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Updated: May 14, 2026
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Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Obstructive sleep apnea and heart rate asymmetry microstructure during sleep
Przemyslaw Guzik1, Jaroslaw Piskorski, Kokab Awan
1Department of Cardiology-Intensive Therapy, University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznan, Poland. pguzik@ptkardio.pl
Summary
Heart rate asymmetry patterns differ with obstructive sleep apnea (OSA) severity. Severe OSA is linked to fewer short heart rate runs and more prolonged acceleration and deceleration runs, offering insights into sleep apnea
Area of Science:
- Cardiology
- Sleep Medicine
- Physiology
Background:
- Heart rate variability (HRV) analysis is crucial for understanding cardiac autonomic function.
- Heart rate asymmetry (HRA) provides a more detailed insight into HRV microstructure by analyzing patterns of decelerations and accelerations.
- Monotonic runs of heart rate decelerations and accelerations are key components of HRA microstructure.
Purpose of the Study:
- To investigate the relationship between the severity of obstructive sleep apnea (OSA) and the microstructure of heart rate asymmetry (HRA) during sleep.
- To quantify HRA microstructure using measures of monotonic runs of heart rate decelerations and accelerations.
Main Methods:
- Seventy-eight patients with suspected OSA underwent overnight polysomnography.
- Analysis of 300-minute ECG recordings to quantify HRA microstructure.
- Measurements included the contribution of monotonic runs of varying lengths and the length of the longest runs for decelerations and accelerations.
Main Results:
- Patients were categorized into no/mild (AHI 5.1 ± 2.5/h), moderate (AHI 21.8 ± 4.0/h), and severe OSA (AHI 42.8 ± 17.4/h).
- Severe OSA patients exhibited significantly fewer short (length 1) deceleration and acceleration runs compared to moderate OSA.
- Severe OSA patients showed a significantly increased number of longer runs (5-10 for accelerations, 5-8 for decelerations) and longer maximum acceleration runs.
Conclusions:
- Heart rate asymmetry microstructure is significantly associated with obstructive sleep apnea severity.
- An increased prevalence of longer deceleration and acceleration runs is characteristic of severe OSA.
- HRA microstructure analysis offers a potential biomarker for OSA severity.
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