P.2.35 Heart rate variability and sleep-related breathing disorders in commercial drivers

BackgroundSleep-related breathing disorders, such as obstructive sleep apnea (OSA), seems to have an important influence on the autonomic nervous function on the heart, and associated with cardiovascular mortality. Therefore, we assessed the relations of sleep apnea-related parameters with 5 min heart rate variability (HRV) in a large cohort of male commercial drivers.MethodsThis cross-sectional study recruited 245 male bus drivers from one transportation company in Taiwan. Each participant was evaluated by a polysomnography (PSG) test and by blood lipids examination. Severity of OSA was categorized according to the apnea-hypopnea index (AHI). In addition, short-term HRV was tested.ResultsSubjects were categorized into severe OSA group (n=44; 17.9%), moderate and mild OSA group (n=117; 47.8%), and non-OSA group (n=84; 34.3%). AHI had negative correlations with SDNN (β=−0.075, p=0.007) and RMSSD (β=−0.121, p<0.001), adjusting for age, body mass index, smoking, drinking, systolic blood pressure, HDL, and fasting blood glucose. RMSSD level was decreased with severe OSA (β=−0.266, p=0.042) even adjusting for confounders.ConclusionsThe findings showed a low level of RMSSD in OSA among commercial drivers, especially in the severe group category. Decreased SDNN and RMSSD levels are associated with AHI level in commercial drivers, suggesting that they are tightly linked with autonomic dysfunction.

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Abstract 17063: Sleep Related Breathing Disorders and Heart Rate Variability in Young and Healthy Adults From the General Population

Circulation ◽

10.1161/circ.132.suppl_3.17063 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Stefanie Aeschbacher ◽

Matthias Bossard ◽

Mirco von Rotz ◽

Tobias Schoen ◽

Anna Maseli ◽

...

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Sleep Apnea ◽

Large Population ◽

Healthy Adults ◽

Apnea Hypopnea Index ◽

Sleep Related Breathing Disorders ◽

Breathing Disorders ◽

Relationship Of ◽

The Relationship

Background: The influence of sleep related breathing disorders on heart rate variability (HRV), a measure of autonomic nervous function, is not well studied. We therefore assessed the relationship of the Apnea-Hypopnea Index (AHI) and the Oxygen Desaturation Index (ODI) with 24-hour HRV in a large population of young and healthy adults. Methods: Individuals aged between 25-41 years with a body mass index ≤35km/kg2 and without known sleep apnea syndrome (SAS) or cardiovascular disease were included in the population-based GAPP-study. A 24-hour electrocardiogram (ECG) was obtained in every participant, and systematic post-processing performed with a dedicated software. The standard deviation of all normal RR intervals (SDNN) was used as main HRV marker. AHI and ODI were obtained from nighttime pulsoxymetry with nasal airflow measurements. Sleep apnea (SA) was defined as either an AHI ≥5 or an ODI ≥5. Multivariable regression models were constructed to assess the relationship of SDNN with either AHI or ODI and to adjust for a large number of confounders. Results: We included 1266 participants (47% men) with a median age of 35 years. Mean SDNN among men and women was 162 and 148ms (p<0.0001), respectively. The proportion of participants with SA using an AHI- or ODI-based definition was 10 and 11%, respectively. Compared to individuals without SA, the beta coefficient (95% confidence interval (CI)) for SDNN was -7.48 (-14.75; -0.23, p=0.04) among those with an AHI-based SA definition, and was -11.45 (-18.39; -4.52, p=0.001) among those with an ODI-based SA definition. A highly significant inverse trend across different categories of AHI and ODI was observed, as shown in the Table. Conclusion: Early stages of sleep related breathing disorders are strongly associated with decreasing HRV in young and healthy adults, without evidence of a threshold. These findings suggest a tight link between sleep related breathing disorders and autonomic dysfunction.

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Heart Rate Dynamics in Patients with Obstructive Sleep Apnea: Heart Rate Variability and Entropy

Entropy ◽

10.3390/e21100927 ◽

2019 ◽

Vol 21 (10) ◽

pp. 927

Author(s):

Lulu Zhang ◽

Mingyu Fu ◽

Fengguo Xu ◽

Fengzhen Hou ◽

Yan Ma

Keyword(s):

Heart Rate ◽

Obstructive Sleep Apnea ◽

Heart Rate Variability ◽

Sleep Apnea ◽

Apnea Hypopnea Index ◽

Cross Sectional ◽

Sleep Study ◽

Ecg Signals ◽

Potential Association ◽

Obstructive Sleep

Background: Obstructive sleep apnea (OSA), a highly prevalent sleep disorder, is closely related to cardiovascular disease (CVD). Our previous work demonstrated that Shannon entropy of the degree distribution (EDD), obtained from the network domain of heart rate variability (HRV), might be a potential indicator for CVD. Method: To investigate the potential association between OSA and EDD, OSA patients and healthy controls (HCs) were identified from a sleep study database. Then EDD was calculated from electrocardiogram (ECG) signals during sleep, followed by cross-sectional comparisons between OSA patients and HCs, and longitudinal comparisons from baseline to follow-up visits. Furthermore, for OSA patients, the association between EDD and OSA severity, measured by apnea-hypopnea index (AHI), was also analyzed. Results: Compared with HCs, OSA patients had significantly increased EDD during sleep. A positive correlation between EDD and the severity of OSA was also observed. Although the value of EDD became larger with aging, it was not OSA-specified. Conclusion: Increased EDD derived from ECG signals during sleep might be a potential dynamic biomarker to identify OSA patients from HCs, which may be used in screening OSA with high risk before polysomnography is considered.

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Treatment-Related Changes in Heart Rate Variability in Children with Sleep Apnea

Otolaryngology ◽

10.1177/0194599820907882 ◽

2020 ◽

Vol 162 (5) ◽

pp. 737-745 ◽

Cited By ~ 1

Author(s):

Amal Isaiah ◽

Dylan Bertoni ◽

Kevin D. Pereira ◽

Montserrat Diaz-Abad ◽

Ron B. Mitchell ◽

...

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Sleep Apnea ◽

Secondary Analysis ◽

Specific Treatment ◽

Demographic Variables ◽

Apnea Hypopnea Index ◽

Average Heart Rate ◽

Oxygen Desaturation Index ◽

Obstructive Sleep

Objective Heart rate variability (HRV), a noninvasive indicator of autonomic regulation of cardiac rhythm, may represent the physiologic burden of obstructive sleep apnea (OSA). We hypothesized that the treatment-related effects of OSA on HRV in children are causally attributable to the improvement in OSA severity. Study Design Secondary analysis of outcomes from the Childhood Adenotonsillectomy Trial (CHAT). Setting Analysis of database. Subjects and Methods Time- and frequency-domain HRV parameters along with polysomnographic (PSG) and demographic variables were obtained from the CHAT study, which compared early adenotonsillectomy (eAT) to watchful waiting (WW) in children with OSA. The relative contributions of PSG variables and covariates to each HRV parameter were quantified. The proportion of changes in HRV parameters causally attributable to changes in OSA severity, measured by the apnea-hypopnea index (AHI) and oxygen desaturation index (ODI), was estimated. Results In total, 404 children aged 5 to 10 years were included. The median (interquartile range) age was 6 (3-9) years. The median body mass index percentile was 82 (53), 195 (48%) children were male, and 147 (36%) were African American. The average heart rate during PSG was the strongest independent predictor of each HRV parameter ( P < .001). Although eAT resulted in statistically significant changes in the majority of HRV parameters, these effects were not causally attributable to treatment-related changes in AHI or ODI. Conclusions The average heart rate strongly modulates HRV in children with OSA. Although eAT results in discernible changes in HRV, it appears to not be causally attributable to specific treatment-related changes in AHI or ODI.

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Benefits of oxytocin administration in obstructive sleep apnea

AJP Lung Cellular and Molecular Physiology ◽

10.1152/ajplung.00206.2017 ◽

2017 ◽

Vol 313 (5) ◽

pp. L825-L833 ◽

Cited By ~ 11

Author(s):

Vivek Jain ◽

Joseph Marbach ◽

Shawn Kimbro ◽

David C. Andrade ◽

Arad Jain ◽

...

Keyword(s):

Heart Rate ◽

Obstructive Sleep Apnea ◽

Heart Rate Variability ◽

Sleep Apnea ◽

Sleep Time ◽

Apnea Hypopnea Index ◽

Beneficial Effects ◽

Oxytocin Receptors ◽

Obstructive Sleep ◽

Patient Reported

Activation of oxytocin receptors has shown benefits in animal models of obstructive sleep apnea (OSA). We tested if nocturnal oxytocin administration could have beneficial effects in OSA patients. Eight patients diagnosed with OSA were administered intranasal oxytocin (40 IU). Changes in cardiorespiratory events during sleep, including apnea and hypopnea durations and frequency, risk of event-associated arousals, and heart rate variability, were assessed. Oxytocin significantly increased indexes of parasympathetic activity, including heart rate variability, total sleep time, and the postpolysommogram sleep assessment score, an index of self-reported sleep satisfaction. Although the apnea-hypopnea index was not significantly changed with oxytocin administration, when apnea and hypopnea events were compared independently, the frequency of hypopneas, but not apneas, was significantly ( P ≤ 0.005) decreased with oxytocin treatment. Both apneas and hypopneas were significantly shortened in duration with oxytocin treatment. Oxytocin treatment significantly decreased the percent of apnea and hypopnea events that were accompanied with an arousal. Oxytocin administration has the potential to restore cardiorespiratory homeostasis and reduce some clinically important (objective and patient-reported) adverse events that occur with OSA. Additional studies are needed to further understand the mechanisms by which oxytocin promotes these changes in cardiorespiratory and autonomic function in OSA patients.

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The correlation of the severity of polysomnography with clinical assessment in cases of adult OSA in a tertiary hospital

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20182717 ◽

2018 ◽

Vol 4 (4) ◽

pp. 1076

Author(s):

Suresh V. ◽

Gowri Shankar M. ◽

Prabhu D. ◽

Natarajan S.

Keyword(s):

Heart Rate ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Oxygen Saturation ◽

Clinical Assessment ◽

Apnea Hypopnea Index ◽

Tertiary Referral Centre ◽

Sleep Related Breathing Disorders ◽

Obstructive Sleep ◽

The Mean

Background: Now days increasing number of people with sleep related breathing disorders especially obstructive sleep apnea are reporting every day in our institute, which is a tertiary referral centre. The objective was to correlate between clinical assessment andpolysomnographic features in an obstructive sleep apnea patient.Methods: A total number of 60 cases were analyzed retrospectively and those who were already clinically assessed and diagnosed as OSA by AHI>5/h in overnight PSG study. The clinical history, body mass index, Epworth sleepiness scale score and full night polysomnograpic data were obtained for all 60 cases. The age and gender differences in OSA cases were analyzed. The correlations between the BMI, ESS score, AHI, oxygen saturation sleep apnea, Epworth sleeps scale and apnea hypopnea index were explored. Results: Of the 60 cases OSA were analyzed, the mean (SD) age was 36.62 (±11.90) years and the men was mostly affected 96.7% than women only 3.3%. Of 60 cases, 30% of patients having mild form, 25% of patients moderate form, 45% of patients having severe form. The obese patients affected more 83.3% (50/60) than normal only 10% (6/60). The clinical symptom were analyzed by ESS score the normal 18.3%, mild 18.3%, moderate 28.3% and severe 35%. The mean oxygen saturation and heart rate of OSA patients were 72.35 (±11.47) and 69.90 (±15.26) respectively.Conclusions: The BMI and ESS score were positively correlated with severity of OSA. The oxygen saturation and heart rate were negatively correlated with OSA.

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The effect of sleep apnea severity on cardiac autonomic activity during night time in obstructive sleep apnea patients

Sao Paulo Medical Journal ◽

10.1590/1516-3180.2015.0189070116 ◽

2016 ◽

Vol 134 (5) ◽

pp. 430-436 ◽

Cited By ~ 2

Author(s):

Gulay Ozkececi ◽

Sevinc Sarinc Ulasli ◽

Onder Akci ◽

Alaettin Avsar ◽

Mehmet Unlu ◽

...

Keyword(s):

Heart Rate ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Cardiac Function ◽

Cross Sectional Study ◽

Apnea Hypopnea Index ◽

Night Time ◽

Cross Sectional ◽

Obstructive Sleep ◽

The Impact

ABSTRACT CONTEXT AND OBJECTIVE: Impaired autonomic cardiac function is an important consequence of obstructive sleep apnea (OSA). This impairment is mainly due to intermittent hypoxia episodes following apneas. However, the impact of apnea severity on autonomic cardiac function remains unclear. The aim of this study was to evaluate the relationship between the severity of sleep apnea and heart rate turbulence (HRT) and heart rate variability (HRV) in OSA. DESIGN AND SETTING: Observational cross-sectional study conducted in the Departments of Cardiology and Pulmonary Diseases, Afyon Kocatepe University, Turkey. METHODS: 106 patients with OSA and 27 healthy volunteers were enrolled. Based on apnea hypopnea index (AHI) values, obstructive sleep apnea severity was classified as follows: mild OSA (AHI ≥ 5 and < 15), moderate OSA (AHI ≥ 15 and ≤ 30) and severe OSA (AHI > 30). HRV and HRT parameters were assessed via 24-hour digital Holter electrocardiogram recordings for all subjects. RESULTS: HRV and HRT results were significantly lower among OSA patients than among control subjects (P < 0.05). However, there were no significant differences in HRT and HRV between the three patient subgroups. Correlations did emerge between AHI and the NN-interval parameter RMSSD and between oxygen desaturation and turbulence slope (respectively: r = -0.22, P = 0.037; and r = -0.28, P = 0.025). CONCLUSION: HRT and HRV results deteriorate in OSA. Correlations between apnea severity and these parameters seem to be present.

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