Acute Effect of Positive Airway Pressure on Heart Rate Variability in Obstructive Sleep Apnea
1
Citation
75
Reference
10
Related Paper
Citation Trend
Abstract:
Autonomic dysregulation is associated with cardiovascular consequences in obstructive sleep apnea (OSA). This study aimed to investigate the effect of acute continuous positive airway pressure (CPAP) treatment on autonomic activity and to identify factors contributing to the heart rate variability (HRV) changes in OSA. Frequency domain HRV parameters were calculated and compared between the baseline polysomnography and during the CPAP titration in 402 patients with moderate to severe OSA. There were significant reductions in total power, very low-frequency band power, low-frequency band power, and high-frequency band power during the CPAP titration as compared to the baseline polysomnography. This tendency was more pronounced in men than in women, and in patients with severe OSA than those with moderate OSA. Multivariate analysis found that changes in apnea-hypopnea index and oxygen saturation were significantly associated with changes in sympathetic and parasympathetic activity, respectively. This study demonstrated that HRV parameters significantly changed during the CPAP titration, indicating a beneficial effect of CPAP in restoration of sympathetic and parasympathetic hyperactivity in OSA. Prospective longitudinal studies should determine whether long-term CPAP treatment aids in maintaining the long-lasting improvement of the autonomic functions, thereby contributing to the prevention of cardiovascular and cerebrovascular diseases in patients with OSA.Keywords:
Apnea–hypopnea index
Heart rate variability (HRV) is defined as the momentary variation in the end heart rate (EHR) estimated at various intervals (time domains), such as from 2 min (ultra-short HRV) to 24 h (long HRV) intervals. The R peak interval (RRI) between two consecutive beats called momentary heart rate (MHR) provides insight into the impending cardiovascular risk and not the EHR. The autonomic nervous system (ANS) is in charge of maintaining physiological homeostasis by keeping the MHR and in turn the EHR within the normal range of 60–100 bpm. ANS has two components – the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS). The former increases HR (reduces RRI) while the latter reduces it. Therefore, the RR time-domain-HRV-data (THD) provides better insight into overall health than the EHR. Six types of THDs, e.g., mean-HR, mean-RR, SDNN, SDHR, RMSSD, and pNN50 are discussed in this article.
RR interval
Cite
Citations (4)
Apnea–hypopnea index
Positive airway pressure
Cite
Citations (61)
Sleep
Positive airway pressure
Cite
Citations (116)
In patients with obstructive sleep apnea (OSA) and epilepsy, the frequency of generalized spike and wave complexes (GSWCs) usually decreases after the initiation of nasal continuous positive airway pressure (nCPAP) therapy. However, we herein report a patient who had a transient increase in GSWCs following nCPAP treatment. A woman with epilepsy underwent polysomnography, who showed severe OSA and 30 GSWCs during the sleep study. Polysomnography at the introduction nCPAP showed that the GSWCs increased to 94 times during the monitoring period, despite improvement of her OSA. Polysomnography was again performed four months later, and the GSWCs had decreased to 23 times. Physicians should therefore be cautious regarding a possible increase in epileptiform discharges and seizures immediately after the introduction of nCPAP.
Sleep
Cite
Citations (4)
Heart rate variability (HRV), the indicator of the autonomic nervous system-induced modulation of heart rate, is a focal topic in psychophysiological research. The effect of indoor light on HRV may be related to various psychophysiological functions. The current study (N = 20) examined the response of the autonomic nervous system (ANS) to bright vs. dim blue-enriched light (1200 lx or 200 lx at eye level, 6500 K) exposure for five hours in the afternoon among healthy young adults. The results revealed a significant main effect of light condition on the time-domain indicators, with the significantly higher HRV (SDNN and RMSSD) under 200 lx versus 1200 lx condition, and the same case was revealed for the standard deviations of the Poincaré plot in non-linear effects. Conversely, no significant effects were revealed for the frequency- domain indicators of HRV measured with the subjects’ eyes open. These findings suggested that the autonomic nervous system modulation of HRV was stronger under bright light conditions.
Poincaré plot
Cite
Citations (0)
Sympathetic nervous system
Parasympathetic nervous system
Cite
Citations (7)
Cite
Citations (0)
Background: The heart is the central organ of the circulatory system which maintains the flow of blood along with the transport of nutrients to different cells and tissues. A well-functioning cardiac state is a complicated mode of changeability. A healthy heart is not only about oscillation as the rhythmometer is not the same in every circumstance. Heart rate shows variations so that it can be regulated according to psychophysiological conditions to maintain the effect of the internal-external stimulus. Objective: The main objective of this review is to provide a piece of all-inclusive information about heart rate variability (HRV) and different variables affecting HRV. The direct interconnection among factors and so that HRV can be used in clinical practices. Methods: This review article contains a detailed survey of literature about HRV available in different online sources such as; Google Scholar, Science Direct, PubMed, and Web of Science, etc. In this review, the authors have focused on the role of the autonomic nervous system in the regulation of HRV and the role of various factors affecting HRV. Results: The variation in the time between two heartbeats is termed as HRV. It is one of the indicators of many pathological conditions related to cardiovascular health. It provided reliable information about the interaction of the sympathetic and parasympathetic nervous systems. The analysis of the variation of heart rate is a well-known non-invasive technique to identify the functioning of the autonomic nervous system. The autonomic nervous system (ANS) depends on the sympathetic and parasympathetic nervous system for transferring information. The cardio-accelerating center, lungs, and non-striated muscles are innervated by cardiac sympathetic nerves. This division of ANS latches upon the heart accordingly via the cervicothoracic ganglion and vagus nerve. It is found that cardiac normal variability depends upon this stimulation towards the sinoatrial node (pacemaker) which can be evaluated by analyzing the HRV. In human- based studies, it has been found that low level of HRV is one of the main causes of death rate among adults. Hence, HRV helps in identifying the risk of cardiac diseases and the state of ANS. Conclusion: The heart plays a vital role in the human body and the well-functioning of the cardiac system is the need for a healthy life. The heart contains its nervous system termed as neurocardio system in which ANS plays a key role in which the sympathetic and parasympathetic system interplay to regulate HRV. High HRV is associated with healthy condition while low HRV is associated with pathological conditions. The HRV is influenced by various variables such as; pathological, physiological, psychological, environmental factors, lifestyle factors, and genetic factors, etc.
Stimulus (psychology)
Sympathetic nervous system
Parasympathetic nervous system
Cite
Citations (194)
Introduction: The analysis of heart rate variability (HRV) has been used as a resource for the measurement of autonomic nervous system activity in different situations. This analysis is based on identifying the strength of bands of low and high frequencies of the spectral function of the RR intervals in heart rate. Studies have shown that the related high frequency band parasympathetic tone controls the resting state, while exercise is associated with sympathetic activation, linked to lower frequency bands. The autonomic nervous system plays an important role in mediating the cardiovascular responses induced by stress. Objective: To describe a technique for analysis of heart rate variability in the measurement of autonomic nervous system activity. Discussion: To perform HRV analysis the “Nerve-Express” uses an effective and transparent visual representation, known as rhythmography method which reflects the structure of HRV wave and acts as a “fingerprint” of autonomic regulatory mechanisms. The wave RR intervals are recorded sequentially forming a rhythmogram, namely a picture of curved wave-specific variability of RR intervals.
Spectral Analysis
Sympathetic nervous system
Parasympathetic nervous system
RR interval
Cite
Citations (0)
Introduction: The analysis of heart rate variability (HRV) has been used as a resource for the measurement of autonomic nervous system activity in different situations. This analysis is based on identifying the strength of bands of low and high frequencies of the spectral function of the RR intervals in heart rate. Studies have shown that the related high frequency band parasympathetic tone controls the resting state, while exercise is associated with sympathetic activation, linked to lower frequency bands. The autonomic nervous system plays an important role in mediating the cardiovascular responses induced by stress. Objective: To describe a technique for analysis of heart rate variability in the measurement of autonomic nervous system activity. Discussion: To perform HRV analysis the "Nerve-Express" uses an effective and transparent visual representation, known as rhythmography method which reflects the structure of HRV wave and acts as a "fingerprint" of autonomic regulatory mechanisms. The wave RR intervals are recorded sequentially forming a rhythmogram, namely a picture of curved wave-specific variability of RR intervals.
Parasympathetic nervous system
Spectral Analysis
Sympathetic nervous system
Autonomic function
Cite
Citations (9)