The association between obstructive sleep apnea during REM sleep and autonomic dysfunction as measured by heart rate variability

Seong Min Oh, Sang Ho Choi, Hyun Jik Kim, Kwang Suk Park, Yu Jin Lee

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Purpose: To determine the effect of obstructive sleep apnea (OSA) during rapid eye movement (REM) sleep on autonomic dysfunction using heart rate variability (HRV) analysis. Methods: The medical records of adults who underwent nocturnal polysomnography at the Sleep and Chronobiology Center at Seoul National University Hospital were retrospectively reviewed. HRV parameters (mean RR interval, the standard deviation of all normal RR intervals [SDNN], square root of the mean squared differences of adjacent RR intervals [RMSSD], normalized low frequency [LF], normalized high frequency [HF], and the ratio of LF to HF [LF/HF]) were measured in 5-min electrocardiogram recordings obtained during W, N2, and R sleep stages. Comparisons were made among the control (apnea–hypopnea index (AHI < 15 and AHI during REM sleep (AHIREM) < 15, n = 27), REM-associated OSA (AHI < 15 and AHIREM ≥ 15, n = 27), and OSA (AHI ≥ 15, n = 27) groups. The groups were matched for age, sex, and body mass index. Results: No significant differences were observed between the control and the REM-associated OSA groups for any of the HRV parameters. In contrast, compared with controls, the OSA group showed significantly lower normalized HF (p = 0.031) and higher LF/HF (p = 0.018) in stage W and a significantly shorter mean RR interval (p = 0.046) and lower RMSSD (p = 0.034) in stage N2. Conclusions: Our findings suggest that OSA during REM sleep is not a major contributor to autonomic dysfunction.

Original languageEnglish
Pages (from-to)865-871
Number of pages7
JournalSleep and Breathing
Volume23
Issue number3
DOIs
StatePublished - 1 Sep 2019

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REM Sleep
Obstructive Sleep Apnea
Sleep
Heart Rate
Polysomnography
Sleep Stages
Medical Records
Electrocardiography
Body Mass Index
Research Design

Keywords

  • Autonomic nervous system
  • Heart rate variability
  • Sleep apnea, obstructive
  • Sleep, REM

Cite this

@article{82bed10c64984e7cba8d946b7213c266,
title = "The association between obstructive sleep apnea during REM sleep and autonomic dysfunction as measured by heart rate variability",
abstract = "Purpose: To determine the effect of obstructive sleep apnea (OSA) during rapid eye movement (REM) sleep on autonomic dysfunction using heart rate variability (HRV) analysis. Methods: The medical records of adults who underwent nocturnal polysomnography at the Sleep and Chronobiology Center at Seoul National University Hospital were retrospectively reviewed. HRV parameters (mean RR interval, the standard deviation of all normal RR intervals [SDNN], square root of the mean squared differences of adjacent RR intervals [RMSSD], normalized low frequency [LF], normalized high frequency [HF], and the ratio of LF to HF [LF/HF]) were measured in 5-min electrocardiogram recordings obtained during W, N2, and R sleep stages. Comparisons were made among the control (apnea–hypopnea index (AHI < 15 and AHI during REM sleep (AHIREM) < 15, n = 27), REM-associated OSA (AHI < 15 and AHIREM ≥ 15, n = 27), and OSA (AHI ≥ 15, n = 27) groups. The groups were matched for age, sex, and body mass index. Results: No significant differences were observed between the control and the REM-associated OSA groups for any of the HRV parameters. In contrast, compared with controls, the OSA group showed significantly lower normalized HF (p = 0.031) and higher LF/HF (p = 0.018) in stage W and a significantly shorter mean RR interval (p = 0.046) and lower RMSSD (p = 0.034) in stage N2. Conclusions: Our findings suggest that OSA during REM sleep is not a major contributor to autonomic dysfunction.",
keywords = "Autonomic nervous system, Heart rate variability, Sleep apnea, obstructive, Sleep, REM",
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The association between obstructive sleep apnea during REM sleep and autonomic dysfunction as measured by heart rate variability. / Oh, Seong Min; Choi, Sang Ho; Kim, Hyun Jik; Park, Kwang Suk; Lee, Yu Jin.

In: Sleep and Breathing, Vol. 23, No. 3, 01.09.2019, p. 865-871.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - The association between obstructive sleep apnea during REM sleep and autonomic dysfunction as measured by heart rate variability

AU - Oh, Seong Min

AU - Choi, Sang Ho

AU - Kim, Hyun Jik

AU - Park, Kwang Suk

AU - Lee, Yu Jin

PY - 2019/9/1

Y1 - 2019/9/1

N2 - Purpose: To determine the effect of obstructive sleep apnea (OSA) during rapid eye movement (REM) sleep on autonomic dysfunction using heart rate variability (HRV) analysis. Methods: The medical records of adults who underwent nocturnal polysomnography at the Sleep and Chronobiology Center at Seoul National University Hospital were retrospectively reviewed. HRV parameters (mean RR interval, the standard deviation of all normal RR intervals [SDNN], square root of the mean squared differences of adjacent RR intervals [RMSSD], normalized low frequency [LF], normalized high frequency [HF], and the ratio of LF to HF [LF/HF]) were measured in 5-min electrocardiogram recordings obtained during W, N2, and R sleep stages. Comparisons were made among the control (apnea–hypopnea index (AHI < 15 and AHI during REM sleep (AHIREM) < 15, n = 27), REM-associated OSA (AHI < 15 and AHIREM ≥ 15, n = 27), and OSA (AHI ≥ 15, n = 27) groups. The groups were matched for age, sex, and body mass index. Results: No significant differences were observed between the control and the REM-associated OSA groups for any of the HRV parameters. In contrast, compared with controls, the OSA group showed significantly lower normalized HF (p = 0.031) and higher LF/HF (p = 0.018) in stage W and a significantly shorter mean RR interval (p = 0.046) and lower RMSSD (p = 0.034) in stage N2. Conclusions: Our findings suggest that OSA during REM sleep is not a major contributor to autonomic dysfunction.

AB - Purpose: To determine the effect of obstructive sleep apnea (OSA) during rapid eye movement (REM) sleep on autonomic dysfunction using heart rate variability (HRV) analysis. Methods: The medical records of adults who underwent nocturnal polysomnography at the Sleep and Chronobiology Center at Seoul National University Hospital were retrospectively reviewed. HRV parameters (mean RR interval, the standard deviation of all normal RR intervals [SDNN], square root of the mean squared differences of adjacent RR intervals [RMSSD], normalized low frequency [LF], normalized high frequency [HF], and the ratio of LF to HF [LF/HF]) were measured in 5-min electrocardiogram recordings obtained during W, N2, and R sleep stages. Comparisons were made among the control (apnea–hypopnea index (AHI < 15 and AHI during REM sleep (AHIREM) < 15, n = 27), REM-associated OSA (AHI < 15 and AHIREM ≥ 15, n = 27), and OSA (AHI ≥ 15, n = 27) groups. The groups were matched for age, sex, and body mass index. Results: No significant differences were observed between the control and the REM-associated OSA groups for any of the HRV parameters. In contrast, compared with controls, the OSA group showed significantly lower normalized HF (p = 0.031) and higher LF/HF (p = 0.018) in stage W and a significantly shorter mean RR interval (p = 0.046) and lower RMSSD (p = 0.034) in stage N2. Conclusions: Our findings suggest that OSA during REM sleep is not a major contributor to autonomic dysfunction.

KW - Autonomic nervous system

KW - Heart rate variability

KW - Sleep apnea, obstructive

KW - Sleep, REM

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U2 - 10.1007/s11325-018-01779-y

DO - 10.1007/s11325-018-01779-y

M3 - Article

VL - 23

SP - 865

EP - 871

JO - Sleep and Breathing

JF - Sleep and Breathing

SN - 1520-9512

IS - 3

ER -