0051 Respiratory Cycle-Related EEG Changes (RCREC) Predict Incidence and Recurrence of Cardiovascular Disease

Abstract

Introduction Sleep-disordered breathing (SDB) is a common sleep disturbance and is associated with both incident and recurrent cardiovascular disease (CVD). Respiratory Cycle-Related EEG Changes (RCREC), an SDB biomarker, are thought to reflect inspiratory microarousals and are based on quantitative analysis of sleep EEG and breathing. The objective of this study was to assess whether RCREC may predict CVD incidence or recurrence in a large cohort of adults. The RCREC for several frequency bands have been previously shown to predict either higher or lower all-cause mortality in the same cohort. Methods Data were obtained from the Sleep Heart Health Study (SHHS), a multicenter longitudinal study that included polysomnograms in middle-aged to older adults. Information about CVD events was collected at baseline and for up to 16 years later. The RCREC values at baseline were computed in the delta, theta, alpha, sigma, beta, and gamma frequency bands during scored epochs of sleep. Cox Proportional Hazard models, were used to assess the relation of each RCREC frequency band and incidence or recurrence of CVD. These models were stratified by sex and adjusted for body-mass index, age, race, smoking status, diabetic status, hypertensive status, HDL cholesterol, LDL cholesterol, and the apnea-hypopnea index (AHI). Results There were 3,032 adults with sufficient data quality (mean age at baseline 62±11(SD) years, 58% female). Among 2,500 adults with no reported prior CVD history at baseline, the adjusted odds ratios (95% CI) for delta RCREC 0.948(0.920–0.977), theta RCREC 0.938(0.895–0.984), and alpha RCREC 0.946(0.902–0.993) separately suggested associations with lower CVD incidence, whereas gamma RCREC 1.017(1.001–1.032) predicted a marginal increase. Among 532 adults having prior CVD history at baseline, delta RCREC 0.958(0.927–0.989) and sigma RCREC 0.931(0.895–0.969) separately predicted decreased CVD recurrence. The apnea-hypopnea index (AHI) was not similarly predictive in any model. Conclusion The RCREC for several frequency bands, in contrast to AHI, may predict CVD incidence and recurrence. The directionality of the association was surprising and merits further exploration. Support NIH:NCATS-TL1-TR-002242, BD2K-K01-ES-026839, HL105999