scholarly journals O014 Heart rate response to obstructive respiratory events in children born preterm with OSA

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A7-A7
Author(s):  
L Walter ◽  
A Bassam ◽  
M Davey ◽  
N Gillian ◽  
R Horne
Keyword(s):  
Heart Rate ◽  
Heart Rate Response ◽  
Sleep Apnoea ◽  
Cardiovascular Outcomes ◽  
Respiratory Events ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
And Gender ◽  
Preterm Born ◽  
Acute Changes

Abstract Background Preterm-born (PT) children have an increased risk for obstructive sleep apnoea (OSA) and adverse cardiovascular outcomes. Respiratory events elicit acute changes in heart rate (HR) in term-born (T) children. Whether this response is augmented in PT children with OSA remains unclear. We aimed to analyse the HR response during obstructive respiratory events in PT children with OSA. Methods Nine PT children (3–12 y), were matched for obstructive apnoea hypopnoea index (OAHI), age and gender with T children. Beat-to-beat HR was averaged 10s before, during and the peak after (post) each obstructive event, and peak HR was expressed as percentage change. Results 323 obstructive events in PT and 376 in T children were identified, consisting of 681 hypopnoeas (PT 320; T 361) and 18 apnoeas (PT 3; T 15). There were insufficient apnoeas in the PT group for analysis. For hypopnoeas during total sleep, the PT group had significantly lower HR compared to the T group before median 81bpm (IQR 74–87) vs 88 bpm (79–99); p<0.001), during (76 bpm (69–83) vs 82 bpm (74–92; p<0.001) and post (97 bpm (89–103) vs 105 bpm (95–115; p<0.001) events. The post event increase in HR was significantly higher in the PT (26%, (16–39)) compared with the T (23%, (14–36)) group, p=0.008. Conclusion Although HR was lower during obstructive hypopnoeas in preterm compared with term-born children, the post event surge was significantly higher. This heightened HR response to respiratory events in children born preterm may underlie the worse cardiovascular outcomes in these children.

scholarly journals Polysomnographic phenotypes and their cardiovascular implications in obstructive sleep apnoea

Thorax ◽  
2017 ◽  
Vol 73 (5) ◽  
pp. 472-480 ◽  
Author(s):  
Andrey V Zinchuk ◽  
Sangchoon Jeon ◽  
Brian B Koo ◽  
Xiting Yan ◽  
Dawn M Bravata ◽  
...  
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Cardiovascular Outcomes ◽  
Periodic Limb Movements ◽  
Poor Sleep ◽  
Cross Sectional ◽  
Coronary Syndrome ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
Ischaemic Attack

BackgroundObstructive sleep apnoea (OSA) is a heterogeneous disorder, and improved understanding of physiologic phenotypes and their clinical implications is needed. We aimed to determine whether routine polysomnographic data can be used to identify OSA phenotypes (clusters) and to assess the associations between the phenotypes and cardiovascular outcomes.MethodsCross-sectional and longitudinal analyses of a multisite, observational US Veteran (n=1247) cohort were performed. Principal components-based clustering was used to identify polysomnographic features in OSA’s four pathophysiological domains (sleep architecture disturbance, autonomic dysregulation, breathing disturbance and hypoxia). Using these features, OSA phenotypes were identified by cluster analysis (K-means). Cox survival analysis was used to evaluate longitudinal relationships between clusters and the combined outcome of incident transient ischaemic attack, stroke, acute coronary syndrome or death.ResultsSeven patient clusters were identified based on distinguishing polysomnographic features: ‘mild’, ‘periodic limb movements of sleep (PLMS)’, ‘NREM and arousal’, ‘REM and hypoxia’, ‘hypopnoea and hypoxia’, ‘arousal and poor sleep’ and ‘combined severe’. In adjusted analyses, the risk (compared with ‘mild’) of the combined outcome (HR (95% CI)) was significantly increased for ‘PLMS’, (2.02 (1.32 to 3.08)), ‘hypopnoea and hypoxia’ (1.74 (1.02 to 2.99)) and ‘combined severe’ (1.69 (1.09 to 2.62)). Conventional apnoea–hypopnoea index (AHI) severity categories of moderate (15≤AHI<30) and severe (AHI ≥30), compared with mild/none category (AHI <15), were not associated with increased risk.ConclusionsAmong patients referred for OSA evaluation, routine polysomnographic data can identify physiological phenotypes that capture risk of adverse cardiovascular outcomes otherwise missed by conventional OSA severity classification.

Modifying effects of the R389G β1-adrenoceptor polymorphism on resting heart rate and blood pressure in patients with obstructive sleep apnoea

2005 ◽  
Vol 110 (1) ◽  
pp. 117-123 ◽  
Author(s):  
Jan Börgel ◽  
Tino Schulz ◽  
Nina K. Bartels ◽  
Jörg T. Epplen ◽  
Nikolaus Büchner ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Obstructive Sleep Apnoea ◽  
Nervous Activity ◽  
Sleep Apnoea ◽  
Cpap Therapy ◽  
Pressure Therapy ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
The Impact

OSA (obstructive sleep apnoea) stimulates sympathetic nervous activity and elevates resting HR (heart rate) and BP (blood pressure). In the present study in a cohort of 309 untreated OSA patients, the resting HR and BP during the daytime were correlated with AHI (apnoea/hypopnea index) and compared with patients with R389R (n=162), R389G (n=125) and G389G (n=22) genotypes of the β1-adrenoreceptor R389G polymorphism. We analysed the impact of the genotype on the decline of HR and BP in a subgroup of 148 patients (R389R, n=86; R389G, n=54; G389G, n=8) during a 6-month follow-up period under CPAP (continuous positive airway pressure) therapy during which cardiovascular medication remained unchanged. In untreated OSA patients, we found an independent relationship between AHI and resting HR (β=0.096, P<0.001), systolic BP (β=0.09, P=0.021) and diastolic BP (β=0.059, P=0.016). The resting HR/BP, however, did not differ among carriers with the R389R, R389G and G389G genotypes. CPAP therapy significantly reduced HR [−2.5 (−1.1 to −4.0) beats/min; values are mean difference (95% confidence intervals)] and diastolic BP [−3.2 (−1.5 to −5.0) mmHg]. The decline in HR was more significantly pronounced in the R389R group compared with the Gly389 carriers [−4.1 (−2.3 to −5.9) beats/min (P<0.001) compared with −0.2 (2.1 to −2.6) beats/min (P=0.854) respectively; Student's t test between groups, P=0.008]. Diastolic BP was decreased significantly (P<0.001) only in Gly389 carriers (R389G or G389G) compared with R389R carriers [−5.0 (−2.3 to −7.6) mmHg compared with −2.0 (0.4 to −4.3) mmHg respectively]. ANOVA revealed a significant difference (P=0.023) in HR reduction between the three genotypes [−4.1 (±8.4) beats/min for R389R, −0.5 (±9.3) beats/min for R389G and +1.9 (±7.2) beats/min for G389G]. In conclusion, although the R389G polymorphism of the β1-adrenoceptor gene did not influence resting HR or BP in untreated OSA patients, it may modify the beneficial effects of CPAP therapy on these parameters.

Immediate Effect of Acupuncture on the Sleep Pattern of Patients with Obstructive Sleep Apnoea

2010 ◽  
Vol 28 (3) ◽  
pp. 115-119 ◽  
Author(s):  
Anaflávia O Freire ◽  
Gisele C M Sugai ◽  
Sônia Maria Togeiro ◽  
Luiz Eugênio Mello ◽  
Sérgio Tufik
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Placebo Treatment ◽  
Acute Effect ◽  
Sham Acupuncture ◽  
Sleep Apnoea ◽  
Sleep Pattern ◽  
Control Group ◽  
Respiratory Events ◽  
Obstructive Sleep ◽  
Before And After

Background Most patients with obstructive sleep apnoea (OSA) do not tolerate treatment with nasal continuous positive airway pressure, the ‘gold standard’ treatment for this condition. It was shown in a pilot study that acupuncture was more effective than placebo treatment (sham acupuncture) in producing significant changes in the respiratory events assessed by polysomnography (PSG). Objectives To investigate the immediate effect of manual acupuncture (MA) and electroacupuncture (EA) on the sleep pattern of patients presenting with moderate OSA. Methods 40 patients with an Apnoea–Hypopnoea Index (AHI) of 15–30/h were randomly allocated to MA treatment (n=10), EA 10 Hz treatment (n=10), EA 2 Hz treatment (n=10) and a no-treatment control group (n=10). The patients received MA or EA (2 or 10 Hz) just before the PSG study at 20:00. Results The AHI (p=0.005; p=0.005), the Apnoea Index (p=0.038; p=0.009) and the respiratory events (p=0.039; p=0.014) decreased significantly in the MA and EA 10 Hz groups, respectively (AHI (21.9, 11.2), Apnoea Index (5.15, 0.7), respiratory events (120.5, 61.0) in the MA group before and after. AHI (20.6, 9.9), Apnoea Index (8.2, 0.3), respiratory events (117.0, 56.0) in the EA 10 Hz group before and after). The micro-arousals decreased only in the MA group (146.0 vs 88.5, p=0.0002). There were no significant changes in the EA 2 Hz group or in the control group. Conclusion A single session of either MA or EA 10 Hz had an acute effect in reducing the AHI as well as the number of nocturnal respiratory events of patients presenting with moderate OSA.

Obstructive Sleep Apnoea Impairs Heart Rate Variability in Patients with the Metabolic Syndrome

2007 ◽  
Vol 16 ◽  
pp. S84
Author(s):  
B. Weatherhead ◽  
C. Neil ◽  
M. Barnes ◽  
R. Pierce ◽  
A. Collins ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
The Metabolic Syndrome ◽  
Obstructive Sleep

scholarly journals P095 Heart Rate Variability during Sleep in Paroxysmal Atrial Fibrillation patients with and without Obstructive Sleep Apnoea

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A52-A52
Author(s):  
A Mohammadieh ◽  
H Dissanayake ◽  
K Sutherland ◽  
S Ucak ◽  
P de Chazal ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Obstructive Sleep Apnoea ◽  
Paroxysmal Atrial Fibrillation ◽  
Sleep Apnoea ◽  
Relative Reduction ◽  
Obstructive Sleep ◽  
Sympathetic Modulation ◽  
Ectopic Beats

Abstract Introduction Physiological studies have demonstrated the importance of the autonomic nervous system in mediating acute apnoea-induced atrial fibrillation (AF). We aimed to compare Heart Rate Variability (HRV) markers of autonomic function in paroxysmal atrial fibrillation (PAF) patients with and without obstructive sleep apnoea (OSA). A secondary aim was the analysis of ectopic beats in these groups. Methods Nocturnal ECG traces from 89 PAF patients who underwent in-laboratory polysomnography were included. After identifying ectopic beats in the ECGs, periods of arrhythmia as well as sleep apnoea events were excluded. HRV time and frequency domains were reported by sleep stage (REM vs Non-REM) for patients with and without OSA. Results Frequency domain analysis of HRV during non-REM sleep in PAF patients with OSA showed increased cardiac parasympathetic modulation (HF-nu: 39.13 ± 15.74 vs 47.98 ± 14.60, p = 0.008*) and reduced cardiac sympathetic modulation (LF/HF ratio: 2.05 ± 2.02 vs 1.17 ± 0.98, p = 0.007*). Results remained significant after adjusting for age, sex and BMI (adjusted p values 0.024 and 0.018 respectively). PAF patients with severe OSA (AHI ≥ 30/hr) had more AF beats and Ventricular Ectopic Beats than those without severe OSA (22.7 ± 42.8% vs 3.7 ± 17.9%, p = 0.006*, 1.7 ± 3.8 vs 0.3 ± 0.9%, p = 0.004* respectively). Conclusions This is the first study of HRV in AF patients with and without OSA. It suggests a chronic increase in parasympathetic nervous modulation and relative reduction in sympathetic modulation in PAF patients with OSA.

scholarly journals Obstructive Sleep Apnoea and Type 2 Diabetes

2014 ◽  
Vol 10 (01) ◽  
pp. 35 ◽  
Author(s):  
Abd A Tahrani ◽  
Asad Ali ◽  
◽  
Keyword(s):  
Type 2 Diabetes ◽  
Risk Factor ◽  
Medical Condition ◽  
Diabetes Type 2 ◽  
Sleep Apnoea ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
Osa Treatment ◽  
The Impact

With the growing prevalence of obesity, the burden of type 2 diabetes is increasing. Obstructive sleep apnea (OSA) is a very common medical condition that is associated with increased risk for cardiovascular disease and mortality. Obesity is a common risk factor for OSA and type 2 diabetes and hence it is not surprising that OSA and type 2 diabetes are interlinked. OSA has been shown to be an independent risk factor for the development of incident pre-diabetes/type 2 diabetes. OSA is also associated with worse glycemic control and vascular disease in patients with type 2 diabetes. However, evidence for the benefits of OSA treatment in patients with type 2 diabetes is still lacking. The aim of this article is to provide an overview of OSA, the relationships between OSA and dysglycemia and the impact of OSA in patients with type 2 diabetes, highlighting recent advances in the field.

scholarly journals Increased liver stiffness in patients with severe sleep apnoea and metabolic comorbidities

2018 ◽  
Vol 51 (6) ◽  
pp. 1800601 ◽  
Author(s):  
Wojciech Trzepizur ◽  
Jérôme Boursier ◽  
Marc Le Vaillant ◽  
Pierre-Henri Ducluzeau ◽  
Séverine Dubois ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Liver Disease ◽  
Liver Fibrosis ◽  
Liver Stiffness ◽  
Sleep Apnoea ◽  
Screening Tools ◽  
The Metabolic Syndrome ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
Metabolic Comorbidities

The goal of this study was to assess the relationship between the severity of obstructive sleep apnoea (OSA) and liver stiffness measurement (LSM), one of the most accurate noninvasive screening tools for liver fibrosis in nonalcoholic fatty liver disease.The study included 147 patients with at least one criterion for the metabolic syndrome, assessed by polysomnography for suspected OSA. LSM was performed using transient elastography (FibroScan). Significant liver disease and advanced liver fibrosis were defined as LSM ≥7.3 and ≥9.6 kPa, respectively.23 patients were excluded because of unreliable LSM. Among 124 patients, 34 (27.4%) had mild OSA, 38 (30.6%) had moderate OSA and 52 (42.0%) had severe OSA. LSM values were 7.3– <9.6 kPa in 18 (14.5%) patients and ≥9.6 kPa in 15 (12.1%) patients. A dose–response relationship was observed between OSA severity and LSM values (p=0.004). After adjustment for age, sex, metabolic syndrome and insulin resistance, severe OSA was associated with an increased risk of LSM ≥7.3 kPa (OR 7.17, 95% CI 2.51–20.50) and LSM ≥9.6 kPa (OR 4.73, 95% CI 1.25–17.88).In patients with metabolic comorbidities, severe OSA is independently associated with increased liver stiffness, which may predispose to a higher risk of significant liver disease and poorer prognosis.

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