Heart Rate and Systolic Blood Pressure Variability Before and During Obstructive Sleep Apnea Episodes

Cardiac rate-variability control and an initial demonstration of systolic blood-pressure variability control using visual feedback of physiological information were examined. Continuous measures of respiration, heart rate, EXG waveform analysis, and systolic blood pressure were obtained for both experimental groups and for yoked controls who saw the same visual display as the experimental Ss. Ss successful at reducing heart-rate variability showed clear changes in the P-R wave relationships of the EKG, indicating possible direct attempts to manipulate heart rate so as to reduce variability. Ss controlling blood-pressure variability who had high heart rates were more successful in reducing variability than those with low rates, possibly because of differential feedback to Ss with high and low heart rates. In addition, apparently as a reaction to E's adjustment of the visual target range, experimental Ss showed decreases in mean blood-pressure levels.

Download Full-text

Nycthemeral blood pressure variability in obstructive sleep apnea syndrome

Journal of Hypertension ◽

10.1097/00004872-199312050-00124 ◽

1993 ◽

Vol 11 (5) ◽

pp. S290???S291

Author(s):

Francois Begasse ◽

Bernard Chamontin ◽

Michel Tiberge ◽

Pierre Chollet ◽

Jacques Amar ◽

...

Keyword(s):

Blood Pressure ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Obstructive Sleep Apnea Syndrome ◽

Blood Pressure Variability ◽

Sleep Apnea Syndrome ◽

Obstructive Sleep ◽

Apnea Syndrome

Download Full-text

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

Journal of Applied Physiology ◽

10.1152/japplphysiol.00494.2005 ◽

2006 ◽

Vol 100 (1) ◽

pp. 343-348 ◽

Cited By ~ 83

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.

Download Full-text

Predictors of chronic kidney disease in obstructive sleep apnea patients

Multidisciplinary Respiratory Medicine ◽

10.4081/mrm.2020.470 ◽

2020 ◽

Vol 15 ◽

Author(s):

Phunphai Somkearti ◽

Paiboon Chattakul ◽

Sittichai Khamsai ◽

Panita Limpawattana ◽

Jarin Chindaprasirt ◽

...

Keyword(s):

Blood Pressure ◽

Body Mass Index ◽

Chronic Kidney Disease ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Kidney Disease ◽

Systolic Blood Pressure ◽

High Systolic Blood Pressure ◽

Mallampati Score ◽

Obstructive Sleep

Introduction: Obstructive sleep apnea (OSA) is a common condition in patients with chronic kidney disease (CKD). It may worsen renal function in CKD patients and is associated with uncontrolled blood pressure. Although OSA is found in up to 80% of CKD patients, there are limited data available on its clinical features in patients with and without CKD. Objective: This study aimed to identify the differences in the clinical characteristics of OSA between CKD and non-CKD OSA patients and determine the clinical predictors for CKD in OSA patients. Methods: This was a retrospective study conducted at Khon Kaen University's Srinagarind Hospital in Thailand between July and December 2018. The inclusion criteria were diagnosis with OSA via polysomnography and having undergone laboratory tests for CKD. Obstructive sleep apnea is diagnosed according to the apnea-hypopnea index (AHI) as experiencing >5 events/hour, while CKD diagnosed based on the KDOQI guidelines. Eligible patients were divided into two groups: OSA with CKD and OSA without CKD. Predictors of CKD in OSA patients were analyzed using multivariate logistic regression analysis. Results: During the study period, there were 178 OSA patients who met the study criteria, 88 (49.44%) of whom were in the OSA with CKD group. Both age and body mass index were comparable between OSA patients with CKD and those without (age: 59 and 57 years, respectively; body mass index: 30 and 29 kg/m2, respectively. There were three significant factors that differed between those with and without CKD group including systolic blood pressure (147 vs 135 mmHg), proportion of patients with diabetes (55% vs 34%), and proportion of patients with Mallampati scores of 3-4 (73% vs 39%). There were three independent predictors for OSA in patients with CKD: female sex, high systolic blood pressure, and Mallampati score of 3 or 4, with adjusted odds ratios (95% confidence interval) of 4.624 (1.554, 13.757), 1.060 (1.020, 1.101), and 2.816 (1.356, 5.849), respectively. The Hosmer-Lemeshow chi square statistic of the predictive model was 6.06 (p 0.640). Systolic blood pressure of more than 130 and 150 mmHg resulted in sensitivity of 84.21% and specificity of 81.40%, respectively. Conclusions: Female sex, high systolic blood pressure, and Mallampati score of 3-4 were suggestive of OSA with CKD. Obstructive sleep apnea patients with one or more of these predictors may have a high risk of CKD.

Download Full-text