Continuous positive airway pressure decreased heart rate variability, including SDNN (61.5 vs 49.5 ms, P=0.021), in patients with chronic heart failure and central sleep apnoea.
Observational (n=10)
Does continuous positive airway pressure alter heart rate variability during sleep in patients with chronic heart failure and central sleep apnoea?
CPAP therapy acutely decreases heart rate variability in CHF patients with central sleep apnea, likely driven by the stabilization of breathing patterns and reduction in AHI.
Absolute Event Rate: 49.5% vs 61.5%
p-value: p=.021
Summary Continuous positive airway pressure ( CPAP ) improves autonomic activity in patients with chronic heart failure ( CHF ) and central sleep apnoea ( CSA ), but its effect on heart rate variability ( HRV ) during therapy has not been reported. We hypothesized that CPAP may decrease HRV , despite its beneficial effects on sympathetic overactivation, due to the expected stabilization of breathing. Sixty‐seven CHF patients underwent polysomnography ( PSG ). Ten of them presented with CSA (age 66.1±8.5 years, apnoea‐hypopnea index AHI =57.6±23.3, central AHI cAHI =41.6±24.6 mean± SD ) and were subjected to a second PSG with manual CPAP titration. Beat‐to‐beat heart intervals for a 6‐hour period of sleep were extracted from each recording and HRV was analysed. CPAP significantly reduced AHI ( AHI =23.1±18.3 P =.004). Standard deviation of normal‐normal interbeat interval ( SDNN ) (61.5±29.0 vs 49.5±19.3 ms, P =.021), root mean square of successive differences ( RMSSD ) (21.8±9.2 vs 16.4±7.1 ms, P =.042), total power (ln TP =7.8±1.1 vs 7.4±0.8 ms 2 , P =.037), low frequency power (ln LF =5.5±1.5 vs 5.0±1.4 ms 2 , P =.003) and high frequency power (ln HF =4.6±1.0 vs 4.0±1.0 ms 2 , P =.024) were decreased. There was a strong correlation between the decrease in AHI and the decrease in ln HF (Spearman's ρ=.782). CPAP leads to a decrease in spectral and time domain parameters of HRV during therapy in CHF patients with CSA . These changes are best explained by the effect which CPAP ‐influenced breathing pattern and lowered AHI exert on HRV .
Terziyski et al. (Thu,) conducted a observational in Chronic heart failure and central sleep apnoea (n=10). Continuous positive airway pressure (CPAP) vs. Baseline (without CPAP) was evaluated on Standard deviation of normal-normal interbeat interval (SDNN) (p=.021). Continuous positive airway pressure decreased heart rate variability, including SDNN (61.5 vs 49.5 ms, P=0.021), in patients with chronic heart failure and central sleep apnoea.
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