title: Heart Rate Variability and Sleep-Related Breathing Disorders in the General Population.
abstract: Obstructive sleep apnea seems to have an important influence on the autonomic nervous system. In this study, we assessed the relations of sleep apnea-related parameters with 24-hour heart rate variability (HRV) in a large population of young and healthy adults. Participants aged 25 to 41 years with a body mass index <35 kg/m(2) and without known obstructive sleep apnea were included in a prospective population-based cohort study. HRV was assessed using 24-hour electrocardiographic monitoring. The SD of all normal RR intervals (SDNN) was used as the main HRV variable. Apnea-Hypopnea Index (AHI) and oxygen desaturation index (ODI) were obtained from nighttime pulse oximetry with nasal airflow measurements. We defined sleep-related breathing disorders as an AHI ≥5 or an ODI ≥5. Multivariable regression models were constructed to assess the relation of HRV with either AHI or ODI. Median age of the 1,255 participants was 37 years, 47% were men, and 9.6% had an AHI ≥5. Linear inverse associations of SDNN across AHI and ODI groups were found (p for trend = 0.006 and 0.0004, respectively). The β coefficients (95% CI) for the relation between SDNN and elevated AHI were -0.20 (-0.40 to -0.11), p = 0.04 and -0.29 (-0.47 to -0.11), p = 0.002 for elevated ODI. After adjustment for 24-hour heart rate, the same β coefficients (95% CI) were -0.06 (-0.22 to 0.11), p = 0.51 and -0.14 (-0.30 to 0.01), p = 0.07, respectively. In conclusion, even early stages of sleep-related breathing disorders are inversely associated with HRV in young and healthy adults, suggesting that they are tightly linked with autonomic dysfunction. However, HRV and 24-hour heart rate seem to have common information.
authors.affiliation: Division of Internal Medicine, Department of Medicine, University Hospital Basel, Basel, Switzerland; Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Aeschbacher
authors.affiliation: Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland; Cardiology Division, Department of Medicine, University Hospital Basel, Basel, Switzerland.
authors.forename: Matthias
authors.initials: M
authors.lastname: Bossard
authors.affiliation: Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland; Cardiology Division, Department of Medicine, University Hospital Basel, Basel, Switzerland.
authors.forename: Tobias
authors.initials: T
authors.lastname: Schoen
authors.affiliation: Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland.
authors.forename: Delia
authors.initials: D
authors.lastname: Schmidlin
authors.affiliation: Division of Internal Medicine, Department of Medicine, University Hospital Basel, Basel, Switzerland; Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland.
authors.forename: Christoph
authors.initials: C
authors.lastname: Muff
authors.affiliation: Division of Internal Medicine, Department of Medicine, University Hospital Basel, Basel, Switzerland; Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland.
authors.forename: Anna
authors.initials: A
authors.lastname: Maseli
authors.affiliation: Medical University Clinic, Kantonsspital Baselland, Liestal, Switzerland.
authors.forename: Jörg D
authors.initials: JD
authors.lastname: Leuppi
authors.affiliation: Medical University Clinic, Kantonsspital Baselland, Liestal, Switzerland.
authors.forename: David
authors.initials: D
authors.lastname: Miedinger
authors.affiliation: Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland.
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Probst-Hensch
authors.affiliation: Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland.
authors.forename: Arno
authors.initials: A
authors.lastname: Schmidt-Trucksäss
authors.affiliation: Labormedizinisches Zentrum Dr. Risch, Schaan, Principality of Liechtenstein; Division of Laboratory Medicine, Kantonsspital Graubünden, Chur, Switzerland.
authors.forename: Martin
authors.initials: M
authors.lastname: Risch
authors.affiliation: Labormedizinisches Zentrum Dr. Risch, Schaan, Principality of Liechtenstein; Division of Clinical Biochemistry, Medical University, Innsbruck, Austria; Private University, Triesen, Principality of Liechtenstein.
authors.forename: Lorenz
authors.initials: L
authors.lastname: Risch
authors.affiliation: Division of Internal Medicine, Department of Medicine, University Hospital Basel, Basel, Switzerland; Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland. Electronic address: david.conen@usb.ch.
authors.forename: David
authors.initials: D
authors.lastname: Conen
mesh_terms: D000328:Adult; D001341:Autonomic Nervous System / Q000503:physiopathology*; D001794:Blood Pressure; D015992:Body Mass Index; D015331:Cohort Studies; D015716:Electrocardiography, Ambulatory; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D016014:Linear Models; D008297:Male; D015999:Multivariate Analysis; D009765:Obesity / Q000453:epidemiology; D050177:Overweight; D010092:Oximetry; D011446:Prospective Studies; D012123:Pulmonary Ventilation; D012737:Sex Factors; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology / Q000503:physiopathology*