All Obstructive Sleep Apnea Events Are Not Created Equal: The Relationship between Event-related Hypoxemia and Physiologic Response

医学 多导睡眠图 低氧血症 呼吸暂停 阻塞性睡眠呼吸暂停 心脏病学 体质指数 光容积图 睡眠呼吸暂停 内科学 队列 麻醉 氧饱和度 呼吸不足 化学 有机化学 滤波器(信号处理) 氧气 计算机科学 计算机视觉
作者
Mohammadreza Hajipour,A. J. Hirsch Allen,Andrew E. Beaudin,Jill K. Raneri,Rachel Jen,Glen E. Foster,Stuart Fogel,Tetyana Kendzerska,Frédéric Sériès,Robert Skomro,Rébecca Robillard,R. John Kimoff,Patrick J. Hanly,Sidney Fels,Amrit Singh,Ali Azarbarzin,Najib Ayas
出处
期刊:Annals of the American Thoracic Society [American Thoracic Society]
卷期号:21 (5): 794-802 被引量:3
标识
DOI:10.1513/annalsats.202309-777oc
摘要

Rationale: Obstructive sleep apnea (OSA) severity is typically assessed by the apnea-hypopnea index (AHI), a frequency-based metric that allocates equal weight to all respiratory events. However, more severe events may have a greater physiologic impact. Objective: The purpose of this study was to determine whether the degree of event-related hypoxemia would be associated with the post-event physiologic response. Methods: OSA patients (AHI>5/h) from the multi-center Canadian Sleep and Circadian Network cohort were studied. Using mixed-effect linear regression, we examined associations between event-related hypoxic burden (HBev) assessed by the area under the event-related oxygen saturation recording with heart rate changes (ΔHRev), vasoconstriction (vasoconstriction burden (VCBev) assessed with photoplethysmography), and electroencephalographic responses (power ratio before and after events). Results: Polysomnography recordings from 658 patients (Median [IQR] age= 55.00 [45.00, 64.00] years, AHI= 27.15 [14.90, 64.05] event/h, 42% female) were included in the analyses. HBev was associated with an increase in all physiologic responses after controlling for age, sex, body mass index (BMI), sleep stage, total sleep time, and study centers; for example, one standard deviation (SD) increase in HBev was associated with a 0.21 [95% CI: 0.2, 0.22], 0.08 [0.08, 0.09] and 0.22 [0.21, 0.23] SD increase in ΔHRev, VCBev and Beta power ratio respectively). Conclusion: Increased event-related hypoxic burden was associated with greater responses across a broad range of physiologic signals. Future metrics that incorporate information about the variability of these physiologic responses may have promise in providing a more nuanced assessment of OSA severity.

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