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Heart rate acceleration runs and deceleration runs in patients with obstructive sleep apnea syndrome

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Purpose

This study aimed to explore the patterns of heart rate acceleration runs and deceleration runs in patients with obstructive sleep apnea syndrome and to investigate the influence of apnea events on this pattern.

Methods

The 6-h electrocardiography results of patients who were referred for overnight polysomnography were retrospectively analyzed. The frequencies of heart rate acceleration runs and deceleration runs of different lengths were calculated for each patient and compared among patients with obstructive sleep apnea syndrome of varying degrees of severity, between patients with obstructive sleep apnea on and off continuous positive airway pressure, and between two matched groups of patients with idiopathic central sleep apnea and obstructive sleep apnea.

Results

A total of 231 patients were enrolled. Patients with severe obstructive sleep apnea exhibited significantly increased frequencies of long acceleration and deceleration runs after multivariate adjustment, while no significant differences were observed in the frequencies of short runs. Thirty-nine obstructive sleep apnea patients who were treated with continuous positive airway pressure showed a significant decrease in the frequency of long deceleration runs and a decreasing trend in the frequency of long acceleration runs. Patients with idiopathic pure central sleep apnea exhibited no significant changes in the frequencies of acceleration and deceleration runs after they were placed on continuous positive airway pressure.

Conclusions

The distributions of heart rate acceleration and deceleration runs are related to the severity of obstructive sleep apnea. Long runs are more closely related to obstructive respiratory events, while short runs do not appear to be related to these events.

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References

  1. Caples SM, Gami AS, Somers VK (2005) Obstructive sleep apnea. Ann Intern Med 142:187–197

    Article  PubMed  Google Scholar 

  2. Kapur VK (2010) Obstructive sleep apnea: diagnosis, epidemiology, and economics. Respir Care 55:1155–1167

    PubMed  Google Scholar 

  3. Park JG, Ramar K, Olson EJ (2011) Updates on definition, consequences, and management of obstructive sleep apnea. Mayo Clin Proc 86:549–554

    Article  PubMed  PubMed Central  Google Scholar 

  4. Tufik S, Santos-Silva R, Taddei JA, Bittencourt LR (2010) Obstructive sleep apnea syndrome in the Sao Paulo epidemiologic sleep study. Sleep Med 11:441–446

    Article  PubMed  Google Scholar 

  5. Mateika JH, Kavey NB, Mitru G (1999) Spontaneous baroreflex analysis in non–apneic snoring individuals during NREM sleep. Sleep 22(4):461–468

    Article  CAS  PubMed  Google Scholar 

  6. Mateika JH, Mitru G (2001) Cardiorespiratory and autonomic interactions during snoring related resistive breathing. Sleep 24(2):211–217

    CAS  PubMed  Google Scholar 

  7. Resta O, Foschino-Barbaro MP, Legari G, Talamo S, Bonfitto P, Palumbo A, Minenna A, Giorgino R, De Pergola G (2001) Sleep-related breathing disorders, loud snoring and excessive daytime sleepiness in obese subjects. Int J Obes Relat Metab Disord 25:669–675

    Article  CAS  PubMed  Google Scholar 

  8. Somers VK, Dyken ME, Clary MP, Abboud FM (1995) Sympathetic neural mechanisms in obstructive sleep apnea. J Clin Invest 96:1897–1904

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Wolk R, Kara T, Somers VK (2003) Sleep-disordered breathing and cardiovascular disease. Circulation 108:9–12

    Article  PubMed  Google Scholar 

  10. Figueroa MS, Peters JI (2006) Congestive heart failure: diagnosis, pathophysiology, therapy, and implications for respiratory care. Respir Care 51:403–412

    PubMed  Google Scholar 

  11. Gami AS, Howard DE, Olson EJ, Somers VK (2005) Day-night pattern of sudden death in obstructive sleep apnea. N Engl J Med 352:1206–1214

    Article  CAS  PubMed  Google Scholar 

  12. Marshall NS, Wong KK, Liu PY, Cullen SR, Knuiman MW, Grunstein RR (2008) Sleep apnea as an independent risk factor for all-cause mortality: the Busselton health study. Sleep 31:1079–1085

    Article  PubMed  PubMed Central  Google Scholar 

  13. Narkiewicz K, Montano N, Cogliati C, Van De Borne PJ, Dyken ME, Somers VK (1998) Altered cardiovascular variability in obstructive sleep apnea. Circulation 98:1071–1077

    Article  CAS  PubMed  Google Scholar 

  14. Narkiewicz K, Van De Borne PJ, Montano N, Dyken ME, Phillips BG, Somers VK (1998) Contribution of tonic chemoreflex activation to sympathetic activity and blood pressure in patients with obstructive sleep apnea. Circulation 97:943–945

    Article  CAS  PubMed  Google Scholar 

  15. Guzik P, Piskorski J, Krauze T, Wykretowicz A, Wysocki H (2006) Heart rate asymmetry by poincare plots of RR intervals. Biomed Tech (Berl) 51:272–275

    Article  Google Scholar 

  16. Piskorski J, Guzik P (2007) Geometry of the poincare plot of RR intervals and its asymmetry in healthy adults. Physiol Meas 28:287–300

    Article  CAS  PubMed  Google Scholar 

  17. Piskorski J, Guzik P (2011) The structure of heart rate asymmetry: deceleration and acceleration runs. Physiol Meas 32:1011–1023

    Article  CAS  PubMed  Google Scholar 

  18. Guzik P, Piskorski J, Barthel P, Bauer A, Müller A, Junk N, Ulm K, Malik M, Schmidt G (2012) Heart rate deceleration runs for postinfarction risk prediction. J Electrocardiol 45:70–76

    Article  PubMed  Google Scholar 

  19. Bauer A, Kantelhardt JW, Barthel P, Schneider R, Mäkikallio T, Ulm K, Hnatkova K, Schömig A, Huikuri H, Bunde A, Malik M, Schmidt G (2006) Deceleration capacity of heart rate as a predictor of mortality after myocardial infarction: cohort study. Lancet 367:1674–1681

    Article  PubMed  Google Scholar 

  20. Ludka O, Stepanova R, Vyskocilova M, Galkova L, Mikolaskova M, Belehrad M, Kostalova J, Mihalova Z, Drozdova A, Hlasensky J, Gacik M, Pudilova L, Mikusova T, Fischerova B, Sert-Kuniyoshi F, Somers VK, Spinar J, Kara T (2014) Sleep apnea prevalence in acute myocardial infarction—the sleep apnea in post-acute myocardial infarction patients (SAPAMI) study. Int J Cardiol 176:13–19

    Article  PubMed  PubMed Central  Google Scholar 

  21. Wang W, Tretriluxana S, Redline S, Surovec S, Gottlieb DJ, Khoo MC (2008) Association of cardiac autonomic function measures with severity of sleep-disordered breathing in a community-based sample. J Sleep Res 17:251–262

    Article  PubMed  PubMed Central  Google Scholar 

  22. Epstein LJ, Kristo D, Strollo PJ Jr, Friedman N, Malhotra A, Patil SP, Ramar K, Rogers R, Schwab RJ, Weaver EM, Weinstein MD (2009) Adult obstructive sleep apnea task force of the American Academy of Sleep Medicine.Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med 5:263–276

    PubMed  Google Scholar 

  23. American Academy of Sleep Medicine (2014) International classification of sleep disorders: diagnostic and coding manual. American Academy of Sleep Medicine, Chicago, IL

    Google Scholar 

  24. Akselrod S, Gordon D, Ubel FA, Shannon DC, Berger AC, Cohen RJ (1981) Power spectrum analysis of heart rate fluctuation: a quantitative probe of beat-to-beat cardiovascular control. Science 213:220–222

    Article  CAS  PubMed  Google Scholar 

  25. Bigger JT Jr, Fleiss JL, Steinman RC, Rolnitzky LM, Kleiger RE, Rottman JN (1992) Frequency domain measures of heart period variability and mortality after myocardial infarction. Circulation 85:164–171

    Article  PubMed  Google Scholar 

  26. Zhong Y, Wang H, Ju KH, Jan KM, Chon KH (2004) Nonlinear analysis of the separate contributions of autonomic nervous systems to heart rate variability using principal dynamic modes. IEEE Trans Biomed Eng 51:255–262

    Article  PubMed  Google Scholar 

  27. Guzik P, Piskorski J, Awan K, Krauze T, Fitzpatrick M, Baranchuk A (2013) Obstructive sleep apnea and heart rate asymmetry microstructure during sleep. Clin Auton Res 23:91–100

    Article  PubMed  Google Scholar 

  28. Porta A, Casali KR, Casali AG, Gnecchi-Ruscone T, Tobaldini E, Montano N, Lange S, Geue D, Cysarz D, Van Leeuwen P (2008) Temporal asymmetries of short-term heart period variability are linked to autonomic regulation. Am J Physiol Regul Integr Comp Physiol 295:R550–R557

    Article  CAS  PubMed  Google Scholar 

  29. Riedl M, Müller A, Kraemer JF, Penzel T, Kurths J, Wessel N (2014) Cardio-respiratory coordination increases during sleep apnea. PLoS One 9:e93866

    Article  PubMed  PubMed Central  Google Scholar 

  30. Wang YP, Kuo TB, Lai CT, Yang CC (2015) Effects of breathing frequency on the heart rate deceleration capacity and heart rate acceleration capacity. Eur J Appl Physiol 115:2415–2420

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Cardiology, Peking University First Hospital, Beijing, 100034, China

    Jie Jiang

  2. Advanced Academy of Interdisciplinary Studies, Peking University, Beijing, 100871, China

    Xue Chen, Jing Fang & Jue Zhang

  3. Department of Respiratory and Critical Care Medicine, Peking University First Hospital, 8#, Xi Shiku Street, Beijing, Xicheng District, 10034, China

    Cheng Zhang, Guangfa Wang & Jing Ma

  4. College of Engineering, Peking University, Beijing, 100871, China

    Jing Fang & Jue Zhang

Authors
  1. Jie Jiang
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  2. Xue Chen
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  3. Cheng Zhang
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  4. Guangfa Wang
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  5. Jing Fang
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  7. Jue Zhang
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Corresponding author

Correspondence to Jing Ma.

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Funding

State Scientific and Technological Commission of China provided financial support in the form of the National Natural Science Foundation (81341005).

The sponsor had no role in the design or conduct of this research.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

This study is a retrospective analysis of medical records. No written informed consent was obtained.

Additional information

Jie Jiang and Xue Chen are contributed equally to this work.

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Cite this article

Jiang, J., Chen, X., Zhang, C. et al. Heart rate acceleration runs and deceleration runs in patients with obstructive sleep apnea syndrome. Sleep Breath 21, 443–451 (2017). https://doi.org/10.1007/s11325-016-1437-6

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  • DOI: https://doi.org/10.1007/s11325-016-1437-6

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