Shiomi T, Guilleminault C, Sasanabe R, Hirota I, Maekawa M, Kobayashi T
Third Department of Medicine, Aichi Medical University, Japan.
Sleep. 1996 Jun;19(5):370-7. doi: 10.1093/sleep/19.5.370.
After documenting the presence of obstructive sleep apnea syndrome (OSAS) through polysomnographic monitoring, we performed simultaneous ambulatory recordings of electrocardiogram, oronasal airflow, and pulse oximetry on 12 OSAS patients with normal autonomic nervous function for a period of 24 hours. The power spectrum of heart rate variability was investigated before and during treatments using dental appliances. Freuquency domain analysis showed that the very low frequency component of heart rate (0.008-0.04 Hz) was increased in OSAS patients and that a very low frequency peak appeared during episodes of obstructive sleep apnea. The increase in very low frequency identification was synchronized with episodes of absence of air exchange or hypoxemia (decreased arterial oxygen saturation) that occurred repeatedly at a cycle length of 25-120 seconds in our subjects. Frequency domain analysis of heart rate variability before and during prosthetic mandibular advancement treatment showed that only the very low frequency was significantly decreased during prosthetic mandibular advancement treatment, whereas the other frequencies, i.e. high, low, and ultralow frequency component values, showed no significant changes. Time domain analysis of heart rate variability before and during prosthetic mandibular advancement treatment showed no significant changes in any of these parameters. Frequency domain analysis of heart rate variability during nocturnal sleep, especially investigation of very low frequency and very low frequency peak, can be a noninvasive low-cost approach to diagnose and even better monitor subjects undergoing treatment at home, particularly considering that R-R intervals can be extracted from pulse oximetry and that analysis software programs are already commercially available.
通过多导睡眠图监测记录阻塞性睡眠呼吸暂停综合征（OSAS）的存在后，我们对12名自主神经功能正常的OSAS患者进行了24小时的动态心电图、口鼻气流和脉搏血氧饱和度同步记录。在使用牙具治疗前和治疗期间研究了心率变异性的功率谱。频域分析显示，OSAS患者心率的极低频成分（0.008 - 0.04 Hz）增加，并且在阻塞性睡眠呼吸暂停发作期间出现一个极低频峰值。极低频识别的增加与我们研究对象中以25 - 120秒的周期长度反复出现的无气体交换或低氧血症（动脉血氧饱和度降低）发作同步。下颌前伸修复治疗前和治疗期间心率变异性的频域分析表明，在下颌前伸修复治疗期间只有极低频显著降低，而其他频率，即高频、低频和超低频成分值均无显著变化。下颌前伸修复治疗前和治疗期间心率变异性的时域分析表明，这些参数中的任何一个均无显著变化。夜间睡眠期间心率变异性的频域分析，特别是对极低频和极低频峰值的研究，可能是一种无创、低成本的方法，用于诊断甚至更好地监测在家接受治疗的患者，特别是考虑到可以从脉搏血氧饱和度中提取R - R间期，并且分析软件程序已经在市场上有售。
