Open AccessCardiac parasympathetic index identifies subjects with adult obstructive sleep apnea: A simultaneous polysomnographic-heart rate variability study
Author(s) -
Maria Salsone,
Basilio Vescio,
Andrea Quattrone,
Ferdinando Roccia,
Miriam Sturniolo,
Francesco Bono,
Umberto Aguglia,
Antonio Gambardella,
Aldo Quattrone
Publication year - 2018
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0193879
Subject(s) - heart rate variability , medicine , cardiology , obstructive sleep apnea , heart rate , polysomnography , circadian rhythm , autonomic nervous system , apnea , anesthesia , blood pressure
Objective To evaluate circadian fluctuations and night/day ratio of Heart Rate Variability (HRV) spectral components in patients with obstructive sleep apnea (OSA) in comparison with controls. Participants and methods This is a simultaneous HRV-polysomnographic (PSG) study including 29 patients with OSA and 18 age-sex-matched controls. Four patients with OSA dropped out. All participants underwent PSG and HRV analysis. We measured the 24-hour fluctuations and the night/day ratio of low frequency (LF) and high frequency (HF) spectral components of HRV in all subjects and controls. The LF night/day ratio was termed the cardiac sympathetic index while the HF night/day ratio was termed the cardiac parasympathetic index. Results All twenty-five OSA patients were PSG positive (presence of OSA) while 18 controls were PSG negative (absence of OSA). There was no significant difference in LF and HF 24-hour fluctuation values between OSA patients and controls. In OSA patients, LF and HF values were significantly higher during night-time than day time recordings (p<0.001). HF night/day ratio (cardiac parasympathetic index) accurately (100%) differentiated OSA patients from controls without an overlap of individual values. The LF night/day ratio (cardiac sympathetic index) had sensitivity of 84%, specificity of 72.2% and accuracy of 79.1% in distinguishing between groups. Conclusions The cardiac parasympathetic index accurately differentiated patients with OSA from controls, on an individual basis.