scholarly journals Longer apneas and hypopneas are associated with greater ultra-short-term HRV in obstructive sleep apnea

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Salla Hietakoste ◽  
Henri Korkalainen ◽  
Samu Kainulainen ◽  
Saara Sillanmäki ◽  
Sami Nikkonen ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Short Term ◽  
Event Duration ◽  
Rr Intervals ◽  
Rr Interval ◽  
Respiratory Events ◽  
Obstructive Sleep ◽  
Respiratory Event ◽  
S Period

AbstractLow long-term heart rate variability (HRV), often observed in obstructive sleep apnea (OSA) patients, is a known risk factor for cardiovascular diseases. However, it is unclear how the type or duration of individual respiratory events modulate ultra-short-term HRV and beat-to-beat intervals (RR intervals). We aimed to examine the sex-specific changes in RR interval and ultra-short-term HRV during and after apneas and hypopneas of various durations. Electrocardiography signals, recorded as a part of clinical polysomnography, of 758 patients (396 men) with suspected OSA were analysed retrospectively. Average RR intervals and time-domain HRV parameters were determined during the respiratory event and the 15-s period immediately after the event. Parameters were analysed in three pooled sex-specific subgroups based on the respiratory event duration (10–20 s, 20–30 s, and > 30 s) separately for apneas and hypopneas. We observed that RR intervals shortened after the respiratory events and the magnitude of these changes increased in both sexes as the respiratory event duration increased. Furthermore, ultra-short-term HRV generally increased as the respiratory event duration increased. Apneas caused higher ultra-short-term HRV and a stronger decrease in RR interval compared to hypopneas. In conclusion, the respiratory event type and duration modulate ultra-short-term HRV and RR intervals. Considering HRV and the respiratory event characteristics in the diagnosis of OSA could be useful when assessing the cardiac consequences of OSA in a more detailed manner.

scholarly journals Predictors of changes in cerebral perfusion and oxygenation during obstructive sleep apnea

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Zhongxing Zhang ◽  
Ming Qi ◽  
Gordana Hügli ◽  
Ramin Khatami
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Near Infrared ◽  
Sleep Apnea Syndrome ◽  
Apnea Hypopnea Index ◽  
Mixed Effect ◽  
Respiratory Events ◽  
Obstructive Sleep ◽  
Respiratory Event ◽  
Titration Protocol

AbstractObstructive sleep apnea syndrome (OSAS) is a common sleep disorder. Severe OSAS defined as apnea–hypopnea index (AHI) ≥ 30/h is a risk factor for developing cerebro-cardiovascular diseases. The mechanisms of how repetitive sleep apneas/hypopneas damage cerebral hemodynamics are still not well understood. In this study, changes in blood volume (BV) and oxygen saturation (StO2) in the left forehead of 29 newly diagnosed severe OSAS patients were measured by frequency-domain near-infrared spectroscopy during an incremental continuous positive airway pressure (CPAP) titration protocol together with polysomnography. The coefficients of variation of BV (CV-BV) and the decreases of StO2 (de-StO2) of more than 2000 respiratory events were predicted using linear mixed-effect models, respectively. We found that longer events and apneas rather than hypopneas induce larger changes in CV-BV and stronger cerebral desaturation. Respiratory events occurring during higher baseline StO2 before their onsets, during rapid-eye-movement sleep and those associated with higher heart rate induce smaller changes in CV-BV and de-StO2. The stepwise increased CPAP pressures can attenuate these changes. These results suggest that in severe OSAS the length and the type of respiratory event rather than widely used AHI may be better parameters to indicate the severity of cerebral hemodynamic changes.

Postevent ventilation as a function of CO2 load during respiratory events in obstructive sleep apnea

2002 ◽  
Vol 93 (3) ◽  
pp. 917-924 ◽  
Author(s):  
Kenneth I. Berger ◽  
Indu Ayappa ◽  
I. Barry Sorkin ◽  
Robert G. Norman ◽  
David M. Rapoport ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Inverse Relationship ◽  
Direct Relationship ◽  
Ventilatory Response ◽  
Respiratory Events ◽  
Response Slope ◽  
Obstructive Sleep ◽  
Respiratory Event ◽  
Preceding Event

Maintenance of eucapnia during sleep in obstructive sleep apnea (OSA) requires a balance between CO2 loading during apnea and CO2 elimination. This study examines individual respiratory events and relates magnitude of postevent ventilation to CO2 load during the preceding respiratory event in 14 patients with OSA (arterial Pco 2 42–56 Torr). Ventilation and expiratory CO2 and O2 fractions were measured on a breath-by-breath basis during daytime sleep. Calculations included CO2 load during each event (metabolic CO2 production − exhaled CO2) and postevent ventilation in the 10 s after an event. In 12 of 14 patients, a direct relationship existed between postevent ventilation and CO2 load during the preceding event ( P < 0.05); the slope of this relationship varied across subjects. Thus the postevent ventilation is tightly linked to CO2 loading during each respiratory event and may be an important mechanism that defends against development of acute hypercapnia in OSA. An inverse relationship was noted between this postevent ventilatory response slope and the chronic awake arterial Pco 2 ( r = 0.90, P < 0.001), suggesting that this mechanism is impaired in patients with chronic hypercapnia. The link between development of acute hypercapnia during respiratory events asleep and maintenance of chronic awake hypercapnia in OSA remains to be further investigated.

scholarly journals Short-Term HRV Analysis Using Nonparametric Sample Entropy for Obstructive Sleep Apnea

Entropy ◽  
2021 ◽  
Vol 23 (3) ◽  
pp. 267
Author(s):  
Duan Liang ◽  
Shan Wu ◽  
Lan Tang ◽  
Kaicheng Feng ◽  
Guanzheng Liu
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sample Entropy ◽  
Biomedical Signal Processing ◽  
Apnea Hypopnea Index ◽  
Short Term ◽  
Autonomic Nervous System Dysfunction ◽  
Obstructive Sleep ◽  
Hrv Analysis ◽  
Frequency Power

Obstructive sleep apnea (OSA) is associated with reduced heart rate variability (HRV) and autonomic nervous system dysfunction. Sample entropy (SampEn) is commonly used for regularity analysis. However, it has limitations in processing short-term segments of HRV signals due to the extreme dependence of its functional parameters. We used the nonparametric sample entropy (NPSampEn) as a novel index for short-term HRV analysis in the case of OSA. The manuscript included 60 6-h electrocardiogram recordings (20 healthy, 14 mild-moderate OSA, and 26 severe OSA) from the PhysioNet database. The NPSampEn value was compared with the SampEn value and frequency domain indices. The empirical results showed that NPSampEn could better differentiate the three groups (p < 0.01) than the ratio of low frequency power to high frequency power (LF/HF) and SampEn. Moreover, NPSampEn (83.3%) approached a higher OSA screening accuracy than the LF/HF (73.3%) and SampEn (68.3%). Compared with SampEn (|r| = 0.602, p < 0.05), NPSampEn (|r| = 0.756, p < 0.05) had a significantly stronger association with the apnea-hypopnea index (AHI). Hence, NPSampEn can fully overcome the influence of individual differences that are prevalent in biomedical signal processing, and might be useful in processing short-term segments of HRV signal.

Relationship between sleep bruxism and sleep respiratory events in patients with obstructive sleep apnea syndrome

2014 ◽  
Vol 18 (4) ◽  
pp. 837-844 ◽  
Author(s):  
Hisashi Hosoya ◽  
Hideki Kitaura ◽  
Takashi Hashimoto ◽  
Mau Ito ◽  
Masayuki Kinbara ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Sleep Bruxism ◽  
Respiratory Events ◽  
Obstructive Sleep ◽  
Apnea Syndrome

scholarly journals Evaluation of Respiratory Resistance as a Predictor for Oral Appliance Treatment Response in Obstructive Sleep Apnea: A Pilot Study

2021 ◽  
Vol 10 (6) ◽  
pp. 1255
Author(s):  
Hiroyuki Ishiyama ◽  
Masayuki Hideshima ◽  
Shusuke Inukai ◽  
Meiyo Tamaoka ◽  
Akira Nishiyama ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Pilot Study ◽  
Reduction Rate ◽  
Oral Appliance ◽  
Respiratory Resistance ◽  
Obstructive Sleep ◽  
Respiratory Event ◽  
Significant Difference ◽  
Treatment Responses

The aim of this study was to determine the utility of respiratory resistance as a predictor of oral appliance (OA) response in obstructive sleep apnea (OSA). Twenty-seven patients with OSA (mean respiratory event index (REI): 17.5 ± 6.5 events/h) were recruited. At baseline, the respiratory resistance (R20) was measured by impulse oscillometry (IOS) with a fitted nasal mask in the supine position, and cephalometric radiographs were obtained to analyze the pharyngeal airway space (SPAS: superior posterior airway space, MAS: middle airway space, IAS: inferior airway space). The R20 and radiographs after the OA treatment were evaluated, and the changes from the baseline were analyzed. A sleep test with OA was carried out using a portable device. The subjects were divided into Responders and Non-responders based on an REI improvement ≥ 50% from the baseline, or REI < 5 after treatment, and the R20 reduction rate between the two groups were compared. The subjects comprised 20 responders and 7 non-responders. The R20 reduction rate with OA in responders was significantly greater than it was in non-responders (14.4 ± 7.9 % versus 2.4 ± 9.8 %, p < 0.05). In responders, SPAS, MAS, and IAS were significantly widened and R20 was significantly decreased with OA (p < 0.05). There was no significant difference in non-responders (p > 0.05). A logistic multiple regression analysis showed that the R20 reduction rate was predictive for OA treatment responses (2% incremental odds ratio (OR), 24.5; 95% CI, 21.5–28.0; p = 0.018). This pilot study confirmed that respiratory resistance may have significant clinical utility in predicting OA treatment responses.

Association between sleep disordered breathing in early pregnancy and glucose metabolism

SLEEP ◽  
2022 ◽  
Author(s):  
Laura Sanapo ◽  
Margaret H Bublitz ◽  
Alice Bai ◽  
Niharika Mehta ◽  
Geralyn M Messerlian ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Glucose Metabolism ◽  
Early Pregnancy ◽  
Airway Pressure ◽  
Sleep Disordered Breathing ◽  
Positive Airway Pressure ◽  
Obstructive Sleep ◽  
Respiratory Event

Abstract Study Objectives To examine the association between maternal sleep disordered breathing (SDB) and glucose metabolism in early gestation. Methods Women with body mass index (BMI) ≥27 kg/m2 and singleton pregnancies underwent in-home sleep study (HSAT) and homeostatic model assessment (HOMA) in early pregnancy. Insulin resistance (HOMA-IR) and β-cell function (HOMA %B) were derived. Exclusion criteria included pregestational diabetes, use of continuous positive airway pressure and chronic steroid therapy. We performed linear regression analyses to evaluate the association between continuous measures of SDB (respiratory event index (REI), and oxygen desaturation index (ODI)) and glucose metabolism parameters (HOMA-IR and HOMA %B). Analyses were adjusted for a set of a priori selected variables which included gestational age, maternal age, BMI, ethnicity, race, and parity. Results One hundred and ninety-two pregnant women with median (interquartile range) BMI of 35.14 (8.30) kg/m2 underwent HSAT and HOMA assessment at 11.14 (3) and 15.35 (4.14) gestational weeks, respectively. REI and ODI, as continuous values, were associated with HOMA-IR after adjusting for covariates. OSA (obstructive sleep apnea) diagnosis (REI &gt; 5 events per hour) was not associated with HOMA-IR after adjusting for BMI (p ≥ 0.05). None of the parameters were associated with HOMA %B (p &gt; 0.07). Conclusions SDB and insulin resistance are associated in early pregnancy, with a dose response association between respiratory event index severity and insulin resistance. Further studies are needed to establish if pregnant women with overweight and obesity may benefit from early SDB screening to improve glucose metabolic outcome. Clinical trials: NCT02412696, Positive Airway Pressure, Sleep Apnea, and the Placenta (PAP-SAP) https://clinicaltrials.gov/ct2/show/NCT02412696?term=Bourjeily&draw=2&rank=2 and NCT02917876, Predictors of De-novo Development of Obstructive Sleep Apnea in Pregnancy (Predictors) https://clinicaltrials.gov/ct2/show/NCT02917876?term=Bourjeily&draw=2&rank=1

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