scholarly journals 0556 Sex-Specific Relationship Between Anxiety and Autonomic Nervous System Dysfunction in Obstructive Sleep Apnea

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A213-A213
Author(s):  
A Pal ◽  
M A Akey ◽  
R Chatterjee ◽  
A P Aguila ◽  
F Martinez ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Obstructive Sleep Apnea ◽  
Nervous System ◽  
Autonomic Nervous System ◽  
Sleep Apnea ◽  
Anxiety Symptoms ◽  
Female Age ◽  
Obstructive Sleep ◽  
Post Hoc

Abstract Introduction Cardiovascular co-morbidities in obstructive sleep apnea (OSA) are hard to treat, perhaps due to autonomic nervous system (ANS) dysfunction. In OSA, intermittent hypoxia and poor tissue oxygen perfusion damage endothelial and nervous tissue, potentially underlying the dysfunction. Moreover, OSA is strongly associated with anxiety, which is independently associated with ANS dysfunction. We assessed sex-specific relationships between anxiety and cardiovascular markers of ANS dysfunction in OSA. Methods We studied people diagnosed with OSA and healthy controls. We collected 5 minutes of wakeful resting ECG, continuous non-invasive blood pressure, and respiration data. We calculated heart rate (HR), heart rate variability (HRV; sympathetic-vagal balance related to brainstem ANS output), mean arterial blood pressure (MAP), beat-to-beat MAP variability (BPV; related to peripheral autonomic function) and breathing rate (BR). We analyzed these measures with a multivariate regression model of anxiety symptoms (generalized anxiety disorder; GAD-7 scores), sex, and group (OSA vs. control), age/BMI/AHI covariates, and Bonferroni-corrected post-hoc comparisons (p≤0.05). Results We analyzed 64 subjects (32 OSA: AHI [mean±SEM] 24±4events/hour, 12 female, age 52±21years, BMI 33±2kg/m2; 32 control: 19 female, age 46±2; BMI 26±1). We observed significant main effects of anxiety, BMI, AHI, sex on HRV, but only group on BPV; post-hoc comparisons revealed high BPV only in OSA females. Secondary analyses included classifying by anxiety symptoms (GAD-7≥5), showing only OSA females with anxiety had higher BPV. Males showed higher HRV. AHI and anxiety were positively correlated with HRV in OSA males. AHI was negatively correlated with BR in OSA females. Conclusion We observed higher anxiety associated with higher BPV in OSA, especially in females. Unexpectedly, BR was lower in OSA females; longer breaths may have led to the greater BPV. Higher HRV in males complicated by OSA severity and anxiety could be related to higher sympathetic tone. The slightly older control group may have influenced the findings. Overall, our findings suggest anxiety in OSA is associated with peripheral and centrally-mediated autonomic dysfunction, but in a sex-specific manner. Support National Institutes of Health R56-NR-017435 and RO1-HL-135562.

scholarly journals The Worsening of Positional Mild Obstructive Sleep Apnea over Time Is Associated with an Increase in Body Weight: Impact on Blood Pressure and Autonomic Nervous System

Respiration ◽  
2021 ◽  
pp. 1-10
Author(s):  
Wei-Hsiu Chang ◽  
Hsien-Chang Wu ◽  
Chou-Chin Lan ◽  
Yao-Kuang Wu ◽  
Mei-Chen Yang
Keyword(s):  
Blood Pressure ◽  
Obstructive Sleep Apnea ◽  
Nervous System ◽  
Autonomic Nervous System ◽  
Sleep Apnea ◽  
Obstructive Sleep ◽  
Mild Obstructive Sleep Apnea ◽  
Positional Dependency ◽  
Over Time

<b><i>Background:</i></b> Most patients with mild obstructive sleep apnea (OSA) are positional dependent. Although mild OSA worsens over time, no study has assessed the natural course of positional mild OSA. <b><i>Objectives:</i></b> The aim of this study was to evaluate the natural course of positional mild OSA, its most valuable progression predictor, and its impact on blood pressure (BP) and the autonomic nervous system (ANS). <b><i>Methods:</i></b> This retrospective observational cohort study enrolled 86 patients with positional mild OSA and 26 patients with nonpositional mild OSA, with a follow-up duration of 32.0 ± 27.6 months and 37.6 ± 27.8 months, respectively. Polysomnographic variables, BP, and ANS functions were compared between groups at baseline and after follow-up. <b><i>Results:</i></b> In patients with positional mild OSA after follow-up, the apnea/hypopnea index (AHI) increased (9.1 ± 3.3/h vs. 22.0 ± 13.2/h, <i>p</i> = 0.000), as did the morning systolic BP (126.4 ± 13.3 mm Hg vs. 130.4 ± 15.9 mm Hg, <i>p</i> = 0.011), and the sympathetic activity (49.4 ± 12.3% vs. 55.3 ± 13.1%, <i>p</i> = 0.000), while the parasympathetic activity decreased (50.6 ± 12.3% vs. 44.7 ± 13.1%, <i>p</i> = 0.000). The body mass index changes were the most important factor associated with AHI changes among patients with positional mild OSA (Beta = 0.259, adjust <i>R</i><sup>2</sup> = 0.056, <i>p</i> = 0.016, 95% confidence interval 0.425 and 3.990). The positional dependency disappeared over time in 66.3% of patients with positional mild OSA while 69.2% of patients with nonpositional mild OSA retained nonpositional. <b><i>Conclusions:</i></b> In patients with positional mild OSA, disease severity, BP, and ANS regulation worse over time. Increased weight was the best predictor for its progression and the loss of positional dependency. Better treatments addressing weight control and consistent follow-up are needed for positional mild OSA.

O163 Autonomic nervous system dysfunction in patients with high obstructive sleep apnea risk

2017 ◽  
Vol 128 (9) ◽  
pp. e231
Author(s):  
Barbara Barun ◽  
Marina Mioc ◽  
Magdalena Krbot Skoric ◽  
Monika Mudrovcic ◽  
Natasa Milosevic ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Nervous System ◽  
Autonomic Nervous System ◽  
Sleep Apnea ◽  
Autonomic Nervous System Dysfunction ◽  
Autonomic Nervous ◽  
Obstructive Sleep

Effects of nasal continuous positive airway pressure and oxygen supplementation on norepinephrine kinetics and cardiovascular responses in obstructive sleep apnea

2006 ◽  
Vol 100 (1) ◽  
pp. 343-348 ◽  
Author(s):  
Paul J. Mills ◽  
Brian P. Kennedy ◽  
Jose S. Loredo ◽  
Joel E. Dimsdale ◽  
Michael G. Ziegler
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Continuous Positive Airway Pressure ◽  
Release Rate ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Oxygen Supplementation ◽  
Obstructive Sleep

Obstructive sleep apnea (OSA) is characterized by noradrenergic activation. Nasal continuous positive airway pressure (CPAP) is the treatment of choice and has been shown to effectively reduce elevated norepinephrine (NE) levels. This study examined whether the reduction in NE after CPAP is due to an increase in NE clearance and/or a decrease of NE release rate. Fifty CPAP-naive OSA patients with an apnea-hypopnea index >15 were studied. NE clearance and release rates, circulating NE levels, urinary NE excretion, and blood pressure and heart rate were determined before and after 14 days of CPAP, placebo CPAP (CPAP administered at ineffective pressure), or oxygen supplementation. CPAP led to a significant increase in NE clearance ( P ≤ 0.01), as well as decreases in plasma NE levels ( P ≤ 0.018) and daytime ( P < 0.001) and nighttime ( P < 0.05) NE excretion. NE release rate was unchanged with treatment. Systolic ( P ≤ 0.013) and diastolic ( P ≤ 0.026) blood pressure and heart rate ( P ≤ 0.014) were decreased in response to CPAP but not in response to oxygen or placebo CPAP treatment. Posttreatment systolic blood pressure was best predicted by pretreatment systolic blood pressure and posttreatment NE clearance and release rate ( P < 0.01). The findings indicate that one of the mechanisms through which CPAP reduces NE levels is through an increase in the clearance of NE from the circulation.

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