Heart Rate Variability and Sleep-Related Breathing Disorders in the General Population

详细信息    查看全文

• 作者：Stefanie Aeschbacher ; PhD^a ; ^b ; Matthias Bossard ; MD^b ; ^c ; Tobias Schoen ; MD^b ; ^c ; Delia Schmidlin ; BMed^b ; Christoph Muff ; MD^a ; ^b ; Anna Maseli ; MD^a ; ^b ; Jö ; rg D. Leuppi ; MD ; PhD^d ; David Miedinger ; MD^d ; Nicole M. Probst-Hensch ; PhD^e ; Arno Schmidt-Trucksä ; ss ; MD^f ; Martin Risch ; MD^g ; ^h ; Lorenz Risch ; MD ; MPH^g ; ⁱ ; ^j ; David Conen ; MD ; MPH^a ; ^b ; ^{david.conen@usb.ch" class="auth_mail" title="E-mail the corresponding author}
• 刊名：The American Journal of Cardiology
• 出版年：2016
• 出版时间：15 September 2016
• 年：2016
• 卷：118
• 期：6
• 页码：912-917
• 全文大小：163 K

文摘

Obstructive sleep apnea seems to have an important influence on the autonomic nervous system. In this study, we assessed the relations of sleep apnea–related parameters with 24-hour heart rate variability (HRV) in a large population of young and healthy adults. Participants aged 25 to 41 years with a body mass index <35 kg/m² and without known obstructive sleep apnea were included in a prospective population-based cohort study. HRV was assessed using 24-hour electrocardiographic monitoring. The SD of all normal RR intervals (SDNN) was used as the main HRV variable. Apnea-Hypopnea Index (AHI) and oxygen desaturation index (ODI) were obtained from nighttime pulse oximetry with nasal airflow measurements. We defined sleep-related breathing disorders as an AHI ≥5 or an ODI ≥5. Multivariable regression models were constructed to assess the relation of HRV with either AHI or ODI. Median age of the 1,255 participants was 37 years, 47% were men, and 9.6% had an AHI ≥5. Linear inverse associations of SDNN across AHI and ODI groups were found (p for trend = 0.006 and 0.0004, respectively). The β coefficients (95% CI) for the relation between SDNN and elevated AHI were −0.20 (−0.40 to −0.11), p = 0.04 and −0.29 (−0.47 to −0.11), p = 0.002 for elevated ODI. After adjustment for 24-hour heart rate, the same β coefficients (95% CI) were −0.06 (−0.22 to 0.11), p = 0.51 and −0.14 (−0.30 to 0.01), p = 0.07, respectively. In conclusion, even early stages of sleep-related breathing disorders are inversely associated with HRV in young and healthy adults, suggesting that they are tightly linked with autonomic dysfunction. However, HRV and 24-hour heart rate seem to have common information.