Jing Xu1, Ning Ding2, Liang Chen1, Yi Zhang1, Mao Huang2, Yanli Wang2, Zili Meng3, Xilong Zhang4. 1. Department of Respiratory, Huai'an First People's Hospital, Nanjing Medical University, 6 Beijing Road West, Huai'an, 223300, Jiangsu, People's Republic of China. 2. Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China. 3. Department of Respiratory, Huai'an First People's Hospital, Nanjing Medical University, 6 Beijing Road West, Huai'an, 223300, Jiangsu, People's Republic of China. mzl0807@126.com. 4. Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China. zhangxilong1952@163.com.
Abstract
PURPOSE: This study investigated the properties of blood pressure (BP) fluctuation and sympathovagal imbalance with the severity of OSAS. METHODS: Nocturnal BP was continuously monitored by polysomnography for mild (n = 33), moderate (n = 34), and severe (n = 37) OSAS patients. Apnea-related systolic BP elevation (△SBP) indicated the amplitude of BP fluctuation. The SBP index, number of △SBP > 10 mmHg/h of sleep, indicated the frequency of significant BP fluctuations. The low frequency/high frequency (LF/HF) ratios indicated heart rate variability and sympathovagal imbalance. RESULTS: △SBP and the SBP index were the highest in severe OSAS (12.9 ± 2.3 mmHg and 33.7 ± 14.7/h), followed by moderate OSAS (9.5 ± 2.6 mmHg and 7.1 ± 4.4/h), and mild OSAS (8.3 ± 1.6 mmHg and 3.4 ± 2.1/h). The LF/HF ratios in severe OSAS were significantly higher than that in moderate and mild OSAS. In mild OSAS, arousal played a more important role in BP fluctuation. In moderate OSAS, the oxygen desaturation index (ODI) and the SBP index were correlated. The difference in △SBP induced by hypoxia or by arousal was not significant. In severe OSAS, the apnea-hypopnea index (AHI) and LF/HF ratio were correlated with the SBP index, and △SBP was larger with hypoxia than arousal. CONCLUSIONS: BP fluctuation and sympathovagal imbalance were both related to obstructive sleep apnea severity. The influence of arousal and hypoxia on BP fluctuation varied with OSAS severity. TRIAL REGISTRATION: NCT02876471.
PURPOSE: This study investigated the properties of blood pressure (BP) fluctuation and sympathovagal imbalance with the severity of OSAS. METHODS: Nocturnal BP was continuously monitored by polysomnography for mild (n = 33), moderate (n = 34), and severe (n = 37) OSAS patients. Apnea-related systolic BP elevation (△SBP) indicated the amplitude of BP fluctuation. The SBP index, number of △SBP > 10 mmHg/h of sleep, indicated the frequency of significant BP fluctuations. The low frequency/high frequency (LF/HF) ratios indicated heart rate variability and sympathovagal imbalance. RESULTS: △SBP and the SBP index were the highest in severe OSAS (12.9 ± 2.3 mmHg and 33.7 ± 14.7/h), followed by moderate OSAS (9.5 ± 2.6 mmHg and 7.1 ± 4.4/h), and mild OSAS (8.3 ± 1.6 mmHg and 3.4 ± 2.1/h). The LF/HF ratios in severe OSAS were significantly higher than that in moderate and mild OSAS. In mild OSAS, arousal played a more important role in BP fluctuation. In moderate OSAS, the oxygen desaturation index (ODI) and the SBP index were correlated. The difference in △SBP induced by hypoxia or by arousal was not significant. In severe OSAS, the apnea-hypopnea index (AHI) and LF/HF ratio were correlated with the SBP index, and △SBP was larger with hypoxia than arousal. CONCLUSIONS: BP fluctuation and sympathovagal imbalance were both related to obstructive sleep apnea severity. The influence of arousal and hypoxia on BP fluctuation varied with OSAS severity. TRIAL REGISTRATION: NCT02876471.
Authors: J Hayano; Y Sakakibara; A Yamada; M Yamada; S Mukai; T Fujinami; K Yokoyama; Y Watanabe; K Takata Journal: Am J Cardiol Date: 1991-01-15 Impact factor: 2.778
Authors: Frauke Picard; Petroula Panagiotidou; Anne-Beke Tammen; Anamaria Wolf-Pütz; Maximilian Steffen; Hanno Julian Gerhardy; Sebastian Waßenberg; Rolf Michael Klein Journal: J Clin Sleep Med Date: 2022-02-01 Impact factor: 4.062