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Association of cardiac autonomic function measures with severity of sleep‐disordered breathing in a community‐based sample
Author(s) -
WANG WENLI,
TRETRILUXANA SURADEJ,
REDLINE SUSAN,
SUROVEC SUSAN,
GOTTLIEB DANIEL J.,
KHOO MICHAEL C. K.
Publication year - 2008
Publication title -
journal of sleep research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.297
H-Index - 117
eISSN - 1365-2869
pISSN - 0962-1105
DOI - 10.1111/j.1365-2869.2008.00652.x
Subject(s) - heart rate variability , medicine , cardiology , body mass index , polysomnogram , heart rate , wakefulness , autonomic nervous system , respiratory disturbance index , audiology , polysomnography , electroencephalography , blood pressure , apnea , psychiatry
Summary The goal of this study was to test the hypothesis that spectral indices of heart rate variability, such as high‐frequency power (HFP), low‐to‐high frequency power (LHR), and their respiration‐adjusted counterparts (HFPra, LHRra) are correlated with severity of sleep‐disordered breathing (SDB), as quantified by the respiratory disturbance index (RDI). A total of 436 subjects, non‐smoking, normotensive, and free of cardiovascular disease and diabetes were selected from the Sleep Heart Health Study (SHHS). Of these, 288 records with sufficiently high quality electrocardiogram signals were selected for further analysis [males/females: 221/67; age: 46.1 to 74.9 years; body mass index (BMI): 21.5 to 46.4 kg m −2 ; 0.3 < RDI < 85.0 −1 ]. From each polysomnogram, the respiration channels (thoracic and abdominal) and R‐R interval (RRI) derived from the electrocardiogram were subjected to spectral analysis and autoregressive moving average modeling in consecutive 5‐min segments. After adjusting for age and BMI, mean RRI was found to be negatively correlated with RDI in men in all sleep‐wake states (all P < 0.001). HFP and HFPra were negatively correlated with RDI in men only during wakefulness (all P < 0.01). In women, LHR and LHRra were not correlated with RDI during wakefulness, but were positively correlated during non‐rapid eye movement Stage 1 and 2 sleep (all P < 0.01). These findings suggest that the indices of cardiac autonomic control are correlated with SDB severity, but gender and state affect the nature of these correlations. In both genders, however, vagal modulation of heart rate increases while sympathetic modulation decreases from wakefulness to sleep.