Heart rate variability during wakefulness as a marker of obstructive sleep apnea severity.

Autor:	Qin H; Interdisciplinary Center of Sleep Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany., Keenan BT; Division of Sleep Medicine, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA., Mazzotti DR; Division of Medical Informatics, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS., Vaquerizo-Villar F; Biomedical Engineering Group, Universidad de Valladolid, Valladolid, Spain.; Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain., Kraemer JF; Department of Physics, Humboldt Universität zu Berlin, Berlin, Germany., Wessel N; Department of Physics, Humboldt Universität zu Berlin, Berlin, Germany., Tufik S; Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil., Bittencourt L; Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil., Cistulli PA; Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney Sydney, Australia.; Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, Sydney, Australia., de Chazal P; Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney Sydney, Australia., Sutherland K; Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney Sydney, Australia.; Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, Sydney, Australia., Singh B; West Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital, Nedlands, WA, Australia.; School of Human Sciences, University of Western Australia, Crawley, WA, Australia., Pack AI; Division of Sleep Medicine, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA., Chen NH; Division of Pulmonary, Critical Care Medicine and Sleep Medicine, Chang Gung Memorial Hospital, Taoyuan City, Taiwan., Fietze I; Interdisciplinary Center of Sleep Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany., Gislason T; Department of Sleep Medicine, Landspitali University Hospital, Reykjavik, Iceland.; Medical Faculty, University of Iceland, Reykjavik, Iceland., Holfinger S; Division of Pulmonary, Critical Care, and Sleep Medicine, The Ohio State University Wexner Medical Center, Columbus, OH., Magalang UJ; Division of Pulmonary, Critical Care, and Sleep Medicine, The Ohio State University Wexner Medical Center, Columbus, OH., Penzel T; Interdisciplinary Center of Sleep Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Jazyk:	angličtina
Zdroj:	Sleep [Sleep] 2021 May 14; Vol. 44 (5).
DOI:	10.1093/sleep/zsab018
Abstrakt:	Study Objectives: Patients with obstructive sleep apnea (OSA) exhibit heterogeneous heart rate variability (HRV) during wakefulness and sleep. We investigated the influence of OSA severity on HRV parameters during wakefulness in a large international clinical sample. Methods: 1247 subjects (426 without OSA and 821 patients with OSA) were enrolled from the Sleep Apnea Global Interdisciplinary Consortium. HRV parameters were calculated during a 5-minute wakefulness period with spontaneous breathing prior to the sleep study, using time-domain, frequency-domain and nonlinear methods. Differences in HRV were evaluated among groups using analysis of covariance, controlling for relevant covariates. Results: Patients with OSA showed significantly lower time-domain variations and less complexity of heartbeats compared to individuals without OSA. Those with severe OSA had remarkably reduced HRV compared to all other groups. Compared to non-OSA patients, those with severe OSA had lower HRV based on SDNN (adjusted mean: 37.4 vs. 46.2 ms; p < 0.0001), RMSSD (21.5 vs. 27.9 ms; p < 0.0001), ShanEn (1.83 vs. 2.01; p < 0.0001), and Forbword (36.7 vs. 33.0; p = 0.0001). While no differences were found in frequency-domain measures overall, among obese patients there was a shift to sympathetic dominance in severe OSA, with a higher LF/HF ratio compared to obese non-OSA patients (4.2 vs. 2.7; p = 0.009). Conclusions: Time-domain and nonlinear HRV measures during wakefulness are associated with OSA severity, with severe patients having remarkably reduced and less complex HRV. Frequency-domain measures show a shift to sympathetic dominance only in obese OSA patients. Thus, HRV during wakefulness could provide additional information about cardiovascular physiology in OSA patients. Clinical Trial Information: A Prospective Observational Cohort to Study the Genetics of Obstructive Sleep Apnea and Associated Co-Morbidities (German Clinical Trials Register - DKRS, DRKS00003966) https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00003966. (© Sleep Research Society 2021. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
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