Surge of Sympathetic Activity during Hyperventilation at the End of Apnea for Patients with Obstructive Sleep Apnea
<i>Background and Objectives</i>: The mechanisms connecting obstructive sleep apnea (OSA) and cardiovascular disease are multifactorial, involving intermittent hypoxia, hypercapnia, and sympathetic activation. The aim of this study was to explore the oscillations of sympathetic activity...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2024-02-01
|
| Series: | Medicina |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1648-9144/60/3/366 |
| _version_ | 1827305647065006080 |
|---|---|
| author | Jui-Kun Chiang Yen-Chang Lin Hsueh-Hsin Kao Yee-Hsin Kao |
| author_facet | Jui-Kun Chiang Yen-Chang Lin Hsueh-Hsin Kao Yee-Hsin Kao |
| author_sort | Jui-Kun Chiang |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: The mechanisms connecting obstructive sleep apnea (OSA) and cardiovascular disease are multifactorial, involving intermittent hypoxia, hypercapnia, and sympathetic activation. The aim of this study was to explore the oscillations of sympathetic activity during the sleep apnea episodes throughout the entire night in patients with OSA. <i>Materials and Methods</i>: The participants received whole-night polysomnography (PSG), and electrocardiogram (EKG) data from the PSG were collected for heart rate variability (HRV) analysis. HRV measurements were conducted in the time and frequency domains. The root mean square of successive differences between normal heartbeats (RMSSD), which reflects parasympathetic activity, and the ratio of the absolute power of the low-frequency band (0.04–0.15 Hz) to the absolute power of the high-frequency band (0.015–0.4 Hz) (LF/HF ratio), which indicates sympathetic activity, were computed. <i>Results</i>: A total of 43 participants (35 men and 8 women) were included in the analysis. The mean age of the participants was 44.1 ± 11.3 years old, and the mean BMI was 28.6 ± 5.4 kg/m<sup>2</sup>. The sleep apnea episodes throughout the entire night in patients with OSA were selected randomly and occurred most frequently during the non-REM stages (39, 90.7%). The selected sleep apnea episodes typically exhibited multiple apneas, often interrupted by snoring respiration and followed by hyperventilation at the end of the episode (HE). Our findings indicate that the centers of the 5 min HRV window for the lowest and highest LF/HF ratios, at 111.8 ± 88.2 and 117.4 ± 88.6 min after sleep onset, respectively, showed a statistically significant difference (<i>p</i> < 0.001). Similarly, the ratios of the lowest and highest LF/HF, at 0.82 ± 0.56 and 3.53 ± 2.94, respectively, exhibited a statistically significant difference (<i>p</i> < 0.001). <i>Conclusions</i>: In the current study, the selected sleep apnea episodes throughout the entire night in patients with OSA occurred primarily during the non-REM stages. Additionally, we observed that sympathetic activity reached its peak in the window that includes hyperventilation at the end stage of apnea, potentially posing a cardiovascular risk. However, additional studies are needed to validate these results. |
| first_indexed | 2024-04-24T18:02:43Z |
| format | Article |
| id | doaj.art-84c6fae6c94a404da9a96d017037d8b3 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-04-24T18:02:43Z |
| publishDate | 2024-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-84c6fae6c94a404da9a96d017037d8b32024-03-27T13:53:25ZengMDPI AGMedicina1010-660X1648-91442024-02-0160336610.3390/medicina60030366Surge of Sympathetic Activity during Hyperventilation at the End of Apnea for Patients with Obstructive Sleep ApneaJui-Kun Chiang0Yen-Chang Lin1Hsueh-Hsin Kao2Yee-Hsin Kao3Department of Family Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 2, Minsheng Road, Dalin, Chiayi 622, TaiwanNature Dental Clinic, Nantou 545, TaiwanDepartment of Radiation Oncology, Taichung Veterans General Hospital, Taichung 407, TaiwanDepartment of Family Medicine, Tainan Municipal Hospital (Managed by Show Chwan Medical Care Corporation), 670 Chung-Te Road, Tainan 701, Taiwan<i>Background and Objectives</i>: The mechanisms connecting obstructive sleep apnea (OSA) and cardiovascular disease are multifactorial, involving intermittent hypoxia, hypercapnia, and sympathetic activation. The aim of this study was to explore the oscillations of sympathetic activity during the sleep apnea episodes throughout the entire night in patients with OSA. <i>Materials and Methods</i>: The participants received whole-night polysomnography (PSG), and electrocardiogram (EKG) data from the PSG were collected for heart rate variability (HRV) analysis. HRV measurements were conducted in the time and frequency domains. The root mean square of successive differences between normal heartbeats (RMSSD), which reflects parasympathetic activity, and the ratio of the absolute power of the low-frequency band (0.04–0.15 Hz) to the absolute power of the high-frequency band (0.015–0.4 Hz) (LF/HF ratio), which indicates sympathetic activity, were computed. <i>Results</i>: A total of 43 participants (35 men and 8 women) were included in the analysis. The mean age of the participants was 44.1 ± 11.3 years old, and the mean BMI was 28.6 ± 5.4 kg/m<sup>2</sup>. The sleep apnea episodes throughout the entire night in patients with OSA were selected randomly and occurred most frequently during the non-REM stages (39, 90.7%). The selected sleep apnea episodes typically exhibited multiple apneas, often interrupted by snoring respiration and followed by hyperventilation at the end of the episode (HE). Our findings indicate that the centers of the 5 min HRV window for the lowest and highest LF/HF ratios, at 111.8 ± 88.2 and 117.4 ± 88.6 min after sleep onset, respectively, showed a statistically significant difference (<i>p</i> < 0.001). Similarly, the ratios of the lowest and highest LF/HF, at 0.82 ± 0.56 and 3.53 ± 2.94, respectively, exhibited a statistically significant difference (<i>p</i> < 0.001). <i>Conclusions</i>: In the current study, the selected sleep apnea episodes throughout the entire night in patients with OSA occurred primarily during the non-REM stages. Additionally, we observed that sympathetic activity reached its peak in the window that includes hyperventilation at the end stage of apnea, potentially posing a cardiovascular risk. However, additional studies are needed to validate these results.https://www.mdpi.com/1648-9144/60/3/366sympathetic activityhyperventilationheart rate variability (HRV)obstructive sleep apnea (OSA)polysomnography (PSG) |
| spellingShingle | Jui-Kun Chiang Yen-Chang Lin Hsueh-Hsin Kao Yee-Hsin Kao Surge of Sympathetic Activity during Hyperventilation at the End of Apnea for Patients with Obstructive Sleep Apnea Medicina sympathetic activity hyperventilation heart rate variability (HRV) obstructive sleep apnea (OSA) polysomnography (PSG) |
| title | Surge of Sympathetic Activity during Hyperventilation at the End of Apnea for Patients with Obstructive Sleep Apnea |
| title_full | Surge of Sympathetic Activity during Hyperventilation at the End of Apnea for Patients with Obstructive Sleep Apnea |
| title_fullStr | Surge of Sympathetic Activity during Hyperventilation at the End of Apnea for Patients with Obstructive Sleep Apnea |
| title_full_unstemmed | Surge of Sympathetic Activity during Hyperventilation at the End of Apnea for Patients with Obstructive Sleep Apnea |
| title_short | Surge of Sympathetic Activity during Hyperventilation at the End of Apnea for Patients with Obstructive Sleep Apnea |
| title_sort | surge of sympathetic activity during hyperventilation at the end of apnea for patients with obstructive sleep apnea |
| topic | sympathetic activity hyperventilation heart rate variability (HRV) obstructive sleep apnea (OSA) polysomnography (PSG) |
| url | https://www.mdpi.com/1648-9144/60/3/366 |
| work_keys_str_mv | AT juikunchiang surgeofsympatheticactivityduringhyperventilationattheendofapneaforpatientswithobstructivesleepapnea AT yenchanglin surgeofsympatheticactivityduringhyperventilationattheendofapneaforpatientswithobstructivesleepapnea AT hsuehhsinkao surgeofsympatheticactivityduringhyperventilationattheendofapneaforpatientswithobstructivesleepapnea AT yeehsinkao surgeofsympatheticactivityduringhyperventilationattheendofapneaforpatientswithobstructivesleepapnea |