Fluctuations in autonomic nervous activity during sleep displayed by power spectrum analysis of heart rate variability

Baharav, A.; Kotagal, Suresh; Gibbons, Veronique; Rubin, Bruce K.; Pratt, G. E.; Karin, J.; Akselrod, Solange

doi:10.1212/wnl.45.6.1183

Cited by 253 publications

(164 citation statements)

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“…54,55 Moreover, there may be more pronounced neurohormonal perturbations and cytokine release during REM sleep caused by apnea and hypopnea, as compared to NREM sleep. [56][57][58][59] All these pathophysiological changes may be the underlying mechanisms to explain why the AHI in REM sleep, but not the AHI in NREM sleep, was significantly associated with cardiovascular remodeling and ventricular diastolic dysfunction in this study. It is also possible that muscular compensatory ability decreases significantly in patient with occult cardiac dysfunction.…”

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confidence: 60%

Influence and Predicting Variables of Obstructive Sleep Apnea on Cardiac Function and Remodeling in Patients without Congestive Heart Failure

Chen

Liu

et al. 2014

Journal of Clinical Sleep Medicine

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Study Objective: Obstructive sleep apnea syndrome (OSAS) has been considered to be an important predisposing factor for cardiovascular disease. This study aims to investigate the impact of OSAS on cardiac function and remodeling in patients without congestive heart failure. Methods: A total of 79 patients with sleep disordered breathing, preserved systolic function, and normal pro-brain natriuretic peptide level were enrolled. Sixty-fi ve patients were classifi ed to have moderate to severe OSAS (apnea-hypopnea index [AHI] ≥ 15/h), while the other 14 patients with mild or no OSAS (AHI < 15/h) served as control subjects. Baseline clinical and polysomnographic variables as well as tissue Doppler imaging and three-dimensional echocardiographic parameters were obtained. Results:The body mass index, neck circumference, Epworth Sleepiness Scale, desaturation index, arousal index, and snoring index were signifi cantly higher in patients with moderate to severe OSAS than those without (p < 0.05). The left atrial size, mitral A-wave velocity, and left ventricular end-diastolic volume were signifi cantly larger, while E/A ratio was lower in patients with moderate to severe OSAS than those without (p < 0.05). Notably, AHI in REM sleep was signifi cantly correlated with the aortic root size, E/A ratio, left ventricular volume, and stroke volume. In addition, the area under the receiver operator characteristic curve for AHI in REM sleep ≥ 32.3/h was 0.647 (95% CI [0.525, 0.769]) in predicting the development of left ventricular diastolic dysfunction. AHI in REM sleep ≥ 32.3/h was the only independent variant in predicting diastolic dysfunction after adjusting the variables including age, gender, hypertension, and body mass index. Conclusions: Patients with moderate to severe OSAS tend to have cardiac dysfunction revealed by echocardiography. High AHI in REM sleep is signifi cantly associated with cardiovascular remodeling and ventricular diastolic dysfunction, and may be a potential variable to predict cardiac dysfunction. Keywords: Echocardiography, sleep apnea syndrome, diastolic dysfunction, cardiovascular remodeling Citation: Chen YL; Su MC; Liu WH; Wang CC; Lin MC; Chen MC. Infl uence and predicting variables of obstructive sleep apnea on cardiac function and remodeling in patients without congestive heart failure.

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confidence: 60%

Influence and Predicting Variables of Obstructive Sleep Apnea on Cardiac Function and Remodeling in Patients without Congestive Heart Failure

Chen

Liu

et al. 2014

Journal of Clinical Sleep Medicine

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“…26,27 The autonomic function is even synchronized with REM/non-REM ultradian sleep rhythm. 44 Our daily short-term HRV measurements can partially answer some sleep problems in HD patients.…”

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confidence: 99%

The Subjective Sleep Quality and Heart Rate Variability in Hemodialysis Patients

Wei

Chung

et al. 2011

Renal Failure

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Introduction: Sleep disturbances and cardiovascular autonomic dysfunction are major complications of hemodialysis (HD). The goal of this study is to identify clinical, heart rate variability (HRV) or laboratory parameters that are independently associated with subjective sleep quality. Patient and methods: Forty-six stable HD patients filled out sleep questionnaires -Pittsburgh sleep quality index (PSQI), Athens insomnia scale (AIS), and Epworth sleepiness scale (ESS). In addition, they received analyses of 5-minute HRV twice, in lying posture before and after HD. We also recruited 50 healthy subjects who received 5-min HRV. Results: The patients with end-stage renal disease have a high rate of poor sleep quality according to PSQI, AIS, and ESS. The activities of total power (0-0.5 Hz), high-frequency power (HF, 0.15-0.40 Hz), low-frequency power (0.04-0.15 Hz), and very-low-frequency power (0.003-0.04 Hz) in HD patients are obviously lower than that in the healthy people. The poor sleepers (PSQI > 5) show lower heart rate, higher HF and variance before HD, but did not show a significant difference after HD. There is no significant difference between HRV and global score of AIS, but the insomnia group (AIS > 5) has higher BMI. These patients with sleepiness (ESS > 9) only reveal lower hemoglobin, although the global score of ESS reveals no significant relationship with HRV. Conclusion: HD patients have a high rate of poor sleep quality and autonomic dysfunction. Greater attention for the evaluation of sleep quality is needed for the better care of HD patients.

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“…However, several prior studies have demonstrated that the measurement of HRV while a person is awake may not reflect their HRV state during sleep (13,14), since some delicate alternations -such as sympathetic activation accompanied by hypertension -are not readily detected without conducting a sleep study (13,15). Recent improvements in sleep research techniques (13,(15)(16)(17)(18) now allow us to test whether sleep patterns and sleep-related cardiac autonomic regulation are influenced by long-term night shift work in nurses.…”

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Sleep and autonomic nervous system changes – enhanced cardiac sympathetic modulations during sleep in permanent night shift nurses

Chung¹,

Kuo²,

Hsu³

et al. 2009

Scand J Work Environ Health

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Fluctuations in autonomic nervous activity during sleep displayed by power spectrum analysis of heart rate variability

Cited by 253 publications

References 0 publications

Influence and Predicting Variables of Obstructive Sleep Apnea on Cardiac Function and Remodeling in Patients without Congestive Heart Failure

Influence and Predicting Variables of Obstructive Sleep Apnea on Cardiac Function and Remodeling in Patients without Congestive Heart Failure

The Subjective Sleep Quality and Heart Rate Variability in Hemodialysis Patients

Sleep and autonomic nervous system changes – enhanced cardiac sympathetic modulations during sleep in permanent night shift nurses

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