The importance of sleep fragmentation on the hemodynamic dipping in obstructive sleep apnea patients

Detalhes bibliográficos
Autor(a) principal: Staats, Richard
Data de Publicação: 2020
Outros Autores: Barros, Inês, Fernandes, Dina, Grencho, Dina, Reis, Cátia, Matos, Filipa, Rodrigues, João Valença, Marôco, João, Almeida, Antonio Bugalho de, Bárbara, Cristina
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10451/42643
Resumo: Copyright © 2020 Staats, Barros, Fernandes, Grencho, Reis, Matos, Valença, Marôco,de Almeida and Bárbara. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journalis cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
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spelling The importance of sleep fragmentation on the hemodynamic dipping in obstructive sleep apnea patientsSleep disordered breathingCardiovascular riskSleep disturbanceArterial blood pressureStroke volumeCopyright © 2020 Staats, Barros, Fernandes, Grencho, Reis, Matos, Valença, Marôco,de Almeida and Bárbara. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journalis cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.Introduction: Obstructive sleep apnea (OSA) has been associated with non-dipping blood pressure (BP). The precise mechanism is still under investigation, but repetitive oxygen desaturation and arousal induced sleep fragmentation are considered the main contributors. Methods: We analyzed beat-to-beat measurements of hemodynamic parameters (HPs) during a 25-min period of wake–sleep transition. Differences in the mean HP values for heart rate (HR), systolic BP (SBP), and stroke volume (SV) during wake and sleep and their standard deviations (SDs) were compared between 34 controls (C) and 22 OSA patients. The Student’s t-test for independent samples and the effect size by Cohen’s d (d) were calculated. HP evolution was investigated by plotting the measured HP values against each consecutive pulse wave. After a simple regression analysis, the calculated coefficient beta (SCB) was used to indicate the HP evolution. We furthermore explored by a hierarchical block regression which variables increased the prediction for the SCB: model 1 BMI and age, model 2 + apnea/hypopnea index (AHI), and model 3 + arousal index (AI). Results: Between the two groups, the SBP increased in OSA and decreased in C resulting in a significant difference (p = 0.001; d = 0.92). The SV demonstrated a similar development (p = 0.047; d = 0.56). The wake/sleep variation of the HP measured by the SD was higher in the OSA group—HR: p < 0.001; d = 1.2; SBP: p = 0.001; d = 0.94; and SV: p = 0.005; d = 0.82. The hierarchical regression analysis of the SCB demonstrated in SBP that the addition of AI to AHI resulted in ΔR2: +0.163 and ΔF + 13.257 (p = 0.001) and for SV ΔR2: +0.07 and ΔF 4.83 (p = 0.003). The AI but not the AHI remained statistically significant in the regression analysis model 3—SBP: β = 0.717, p = 0.001; SV: β = 0.469, p = 0.033. Conclusion: In this study, we demonstrated that in OSA, the physiological dipping in SBP and SV decreased, and the variation of all investigated parameters increased. Hierarchical regression analysis indicates that the addition of the AI to BMI, age, and AHI increases the prediction of the HP evolution following sleep onset for both SBP and SV and may be the most important variable.This manuscript was funded by the Fundação para a Ciência e a TecnologiaFrontiers MediaRepositório da Universidade de LisboaStaats, RichardBarros, InêsFernandes, DinaGrencho, DinaReis, CátiaMatos, FilipaRodrigues, João ValençaMarôco, JoãoAlmeida, Antonio Bugalho deBárbara, Cristina2020-03-30T15:05:38Z20202020-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10451/42643engFront. Physiol. 11:10410.3389/fphys.2020.001041664-1078info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-11-08T16:42:42Zoai:repositorio.ul.pt:10451/42643Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T21:55:36.977295Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv The importance of sleep fragmentation on the hemodynamic dipping in obstructive sleep apnea patients
title The importance of sleep fragmentation on the hemodynamic dipping in obstructive sleep apnea patients
spellingShingle The importance of sleep fragmentation on the hemodynamic dipping in obstructive sleep apnea patients
Staats, Richard
Sleep disordered breathing
Cardiovascular risk
Sleep disturbance
Arterial blood pressure
Stroke volume
title_short The importance of sleep fragmentation on the hemodynamic dipping in obstructive sleep apnea patients
title_full The importance of sleep fragmentation on the hemodynamic dipping in obstructive sleep apnea patients
title_fullStr The importance of sleep fragmentation on the hemodynamic dipping in obstructive sleep apnea patients
title_full_unstemmed The importance of sleep fragmentation on the hemodynamic dipping in obstructive sleep apnea patients
title_sort The importance of sleep fragmentation on the hemodynamic dipping in obstructive sleep apnea patients
author Staats, Richard
author_facet Staats, Richard
Barros, Inês
Fernandes, Dina
Grencho, Dina
Reis, Cátia
Matos, Filipa
Rodrigues, João Valença
Marôco, João
Almeida, Antonio Bugalho de
Bárbara, Cristina
author_role author
author2 Barros, Inês
Fernandes, Dina
Grencho, Dina
Reis, Cátia
Matos, Filipa
Rodrigues, João Valença
Marôco, João
Almeida, Antonio Bugalho de
Bárbara, Cristina
author2_role author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Repositório da Universidade de Lisboa
dc.contributor.author.fl_str_mv Staats, Richard
Barros, Inês
Fernandes, Dina
Grencho, Dina
Reis, Cátia
Matos, Filipa
Rodrigues, João Valença
Marôco, João
Almeida, Antonio Bugalho de
Bárbara, Cristina
dc.subject.por.fl_str_mv Sleep disordered breathing
Cardiovascular risk
Sleep disturbance
Arterial blood pressure
Stroke volume
topic Sleep disordered breathing
Cardiovascular risk
Sleep disturbance
Arterial blood pressure
Stroke volume
description Copyright © 2020 Staats, Barros, Fernandes, Grencho, Reis, Matos, Valença, Marôco,de Almeida and Bárbara. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journalis cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
publishDate 2020
dc.date.none.fl_str_mv 2020-03-30T15:05:38Z
2020
2020-01-01T00:00:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10451/42643
url http://hdl.handle.net/10451/42643
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv Front. Physiol. 11:104
10.3389/fphys.2020.00104
1664-1078
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Frontiers Media
publisher.none.fl_str_mv Frontiers Media
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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