Heart Rate Detrended Fluctuation Indexes as Estimate of Obstructive Sleep Apnea Severity

Author(s)

Pereira da Silva, Eduardo Luiz ^{[1, 2]} ; Pereira, Rafael ^[3] ; Reis, Luciano Neves ^[4] ; Pereira, Jr., Valter Luis ^[1] ; Campos, Luciana Aparecida ^[1] ; Wessel, Niels ^[5] ; Baltatu, Ovidiu Constantin ^[1]

Affiliation

^[1] Camilo Castelo Branco Univ UNICASTELO, CITE, BR-12247016 Sao Jose Dos Campos, SP - Brazil

^[2] Univ Iguacu Campus V, Rio De Janeiro - Brazil

^[3] State Univ Southwest Bahia UESB, Dept Biol Sci, Jequie, BA - Brazil

^[4] Sleep Inst Itaperuna, Rio De Janeiro - Brazil

^[5] Humboldt Univ, D-10099 Berlin - Germany

• Document type: Journal article
• Source: MEDICINE; v. 94, n. 4 JAN 2015.
• Web of Science Citations: 5

Abstract

In the present study, we aimed at investigating a heart rate variability (HRV) biomarker that could be associated with the severity of the apnea-hypopnea index (AHI), which could be used for an early diagnosis of obstructive sleep apnea (OSA). This was a cross-sectional observational study on 47 patients (age 36 + 9.2 standard deviation) diagnosed with mild (23.4%), moderate (34%), or severe (42.6%) OSA. HRV was studied by linear measures of fast Fourier transform, nonlinear Poincare analysis, and detrended fluctuation analysis (DFA)-DFA alpha 1 characterizes short-term fluctuations, DFA alpha 2 characterizes long-term fluctuations. Associations between polysomnography indexes (AHI, arousal index {[}AI], and oxygen desaturation index {[}ODI]) and HRV indexes were studied. Patients with different grades of AHI had similar sympathovagal balance levels as indicated by the frequency-domain and Poincare HRV indexes. The DFA alpha 2 index was significantly positive correlated with AHI, AI, and ODI (Pearson r: 0.55, 0.59, and 0.59, respectively, with P < 0.0001). The ROC analysis revealed that DFA alpha 2 index predicted moderate and severe OSA with a sensitivity/specificity/area under the curve of 0.86/0.64/0.8 (P = 0.005) and 0.6/0.89/0.76 (P = 0.003), respectively. Our data indicate that the DFA alpha 2 index may be used as a reliable index for the detection of OSA severity. (AU)

• FAPESP's process: 13/06698-0 - Mathematical biomarkers for autonomic regulation of cardiovascular system
• Grantee: Luciana Aparecida Campos Baltatu
• Support Opportunities: Regular Research Grants
• FAPESP's process: 13/14724-0 - Functional biomarkers for the extracranial vascular disease
• Grantee: Ovidiu Constantin Baltatu
• Support Opportunities: Regular Research Grants