What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Severe Obstructive Sleep Apnea (OSA) (n=39). Intervention: Continuous Positive Airway Pressure (CPAP) vs. Basal study (first night without CPAP). Primary outcome: Heart rate variability (SDNN) (p=0.045).

March 16, 2012PLoS ONEOpen Access

Changes in the Heart Rate Variability in Patients with Obstructive Sleep Apnea and Its Response to Acute CPAP Treatment

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Key result

Acute CPAP treatment during a single night significantly altered heart rate variability in patients with severe obstructive sleep apnea, independently of gender or weight.

Why the study?

Does acute CPAP treatment improve heart rate variability in patients with severe obstructive sleep apnea?

Population

39 patients with severe Obstructive Sleep Apnea, mean age 50.67 years, mean BMI 33.41 kg/m2, from a single…

Comparison

Acute Continuous Positive Airway Pressure… vs Basal sleep study.

Design

Cross-sectional

Follow-up

1 night

Authors

EKErnesto Kufoy JPJose‐Alberto PalmaTufts University JLJon LopezUniversidad de Navarra

Discussion

Member takes

Implication

Acute CPAP alters HRV in severe OSA; hypothesis-generating and requires prospective trials before clinical adoption.

Study Design

Type

Cross-Sectional (n=39)

Multicenter

Structured PICO

Does acute CPAP treatment improve heart rate variability in patients with severe obstructive sleep apnea?

Population

39 patients (15 females, 24 males) with severe Obstructive Sleep Apnea (AHI ≥30), mean age 50.67 years, mean BMI 33.41 kg/m2, from a single center in Spain. Inclusion criteria: 30-60 years old, complete reversal of OSA with CPAP, non-smokers, no alcohol or recreational drugs. Exclusion criteria: atrial fibrillation, cardiac arrhythmias, myocardial ischemia, cardiomyopathy, myocardial infarction, recent major surgery, cardiac pacemaker, cerebrovascular disease, psychiatric disorders, other sleep disorders, endocrine diseases, and treatment with antiarrhythmic, anticholinergic, or antidepressant medications.

Intervention

Acute Continuous Positive Airway Pressure (CPAP) treatment during the first night of use, with pressure calculated according to neck circumference, BMI, and AHI.

Comparator

Basal sleep study (first night without CPAP treatment).

Outcome

Changes in heart rate mean (HRM) and heart rate variability (HRV, measured as SDNN) comparing the basal study and CPAP night.surrogate

Main Result

Absolute Event Rate: 0.0935% vs 0.0673%

p-value: p=0.045

Acute CPAP treatment significantly alters heart rate variability during the first night of use in patients with severe obstructive sleep apnea, particularly during non-REM sleep, independent of gender or obesity.

Limitations

Transversal and retrospective nature of the study
Small sample size
Changes in HRV might reflect normalization of respiratory pattern or venous return rather than cardiovascular control mechanisms
Did not study whether changes were associated with OSA severity
Did not provide data regarding the percentage of stage 2 and stage 3 sleep in the NREM segments
Did not study frequency-domain measures (HF, LF, and VLF)
Transversal retrospective nature (changes may reflect normalization of respiratory pattern or venous return rather than cardiovascular control mechanisms)
Only severe OSA patients included (AHI > 30)
No data on percentage of stage 2 and stage 3 sleep in NREM segments
No frequency-domain measures studied (HF, LF, VLF)

Cite This Study

Kufoy et al. (2012) conducted a cross-sectional in Severe Obstructive Sleep Apnea (OSA) (n=39). Continuous Positive Airway Pressure (CPAP) vs. Basal study (first night without CPAP) was evaluated on Heart rate variability (SDNN) (p=0.045). Acute CPAP treatment during a single night significantly altered heart rate variability in patients with severe obstructive sleep apnea, independently of gender or weight.

synapsesocial.com/papers/6a1001a205c0aeebb1fe1646 https://doi.org/10.1371/journal.pone.0033769

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Changes in the Heart Rate Variability in Patients with Obstructive Sleep Apnea and Its Response to Acute CPAP Treatment

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Changes in the Heart Rate Variability in Patients with Obstructive Sleep Apnea and Its Response to Acute CPAP Treatment

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

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