Night-to-night variability of sleep apnea detected by cyclic variation of heart rate during long-term continuous ECG monitoring

Annals of noninvasive electrocardiology: the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc

article

Junichiro Hayano MD, PhD¹  Emi Yuda DEng, PhD¹ 

[1] Heart Beat Science Lab, Co., Ltd.;Nagoya City University;Center for Data-driven Science and Artificial Intelligence, Tohoku University

关键词: day-to-day variation;    heart rate dynamics;    heart rate variability;    Holter ECG;    intraweek variation;    long-term ECG monitoring;    predictive accuracy;    sensitivity;    specificity;   

DOI  :  10.1111/anec.12901

来源: Wiley

【 摘 要 】

Background Sleep apnea is common in patients with cardiovascular disease and is a factor that worsens prognosis. Holter 24-h ECG screening for sleep apnea is beneficial in the care of these patients, but due to high night-to-night variability of sleep apnea, it can lead to misdiagnosis and misclassification of disease severity. Methods To investigate the long-term dynamic behavior of sleep apnea, seven-day ECGs recorded with a patch ECG recorder in 120 patients were analyzed for the cyclic variation of heart rate (CVHR) during sleep periods as determined by a built-in three-axis accelerometer. Results The frequency of CVHR (Fcv) showed considerable night-to-night variability (coefficient of variance, 66 ± 35%), which was consistent with the night-to-night variability in apnea-hypopnea index and oxygen desaturation index reported in earlier studies. In patients with presumed moderate-to-severe sleep apnea (Fcv > 15 cph at least one night), it was missed on 62% of nights, and on at least one night in 88% of patients. The CV of Fcv was negatively correlated with the average of Fcv, suggesting that patients with mild sleep apnea show greater night-to-night variability and would benefit from long-term assessment. The average Fcv was higher in the supine position, but the night-to-night variability was not explained by the night-to-night variability of time spent in the supine position. Conclusions CVHR analysis of long-term ambulatory ECG recordings is useful for improving the reliability of screening for sleep apnea without placing an extra burden on patients with cardiovascular disease and their care.

【 授权许可】

Unknown