Source: Annual Congress 2001 - Cardiovascular pathophysiology in OSA
Disease area: Sleep and breathing disorders

Abstract

The relationship between obstructive sleep apnoea syndrome (OSAS), cardiac arrhythmias, and conduction disturbances in adults remains controversial. Early studies showed a higher prevalence than more recent and designed epidemiological studies.
To clarify the actual prevalence of cardiac arrhythmias and conduction disturbances in patients referred for assessment of OSAS, we conducted a prospective cohort study: 147 consecutive patients (103 men), with a mean age of 54.5±]10.7 underwent time-synchronised polysomnography and ECG-Holter monitoring.
OSAS was diagnosed in 66 (44.9%) of them based on an apnea hypopnea index (AHI) * 10. Prevalence of heart failure, of prior myocardial infarction, of hypertension, and of ventricular arrhythmias were similar in patients with or without OSAS. Nocturnal paroxysmal asystole was significantly more prevalent in OSAS patients (10.6 vs 1.2%; p<0.03) and the number of episodes of bradycardia and pauses increased with the severity of the syndrome. Almost all bradycardic events occurred in patients with severe OSAS (AHI>30), prolonged periods of arterial oxyhemoglobin desaturation, and low diurnal awake PaO2. Moreover, using heart rate variability analysis, nocturnal sinusal dysfunction contrasted with a blunted diurnal parasympathetic modulation of the sinus node.
Frequent nocturnal non-sustained supraventricular tachycardia were predominantly found in patients with severe sleep-related breathing disorders; however, we did not find an increased risk of ventricular arrhythmias.

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F. Roche, F. Costes, I. Court-Fortune, A. Nguyen, V. Pichot, J. C. Barthelemy (Saint-Etienne, France). Relationship between the severity of sleep apnea syndrome, cardiac arrhythmias and autonomic imbalance. Eur Respir J 2001; 16: Suppl. 31, 3501

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