Qin Hua, Steenbergen Nicolas, Glos Martin, Wessel Niels, Kraemer Jan F, Vaquerizo-Villar Fernando, Penzel Thomas
Interdisciplinary Center of Sleep Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Imperial College London School of Medicine, London, United Kingdom.
Front Psychiatry. 2021 Jul 22;12:642333. doi: 10.3389/fpsyt.2021.642333. eCollection 2021.
Obstructive sleep apnea (OSA), a heterogeneous and multifactorial sleep related breathing disorder with high prevalence, is a recognized risk factor for cardiovascular morbidity and mortality. Autonomic dysfunction leads to adverse cardiovascular outcomes in diverse pathways. Heart rate is a complex physiological process involving neurovisceral networks and relative regulatory mechanisms such as thermoregulation, renin-angiotensin-aldosterone mechanisms, and metabolic mechanisms. Heart rate variability (HRV) is considered as a reliable and non-invasive measure of autonomic modulation response and adaptation to endogenous and exogenous stimuli. HRV measures may add a new dimension to help understand the interplay between cardiac and nervous system involvement in OSA. The aim of this review is to introduce the various applications of HRV in different aspects of OSA to examine the impaired neuro-cardiac modulation. More specifically, the topics covered include: HRV time windows, sleep staging, arousal, sleepiness, hypoxia, mental illness, and mortality and morbidity. All of these aspects show pathways in the clinical implementation of HRV to screen, diagnose, classify, and predict patients as a reasonable and more convenient alternative to current measures.
阻塞性睡眠呼吸暂停（OSA）是一种异质性、多因素的与睡眠相关的呼吸障碍，患病率很高，是公认的心血管发病和死亡的危险因素。自主神经功能障碍通过多种途径导致不良心血管结局。心率是一个复杂的生理过程，涉及神经内脏网络以及诸如体温调节、肾素-血管紧张素-醛固酮机制和代谢机制等相关调节机制。心率变异性（HRV）被认为是自主神经调节反应以及对内源性和外源性刺激适应的可靠且非侵入性的测量指标。HRV测量可能会为理解OSA中心脏和神经系统相互作用增添新的维度。本综述的目的是介绍HRV在OSA不同方面的各种应用，以研究受损的神经心脏调节。更具体地说，涵盖的主题包括：HRV时间窗、睡眠分期、觉醒、嗜睡、缺氧、精神疾病以及死亡率和发病率。所有这些方面都展示了HRV在临床应用中的途径，可作为一种合理且更便捷的替代当前措施的方法，用于筛查、诊断、分类和预测患者。
