Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy.
Faculty of Psychology, 'Vita-Salute' San Raffaele University, Milan, Italy.
J Sleep Res. 2020 Apr;29(2):e12893. doi: 10.1111/jsr.12893. Epub 2019 Jul 31.
Cardiac autonomic indexes, including cardiac parasympathetic index and cardiac sympathetic index, have been reported to accurately identify patients with sleep disorders such as obstructive sleep apnea. Our study aimed to assess cardiac autonomic indexes in patients with obstructive sleep apnea before and during a single full-night continuous positive airway pressure therapy using a combined approach. Our simultaneous heart rate variability-polysomnographic study included 16 never-treated obstructive sleep apnea patients. Two patients dropped out. Patients underwent combined recordings in two consecutive days, at baseline and during a single full-night of acute continuous positive airway pressure treatment. We calculated cardiac parasympathetic index and cardiac sympathetic index as night/day ratio for high-frequency and low-frequency heart rate variability spectral components, respectively. Continuous positive airway pressure treatment significantly reduced cardiac autonomic indexes values in comparison with baseline values (cardiac parasympathetic index: p < .0001; cardiac sympathetic index: p = .001). After acute continuous positive airway pressure treatment, the percentage of decrease of cardiac parasympathetic index was greater than that of cardiac sympathetic index (51.02 ± 15.72 versus 34.64 ± 26.93). A positive statistical correlation was also found between decrease of cardiac parasympathetic index and decrease of apnea-hypopnea index after continuous positive airway pressure (p < .001). This study improves the knowledge on cardiac autonomic modulation during acute continuous positive airway pressure therapy in obstructive sleep apnea. Our results demonstrate that both autonomic indexes decreased significantly after a single-night of acute continuous positive airway pressure therapy. Cardiac parasympathetic index more than cardiac sympathetic index was related to decrease of apnea-hypopnea index after continuous positive airway pressure therapy, thus representing a potential help in everyday clinical practice.
心脏自主神经指数，包括心脏迷走神经指数和心脏交感神经指数，已被报道可准确识别睡眠障碍患者，如阻塞性睡眠呼吸暂停。我们的研究旨在使用综合方法评估阻塞性睡眠呼吸暂停患者在单次全夜持续气道正压通气治疗前后的心脏自主神经指数。我们的同步心率变异性-多导睡眠图研究包括 16 例未经治疗的阻塞性睡眠呼吸暂停患者。两名患者退出。患者在连续两天进行联合记录，在基线和单次全夜急性持续气道正压通气治疗期间。我们分别计算高频和低频心率变异性频谱成分的夜间/日间比值作为心脏迷走神经指数和心脏交感神经指数。与基线值相比，持续气道正压通气治疗显著降低了心脏自主神经指数值（心脏迷走神经指数：p<0.0001；心脏交感神经指数：p=0.001）。急性持续气道正压通气治疗后，心脏迷走神经指数的降低百分比大于心脏交感神经指数（51.02±15.72 比 34.64±26.93）。我们还发现心脏迷走神经指数的降低与持续气道正压通气后呼吸暂停低通气指数的降低之间存在正统计学相关性（p<0.001）。这项研究提高了我们对阻塞性睡眠呼吸暂停急性持续气道正压通气治疗期间心脏自主神经调节的认识。我们的结果表明，单次急性持续气道正压通气治疗后，两种自主神经指数均显著降低。心脏迷走神经指数比心脏交感神经指数与持续气道正压通气后呼吸暂停低通气指数的降低更相关，因此在日常临床实践中可能有帮助。
