The importance of sleep fragmentation on the hemodynamic dipping in obstructive sleep apnea patients
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | , , , , , , , , |
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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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 |
repository.mail.fl_str_mv |
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1799134497703198720 |