0603 The Association Between Obstructive Respiratory Events in REM Sleep and Heart Rate Variability

Oh, Seil; Choi, Sungjun; Park, K; Lee, Y

doi:10.1093/sleep/zsy061.602

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“…En este estudio, en el balance simpático-vagal predomina el componente parasimpático, incrementándose en fase REM, mientras que en pacientes con episodios apneicos hay un incremento de la actividad simpática, aunque menor en pacientes con comorbilidad. Oh et al, en un estudio publicado recientemente, evalúan el efecto de la presencia de apnea en fase REM sobre la modulación cardiaca, comparando los pacientes en función de si presentaban o no un IAH mayor de 15 eventos/h[140]. Estos autores realizan un análisis de la señal de HRV tanto en el dominio del tiempo como espectral, no evidenciando una mayor disfunción autonómica en fase REM en ninguno de los enfoques.…”

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Variabilidad de la frecuencia de pulso mediante análisis no lineal en pacientes con síndrome de apnea del sueño y enfermedad pulmonar obstructiva crónica (EPOC)

Fernández¹

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Background. Chronic obstructive pulmonary disease (COPD) is characterized by a persistent and commonly progressive airflow limitation consequent to an abnormal inflammatory response of the airway and lung tissue due to noxious particles and gases. COPD is among the most common lung diseases, with an estimated prevalence of 9%, becoming a major health problem worldwide. COPD patients show major dysfunction in cardiac autonomic modulation due to sustained hypoxemia, which has been significantly related to higher risk of cardiovascular disease. A substantial number of patients suffering from COPD have major comorbidities, which is linked with diminished health status and quality of life. In this regard, sleep disorders are commonly present in COPD patients. Particularly, sleep apnea-hypopnea syndrome (SAHS) is a frequent comorbidity in COPD. It has been found that patients suffering from both COPD and SAHS simultaneously, the so-called overlap syndrome, have notably higher morbidity and mortality, mostly in the context of cardiovascular disease. Patients showing both conditions have significant imbalances in cardiac autonomic modulation compared to those with COPD or SAHS alone. Heart rate variability (HRV) has been found to be useful to assess changes in autonomic functioning in different clinical conditions. Traditional analysis of HRV recordings has shown that patients with overlap syndrome are characterized by a reduced resting HRV, which has been related to increased risk of cardiac disease. However, there is viii still little scientific evidence on the magnitude of changes in cardiovascular dynamics elicited by the combined effect of both respiratory diseases, primarily during sleep, when apneic events occur. Due to the chaotic behavior of the HRV signal, nonlinear methods are able to gain insight into the influence of COPD and SAHS in the autonomic cardiac modulation. Hypothesis and objectives. In this PhD Thesis, the hypothesis is twofold. Firstly, it is hypothesized that patients with COPD and SAHS simultaneously show higher changes in the autonomic cardiac modulation than patients suffering from either COPD or SAHS alone. Secondly, it is hypothesized that nonlinear analysis is able to provide complementary information to conventional analyses on the characterization of the long-term changes in overnight cardiovascular dynamics of COPD patients due to the presence of concomitant moderate-to-severe SAHS. Accordingly, this study is aimed at assessing the usefulness of sample entropy (SampEn) to distinguish changes in nocturnal pulse rate variability (PRV) recordings among three patient groups while sleeping: (1) COPD patients without moderate or severe sleep apnea; (2) moderate-to-severe SAHS patients without prior history of COPD; and (3) patients showing both COPD and moderate-to-severe SAHS, i.e., overlap syndrome. Material and Methods. In order to achieve this goal, a population composed of 297 patients were studied: 22 with COPD alone, 213 showing moderate-to-severe SAHS, and 62 with COPD and moderate-to...

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Variabilidad de la frecuencia de pulso mediante análisis no lineal en pacientes con síndrome de apnea del sueño y enfermedad pulmonar obstructiva crónica (EPOC)

Fernández¹

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0603 The Association Between Obstructive Respiratory Events in REM Sleep and Heart Rate Variability

Cited by 1 publication

References 0 publications

Variabilidad de la frecuencia de pulso mediante análisis no lineal en pacientes con síndrome de apnea del sueño y enfermedad pulmonar obstructiva crónica (EPOC)

Variabilidad de la frecuencia de pulso mediante análisis no lineal en pacientes con síndrome de apnea del sueño y enfermedad pulmonar obstructiva crónica (EPOC)

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