Heart rate variability during wakefulness as a marker of obstructive sleep apnea severity.
Cast your vote
You can rate an item by clicking the amount of stars they wish to award to this item.
When enough users have cast their vote on this item, the average rating will also be shown.
Your vote was cast
Thank you for your feedback
Thank you for your feedback
Keenan, Brendan T
Mazzotti, Diego R
Kraemer, Jan F
Cistulli, Peter A
de Chazal, Philip
Pack, Allan I
Magalang, Ulysses J
MetadataShow full item record
CitationQin H, Keenan BT, Mazzotti DR, Vaquerizo-Villar F, Kraemer JF, Wessel N, Tufik S, Bittencourt L, Cistulli PA, de Chazal P, Sutherland K, Singh B, Pack AI, Chen NH, Fietze I, Gislason T, Holfinger S, Magalang UJ, Penzel T. Heart rate variability during wakefulness as a marker of obstructive sleep apnea severity. Sleep. 2021 May 14;44(5):zsab018. doi: 10.1093/sleep/zsab018.
AbstractStudy 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. Keywords: autonomic nervous activity; frequency domain analysis; heart rate variability; nonlinear dynamic analysis; obstructive sleep apnea; time domain analysis; wakefulness.
DescriptionTo access publisher's full text version of this article click on the hyperlink below
Rights© Sleep Research Society 2021. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please email: firstname.lastname@example.org.
- Heart rate variability and cardiorespiratory coupling in obstructive sleep apnea: elderly compared with young.
- Authors: Trimer R, Cabidu R, Sampaio LL, Stirbulov R, Poiares D, Guizilini S, Bianchi AM, Costa FS, Mendes RG, Delfino A Jr, Arena R, Borghi-Silva A
- Issue date: 2014 Nov
- Characterizing the phenotypes of obstructive sleep apnea: clinical, sleep, and autonomic features of obstructive sleep apnea with and without hypoxia.
- Authors: Palma JA, Iriarte J, Fernandez S, Valencia M, Alegre M, Artieda J, Urrestarazu E
- Issue date: 2014 Sep
- Autonomic function in sleep apnea patients: increased heart rate variability except during REM sleep in obese patients.
- Authors: Reynolds EB, Seda G, Ware JC, Vinik AI, Risk MR, Fishback NF
- Issue date: 2007 Mar
- Increased sympathetic and decreased parasympathetic cardiac tone in patients with sleep related alveolar hypoventilation.
- Authors: Palma JA, Urrestarazu E, Lopez-Azcarate J, Alegre M, Fernandez S, Artieda J, Iriarte J
- Issue date: 2013 Jun 1
- Alterations in heart rate variability in patients with peripheral arterial disease requiring surgical revascularization have limited association with postoperative major adverse cardiovascular and cerebrovascular events.
- Authors: Utriainen KT, Airaksinen JK, Polo OJ, Scheinin H, Laitio RM, Leino KA, Vahlberg TJ, Kuusela TA, Laitio TT
- Issue date: 2018