title: Heart rate detrended fluctuation indexes as estimate of obstructive sleep apnea severity.
abstract: In the present study, we aimed at investigating a heart rate variability (HRV) biomarker that could be associated with the severity of the apnea-hypopnea index (AHI), which could be used for an early diagnosis of obstructive sleep apnea (OSA). This was a cross-sectional observational study on 47 patients (age 36 ± 9.2 standard deviation) diagnosed with mild (23.4%), moderate (34%), or severe (42.6%) OSA. HRV was studied by linear measures of fast Fourier transform, nonlinear Poincaré analysis, and detrended fluctuation analysis (DFA)—DFA α1 characterizes short-term fluctuations, DFA α2 characterizes long-term fluctuations. Associations between polysomnography indexes (AHI, arousal index [AI], and oxygen desaturation index [ODI]) and HRV indexes were studied. Patients with different grades of AHI had similar sympathovagal balance levels as indicated by the frequency-domain and Poincaré HRV indexes. The DFA α2 index was significantly positive correlated with AHI, AI, and ODI (Pearson r: 0.55, 0.59, and 0.59, respectively, with P < 0.0001). The ROC analysis revealed that DFA α2 index predicted moderate and severe OSA with a sensitivity/specificity/area under the curve of 0.86/0.64/0.8 (P = 0.005) and 0.6/0.89/0.76 (P = 0.003), respectively. Our data indicate that the DFA α2 index may be used as a reliable index for the detection of OSA severity.
authors: From the Center of Innovation, Technology, and Education-CITE (ELPS, VLP, LAC, OCB), Camilo Castelo Branco University (UNICASTELO), Sao Jose dos Campos Technology Park, Sao Jose dos Campos; University Iguaçu Campus-V (ELPS), Itaperuna, Rio de Janeiro; Department of Biological Sciences (RP), State University of Southwest Bahia-UESB, Jequie, Bahia; Sleep Institute of Itaperuna (LNR), Rio de Janeiro, Brazil; and Humboldt-Universität zu Berlin (NW), Berlin, Germany.
authors: Eduardo Luiz Pereira
authors: ELP
authors: da Silva
authors: Rafael
authors: R
authors: Pereira
authors: Luciano Neves
authors: LN
authors: Reis
authors: Valter Luis
authors: VL
authors: Pereira
authors: Luciana Aparecida
authors: LA
authors: Campos
authors: Niels
authors: N
authors: Wessel
authors: Ovidiu Constantin
authors: OC
authors: Baltatu
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D004562:Electrocardiography; D005583:Fourier Analysis; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D017286:Polysomnography; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000503:physiopathology*
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