Cardiac parasympathetic index identifies subjects with adult obstructive sleep apnea: A simultaneous polysomnographic-heart rate variability study.

PLoS One 2018 8;13(3):e0193879. Epub 2018 Mar 8.

Institute of Bioimaging and Molecular Physiology, National Research Council, Germaneto, Catanzaro, Italy.

Objective: To evaluate circadian fluctuations and night/day ratio of Heart Rate Variability (HRV) spectral components in patients with obstructive sleep apnea (OSA) in comparison with controls.

Participants And Methods: This is a simultaneous HRV-polysomnographic (PSG) study including 29 patients with OSA and 18 age-sex-matched controls. Four patients with OSA dropped out. All participants underwent PSG and HRV analysis. We measured the 24-hour fluctuations and the night/day ratio of low frequency (LF) and high frequency (HF) spectral components of HRV in all subjects and controls. The LF night/day ratio was termed the cardiac sympathetic index while the HF night/day ratio was termed the cardiac parasympathetic index.

Results: All twenty-five OSA patients were PSG positive (presence of OSA) while 18 controls were PSG negative (absence of OSA). There was no significant difference in LF and HF 24-hour fluctuation values between OSA patients and controls. In OSA patients, LF and HF values were significantly higher during night-time than day time recordings (p<0.001). HF night/day ratio (cardiac parasympathetic index) accurately (100%) differentiated OSA patients from controls without an overlap of individual values. The LF night/day ratio (cardiac sympathetic index) had sensitivity of 84%, specificity of 72.2% and accuracy of 79.1% in distinguishing between groups.

Conclusions: The cardiac parasympathetic index accurately differentiated patients with OSA from controls, on an individual basis.

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Source
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0193879PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5843243PMC
July 2018
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