EVALUATION OF HEART RATE VARIABILITY IN THE TREATMENT OF OBSTRUCTIVE SLEEP APNEA

Date

2014-03

Authors

Bentkowski, Olivia
Welch, Lindsey
Jouett, Noah
Smith, Michael L.

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Abstract

Heart Rate Variability (HRV) is a non-invasive assessment of the activity of the autonomic nervous system (Xhyheri et al). Previous studies have shown a correlation between higher low/high frequency (LF/HF) values and poor cardiovascular health; however, there is question on how to effectively incorporate these findings into clinical practice and treatment. The aim of this study is to determine a relationship between HRV values and the success of using Positive airway pressure (PAP) (measured by Treatment Success Index) for the treatment of Obstructive Sleep Apnea (OSA). Purpose (a): Obstructive Sleep Apnea (OSA) patients treated with Positive Airway Pressure (PAP) (classified by a Treatment Success Index) will have a lower LF/HF ratio as compared to the untreated group. Methods (b): Subjects were instrumented for 30-45 minutes with a 3-lead ECG, which exported raw data into our data acquisition software. Using WinCPRS, we performed spectral analysis on the calculated R-R intervals, which were derived from raw data. LF/HF Heart Rate Variability (HRV) ratios were then calculated and reported for each subject group. Subjects were stratified into treated and untreated groups depending on their Treatment Success Index (TSI) scores. Subjects with TSI's greater than or equal to 85 were considered treated, while subjects with TSIs less than 85 were considered untreated. Results (c): There was no statistical difference in the low frequency to high frequency ratio (LF/HF) between the treated and untreated subjects (Mann Whitney U, p = 0.175). SDNN was determined to show no statistical difference between the treated and untreated subjects (Student’s t-test, p = 0.273). There was no statistical difference in pNN50 between the treated and untreated subjects (Mann Whitney U, p = 0.254). RMSSD demonstrated no statistical difference between the treated and untreated subjects (Mann Whitney U, p = 0.205). Conclusions (d): RMSSD and pNN50 were not found to be significantly higher in the treated subjects. LF/HF ratio and SDNN were not significantly lower in the treated subjects. However, this does not suggest ineffectiveness of PAP treatment in OSA, but rather inadequate sample size.

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