Heart rate variability in patients with obstructive sleep apnea and comorbid pathology

Abstract

Aim. To study the features of heart rate variability in patients with obstructive sleep apnea (OSA) and comorbid pathology.Materials and methods. Polysomnography and registration of heart rate variability (HRV) were performed in 98 patients who applied to a neurologist.Results. Most of the HRV indicators in patients with OSA were significantly lower compared to the control group with orthostatic loading. The most notable of these were: TP (ms2), SDNN (ms), CV (%), HF (ms2), RMSSD (ms), DX (ms), LF (ms2). There were higher CI at rest (3.29 (1.53; 6.10), p = 0.034) and IVR (455.45 (286.95; 704.87), p = 0.014) during exercise in patients with OSA in comparison with the control group (1.73 (0.79; 3.93) and 344.00 (171.57; 440.87), respectively). It was found that arterial hypertension (94.6 %), chronic cerebral ischemia (80.4 %), and acute cerebrovascular accident (10.7 %) were significantly more common in patients with OSA than those examined without apnea (71.4 %, 42.9 % and 0.0 % respectively).Conclusions. BMI, neck volume, saturation level, and desaturation index can be considered as criteria for referring patients for HRV registration in order to assess the state of adaptive reserves. In patients with OSA, according to HRV indicators, a shift in the autonomic balance was found, which is expressed by a weakening of vagal influences and the degree of participation of the autonomic circuit in the regulation of heart rate with an increase in sympathetic orientation and central control mechanisms, a decrease in the body's adaptive resources. Work should be continued to clarify the contribution of comorbid pathology in patients with OSA to the development of autonomic dysfunction.