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Link between a sleep-related breathing disorder and increased heart rate variability
November 01, 2007WESTCHESTER, Ill. - A sleep-related breathing disorder, common in heart failure, increases one's heart rate variability. Further, central sleep apnea (CSA) and obstructive sleep apnea (OSA) produce different patterns of heart rate variability, which are likely to reflect the different pathophysiological mechanisms involved, according to a study published in the November 1 issue of the journal SLEEP.
Matthew T. Naughton, MD, of Alfred Hospital and Monash University in Melbourne, Australia, evaluated 21 patients with heart failure who were referred for polysomnography for investigation of a sleep-related breathing disorder. For each subject, two conditions were examined: a sleep-related breathing disorder and stable breathing.
There were three main findings of this study:
1. Within the subjects, the transition from stable breathing to a sleep-related breathing disorder was associated with an increase in heart rate variability, as well as an increase in the low frequency/high frequency ratio.
2. No difference in heart rate variability was found from samples taken from the beginning and end of the sleep period and, importantly, no evidence that cardiac autonomic regulation altered during the night independent of a sleep-related breathing disorder.
3. OSA and CSA produced different patterns of heart rate variability, with OSA showing increased absolute high frequency power and reduced very low frequency percentage compared with CSA.
"Heart rate patterns are influenced enormously by breathing patterns," said Dr. Naughton. "In heart failure patients during sleep, this information might be able to determine the presence or absence and type of sleep apnea. This could be useful in determining the stability of heart failure (and therefore predict a decline in heart function and signal when additional anti-heart failure therapies are required) and also signal when alternative therapies may be required (such as those directed towards treating OSA). Further work is required in this field."
OSA is a sleep-related breathing disorder that causes one's body to stop breathing during sleep. OSA occurs when the tissue in the back of the throat collapses and blocks the airway, preventing air from getting into the lungs.
CSA is a breathing disorder that causes one's body to decrease or stop the effort of breathing during sleep. This occurs in an off-and-on cycle. It is a result of a problem in the brain or heart. It is different from OSA because the problem is not caused by a blockage of the airway.
Scientific evidence shows that continuous positive airway pressure (CPAP) is the best treatment for sleep apnea. CPAP provides a steady stream of pressurized air to patients through a mask that they wear during sleep. This airflow keeps the airway open, preventing the pauses in breathing that characterize sleep apnea and restoring normal oxygen levels. CPAP users often express dramatic improvements in how they feel. They are more alert, have more energy and are able to perform at higher levels for longer periods of time.
American Academy of Sleep Medicine
1. Within the subjects, the transition from stable breathing to a sleep-related breathing disorder was associated with an increase in heart rate variability, as well as an increase in the low frequency/high frequency ratio.
2. No difference in heart rate variability was found from samples taken from the beginning and end of the sleep period and, importantly, no evidence that cardiac autonomic regulation altered during the night independent of a sleep-related breathing disorder.
3. OSA and CSA produced different patterns of heart rate variability, with OSA showing increased absolute high frequency power and reduced very low frequency percentage compared with CSA.
"Heart rate patterns are influenced enormously by breathing patterns," said Dr. Naughton. "In heart failure patients during sleep, this information might be able to determine the presence or absence and type of sleep apnea. This could be useful in determining the stability of heart failure (and therefore predict a decline in heart function and signal when additional anti-heart failure therapies are required) and also signal when alternative therapies may be required (such as those directed towards treating OSA). Further work is required in this field."
OSA is a sleep-related breathing disorder that causes one's body to stop breathing during sleep. OSA occurs when the tissue in the back of the throat collapses and blocks the airway, preventing air from getting into the lungs.
CSA is a breathing disorder that causes one's body to decrease or stop the effort of breathing during sleep. This occurs in an off-and-on cycle. It is a result of a problem in the brain or heart. It is different from OSA because the problem is not caused by a blockage of the airway.
Scientific evidence shows that continuous positive airway pressure (CPAP) is the best treatment for sleep apnea. CPAP provides a steady stream of pressurized air to patients through a mask that they wear during sleep. This airflow keeps the airway open, preventing the pauses in breathing that characterize sleep apnea and restoring normal oxygen levels. CPAP users often express dramatic improvements in how they feel. They are more alert, have more energy and are able to perform at higher levels for longer periods of time.
American Academy of Sleep Medicine
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A study in the Aug. 15 issue of the Journal of Clinical Sleep Medicine shows that adults with Down syndrome also frequently suffer from obstructive sleep apnea (OSA).
Complaints of fatigue and tiredness in people with OSA improve with CPAP treatment
A study in the June 15 issue of the Journal of Clinical Sleep Medicine shows that the complaints of fatigue and tiredness in patients with obstructive sleep apnea (OSA) improved significantly with good adherence to continuous positive airway pressure (CPAP) therapy, suggesting that - like the symptom of excessive daytime sleepiness - these complaints are important symptoms of OSA.
Sleep apnea occurring during REM sleep is significantly associated with type 2 diabetes
A multi-ethnic study in the June 15 issue of the Journal of Clinical Sleep Medicine reports that there is a statistically significant relationship between obstructive sleep apnea (OSA) episodes occurring during rapid eye movement (REM) sleep and type 2 diabetes.
Poor sleep quality leads to poorer prognosis after stroke
Stroke victims tend to do worse if they also have diagnosed or undiagnosed obstructive sleep apnea prior to having the stroke.
Airborne asthma allergens
A survey of airborne fungi and fungal spores found in Eastern Puerto Rico suggests that certain species may be a major cause of the high incidence of childhood asthma in this part of the world.
Daytime impairments in older men with obstructive sleep apnea are related to total sleep time
A study in the Feb. 1 issue of the journal SLEEP shows that daytime functional impairments in older men with obstructive sleep apnea (OSA) are largely explained by total sleep time rather than OSA severity.
Study shows major pain research funding decline at NIH
Federal funding for pain research is declining sharply, more than 9 percent a year since 2003, according to a new study published in The Journal of Pain. Pain research, as a result, now accounts for only 0.6 percent of all grants awarded by the National Institutes of Health (NIH), despite the high prevalence of chronic pain in the U.S.
Sleep Apnea May Be Risk Factor for Sudden Cardiac Death, Mayo Clinic Research Concludes
After studying the sleep characteristics of nearly 11,000 adults in an overnight sleep laboratory, Mayo Clinic researchers suggest that obstructive sleep apnea (OSA) - and, in particular, the low nighttime oxygen saturation of the blood it causes - may be a risk factor for sudden cardiac death (SCD).
Primary snoring in children impacts cardiovascular functioning
Primary snoring in children may have an impact on cardiovascular functioning equivalent to that of moderate obstructive sleep apnea (OSA), according to a research abstract that will be presented Wednesday at SLEEP 2008, the 22nd Annual Meeting of the Associated Professional Sleep Societies (APSS).
Sleep problems linked to obesity, lower quality of life in school-aged children
A research abstract that will be presented on Tuesday at SLEEP 2008, the 22nd Annual Meeting of the Associated Professional Sleep Societies (APSS), finds an increased prevalence of sleep problems among school-aged children who are obese and an association between increased weight and lower quality of life.
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