Source: International Congress 2014 – The story continues: impact of OSA on cardiometabolic parameters
Disease area: Sleep and breathing disorders

Abstract

It has been proved that the significant changes of heart rate variability (HRV) in patients with obstructive sleep apnea syndrome (OSAS) can be revealed in the frequency domain by evaluating the LF/HF ratio. This study has a twofold aim: to assess if the nonlinear analysis, performed by fractal dimension (FD) measuring system complexity, may reflect abnormal HRV patterns in OSAS and to compare the FD and the LF/HF ratio performances. 25 HRV overnight recordings of OSAS patients with the apnea-hypopnea index score > 30 were analyzed. For each recording, FD was calculated on epochs of 60, 150 and 300 seconds by Higuchi's algorithm, while LF/HF ratio was evaluated from the power spectral density using the periodogram method on epochs of 150, 300 and 600 s. For each recording, the analysis was carried out on a 600 s segment with normal breathing and on an interval of the same duration with repeated apneic episodes. Both FD and LF/HF ratio showed significant differences between apneic and normal epochs with p < 0.0001 and p < 0.05, respectively. Moreover, the spectral analysis was found sensitive to the segment length with median variations of 25% between 300 and 1200 s epochs and of 6% between 600 and 1200 s epochs, suggesting that the analysis on 300 s segments does not allow a robust estimation of the HRV spectrum. On the contrary, the complexity of the HRV series, reflected by FD, may be reliably assessed also on 60 s, being FD median variations < 1% among all durations. FD analysis revealed to be a robust index to detect apneic events, which overcomes the limitations concerning the interval duration of the LF/HF ratio, being usable also on short data segments.

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E. Fornasa, A. De Felice, G. D'Addio, G. Insalaco, G. Balzano, A. Accardo (Trieste, Telese Terme, Palermo, Italy). HRV analysis in obstructive sleep apnea syndrome by means of LF/HF ratio and fractal dimension. Eur Respir J 2014; 44: Suppl. 58, 1754

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