Abstract
Obstructive sleep apnea (OSA) causes dysfunction of the autonomic nervous system, but the exact mechanism has not been fully understood. The aim of this study was to analyse the relationship between the incidence and severity of OSA and heart rate turbulence (HRT). Seventy one patients with clinical suspicion of OSA were qualified to participate in the study. All participants took part in a survey and were subjected to laboratory tests, 24-hour electrocardiogram (ECG) Holter monitoring with HRT analysis and polysomnography. The group with OSA manifested significantly higher turbulence onset (TO) and lower turbulence slope (TS) as compared to the group without OSA. Older age, diabetes, hypertension and higher apnea/hypopnea index (AHI) were found to be independent risk factors for increased TO, whereas older age, higher body mass index (BMI), higher blood glucose levels, hypertension and higher AHI were independent risk factors for TS reduction. The AHI ≥65 criterion indicates abnormal HRT in patients with OSA with 94.9% sensitivity and 50.0% specificity, which gives a prediction accuracy of 85.7%. In summary, OSA should be considered as a predictor of abnormal HRT.
Highlights
Obstructive sleep apnea (OSA) is a sleep apnea syndrome that increases cardiovascular risk
The aim of this study was to analyse the relationship between the incidence and severity of OSA and heart rate turbulence in patients with clinical suspicion of OSA
In the whole study group of 71 patients admitted to hospital with suspected obstructive sleep apnea, the turbulence onset (TO) parameter was equal to –2.77 ± 2.31 % and the turbulence slope (TS) parameter was equal to 8.43 ± 6.47 Model estimation for the dependent variable TS (ms/RR)
Summary
Obstructive sleep apnea (OSA) is a sleep apnea syndrome that increases cardiovascular risk. It is caused by repeated partial or complete closure of the upper respiratory tract, leading to hypoxaemia, hypercapnia, deterioration of sleep quality and sympathetic hyperactivity [1,2]. OSA is associated with a higher incidence of cardiovascular diseases, including hypertension [3], ischaemic heart disease [4], heart failure [5], stroke [6] and cardiac arrhythmias [7]. Heart rate turbulence (HRT) is an important prognostic indicator for the activity of the autonomic system in cardiovascular diseases. This method was presented by Schmidt et al in 1999 to assess
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