Cardiac autonomic control in the obstructive sleep apnea
Introduction: The sympathetic activation is considered to be the main mechanism involved in the development of cardiovascular diseases in obstructive sleep apnea (OSA). The heart rate variability (HRV) analysis represents a non-invasive tool allowing the study of the autonomic nervous system. The im...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2015-04-01
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| Series: | Libyan Journal of Medicine |
| Subjects: | |
| Online Access: | http://www.libyanjournalofmedicine.net/index.php/ljm/article/view/26989/pdf_9 |
| _version_ | 1828472928416563200 |
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| author | Nouha Gammoudi Ridha Ben Cheikh Mohamed Ali Saafi Ghazi Sakly Mohamed Dogui |
| author_facet | Nouha Gammoudi Ridha Ben Cheikh Mohamed Ali Saafi Ghazi Sakly Mohamed Dogui |
| author_sort | Nouha Gammoudi |
| collection | DOAJ |
| description | Introduction: The sympathetic activation is considered to be the main mechanism involved in the development of cardiovascular diseases in obstructive sleep apnea (OSA). The heart rate variability (HRV) analysis represents a non-invasive tool allowing the study of the autonomic nervous system. The impairment of HRV parameters in OSA has been documented. However, only a few studies tackled the dynamics of the autonomic nervous system during sleep in patients having OSA. Aims: To analyze the HRV over sleep stages and across sleep periods in order to clarify the impact of OSA on cardiac autonomic modulation. The second objective is to examine the nocturnal HRV of OSA patients to find out which HRV parameter is the best to reflect the symptoms severity. Methods: The study was retrospective. We have included 30 patients undergoing overnight polysomnography. Subjects were categorized into two groups according to apnea–hypopnea index (AHI): mild-to-moderate OSAS group (AHI: 5–30) and severe OSAS group (AHI>30). The HRV measures for participants with low apnea–hypopnea indices were compared to those of patients with high rates of apnea–hypopnea across the sleep period and sleep stages. Results: HRV measures during sleep stages for the group with low rates of apnea–hypopnea have indicated a parasympathetic activation during non-rapid eye movement (NREM) sleep. However, no significant difference has been observed in the high AHI group except for the mean of RR intervals (mean RR). The parasympathetic activity tended to increase across the night but without a statistical difference. After control of age and body mass index, the most significant correlation found was for the mean RR (p=0.0001, r=−0.248). Conclusion: OSA affects sympathovagal modulation during sleep, and this impact has been correlated to the severity of the disease. The mean RR seemed to be a better index allowing the sympathovagal balance appreciation during the night in OSA. |
| first_indexed | 2024-12-11T05:36:53Z |
| format | Article |
| id | doaj.art-2c0fe916ec1243f48031066196987648 |
| institution | Directory Open Access Journal |
| issn | 1819-6357 |
| language | English |
| last_indexed | 2024-12-11T05:36:53Z |
| publishDate | 2015-04-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Libyan Journal of Medicine |
| spelling | doaj.art-2c0fe916ec1243f480310661969876482022-12-22T01:19:15ZengTaylor & Francis GroupLibyan Journal of Medicine1819-63572015-04-011001810.3402/ljm.v10.2698926989Cardiac autonomic control in the obstructive sleep apneaNouha Gammoudi0Ridha Ben Cheikh1Mohamed Ali Saafi2Ghazi Sakly3Mohamed Dogui4Neurophysiology Department, University Hospital Sahloul, Sousse, TunisiaNeurophysiology Department, University Hospital Sahloul, Sousse, TunisiaNeurophysiology Department, University Hospital Sahloul, Sousse, TunisiaNeurophysiology Department, University Hospital Sahloul, Sousse, TunisiaNeurophysiology Department, University Hospital Sahloul, Sousse, TunisiaIntroduction: The sympathetic activation is considered to be the main mechanism involved in the development of cardiovascular diseases in obstructive sleep apnea (OSA). The heart rate variability (HRV) analysis represents a non-invasive tool allowing the study of the autonomic nervous system. The impairment of HRV parameters in OSA has been documented. However, only a few studies tackled the dynamics of the autonomic nervous system during sleep in patients having OSA. Aims: To analyze the HRV over sleep stages and across sleep periods in order to clarify the impact of OSA on cardiac autonomic modulation. The second objective is to examine the nocturnal HRV of OSA patients to find out which HRV parameter is the best to reflect the symptoms severity. Methods: The study was retrospective. We have included 30 patients undergoing overnight polysomnography. Subjects were categorized into two groups according to apnea–hypopnea index (AHI): mild-to-moderate OSAS group (AHI: 5–30) and severe OSAS group (AHI>30). The HRV measures for participants with low apnea–hypopnea indices were compared to those of patients with high rates of apnea–hypopnea across the sleep period and sleep stages. Results: HRV measures during sleep stages for the group with low rates of apnea–hypopnea have indicated a parasympathetic activation during non-rapid eye movement (NREM) sleep. However, no significant difference has been observed in the high AHI group except for the mean of RR intervals (mean RR). The parasympathetic activity tended to increase across the night but without a statistical difference. After control of age and body mass index, the most significant correlation found was for the mean RR (p=0.0001, r=−0.248). Conclusion: OSA affects sympathovagal modulation during sleep, and this impact has been correlated to the severity of the disease. The mean RR seemed to be a better index allowing the sympathovagal balance appreciation during the night in OSA.http://www.libyanjournalofmedicine.net/index.php/ljm/article/view/26989/pdf_9autonomic nervous systemsleep apneaheart ratesleepcircadian |
| spellingShingle | Nouha Gammoudi Ridha Ben Cheikh Mohamed Ali Saafi Ghazi Sakly Mohamed Dogui Cardiac autonomic control in the obstructive sleep apnea Libyan Journal of Medicine autonomic nervous system sleep apnea heart rate sleep circadian |
| title | Cardiac autonomic control in the obstructive sleep apnea |
| title_full | Cardiac autonomic control in the obstructive sleep apnea |
| title_fullStr | Cardiac autonomic control in the obstructive sleep apnea |
| title_full_unstemmed | Cardiac autonomic control in the obstructive sleep apnea |
| title_short | Cardiac autonomic control in the obstructive sleep apnea |
| title_sort | cardiac autonomic control in the obstructive sleep apnea |
| topic | autonomic nervous system sleep apnea heart rate sleep circadian |
| url | http://www.libyanjournalofmedicine.net/index.php/ljm/article/view/26989/pdf_9 |
| work_keys_str_mv | AT nouhagammoudi cardiacautonomiccontrolintheobstructivesleepapnea AT ridhabencheikh cardiacautonomiccontrolintheobstructivesleepapnea AT mohamedalisaafi cardiacautonomiccontrolintheobstructivesleepapnea AT ghazisakly cardiacautonomiccontrolintheobstructivesleepapnea AT mohameddogui cardiacautonomiccontrolintheobstructivesleepapnea |