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Breathing irregularities before sleep onset on polysomnography in patients with heart diseases

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Purpose

Severe cardiac dysfunction can manifest with diurnal breathing irregularity. However, it remains to be clarified whether or not diurnal breathing irregularity is observed in patients with heart diseases, including relatively mild chronic heart failure (CHF), compared to those without heart diseases.

Methods

In this cross-sectional study, consecutive inpatients who were admitted for evaluation of sleep-disordered breathing were enrolled. We extracted 3.5 min of stable respiratory signals before sleep onset using polysomnography, analyzed the airflow data using fast Fourier transform, and quantified breathing irregularities using Shannon entropy S.

Results

A total of 162 subjects were evaluated. Among these, 39 subjects had heart diseases, including ischemic heart disease (IHD), atrial fibrillation (Af), CHF, and a history of aortic dissection. The values of Shannon entropy S of airflow signals in subjects with heart diseases were significantly higher than in those without heart diseases (p < 0.001). After excluding CHF, the Shannon entropy S was also significantly higher in subjects with heart diseases than in those without heart diseases (p < 0.001). The values of Shannon entropy S were significantly correlated with plasma brain natriuretic peptide levels (r = 0.443, p < 0.001). Although the values were also significantly correlated with body mass index, the presence of heart diseases was independently associated with breathing irregularity in the multiple logistic analysis. Matching analysis revealed consistent differences between subjects with heart diseases and without heart diseases.

Conclusion

Breathing irregularity was observed before sleep onset in subjects with heart diseases who underwent polysomnography to diagnose sleep-disordered breathing.

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Acknowledgements

We would like to thank Editage (www.editage.jp) for English language editing.

Funding

This work was supported by Grants-in-aid for Scientific Research from the Ministry of Education, Culture, Sports, Science, and Technology of Japan (grant code 18K07440).

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Authors and Affiliations

  1. Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Soshi Okamoto, Masaki Ishii, Shinichiro Hibi, Masahiro Akishita & Yasuhiro Yamaguchi

  2. Department of Respiratory Medicine, Jichi Medical University Saitama Medical Center, 1-847 Amanumacho, Omiya-ku, Saitama-shi, Saitama, 330-8503, Japan

    Yasuhiro Yamaguchi

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  1. Soshi Okamoto
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  2. Masaki Ishii
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  5. Yasuhiro Yamaguchi
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Correspondence to Yasuhiro Yamaguchi.

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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.

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The authors declare no competing interests.

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Okamoto, S., Ishii, M., Hibi, S. et al. Breathing irregularities before sleep onset on polysomnography in patients with heart diseases. Sleep Breath 26, 605–612 (2022). https://doi.org/10.1007/s11325-021-02403-2

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  • DOI: https://doi.org/10.1007/s11325-021-02403-2

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