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Relationship Among the Severity of Sleep Apnea Syndrome, Cardiac Arrhythmias, and Autonomic Imbalance
Abstract
The relationship between obstructive sleep apnea 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, a prospective cohort study was conducted: 147 consecutive patients (103 men; mean age of 54.5 +/- 10.7 years) underwent time-synchronized polysomnography and ECG Holter monitoring. OSAS was diagnosed in 66 (44.9%) of them based on an apnea hypopnea index (AHI) > or = 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 < 0.02) 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 nonsustained supraventricular tachycardias were predominantly found in patients with severe sleep related breathing disorders; however, an increased risk of ventricular arrhythmias was not found. Under continuous positive airway pressure treatment, the 1-year follow-up of OSAS patients with nocturnal pauses did not reveal any arrhythmic event justifying a specific intervention.
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“The majority of the studies indicate that the total cholesterol and LDL were unchanged. However, an increase in triglyceride levels and decrease in the HDL levels were noted in patients with OSA(120, 121).”
From Sleep: important considerations for the prevention of cardiovascular disease (2016) · cites this paper as [120]
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Metadata
- Authors
- ROCHE, F., THANH XUONG, A. N., COURT‐FORTUNE, I., COSTES, F., PICHOT, V., DUVERNEY, D., VERGNON, J., GASPOZ, J., & BARTHÉLÉMY, J.
- Affiliations
- Université Jean Monnet (FR)
- University Hospital of Geneva (CH)
- Corresponding author
- ROCHE, FRÉDÉRIC
- Venue
- Pacing and Clinical Electrophysiology
- Publisher
- Wiley
- Published
- 2003-03
- Volume
- 26
- Issue
- 3
- Pages
- 669-677
- ISSN
- 0147-8389 (ISSN-L)
- 1540-8159
- OpenAlex
- W1986316647
- Cited by
- 151
- References
- 27
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 5 · 2023: 3 · 2022: 7 · 2021: 5 · 2020: 7 · 2019: 3 · 2018: 6 · 2017: 8 · 2016: 12 · 2015: 4 · 2014: 9 · 2013: 7 · 2012: 10
- FWCI
- 2.97
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pacing and Clinical Electrophysiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Keywords
- obstructive sleep apnea, cardiac arrhythmias, autonomic imbalance, bradycardia, cardiac conduction disorders, heart rate variability, sick sinus syndrome, supraventricular tachycardia, ventricular arrhythmias, apnea-hypopnea index, continuous positive airway pressure, nocturnal hypoxemia
- MeSH terms
- Arrhythmias, Cardiac, Autonomic Nervous System Diseases, Female, Follow-Up Studies, Heart Conduction System, Humans, Male, Middle Aged, Prospective Studies, Time Factors, Electrocardiography, Ambulatory, Prevalence, Polysomnography, Sleep Apnea, Obstructive
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