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Nocturnal oxygen desaturation in coronary artery disease
A Cilli1, T Tatlicioğlu, O Köktürk
1Department of Chest Diseases, Gazi University School of Medicine, Ankara, Turkey.
Insights
Patients with coronary artery disease (CAD) experience more nocturnal oxygen desaturation and bradycardia during sleep. These sleep disturbances may worsen CAD progression.
Area of Science:
- Cardiology
- Sleep Medicine
- Pulmonology
Background:
- Nocturnal oxygen desaturation and sleep apnea are linked to myocardial ischemia and arrhythmias in coronary artery disease (CAD) patients.
- These factors may accelerate coronary atherosclerosis and disease progression.
- Limited studies exist on the association between sleep disturbances and CAD.
Purpose of the Study:
- To investigate nocturnal oxygen desaturation and sleep apneas in male CAD patients.
- To assess the association between these sleep factors and CAD.
- To evaluate the risk of bradycardia during sleep in CAD patients.
Main Methods:
- Polysomnography was performed on 22 male CAD patients and 14 age- and sex-matched healthy male controls.
- Patients had confirmed CAD via coronary angiography and no symptomatic pulmonary disease.
- Apnea-hypopnea index and oxygen desaturation index were measured during sleep.
Main Results:
- CAD patients had a higher mean oxygen desaturation index (2.1 vs. 0.5) and spent more sleep time desaturated (3.1% vs. 0.5%) compared to controls.
- Both groups had similar apnea-hypopnea indices.
- Bradycardia during sleep was significantly more frequent in CAD patients (43.3% vs. 25.3%).
Conclusions:
- Sleep-disordered breathing, particularly nocturnal oxygen desaturation, is more prevalent in CAD patients.
- CAD patients exhibit an increased risk of developing bradycardia during sleep.
- Nocturnal oxygen desaturation may contribute to the progression of coronary artery disease.
Abstract:
Nocturnal oxygen desaturation and sleep apnea may provoke myocardial ischemia and arrhythmias in patients with coronary artery disease (CAD). Additionally, these factors may accelerate coronary atherosclerosis in the long term and they may play a role in the progression of the disease process. On the other hand, studies related to this subject are limited. This study was conducted to investigate the nocturnal oxygen desaturation and apneas during sleep in patients with CAD and to assess the possible association of these factors with CAD. We studied 22 male patients with CAD confirmed by coronary angiography who did not have symptomatic pulmonary disease and fourteen male healthy controls without known heart disease. Patients were randomly selected from men undergoing coronary angiography. Controls were age and sex matched and selected from the population registry. The normal controls were of similar body mass index to the patients. None of them were obese. The patients and controls underwent standard polysomnography. Men with CAD and controls had a similar apnea-hypopnea index (2.3 +/- 3.8 vs. 1.2 +/- 1.7). Mean oxygen desaturation index was higher among patients than controls (2.1 vs. 0.5, p < 0.05). Patients with CAD spent 3.1% (9.7 +/- 13.6) of total sleep time desaturated, while the same proportion in controls were 0.5% (1.9 +/- 4.1)(p < 0.05). Although both groups of patients were of similar heart rates at initial, the development of bradycardia during sleep was significantly higher in patients compared with controls (43.3% vs. 25.3%, p < 0.05). The results demonstrate that sleep disordered breathing, in particular nocturnal oxygen desaturation, occurs more common in patients with CAD compared to controls. Additionally, patients are at higher risk of developing bradycardia during sleep. This findings suggest that oxygen desaturation during sleep might contribute to the progression of CAD.