb] and [HbO] oscillations measured by NIRS in the investigation of hemodynamics associated with cerebral physiology, activation, and pathological conditions.

Changes in oxygen partial pressure of brain tissue in an animal model of obstructive apnea

Background

Cognitive impairment is one of the main consequences of obstructive sleep apnea (OSA) and is usually attributed in part to the oxidative stress caused by intermittent hypoxia in cerebral tissues. The presence of oxygen-reactive species in the brain tissue should be produced by the deoxygenation-reoxygenation cycles which occur at tissue level during recurrent apneic events. However, how changes in arterial blood oxygen saturation (SpO₂) during repetitive apneas translate into oxygen partial pressure (PtO₂) in brain tissue has not been studied. The objective of this study was to assess whether brain tissue is partially protected from intermittently occurring interruption of O₂ supply during recurrent swings in arterial SpO₂ in an animal model of OSA.

Methods

Twenty-four male Sprague-Dawley rats (300-350 g) were used. Sixteen rats were anesthetized and non-invasively subjected to recurrent obstructive apneas: 60 apneas/h, 15 s each, for 1 h. A control group of 8 rats was instrumented but not subjected to obstructive apneas. PtO₂ in the cerebral cortex was measured using a fast-response oxygen microelectrode. SpO₂ was measured by pulse oximetry. The time dependence of arterial SpO₂ and brain tissue PtO₂ was carried out by Friedman repeated measures ANOVA.

Results

Arterial SpO₂ showed a stable periodic pattern (no significant changes in maximum [95.5 ± 0.5%; m ± SE] and minimum values [83.9 ± 1.3%]). By contrast, brain tissue PtO₂ exhibited a different pattern from that of arterial SpO₂. The minimum cerebral cortex PtO₂ computed during the first apnea (29.6 ± 2.4 mmHg) was significantly lower than baseline PtO₂ (39.7 ± 2.9 mmHg; p = 0.011). In contrast to SpO₂, the minimum and maximum values of PtO₂ gradually increased (p < 0.001) over the course of the 60 min studied. After 60 min, the maximum (51.9 ± 3.9 mmHg) and minimum (43.7 ± 3.8 mmHg) values of PtO₂ were significantly greater relative to baseline and the first apnea dip, respectively.

Conclusions

These data suggest that the cerebral cortex is partially protected from intermittently occurring interruption of O₂ supply induced by obstructive apneas mimicking OSA.

Noninvasive determination of brain tissue oxygenation during sleep in obstructive sleep apnea: a near-infrared spectroscopic approach

STUDY OBJECTIVES

Recurrent apneas and hypoxemia during sleep in obstructive sleep apnea (OSA) are associated with profound changes in cerebral blood flow to the extent that cerebral autoregulation may be insufficient to protect the brain. Since the brain is sensitive to hypoxia, the cerebrovascular morbidity seen in OSA could be due to chronic, cumulative effects of intermittent hypoxia. Near-infrared spectroscopy (NIRS) has the potential to noninvasively monitor brain tissue oxygen saturation (SO2), and changes in concentration of oxyhemoglobin [O2Hb], deoxyhemoglobin [HHb] and total hemoglobin [tHb] with real-time resolution. We hypothesized that brain tissue oxygenation would be worse during sleep in OSA relative to controls and sought to determine the practical use of NIRS in the sleep laboratory.

DESIGN

We evaluated changes in brain tissue oxygenation using NIRS during overnight polysomnography.

SETTING

Studies were conducted at University of Illinois, Chicago and Carle Hospital, Urbana, Illinois.

PATIENTS

Nineteen subjects with OSA and 14 healthy controls underwent continuous NIRS monitoring during polysomnography.

MEASUREMENTS AND RESULTS

We observed significantly lower indexes of brain tissue oxygenation (SO2: 57.1 +/- 4.9 vs. 61.5 +/- 6.1), [O2Hb]: 22.8 +/- 7.7 vs. 31.5 +/- 9.1, and [tHb]: 38.6 +/- 11.2 vs. 48.6 +/- 11.4 micromol/L) in OSA than controls (all P < 0.05). However, multivariate analysis showed that the differences might be due to age disparity between the two groups.

CONCLUSIONS

NIRS is an effective tool to evaluate brain tissue oxygenation in OSA. It provides valuable data in OSA assessment and has the potential to bridge current knowledge gap in OSA.