Is there a chronic sleep stage-dependent linear and nonlinear cardiac autonomic impairment in obstructive sleep apnea?

Author(s)

Trimer, R. ^{[1, 2]} ; Mendes, R. G. ^[1] ; Costa, F. S. M. ^[3] ; Sampaio, L. M. M. ^[4] ; Delfino, Jr., A. ^[3] ; Arena, R. ^[5] ; Aletti, F. ^[6] ; Ferrario, M. ^[6] ; Borghi-Silva, A. ^[1]

Affiliation

^[1] Univ Fed Sao Carlos, Cardiopulm Physiotherapy Lab, BR-13560 Sao Carlos, SP - Brazil

^[2] Univ Fed Sao Carlos, Cardiopulm Physiotherapy Lab, Physiotherapy Dept, BR-13560 Sao Carlos, SP - Brazil

^[3] Sleep Inst Sao Carlos, Sao Paulo - Brazil

^[4] Nove de Julho Univ, Sao Paulo - Brazil

^[5] Univ Illinois, Dept Phys Therapy, Coll Appl Hlth Sci, Chicago, IL - USA

^[6] Politecn Milan, Dipartimento Bioingn, I-20133 Milan - Italy

• Document type: Journal article
• Source: Sleep and Breathing; v. 18, n. 2, p. 403-409, MAY 2014.
• Web of Science Citations: 12

Abstract

Obstructive sleep apnea (OSA) is a respiratory disorder that has the potential to negatively impact heart rate variability (HRV) during the sleep cycle. However, it is uncertain whether there is a chronic sleep stage-dependent linear and nonlinear cardiac autonomic impairment in OSA. The aim of this study was to perform HRV analysis in apnea-free samples as well as during stage 2 and rapid eye movement (REM) sleep in mild and moderate OSA (MiOSA and MOSA, respectively) subjects as well as health controls (NonOSA). This study included 20 MiOSA (37 +/- 14 years), 20 MOSA (39 +/- 8 years), and 18 NonOSA (36 +/- 8 years) subjects. Subjects underwent in-laboratory overnight polysomnography with electrocardiography recording. HRV indices were obtained by analyzing the R-R intervals (RRis) in 5-min apnea-free samples by the linear frequency domain {[}low frequency (LF), high frequency (HF) and LF/HF], Poincar, plot {[}standard deviation (SD1) and (SD2)], recurrence plot {[}mean line length (Lmean)], recurrence rate (REC), determinism (DET), and Shannon entropy (ShanEn). The MOSA group presented with higher LF, LF/HF, and DET indices compared to NonOSA as well as a lower parasympathetic index (HF), suggesting sympathetic hyperactivity in MOSA subjects. Interestingly, MiOSA subjects failed to show the expected linear HRV difference between sleep stages, as observed in NonOSA, which may represent an early onset of autonomic impairment at this stage of OSA. In OSA patients, there is a chronic sleep stage-dependent impairment of linear and nonlinear cardiac autonomic modulation. Interestingly, this impairment may be identifiable during the early stages of the disease. (AU)

• FAPESP's process: 09/01842-0 - Analysis of central and peripheral muscle metabolism and adjustments on dynamic versus resistance exercise in coronary arterial disease patients: effects of resistance physical training program based on anaerobic threshold by different methodologies
• Grantee: Audrey Borghi Silva
• Support Opportunities: Research Grants - Young Investigators Grants