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Relationship between Sleep Stages and HRV response in Obstructive Sleep Apnea Patients

文献类型： 会议论文

第一作者： Daniel Romero

作者： Daniel Romero 1 ; Raimon Jane 1 ;

作者机构： 1.Institute for Bioengineering of Catalonia (IBEC), the Barcelona Institute of Science and Technology (BIST), and Centro de Investigacion Biomedica en Red de Bioingenieria, Biomateriales y Nanomedicina (CIBER-BBN)

会议名称： Annual International Conference of the IEEE Engineering in Medicine and Biology Society

主办单位：

页码： 5535-5538

摘要： Patients suffering from obstructive sleep apnea (OSA) usually present an increased sympathetic activity caused by the intermittent hypoxia effect on autonomic control. This study evaluated the relationship between sleep stages and the apnea duration, frequency, and type, as well as their impact on HRV markers in different groups of disease severity. The hypnogram and R-R interval signals were extracted in 81 OSA patients from night polysomnographic (PSG) recordings. The apnea-hypopnea index (AHI) defined patient classification as mild-moderate (AHI <=30, n=44) or severe (AHI >30, n=37). The noimalized power in VLH, LF, and HF bands of RR series were estimated by a time-frequency approach and averaged in 1-min epochs of normal and apnea segments. The autonomic response and the impact of sleep stages were assessed in both segments to compare patient groups. Deeper sleep stages (particularly S2) concentrated the shorter and mild apnea episodes (from 10 to 40 s) compared to light (SWS) and REM sleep. Longer episodes (>50 s) although less frequent, were of similar incidence in all stages. This pattern was more pronounced for the group of severe patients. Moreover, during apnea segments, LF_(nu) was higher (p=0.044) for the severe group, since VLF_(nu) and HF_(nu) presented the greatest changes when compared to normal segments. The non-REM sleep seems to better differentiate OSA patients groups, particularly through VLF_(nu) and HF_(nu) (p<0.001). A significant difference in both sympathetic and vagal modulation between REM and non-REM sleep was only found within the severe group. These results confirm the importance of considering sleep stages for HRV analysis to further assess OSA disease severity, beyond the traditional and clinically limited AHI values.

分类号： q81-53

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