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Cerebrovascular Disease and Patterns of Cerebral Oxygenation During Sleep in Elders

Biobehavioral Laboratory, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, bcarlson{at}unc.edu

Virginia J. Neelon, RN, PhD

Biobehavioral Laboratory, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina

John R. Carlson, MS

School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina

Marilyn Hartman, PhD

Institute on Aging The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina

Sunil Dogra, MBBS, FFARCSI

Department of Anesthesiology and Pain Management, School of Medicine The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina

Purpose: The aim of this descriptive exploratory study was to describe patterns of cerebral oxygen reserves during sleep and their association with cerebrovascular risk factors in elders. Method: Participants—115 elders, age 70 ⁺ years—were monitored overnight using standard polysomnography. Measures included arterial oxyhemoglobin (SaO₂) and regional measures of percentage of cerebral oxyhemoglobin saturation (rcSO₂) via cerebral oximetry. Participants were classified based on the magnitude of change in rcSO₂ from resting baseline to the end of the first nonrapideye-movement (NREM) period. One-way ANOVA and Chi-square were used to test group differences in SaO₂ and the prevalence of cerebrovascular risk factors. Findings: 20 participants (Group 1) experienced an increase in rcSO₂ during sleep along with sleeping rcSO₂ levels !55%; 95 participants experienced a decline in rcSO₂; 72 participants (Group 2) had sleeping rcSO₂ levels !55%; and 23 participants had sleeping rcSO₂ levels <55% (Group 3). Although all three groups had equivalent declines in SaO₂ levels during sleep, Group 3 had more cardiovascular comorbidity than Groups 1 and 2. Conclusions: Although SaO₂ levels decline in most people during sleep, compensatory vascular responses to these drops in SaO₂ are important for preventing rcSO₂ from falling during sleep. Those entering sleep with lower baseline rcSO₂ levels and those with greater declines in cerebral oxygenation during sleep may have greater cardiovascular burden and be at greater risk for stroke and other forms of disabling cerebrovascular disease.

Key Words: aging • sleep • oxygenation • cerebral • arterial • blood flow • instrumentation

This version was published on April 1, 2009

Biological Research For Nursing, Vol. 10, No. 4, 307-317 (2009)
DOI: 10.1177/1099800408330396


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