Article

The effect of aging and severity of sleep apnea on heart rate variability indices in obstructive sleep apnea syndrome.

Department of Neuropsychiatry, Konkuk University Hospital, Seoul, Korea.
Psychiatry investigation (impact factor: 0.99). 03/2012; 9(1):65-72. DOI:10.4306/pi.2012.9.1.65 pp.65-72
Source: PubMed

ABSTRACT This study aims to analyze how much heart rate variability (HRV) indices discriminatively respond to age and severity of sleep apnea in the obstructive sleep apnea syndrome (OSAS).
176 male OSAS patients were classified into four groups according to their age and apnea-hypopnea index (AHI). The HRV indices were compared via analysis of covariance (ANCOVA). In particular, the partial correlation method was performed to identify the most statistically significant HRV indices in the time and frequency domains. Stepwise multiple linear regressions were further executed to examine the effects of age, AHI, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), and sleep parameters on the significant HRV indices.
The partial correlation analysis yielded the NN50 count (defined as the number of adjacent R-wave to R-wave intervals differing by more than 50 ms) and low frequency/high frequency (LF/HF) ratio to be two most statistically significant HRV indices in both time and frequency domains. The two indices showed significant differences between the groups. The NN50 count was affected by age (p<0.001) and DBP (p=0.039), while the LF/HF ratio was affected by AHI (p<0.001), the amount of Stage 2 sleep (p=0.005), and age (p=0.021) in the order named in the regression analysis.
The NN50 count more sensitively responded to age than to AHI, suggesting that the index is mainly associated with an age-related parasympathetic system. On the contrary, the LF/HF ratio responded to AHI more sensitively than to age, suggesting that it is mainly associated with a sympathetic tone likely reflecting the severity of sleep apnea.

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Keywords

176 male OSAS patients
 
adjacent R-wave
 
age-related parasympathetic system
 
apnea syndrome
 
apnea-hypopnea index
 
body mass index
 
diastolic blood pressure
 
heart rate variability
 
HRV indices
 
LF/HF ratio
 
low frequency/high frequency
 
NN50 count
 
partial correlation analysis
 
partial correlation method
 
R-wave intervals
 
significant HRV indices
 
Stage 2
 
Stepwise multiple linear regressions
 
sympathetic tone likely
 
systolic blood pressure