Cardiac arrhythmia and conduction disturbances during sleep in 400 patients with sleep apnea syndrome

Guilleminault, Christian; Connolly, Stuart J.; Winkle, Roger A.

doi:10.1016/0002-9149(83)90013-9

Cited by 801 publications

(498 citation statements)

References 11 publications

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“…I 3 The present study confirmed the increase in the prevalence of SA block and/or sinus arrest during sleep, related to apneic episodes longer than 20 s, especially in patients with SSS. Namely, it was disclosed that bradyarrhythmias appeared related to apneic episodes in 62 % patients with the SSS.…”

Section: Arrhythmogenic Properties Of Sleep Apneasupporting

confidence: 86%

Arrhythmogenic properties of disordered breathing during sleep in patients with cardiovascular disorders

Otsuka

Sadakane

Ozawa

1987

Clinical Cardiology

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Summary: The purpose of this study was twofold: to establish an ECG respiration monitoring system, and to evaluate the clinical usefulness of this system. Our purpose was to determine how many patients with cardiovascular disorders may have unrecognized sleep apnea and whether such apneic episodes are an important cause of cardiac arrhythmias. The study group included 81 patients, age range 40-95 years, and 13 healthy males, age range 52-72 years. The 24-h ECG respiration recordings were obtained with the two-channel Holter recorder. Airflow at the nose using a nasal thermister or chest wall movement by impedance pneumography was recorded as respiration record on the second channel. Sleep apnea was observed 69% and 77-100% in the control subjects and patients with cardiovascular disorders, respectively. Episodes of sleep apnea were most frequent in the patients with old myocardial infarction. Grading of apneas was defined according to the length of apnea. Short duration apneas were observed only in the control subjects, but longer apneic episodes were observed in patients with cardiovascular disorders. Bradyarrhythmias observed were to be relative to apneic episodes longer than 20 s, while ventricular arrhythmias were observed only in the patients with old myocardial infarction, coincident with apneas lasting longer than 40 s. Atrioventricular conduction disturbances were also observed to be related to the occurrence of sleep apnea. These results suggest that 24-h ECG respiration monitoring is useful not only for the observation of sleep apneic episodes, but also in clarifying the relationship between cardiac arrhythmias and apneic episodes.

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Section: Arrhythmogenic Properties Of Sleep Apneasupporting

confidence: 86%

Arrhythmogenic properties of disordered breathing during sleep in patients with cardiovascular disorders

Otsuka

Sadakane

Ozawa

1987

Clinical Cardiology

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“…2 There is also an association of OSA with susceptibilities to cardiac arrhythmias. [49][50][51][52] In conclusion, our study is the first to examine the relations between sleep disordered breathing and omega-3 FA levels. We found an independent, inverse relation between RBC DHA levels (and the Omega-3 Index) and the severity of OSA.…”

Section: Dha (% Of Total Fatty Acids) Female Malementioning

confidence: 76%

Membrane Level of Omega-3 Docosahexaenoic Acid Is Associated with Severity of Obstructive Sleep Apnea

Ladesich

Pottala

Romaker³

et al. 2011

Journal of Clinical Sleep Medicine

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background: Patients with obstructive sleep apnea (OSA) are at increased risk of cardiovascular disease (CVD). The omega-3 fatty acid docosahexaenoic acid (DHA) is a major component of neural tissues, and supplementation with fi sh oils improves autonomic tone and reduces risk for CVD. A link between low DHA status and less mature sleep patterns was observed in newborns. Methods: We investigated the relations between red blood cell (RBC) levels of DHA and OSA severity in 350 sequential patients undergoing sleep studies. Severity categories were defi ned as none/mild, moderate, and severe, based on apnea hypopnea index (AHI) scores of 0 to 14, 15 to 34, and > 34, respectively. Results: After controlling for age, sex, race, smoking, BMI, alcohol intake, fi sh intake, and omega-3 supplementation, RBC DHA was inversely related with OSA severity. For each 1-SD increase in DHA levels, a patient was about 50% less likely to be classifi ed with severe OSA. The odds ratios (95% CI) were 0.47 (0.28 to 0.80) and 0.55 (0.31 to 0.99) for being in the severe group versus the none/mild or moderate groups, respectively. Conclusion: These fi ndings suggest that disordered membrane fatty acid patterns may play a causal role in OSA and that the assessment of RBC DHA levels might help in the diagnosis of OSA. The effects of DHA supplementation on OSA should be explored. keywords: Omega-3 fatty acids, docosahexaenoic acid, epidemiology, sleep disordered breathing, biomarkers Citation: Ladesich JB; Pottala JV; Romaker A; Harris WS. Membrane level of omega-3 docosahexaenoic acid is associated with severity of obstructive sleep apnea.

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“…Continuous sympathetic stimuli repeated during each apnoea may promote carotid chemoreflex and increase the sympathetic drive resulting in increased heart rate and rises in systolic blood pressure at the end of each apnoeic event [22]. Evidence from cross-sectional studies in humans suggests an increase in arrhythmias in relation to the number and degree of oxygen desaturations registered during sleep [23][24][25][26]. There is ample evidence from randomised controlled trials proving that treatment of OSA with CPAP reduces sympathetic nervous system activity [27,28].…”

Section: Intermittent Hypoxia and The Autonomic Nervous Systemmentioning

confidence: 99%

Effects of obstructive sleep apnoea on heart rhythm

2012

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Symptomatic obstructive sleep apnoea (OSA) has been proven to be a risk factor for hypertension and vascular dysfunction, and has been proposed to be causally related with cardiac arrhythmias and sudden cardiac death.Searches of bibliographical databases revealed that several mechanisms seem to underpin the association between OSA and cardiac arrhythmias: intermittent hypoxia associated with autonomic nervous system activation and increased oxidative stress, which may lead to cardiac cellular damage and alteration in myocardial excitability; recurrent arousals, resulting in sympathetic activation and coronary vasoconstriction; and increased negative intrathoracic pressure which may mechanically stretch the myocardial walls and, thus, promote acute changes in myocardial excitability as well as structural remodelling of the myocardium.Findings from cross-sectional studies suggest a high prevalence of cardiac arrhythmias in patients with OSA and a high prevalence of OSA in those with cardiac arrhythmias. Preliminary evidence from uncontrolled interventional studies suggests that treatment of OSA may prevent cardiac arrhythmias.In conclusion, there is preliminary evidence that OSA is associated with the development of cardiac arrhythmias. Data from randomised controlled studies are needed to definitively clarify the role of OSA in arrhythmogenesis.

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Cardiac arrhythmia and conduction disturbances during sleep in 400 patients with sleep apnea syndrome

Cited by 801 publications

References 11 publications

Arrhythmogenic properties of disordered breathing during sleep in patients with cardiovascular disorders

Arrhythmogenic properties of disordered breathing during sleep in patients with cardiovascular disorders

Membrane Level of Omega-3 Docosahexaenoic Acid Is Associated with Severity of Obstructive Sleep Apnea

Effects of obstructive sleep apnoea on heart rhythm

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