INTRODUCTION: Obstructive sleep apnea (OSA) has been hypothesized to cause a hypersympathetic state, which may be the mechanism for the increased incidence of cardiovascular disease in OSA. However, there is a high prevalence of hyperglycemia in OSA patients, which may also contribute to autonomic dysfunction. METHODS: Thirty-five patients with OSA and 11 controls with average body mass index (BMI) of 32.0 ± 4.6 underwent polysomnography, glucose tolerance testing, autonomic function tests, lying and standing catecholamines, overnight urine collection, and baseline ECG and continuous blood pressure measurements for spectral analysis. A linear regression model adjusting for age and BMI was used to analyze spectral data, other outcome measures were analyzed with Kruskal-Wallis test. RESULTS: Twenty-three OSA patients and two control patients had hyperglycemia (based on 2001 American Diabetes Association criteria). Apnea-hypopnea index (AHI) correlated with total power and low frequency (LF) power (r = 0.138, 0.177, p = 0.031; and r = 0.013) but not with the LF/high frequency (HF) ratio (p = 0.589). Glucose negatively correlated with LF systolic power (r = -0.171, p = 0.038) but not AHI (p = 0.586) and was marginally associated with pnn50, total power, LF, and HF power (p ranged from 0.07 to 0.08). CONCLUSION: These data suggest that patients with OSA and mild hyperglycemia have a trend towards lower heart rate variability and sympathetic tone. Hyperglycemia is an important confounder and should be evaluated in studies of OSA and autonomic function.
INTRODUCTION:Obstructive sleep apnea (OSA) has been hypothesized to cause a hypersympathetic state, which may be the mechanism for the increased incidence of cardiovascular disease in OSA. However, there is a high prevalence of hyperglycemia in OSA patients, which may also contribute to autonomic dysfunction. METHODS: Thirty-five patients with OSA and 11 controls with average body mass index (BMI) of 32.0 ± 4.6 underwent polysomnography, glucose tolerance testing, autonomic function tests, lying and standing catecholamines, overnight urine collection, and baseline ECG and continuous blood pressure measurements for spectral analysis. A linear regression model adjusting for age and BMI was used to analyze spectral data, other outcome measures were analyzed with Kruskal-Wallis test. RESULTS: Twenty-three OSA patients and two control patients had hyperglycemia (based on 2001 American Diabetes Association criteria). Apnea-hypopnea index (AHI) correlated with total power and low frequency (LF) power (r = 0.138, 0.177, p = 0.031; and r = 0.013) but not with the LF/high frequency (HF) ratio (p = 0.589). Glucose negatively correlated with LF systolic power (r = -0.171, p = 0.038) but not AHI (p = 0.586) and was marginally associated with pnn50, total power, LF, and HF power (p ranged from 0.07 to 0.08). CONCLUSION: These data suggest that patients with OSA and mild hyperglycemia have a trend towards lower heart rate variability and sympathetic tone. Hyperglycemia is an important confounder and should be evaluated in studies of OSA and autonomic function.
Authors: Andrew Grandinetti; Dominic C Chow; David M Sletten; Jared K Oyama; Andre G Theriault; Irwin J Schatz; Phillip A Low Journal: Clin Auton Res Date: 2007-08-23 Impact factor: 4.435
Authors: G G Berntson; J T Bigger; D L Eckberg; P Grossman; P G Kaufmann; M Malik; H N Nagaraja; S W Porges; J P Saul; P H Stone; M W van der Molen Journal: Psychophysiology Date: 1997-11 Impact factor: 4.016
Authors: Y M Smulders; A Jager; J Gerritsen; J M Dekker; G Nijpels; R J Heine; L M Bouter; C D Stehouwer Journal: Diabetes Care Date: 2000-09 Impact factor: 19.112
Authors: Mary S M Ip; Bing Lam; Matthew M T Ng; Wah Kit Lam; Kenneth W T Tsang; Karen S L Lam Journal: Am J Respir Crit Care Med Date: 2002-03-01 Impact factor: 21.405
Authors: Wenli Wang; Suradej Tretriluxana; Susan Redline; Susan Surovec; Daniel J Gottlieb; Michael C K Khoo Journal: J Sleep Res Date: 2008-06-28 Impact factor: 3.981
Authors: Jose-Alberto Palma; Jorge Iriarte; Secundino Fernandez; Manuel Alegre; Miguel Valencia; Julio Artieda; Elena Urrestarazu Journal: Clin Auton Res Date: 2015-05-23 Impact factor: 4.435
Authors: Amanda C Peltier; M Iliza Myers; Kay J Artibee; Audra D Hamilton; Qing Yan; Jiasong Guo; Yaping Shi; Lily Wang; Jun Li Journal: J Peripher Nerv Syst Date: 2013-06 Impact factor: 3.494
Authors: Giovanni Cizza; Paolo Piaggi; Eliane A Lucassen; Lilian de Jonge; Mary Walter; Megan S Mattingly; Heather Kalish; Gyorgy Csako; Kristina I Rother Journal: PLoS One Date: 2013-05-29 Impact factor: 3.240