E-ISSN 2277-338X | ISSN 2320-4664
 

Original Research 


Autonomic function in adults with obstructive sleep apnea

Selvakumar Jagannathan, Suzanne Maria D'cruz, Aanandha Subramaniam Kumar, Vishwanatha Rao Badanidiyur.

Abstract
Background: Obstructive Sleep Apnea (OSA) is the most prevalent form of sleep disordered breathing and could become an important public health issue in India. Patients with OSA have high levels of sympathetic nerve activity during sleep. The autonomic alterations persist during wakefulness and are considered to contribute to the cardiovascular disorders associated with OSA.

Aims & Objective: The aim of the present study was to study autonomic function in adults with Obstructive Sleep Apnea using autonomic cardiovascular tests.

Material and Methods: 30 normal controls (Group I) and 30 patients with Obstructive Sleep Apnea (Group II) of both sexes in the age group of 35-45 years were subjected to a battery of autonomic function tests. The heart rate response to standing (30:15 ratio), heart rate response to deep breathing (E:I ratio), and the Valsalva ratio were used to assess parasympathetic function while the isometric hand- grip exercise and cold pressor tests were used to assess sympathetic function. Statistical analysis was done using SPSS 17 and unpaired student t test.

Results: The 30:15 ratio, E:I ratio and Valsalva Ratio were significantly lower (p value < 0.001) in the patients with OSA when compared to the controls, while the diastolic pressure difference in the isometric hand-grip exercise test and the cold pressor tests were significantly higher (p value < 0.001) in the patients with OSA.

Conclusion: Our study revealed that there was sympatho-vagal imbalance in adult patients with Obstructive Sleep Apnea, with decreased parasympathetic and increased sympathetic activity.

Key words: Autonomic cardiovascular tests, Autonomic function, Obstructive Sleep Apnea


 
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REFERENCES
1. Somers VK, Dyken ME, Mark AL, Abboud FM. Sympathetic-nerve activity during sleep in normal subjects. N Engl J Medicine. 1993;328(5): 303-307. [DOI via Crossref]   
2. Hakim F, Gozal D, Kheirandish-Gozal L: Sympathetic and catecholaminergic alterations in sleep apnea with particular emphasis on children. Front Neurol. 2012, 3:7. [DOI via Crossref]   
3. Stradling JR, Davies RJ. Sleep. 1: Obstructive sleep apnoea/hypopnoea syndrome: definitions, epidemiology, and natural history. Thorax. 2004; 59: 73-8. [DOI via Crossref]   
4. Sharma SK, Ahluwalia G. Epidemiology of adult obstructive sleep apnoea syndrome in India. Indian J Med Res. 2010; 131 : 171-175.
5. Sharma SK, Kumpawat S, Banga A, Goel A. Prevalence and risk factors of obstructive sleep apnea syndrome in a population of Delhi, India. Chest. 2006; 130 : 149-56. [DOI via Crossref]   
6. Reddy EV, Kadhiravan T, Mishra H K, Sreenivas V, Handa K K, Sinha S, & Sharma S K. Prevalence and risk factors of obstructive sleep apnea among middle-aged urban Indians: a community-based study. Sleep Med. 2009; 10(8): 913-918. [DOI via Crossref]   
7. Udwadia ZF, Doshi AV, Lonkar SG, Singh CI. Prevalence of sleep disordered breathing and sleep apnoea in middle-aged urban Indian men. Am J Respir Crit Care Med. 2004; 169 :168-73. [DOI via Crossref]   
8. Narkiewicz K, Somers VK. Sympathetic nerve activity in obstructive sleep apnoea. Acta Physiol Scand.2003;177(3): 385-90. [DOI via Crossref]   
9. Phillips BG, Somers VK. Neural and humoral mechanisms mediating cardiovascular responses to obstructive sleep apnea. Respir Physiol. 2000; 119(2-3): 181-187 [DOI via Crossref]   
10. Lurie A. Hemodynamic and autonomic changes in adults with obstructive sleep apnea. Adv Cardiol. 2011; 46: 171-195. [DOI via Crossref]   
11. Wolf J, Lewicka J, & Narkiewicz K. Obstructive sleep apnea: an update on mechanisms and cardiovascular consequences. NutrMetab Cardiovasc Dis. 2007; 17(3): 233-240. [DOI via Crossref]   
12. Shamsuzzaman AS, Gersh BJ, Somers VK. Obstructive sleep apnea: Implications for cardiac and vascular disease. JAMA. 2003; 290(14): 1906-1914. [DOI via Crossref]   
13. Balachandran JS, Bakker JP, Rahangdale S, Yim-Yeh S, Mietus JE, Goldberger AL, et al. Effect of mild, asymptomatic obstructive sleep apnea on daytime heart rate variability and impedance cardiography measurements. Am J Cardiol. 2012;109(1): 140-145. [DOI via Crossref]   
14. Park DH, Shin CJ, Hong SC, Yu J, Ryu SH, Kim EJ, et al. Correlation between the severity of obstructive sleep apnea and heart rate variability indices. J Korean Med Sci. 2008; 23(2): 226–231. [DOI via Crossref]   
15. Noda A, Yasuma F, Okada T, Yokota M. Circadian rhythm of autonomic activity in patients with obstructive sleep apnea syndrome. Clin Cardiol. 1998; 21(4) :271-276. [DOI via Crossref]   
16. Kufoy E, Palma JA, Lopez J, Alegre M, Urrestarazu E, Artieda J, et al. Changes in the heart rate variability in patients with obstructive sleep apnea and its response to acute CPAP treatment. PLoS One. 2012; 7(3): e33769. [DOI via Crossref]   
17. Ito R, Hamada H, Yokoyama A, Oshima M, Katayama H, Ohnishi H et al. Successful treatment of obstructive sleep apnea syndrome improves autonomic nervous system dysfunction. Clin Exp Hypertens. 2005; 27(2-3):259-267. [DOI via Crossref]   
18. Ryan S, Ward S, Heneghan C, McNicholas WT. Predictors of decreased spontaneous baroreflex sensitivity in obstructive sleep apnea syndrome. Chest. 2007; 131(4): 1100-1107. [DOI via Crossref]   
19. Montesano M, Miano S, Paolino MC, Massolo AC, Ianniello F, Forlani M, et al. Autonomic cardiovascular tests in children with obstructive sleep apnea syndrome. Sleep. 2010; 33(10): 1349.
20. Jagannathan S, D'cruz SM, Selvakumar V, Badanidiyur VR. Heart Rate Variability in Obstructive Sleep Apnea. International Journal of Biomedical and Advance Research. 2013; 4(6): 420-424.
21. Ewing DJ, Clarke BF. Diagnosis and management of diabetic autonomic neuropathy. Br Med J. 1982;285:916–918. [DOI via Crossref]   
22. Deepak KK, Godbole SA, Kochhar KP, Shah P, Kochupillai N. Autonomic dysfunction and peripheral vasodilatory response in diabetes. Indian J Physiol Pharmacol. 1996;40(4):325–329.
23. Ravatis JM. AAEM minimonograph # 48: autonomic nervous system testing. Muscle and Nerve. 1997;20:919–937. [DOI via Crossref]   
24. Pal GK, Pal P. Text book of practical physiology. 2nd ed. Chennai: Orient Longman; 2005.

How to Cite this Article
Pubmed Style

Selvakumar Jagannathan, Suzanne Maria D\cruz, Aanandha Subramaniam Kumar, Vishwanatha Rao Badanidiyur. Autonomic function in adults with obstructive sleep apnea. Int J Med Sci Public Health. 2013; 2(4): 1027-1031. doi:10.5455/ijmsph.2013.170820131


Web Style

Selvakumar Jagannathan, Suzanne Maria D\cruz, Aanandha Subramaniam Kumar, Vishwanatha Rao Badanidiyur. Autonomic function in adults with obstructive sleep apnea. https://www.ijmsph.com/?mno=42611 [Access: April 05, 2022]. doi:10.5455/ijmsph.2013.170820131


AMA (American Medical Association) Style

Selvakumar Jagannathan, Suzanne Maria D\cruz, Aanandha Subramaniam Kumar, Vishwanatha Rao Badanidiyur. Autonomic function in adults with obstructive sleep apnea. Int J Med Sci Public Health. 2013; 2(4): 1027-1031. doi:10.5455/ijmsph.2013.170820131



Vancouver/ICMJE Style

Selvakumar Jagannathan, Suzanne Maria D\cruz, Aanandha Subramaniam Kumar, Vishwanatha Rao Badanidiyur. Autonomic function in adults with obstructive sleep apnea. Int J Med Sci Public Health. (2013), [cited April 05, 2022]; 2(4): 1027-1031. doi:10.5455/ijmsph.2013.170820131



Harvard Style

Selvakumar Jagannathan, Suzanne Maria D\cruz, Aanandha Subramaniam Kumar, Vishwanatha Rao Badanidiyur (2013) Autonomic function in adults with obstructive sleep apnea. Int J Med Sci Public Health, 2 (4), 1027-1031. doi:10.5455/ijmsph.2013.170820131



Turabian Style

Selvakumar Jagannathan, Suzanne Maria D\cruz, Aanandha Subramaniam Kumar, Vishwanatha Rao Badanidiyur. 2013. Autonomic function in adults with obstructive sleep apnea. International Journal of Medical Science and Public Health, 2 (4), 1027-1031. doi:10.5455/ijmsph.2013.170820131



Chicago Style

Selvakumar Jagannathan, Suzanne Maria D\cruz, Aanandha Subramaniam Kumar, Vishwanatha Rao Badanidiyur. "Autonomic function in adults with obstructive sleep apnea." International Journal of Medical Science and Public Health 2 (2013), 1027-1031. doi:10.5455/ijmsph.2013.170820131



MLA (The Modern Language Association) Style

Selvakumar Jagannathan, Suzanne Maria D\cruz, Aanandha Subramaniam Kumar, Vishwanatha Rao Badanidiyur. "Autonomic function in adults with obstructive sleep apnea." International Journal of Medical Science and Public Health 2.4 (2013), 1027-1031. Print. doi:10.5455/ijmsph.2013.170820131



APA (American Psychological Association) Style

Selvakumar Jagannathan, Suzanne Maria D\cruz, Aanandha Subramaniam Kumar, Vishwanatha Rao Badanidiyur (2013) Autonomic function in adults with obstructive sleep apnea. International Journal of Medical Science and Public Health, 2 (4), 1027-1031. doi:10.5455/ijmsph.2013.170820131





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