Cardiac arrhythmias during normal sleep and in obstructive sleep apnea syndrome

Adlakha, Arun; Shepard, John

doi:10.1016/s1087-0792(98)90053-3

Cited by 42 publications

(23 citation statements)

References 57 publications

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“…In addition, ventricular premature beats decreased by 58% after 1 month of CPAP treatment in patients with OSAS and HF [191]. These data are in agreement with the expected effects of hypoxaemia on the heart [179] and may help explain the pathogenesis of nocturnal sudden death in OSAS patients [58,59].…”

Section: Arrhythmiassupporting

confidence: 78%

“…Since the earliest clinical observations, OSAS has been recognised as a potential cause of arrhythmias during sleep [9,[178][179][180][181]. Bradyarrhythmic episodes occur in OSAS patients, possibly reflecting reflex parasympathetic activity evoked by apnoeas; GUILLEMINAULT et al [182] reported bradyarrhythmias in 18% of OSAS patients and BECKER et al [180] reported heart block episodes in 20% of patients with OSAS, especially when OSAS was severe.…”

Section: Arrhythmiasmentioning

confidence: 99%

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Sleep apnoea as an independent risk factor for cardiovascular disease: current evidence, basic mechanisms and research priorities

Mr²

2006

European Respiratory Journal

780

479

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Considerable evidence is available in support of an independent association between obstructive sleep apnoea syndrome (OSAS) and cardiovascular disease, which is particularly strong for systemic arterial hypertension and growing for ischaemic heart disease, stroke, heart failure, atrial fibrillation and cardiac sudden death.The pathogenesis of cardiovascular disease in OSAS is not completely understood but likely to be multifactorial, involving a diverse range of mechanisms including sympathetic nervous system overactivity, selective activation of inflammatory molecular pathways, endothelial dysfunction, abnormal coagulation and metabolic dysregulation, the latter particularly involving insulin resistance and disordered lipid metabolism.The present report, which arose out of a European Union Cooperation in the field of Scientific and Technical Research (COST) action on OSAS (COST B26), reviews the current evidence for an independent association and proposes research priorities to identify the underlying mechanisms involved, with a view to identifying novel therapeutic strategies.Large-scale collaborative studies of carefully defined patient populations with obstructive sleep apnoea syndrome, adequately controlled for potential confounders, are needed. Such studies carry the prospect of evaluating potential interactions between different basic mechanisms operating in obstructive sleep apnoea syndrome and cardiovascular disease, and interactions with other related disorders, such as obesity, diabetes and dyslipidaemia. Furthermore, translational studies involving cell culture and animal models linked to studies of obstructive sleep apnoea syndrome patients are necessary to integrate basic mechanisms with the clinical disorder.

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Section: Arrhythmiassupporting

confidence: 78%

Section: Arrhythmiasmentioning

confidence: 99%

Sleep apnoea as an independent risk factor for cardiovascular disease: current evidence, basic mechanisms and research priorities

Mr²

2006

European Respiratory Journal

780

479

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“…When subsequent apnea termination and temporary arousal from sleep occur, sympathetic activity predominates with resultant heart rate acceleration. 31 Therefore, increased sympathetic tone and baroreflex dysfunction can cause cardiac arrhythmia and sudden death. Sympathetic tone can be evaluated through provocative testing and spectral HRV analysis.…”

Section: Discussionmentioning

confidence: 99%

The effect of sleep apnea severity on cardiac autonomic activity during night time in obstructive sleep apnea patients

et al. 2016

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CONTEXT AND OBJECTIVE: Impaired autonomic cardiac function is an important consequence of obstructive sleep apnea (OSA). This impairment is mainly due to intermittent hypoxia episodes following apneas. However, the impact of apnea severity on autonomic cardiac function remains unclear. The aim of this study was to evaluate the relationship between the severity of sleep apnea and heart rate turbulence (HRT) and heart rate variability (HRV) in OSA. DESIGN AND SETTING: Observational cross-sectional study conducted in the Departments of Cardiology and Pulmonary Diseases, Afyon Kocatepe University, Turkey. METHODS: 106 patients with OSA and 27 healthy volunteers were enrolled. Based on apnea hypopnea index (AHI) values, obstructive sleep apnea severity was classified as follows: mild OSA (AHI ≥ 5 and < 15), moderate OSA (AHI ≥ 15 and ≤ 30) and severe OSA (AHI > 30). HRV and HRT parameters were assessed via 24-hour digital Holter electrocardiogram recordings for all subjects. RESULTS: HRV and HRT results were significantly lower among OSA patients than among control subjects (P < 0.05). However, there were no significant differences in HRT and HRV between the three patient subgroups. Correlations did emerge between AHI and the NN-interval parameter RMSSD and between oxygen desaturation and turbulence slope (respectively: r = -0.22, P = 0.037; and r = -0.28, P = 0.025). CONCLUSION: HRT and HRV results deteriorate in OSA. Correlations between apnea severity and these parameters seem to be present. RMSSD, e entre dessaturação de oxigênio e declive da turbulência (respectivamente; r = -0,22, P = 0,037; e r = -0,28, P = 0,025). CONCLUSÃO: Os resultados da VFC e TFC deterioram em AOS. Parece haver relação entre a gravidade da apneia e tais parâmetros. RESUMO

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“…[30][31][32][33][34] Since the earliest clinical observations, OSAS has been recognized as a potential cause of arrhythmias during sleep. 10,23,[35][36][37] Bradyarrhythmic episodes occur in OSAS patients, possibly reflecting reflex parasympathetic activity evoked by apneas; GUILLEMINAULT et al 38 reported bradyarrhythmias in 18% of OSAS patients and BECKER et al 36 reported heart block episodes in 20% of patients with OSAS, especially when OSAS was severe. A pathogenetic role of OSAS is further suggested by the four-fold increase in the prevalence of atrial fibrillation in subjects with an AHI (Apnea Hypopnea Index) > 30 reported by the Sleep Heart Health Study Investigators.…”

Section: Clinical Features and Riskmentioning

confidence: 99%

Obstructive Sleep Apnea: Part I. Diagnosis and Evaluation.

Babu¹,

PC²,

Reddy³

et al. 2017

IJAR

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Obstructive sleep apnea (OSA) is a common disorder that is characterized by repetitive partial or complete cessation of airflow, associated with oxyhemoglobin desaturation and increased effort to breath. Patients with undiagnosed sleep apnea represent a major public health problem. Dental professionals have a unique doctor patient relationship that can help them in recognizing the sleep disorder and co-managing the patients along with a physician or a sleep-specialist. This article discusses the etiology and pathogenesis, clinical features and risk factors, consequences, diagnosis and evaluation of Obstructive sleep apnea.

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Cardiac arrhythmias during normal sleep and in obstructive sleep apnea syndrome

Cited by 42 publications

References 57 publications

Sleep apnoea as an independent risk factor for cardiovascular disease: current evidence, basic mechanisms and research priorities

Sleep apnoea as an independent risk factor for cardiovascular disease: current evidence, basic mechanisms and research priorities

The effect of sleep apnea severity on cardiac autonomic activity during night time in obstructive sleep apnea patients

Obstructive Sleep Apnea: Part I. Diagnosis and Evaluation.

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