Meng-Ni Wu1,2, Chiou-Lian Lai1,2, Ching-Kuan Liu1,2, Chen-Wen Yen3, Li-Min Liou1,2, Cheng-Fang Hsieh1,4,5, Ming-Ju Tsai5,6, Sharon Chia-Ju Chen7, Chung-Yao Hsu8,9. 1. Department of Neurology, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Road, Kaohsiung City, 80754, Taiwan. 2. Department of Master's Program in Neurology, Kaohsiung Medical University, No. 100, Tzyou 1st Road, Kaohsiung City, 80754, Taiwan. 3. Department of Mechanical and Electro-mechanical Engineering, National Sun Yat-Sen University, 70 Lienhai Rd., Kaohsiung, 80424, Taiwan. 4. Division of Geriatrics and Gerontology, Department of Internal Medicine, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Road, Kaohsiung City, 80754, Taiwan. 5. Faculty of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, No. 100, Tzyou 1st Road, Kaohsiung City, 80754, Taiwan. 6. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Road, Kaohsiung City, 80754, Taiwan. 7. Department of Medical Imaging and Radiation Sciences, Kaohsiung Medical University, No. 100, Tzyou 1st Road, Kaohsiung City, 80754, Taiwan. 8. Department of Neurology, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Road, Kaohsiung City, 80754, Taiwan. cyhsu@kmu.edu.tw. 9. Department of Master's Program in Neurology, Kaohsiung Medical University, No. 100, Tzyou 1st Road, Kaohsiung City, 80754, Taiwan. cyhsu@kmu.edu.tw.
Abstract
PURPOSE: This study investigated the basal autonomic regulation in patients with obstructive sleep apnea (OSA) showing periodic limb movements in sleep (PLMS) emerging after therapy with continuous positive airway pressure (CPAP). METHODS: Data of patients with OSA undergoing a first polysomnography for diagnosis and a second polysomnography for therapy with CPAP were reviewed. Patients with OSA showing PLMS on the first polysomnography were excluded. By using heart rate variability analysis, epochs without any sleep events and continuous effects from the second polysomnography were retrospectively analyzed. RESULTS: Of 125 eligible patients, 30 with PLMS after therapy with CPAP (PLMS group) and 30 not showing PLMS on both polysomnography (non-PLMS group) were randomly selected for the analysis. No significant differences in the demographic characteristics and variables of polysomnographies were identified between the groups. Although one trend of low root mean square of successive differences (RMSSD) between intervals of adjacent normal heart beats (NN intervals) in the PLMS group was observed, patients in the PLMS group had significantly low normalized high-frequency (n-HF) and high-frequency (HF) values, but high normalized low frequency (n-LF) and high ratio of LF to HF (LF/HF ratio). After adjustment for confounding variables, PLMS on the second polysomnography was significantly associated with RMSSD (β = - 6.7587, p = 0.0338), n-LF (β = 0.0907, p = 0.0148), n-HF (β = - 0.0895, p = 0.0163), log LF/HF ratio (β = 0.4923, p = 0.0090), and log HF (β = - 0.6134, p = 0.0199). CONCLUSIONS: Patients with OSA showing PLMS emerging after therapy with CPAP may have a basal sympathetic predominance with potential negative cardiovascular effects.
PURPOSE: This study investigated the basal autonomic regulation in patients with obstructive sleep apnea (OSA) showing periodic limb movements in sleep (PLMS) emerging after therapy with continuous positive airway pressure (CPAP). METHODS: Data of patients with OSA undergoing a first polysomnography for diagnosis and a second polysomnography for therapy with CPAP were reviewed. Patients with OSA showing PLMS on the first polysomnography were excluded. By using heart rate variability analysis, epochs without any sleep events and continuous effects from the second polysomnography were retrospectively analyzed. RESULTS: Of 125 eligible patients, 30 with PLMS after therapy with CPAP (PLMS group) and 30 not showing PLMS on both polysomnography (non-PLMS group) were randomly selected for the analysis. No significant differences in the demographic characteristics and variables of polysomnographies were identified between the groups. Although one trend of low root mean square of successive differences (RMSSD) between intervals of adjacent normal heart beats (NN intervals) in the PLMS group was observed, patients in the PLMS group had significantly low normalized high-frequency (n-HF) and high-frequency (HF) values, but high normalized low frequency (n-LF) and high ratio of LF to HF (LF/HF ratio). After adjustment for confounding variables, PLMS on the second polysomnography was significantly associated with RMSSD (β = - 6.7587, p = 0.0338), n-LF (β = 0.0907, p = 0.0148), n-HF (β = - 0.0895, p = 0.0163), log LF/HF ratio (β = 0.4923, p = 0.0090), and log HF (β = - 0.6134, p = 0.0199). CONCLUSIONS:Patients with OSA showing PLMS emerging after therapy with CPAP may have a basal sympathetic predominance with potential negative cardiovascular effects.
Authors: R Nisha Aurora; David A Kristo; Sabin R Bista; James A Rowley; Rochelle S Zak; Kenneth R Casey; Carin I Lamm; Sharon L Tracy; Richard S Rosenberg Journal: Sleep Date: 2012-08-01 Impact factor: 5.849
Authors: Mark I Boulos; Brian J Murray; Ryan T Muir; Fuqiang Gao; Gregory M Szilagyi; Menal Huroy; Alexander Kiss; Arthur S Walters; Sandra E Black; Andrew S Lim; Richard H Swartz Journal: Sleep Date: 2017-03-01 Impact factor: 5.849