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Sleep Diagnosis and Therapy

Sleep Diagnosis and Therapy

Official Publication of the American Sleep and Breathing Academy

Cardiovascular regulation in different sleep stages in the obstructive sleep apnea syndrome.

August 29, 2011 by admin

Gapelyuk A, Riedl M, Suhrbier A, Kraemer JF, Bretthauer G, Malberg H, Kurths J, Penzel T, Wessel N.

Source

Department of Physics, Humboldt-Universität zu Berlin, Berlin, Germany.

Abstract

Abstract Heart rate and blood pressure variability analysis as well as baroreflex sensitivity have been proven to be powerful tools for the assessment of autonomic control in clinical practice. Their ability to detect systematic changes caused by different states, diseases and treatments shall be shown for sleep disorders. Therefore, we consider 18 normotensive and 10 hypertensive patients suffering from obstructive sleep apnea syndrome (OSAS) before and after a three-month continuous positive airway pressure (CPAP) therapy. Additionally, an age and sex matched control group of 10 healthy subjects is examined. Linear and nonlinear parameters of heart rate and blood pressure fluctuation as well as the baroreflex sensitivity are used to answer the question whether there are differences in cardiovascular regulation between the different sleep stages and groups. Moreover, the therapeutic effect of CPAP therapy in OSAS patients shall be investigated. Kruskal-Wallis tests between the sleep stages for each group show significant differences in the very low spectral component of heart rate (VLF/P: 0.0033-0.04 Hz, p<0.01) which indicates differences in metabolic activity during the night. Furthermore, the decrease of Shannon entropy of word distribution as a parameter of systolic blood pressure during non-REM sleep reflects the local dominance of the vagal system (p<0.05). The increased sympathetic activation of the patients leads to clear differences of cardiovascular regulation in different sleep stages between controls and patients. We found a significant reduction of baroreflex sensitivity in slow wave sleep in the OSAS patients (Mann-Whitney test, p<0.05) compared to controls, which disappeared after three months of CPAP therapy. Hence, our results demonstrate the ability of cardiovascular analyzes to separate between healthy and pathological regulation as well as between different severities of OSAS in this retrospective study.

Biomed Tech (Berl). 2011 Aug;56(4):207-13.

 

Related posts:

  1. Utilization of Healthcare Resources in Obstructive Sleep Apnea Syndrome: a 5- Year Follow-Up Study in Men Using CPAP
  2. Obstructive hypopnea and gastroesophageal reflux as factors associated with residual obstructive sleep apnea syndrome
  3. Randomized Controlled Trial of Variable-Pressure Versus Fixed-Pressure Continuous Positive Airway Pressure (CPAP) Treatment for Patients with Obstructive Sleep Apnea/Hypopnea Syndrome (OSAHS)

Filed Under: Blog Tagged With: Home Sleep Testing, insomnia, Sleep, sleep apnea, sleep disorders, sleep labs

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SleepDT Sleep Diagnosis and Therapy is a clinical Journal for allied Sleep Professionals, Neurologists, Psychiatrists, Pulmonologists, Primary Care Physicians, and other medical specialists. We also advocate on behalf of patient care in the field of Sleep Medicine

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