Severe obstructive sleep apnea was associated with significantly lower heart rate variability during wakefulness compared to non-OSA patients (SDNN 37.4 vs. 46.2 ms; p<0.0001).
Cohort (n=1,247)
Yes
Does severe obstructive sleep apnea reduce heart rate variability during wakefulness compared to patients without OSA?
Severe obstructive sleep apnea is associated with significantly reduced and less complex heart rate variability during wakefulness, indicating altered cardiovascular autonomic physiology.
Absolute Event Rate: 37.4% vs 46.2%
p-value: p=<0.0001
Abstract Study Objectives Patients with obstructive sleep apnea (OSA) exhibit heterogeneous heart rate variability (HRV) during wakefulness and sleep. We investigated the influence of OSA severity on HRV parameters during wakefulness in a large international clinical sample. Methods 1247 subjects (426 without OSA and 821 patients with OSA) were enrolled from the Sleep Apnea Global Interdisciplinary Consortium. HRV parameters were calculated during a 5-minute wakefulness period with spontaneous breathing prior to the sleep study, using time-domain, frequency-domain and nonlinear methods. Differences in HRV were evaluated among groups using analysis of covariance, controlling for relevant covariates. Results Patients with OSA showed significantly lower time-domain variations and less complexity of heartbeats compared to individuals without OSA. Those with severe OSA had remarkably reduced HRV compared to all other groups. Compared to non-OSA patients, those with severe OSA had lower HRV based on SDNN (adjusted mean: 37. 4 vs. 46. 2 ms; p 0. 0001), RMSSD (21. 5 vs. 27. 9 ms; p 0. 0001), ShanEn (1. 83 vs. 2. 01; p 0. 0001), and Forbword (36. 7 vs. 33. 0; p = 0. 0001). While no differences were found in frequency-domain measures overall, among obese patients there was a shift to sympathetic dominance in severe OSA, with a higher LF/HF ratio compared to obese non-OSA patients (4. 2 vs. 2. 7; p = 0. 009). Conclusions Time-domain and nonlinear HRV measures during wakefulness are associated with OSA severity, with severe patients having remarkably reduced and less complex HRV. Frequency-domain measures show a shift to sympathetic dominance only in obese OSA patients. Thus, HRV during wakefulness could provide additional information about cardiovascular physiology in OSA patients. Clinical Trial Information: A Prospective Observational Cohort to Study the Genetics of Obstructive Sleep Apnea and Associated Co-Morbidities (German Clinical Trials Register - DKRS, DRKS00003966) https: //www. drks. de/drksweb/navigate. do? navigationId=trial. HTML&TRIALID=DRKS00003966
Qin et al. (2021) conducted a cohort in Obstructive sleep apnea (n=1,247). Severe OSA vs. Non-OSA was evaluated on SDNN (ms) during wakefulness (p=<0.0001). Severe obstructive sleep apnea was associated with significantly lower heart rate variability during wakefulness compared to non-OSA patients (SDNN 37.4 vs. 46.2 ms; p<0.0001).