Abstract
Heart rate variability (HRV) can reflect the changes in the autonomic nervous system (ANS) that are affected by apnea or hypopnea events among patients with obstructive sleep apnea hypopnea syndrome (OSAHS). To evaluate the possibility of using HRV to screen for OSAHS, we investigated the relationship between HRV and polysomnography (PSG) diagnostic indices using electrocardiography (ECG) and PSG data from 25 patients with OSAHS and 27 healthy participants. We evaluated the relationship between various PSG diagnostic indices (including the apnea hypopnea index [AHI], micro-arousal index [MI], oxygen desaturation index [ODI]) and heart rate variability (HRV) parameters using Spearman’s correlation analysis. Moreover, we used multiple linear regression analyses to construct linear models for the AHI, MI, and ODI. In our analysis, the AHI was significantly associated with relative powers of very low frequency (VLF [%]) (r = 0.641, P = 0.001), relative powers of high frequency (HF [%]) (r = -0.586, P = 0.002), ratio between low frequency and high frequency powers (LF/HF) (r = 0.545, P = 0.049), normalized powers of low frequency (LF [n.u.]) (r = 0.506, P = 0.004), and normalized powers of high frequency (HF [n.u.]) (r = -0.506, P = 0.010) among patients with OSAHS. The MI was significantly related to standard deviation of RR intervals (SDNN) (r = 0.550, P = 0.031), VLF [%] (r = 0.626, P = 0.001), HF [%] (r = -0.632, P = 0.001), LF/HF (r = 0.591, P = 0.011), LF [n.u.] (r = 0.553, P = 0.004), HF [n.u.] (r = -0.553, P = 0.004), and absolute powers of very low frequency (VLF [abs]) (r = 0.525, P = 0.007) among patients with OSAHS. The ODI was significantly correlated with VLF [%] (r = 0.617, P = 0.001), HF [%] (r = -0.574, P = 0.003), LF [n.u.] (r = 0.510, P = 0.012), and HF [n.u.] (r = -0.510, P = 0.012) among patients with OSAHS. The linear models for the PSG diagnostic indices were AHI = -38.357+1.318VLF [%], MI = -13.389+11.297LF/HF+0.266SDNN, and ODI = -55.588+1.715VLF [%]. However, the PSG diagnostic indices were not related to the HRV parameters among healthy participants. Our analysis suggests that HRV parameters are powerful tools to screen for OSAHS patients in place of PSG monitoring.
Highlights
Obstructive sleep apnea hypopnea syndrome (OSAHS) has a prevalence of 2% to 4% among middle-aged adults and is an independent risk factor for many systemic disorders [1]
We evaluated the relationship between various PSG diagnostic indices and heart rate variability (HRV) parameters using Spearman’s correlation analysis
We found that the apnea hypopnea index (AHI) was significantly and positively correlated with VLF [%], HF [%], low frequency and high frequency powers (LF/HF), LF [n.u.], and HF [n.u.]
Summary
Obstructive sleep apnea hypopnea syndrome (OSAHS) has a prevalence of 2% to 4% among middle-aged adults and is an independent risk factor for many systemic disorders [1]. OSAHS includes numerous disordered events (apneas, hypopneas and micro-arousals) reaching to five events/hour in patients with the following symptoms: loud snoring, breathing interruptions, waking up holding their breath, daytime sleepiness, unrefreshing sleep and fatigue [13]. Full-night polysomnography (PSG) is recommended as a routine procedure in the diagnosis of OSAHS [14]. During PSG monitoring to assess OSAHS, the following physiological signals are acquired: electroencephalography (EEG), electromyography (EMG), electrooculogram (EOG), oxygen saturation, electrocardiogram (ECG), body movement, and nasal airflow. Researchers have actively sought an alternative and efficient examination to screen for OSAHS
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