Relations among hypoxemia, sleep stage, and bradyarrhythmia during obstructive sleep apnea
Background Obesity, apneic hypoxemia, and rapid eye movement (REM) sleep are supposed to be the major causes for bradyarrhythmia in patients with obstructive sleep apnea. The aims of this study were to compare clinical findings and diagnoses in patients with obstructive sleep apnea with and without...
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| Veröffentlicht in: | The American heart journal 2000, Vol.139 (1), p.142-148 |
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| creator | Koehler, Ulrich Becker, Heinrich F. Grimm, Wolfram Heitmann, Jörg Peter, Jörg H. Schäfer, Harald |
| description | Background Obesity, apneic hypoxemia, and rapid eye movement (REM) sleep are supposed to be the major causes for bradyarrhythmia in patients with obstructive sleep apnea. The aims of this study were to compare clinical findings and diagnoses in patients with obstructive sleep apnea with and without nocturnal bradyarrhythmia and to analyze the relations among hypoxemia, sleep stage, and bradyarrhythmia.
Methods During a 17-month period 239 patients were found to have sleep apnea in an ambulatory study. Patients with nocturnal bradyarrhythmia were hospitalized for 3 days and polysomnographies were performed over 2 successive nights. A Holter electrocardiogram was recorded for 48 hours.
Results Nocturnal episodes of bradyarrhythmia were identified in 17 (7%) of 239 patients. Body mass index (39 ± 7 vs 31 ± 5 kg/m
2) and respiratory disturbance index (90 ± 36 per hour vs 24 ± 24 per hour) were significantly different (
P < .01) between patients with (n = 17) and without bradyarrhythmia (n = 222). Bradyarrhythmia occurred significantly more often during REM than non-REM sleep (
P < .01). There was a significant difference in end-apneic oxygen saturation in apnea/hypopnea episodes with and without bradyarrhythmia (71% ± 9% vs 75% ± 10%;
P < .01). A linear relation between end-apneic oxygen saturation and number of sinus arrests and heart blocks could not be found.
Conclusions Patients with apnea-associated bradyarrhythmia are more overweight than patients without bradyarrhythmia. The higher respiratory disturbance index measurements found in these patients may be caused by this difference. Bradyarrhythmia occurs predominantly during REM sleep and occurred independently from decrease in oxygen saturation; a threshold value as an upper limit could not be found. (Am Heart J 2000;139:142-8.) |
| doi_str_mv | 10.1016/S0002-8703(00)90321-1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_70815179</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0002870300700214</els_id><sourcerecordid>70815179</sourcerecordid><originalsourceid>FETCH-LOGICAL-c390t-4166c5c0628f625e27611f4477f8da7008b597c186285452fbd17d0b28566cfa3</originalsourceid><addsrcrecordid>eNqFkE1rFEEQQBsxmDX6E5Q5iBjIaNXsdPfMSSQYEwgIfly8NDXdNdmW-bJ7Jrj_Pr3ZxXjLqSl4r7p4QrxCeI-A6sN3ACjySsP6HcBpDesCc3wiVgi1zpUuy6di9Q85Fs9j_J1GVVTqmThGUFhJLVfi1zfuaPbjEDPqx-Em22yn8S_3ns6y2DFPWZzphs8yGlzWBHJbCmGznTeJyNwSfFLGJs5hsbO_5YND08D0Qhy11EV-eXhPxM-Lzz_OL_Prr1-uzj9d53Zdw5yXqJSVdndaqwrJhVaIbVlq3VaONEDVyFpbrBIgS1m0jUPtoElTEltan4i3-71TGP8sHGfT-2i562jgcYlGQ4USdZ1AuQdtGGMM3Jop-J7C1iCYXVRzH9XsihkAcx_VYPJeHz5Ymp7df9a-YgLeHACKlro20GB9fOAKqRGrhH3cY5xq3HoOJlrPg2XnA9vZuNE_cskd4G2S1w</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>70815179</pqid></control><display><type>article</type><title>Relations among hypoxemia, sleep stage, and bradyarrhythmia during obstructive sleep apnea</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Koehler, Ulrich ; Becker, Heinrich F. ; Grimm, Wolfram ; Heitmann, Jörg ; Peter, Jörg H. ; Schäfer, Harald</creator><creatorcontrib>Koehler, Ulrich ; Becker, Heinrich F. ; Grimm, Wolfram ; Heitmann, Jörg ; Peter, Jörg H. ; Schäfer, Harald</creatorcontrib><description>Background Obesity, apneic hypoxemia, and rapid eye movement (REM) sleep are supposed to be the major causes for bradyarrhythmia in patients with obstructive sleep apnea. The aims of this study were to compare clinical findings and diagnoses in patients with obstructive sleep apnea with and without nocturnal bradyarrhythmia and to analyze the relations among hypoxemia, sleep stage, and bradyarrhythmia.
Methods During a 17-month period 239 patients were found to have sleep apnea in an ambulatory study. Patients with nocturnal bradyarrhythmia were hospitalized for 3 days and polysomnographies were performed over 2 successive nights. A Holter electrocardiogram was recorded for 48 hours.
Results Nocturnal episodes of bradyarrhythmia were identified in 17 (7%) of 239 patients. Body mass index (39 ± 7 vs 31 ± 5 kg/m
2) and respiratory disturbance index (90 ± 36 per hour vs 24 ± 24 per hour) were significantly different (
P < .01) between patients with (n = 17) and without bradyarrhythmia (n = 222). Bradyarrhythmia occurred significantly more often during REM than non-REM sleep (
P < .01). There was a significant difference in end-apneic oxygen saturation in apnea/hypopnea episodes with and without bradyarrhythmia (71% ± 9% vs 75% ± 10%;
P < .01). A linear relation between end-apneic oxygen saturation and number of sinus arrests and heart blocks could not be found.
Conclusions Patients with apnea-associated bradyarrhythmia are more overweight than patients without bradyarrhythmia. The higher respiratory disturbance index measurements found in these patients may be caused by this difference. Bradyarrhythmia occurs predominantly during REM sleep and occurred independently from decrease in oxygen saturation; a threshold value as an upper limit could not be found. (Am Heart J 2000;139:142-8.)</description><identifier>ISSN: 0002-8703</identifier><identifier>EISSN: 1097-6744</identifier><identifier>DOI: 10.1016/S0002-8703(00)90321-1</identifier><identifier>PMID: 10618575</identifier><identifier>CODEN: AHJOA2</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Adolescent ; Adult ; Aged ; Biological and medical sciences ; Blood Gas Analysis ; Bradycardia - blood ; Bradycardia - etiology ; Bradycardia - physiopathology ; Electrocardiography, Ambulatory ; Female ; Humans ; Hypoxia - blood ; Hypoxia - etiology ; Hypoxia - physiopathology ; Male ; Medical sciences ; Middle Aged ; Oxygen Consumption ; Pneumology ; Polysomnography ; Respiratory system : syndromes and miscellaneous diseases ; Sleep Apnea, Obstructive - blood ; Sleep Apnea, Obstructive - complications ; Sleep Apnea, Obstructive - physiopathology ; Sleep Stages</subject><ispartof>The American heart journal, 2000, Vol.139 (1), p.142-148</ispartof><rights>2000 Mosby, Inc.</rights><rights>2000 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c390t-4166c5c0628f625e27611f4477f8da7008b597c186285452fbd17d0b28566cfa3</citedby><cites>FETCH-LOGICAL-c390t-4166c5c0628f625e27611f4477f8da7008b597c186285452fbd17d0b28566cfa3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002870300700214$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,4009,27902,27903,27904,65309</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1257118$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10618575$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Koehler, Ulrich</creatorcontrib><creatorcontrib>Becker, Heinrich F.</creatorcontrib><creatorcontrib>Grimm, Wolfram</creatorcontrib><creatorcontrib>Heitmann, Jörg</creatorcontrib><creatorcontrib>Peter, Jörg H.</creatorcontrib><creatorcontrib>Schäfer, Harald</creatorcontrib><title>Relations among hypoxemia, sleep stage, and bradyarrhythmia during obstructive sleep apnea</title><title>The American heart journal</title><addtitle>Am Heart J</addtitle><description>Background Obesity, apneic hypoxemia, and rapid eye movement (REM) sleep are supposed to be the major causes for bradyarrhythmia in patients with obstructive sleep apnea. The aims of this study were to compare clinical findings and diagnoses in patients with obstructive sleep apnea with and without nocturnal bradyarrhythmia and to analyze the relations among hypoxemia, sleep stage, and bradyarrhythmia.
Methods During a 17-month period 239 patients were found to have sleep apnea in an ambulatory study. Patients with nocturnal bradyarrhythmia were hospitalized for 3 days and polysomnographies were performed over 2 successive nights. A Holter electrocardiogram was recorded for 48 hours.
Results Nocturnal episodes of bradyarrhythmia were identified in 17 (7%) of 239 patients. Body mass index (39 ± 7 vs 31 ± 5 kg/m
2) and respiratory disturbance index (90 ± 36 per hour vs 24 ± 24 per hour) were significantly different (
P < .01) between patients with (n = 17) and without bradyarrhythmia (n = 222). Bradyarrhythmia occurred significantly more often during REM than non-REM sleep (
P < .01). There was a significant difference in end-apneic oxygen saturation in apnea/hypopnea episodes with and without bradyarrhythmia (71% ± 9% vs 75% ± 10%;
P < .01). A linear relation between end-apneic oxygen saturation and number of sinus arrests and heart blocks could not be found.
Conclusions Patients with apnea-associated bradyarrhythmia are more overweight than patients without bradyarrhythmia. The higher respiratory disturbance index measurements found in these patients may be caused by this difference. Bradyarrhythmia occurs predominantly during REM sleep and occurred independently from decrease in oxygen saturation; a threshold value as an upper limit could not be found. (Am Heart J 2000;139:142-8.)</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Blood Gas Analysis</subject><subject>Bradycardia - blood</subject><subject>Bradycardia - etiology</subject><subject>Bradycardia - physiopathology</subject><subject>Electrocardiography, Ambulatory</subject><subject>Female</subject><subject>Humans</subject><subject>Hypoxia - blood</subject><subject>Hypoxia - etiology</subject><subject>Hypoxia - physiopathology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Oxygen Consumption</subject><subject>Pneumology</subject><subject>Polysomnography</subject><subject>Respiratory system : syndromes and miscellaneous diseases</subject><subject>Sleep Apnea, Obstructive - blood</subject><subject>Sleep Apnea, Obstructive - complications</subject><subject>Sleep Apnea, Obstructive - physiopathology</subject><subject>Sleep Stages</subject><issn>0002-8703</issn><issn>1097-6744</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkE1rFEEQQBsxmDX6E5Q5iBjIaNXsdPfMSSQYEwgIfly8NDXdNdmW-bJ7Jrj_Pr3ZxXjLqSl4r7p4QrxCeI-A6sN3ACjySsP6HcBpDesCc3wiVgi1zpUuy6di9Q85Fs9j_J1GVVTqmThGUFhJLVfi1zfuaPbjEDPqx-Em22yn8S_3ns6y2DFPWZzphs8yGlzWBHJbCmGznTeJyNwSfFLGJs5hsbO_5YND08D0Qhy11EV-eXhPxM-Lzz_OL_Prr1-uzj9d53Zdw5yXqJSVdndaqwrJhVaIbVlq3VaONEDVyFpbrBIgS1m0jUPtoElTEltan4i3-71TGP8sHGfT-2i562jgcYlGQ4USdZ1AuQdtGGMM3Jop-J7C1iCYXVRzH9XsihkAcx_VYPJeHz5Ymp7df9a-YgLeHACKlro20GB9fOAKqRGrhH3cY5xq3HoOJlrPg2XnA9vZuNE_cskd4G2S1w</recordid><startdate>2000</startdate><enddate>2000</enddate><creator>Koehler, Ulrich</creator><creator>Becker, Heinrich F.</creator><creator>Grimm, Wolfram</creator><creator>Heitmann, Jörg</creator><creator>Peter, Jörg H.</creator><creator>Schäfer, Harald</creator><general>Mosby, Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>2000</creationdate><title>Relations among hypoxemia, sleep stage, and bradyarrhythmia during obstructive sleep apnea</title><author>Koehler, Ulrich ; Becker, Heinrich F. ; Grimm, Wolfram ; Heitmann, Jörg ; Peter, Jörg H. ; Schäfer, Harald</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c390t-4166c5c0628f625e27611f4477f8da7008b597c186285452fbd17d0b28566cfa3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Blood Gas Analysis</topic><topic>Bradycardia - blood</topic><topic>Bradycardia - etiology</topic><topic>Bradycardia - physiopathology</topic><topic>Electrocardiography, Ambulatory</topic><topic>Female</topic><topic>Humans</topic><topic>Hypoxia - blood</topic><topic>Hypoxia - etiology</topic><topic>Hypoxia - physiopathology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Oxygen Consumption</topic><topic>Pneumology</topic><topic>Polysomnography</topic><topic>Respiratory system : syndromes and miscellaneous diseases</topic><topic>Sleep Apnea, Obstructive - blood</topic><topic>Sleep Apnea, Obstructive - complications</topic><topic>Sleep Apnea, Obstructive - physiopathology</topic><topic>Sleep Stages</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Koehler, Ulrich</creatorcontrib><creatorcontrib>Becker, Heinrich F.</creatorcontrib><creatorcontrib>Grimm, Wolfram</creatorcontrib><creatorcontrib>Heitmann, Jörg</creatorcontrib><creatorcontrib>Peter, Jörg H.</creatorcontrib><creatorcontrib>Schäfer, Harald</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The American heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Koehler, Ulrich</au><au>Becker, Heinrich F.</au><au>Grimm, Wolfram</au><au>Heitmann, Jörg</au><au>Peter, Jörg H.</au><au>Schäfer, Harald</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Relations among hypoxemia, sleep stage, and bradyarrhythmia during obstructive sleep apnea</atitle><jtitle>The American heart journal</jtitle><addtitle>Am Heart J</addtitle><date>2000</date><risdate>2000</risdate><volume>139</volume><issue>1</issue><spage>142</spage><epage>148</epage><pages>142-148</pages><issn>0002-8703</issn><eissn>1097-6744</eissn><coden>AHJOA2</coden><abstract>Background Obesity, apneic hypoxemia, and rapid eye movement (REM) sleep are supposed to be the major causes for bradyarrhythmia in patients with obstructive sleep apnea. The aims of this study were to compare clinical findings and diagnoses in patients with obstructive sleep apnea with and without nocturnal bradyarrhythmia and to analyze the relations among hypoxemia, sleep stage, and bradyarrhythmia.
Methods During a 17-month period 239 patients were found to have sleep apnea in an ambulatory study. Patients with nocturnal bradyarrhythmia were hospitalized for 3 days and polysomnographies were performed over 2 successive nights. A Holter electrocardiogram was recorded for 48 hours.
Results Nocturnal episodes of bradyarrhythmia were identified in 17 (7%) of 239 patients. Body mass index (39 ± 7 vs 31 ± 5 kg/m
2) and respiratory disturbance index (90 ± 36 per hour vs 24 ± 24 per hour) were significantly different (
P < .01) between patients with (n = 17) and without bradyarrhythmia (n = 222). Bradyarrhythmia occurred significantly more often during REM than non-REM sleep (
P < .01). There was a significant difference in end-apneic oxygen saturation in apnea/hypopnea episodes with and without bradyarrhythmia (71% ± 9% vs 75% ± 10%;
P < .01). A linear relation between end-apneic oxygen saturation and number of sinus arrests and heart blocks could not be found.
Conclusions Patients with apnea-associated bradyarrhythmia are more overweight than patients without bradyarrhythmia. The higher respiratory disturbance index measurements found in these patients may be caused by this difference. Bradyarrhythmia occurs predominantly during REM sleep and occurred independently from decrease in oxygen saturation; a threshold value as an upper limit could not be found. (Am Heart J 2000;139:142-8.)</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>10618575</pmid><doi>10.1016/S0002-8703(00)90321-1</doi><tpages>7</tpages></addata></record> |
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| subjects | Adolescent Adult Aged Biological and medical sciences Blood Gas Analysis Bradycardia - blood Bradycardia - etiology Bradycardia - physiopathology Electrocardiography, Ambulatory Female Humans Hypoxia - blood Hypoxia - etiology Hypoxia - physiopathology Male Medical sciences Middle Aged Oxygen Consumption Pneumology Polysomnography Respiratory system : syndromes and miscellaneous diseases Sleep Apnea, Obstructive - blood Sleep Apnea, Obstructive - complications Sleep Apnea, Obstructive - physiopathology Sleep Stages |
| title | Relations among hypoxemia, sleep stage, and bradyarrhythmia during obstructive sleep apnea |
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