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There are numerous types of normal and abnormal respiration. Based on ventilatory movements, breathing patterns are classified as regular, deep, or shallow. Examples include Biot's breathing, Cheyne-Stokes respiration, Kussmaul's breathing, hyperventilation, and hypoventilation. Each pattern is clinically significant and aids in evaluating patients.
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REM Sleep Behavior Disorder (RBD) is a sleep disorder characterized by the absence of muscle paralysis that normally occurs during the REM phase of sleep. This absence allows individuals to physically act out their dreams, which are often vivid and disturbing. Common behaviors exhibited during episodes include kicking, punching, and yelling. These actions can be dangerous, potentially leading to injuries for the person with RBD or their bed partner.
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Sleep-Disordered Breathing Destabilizes Ventricular Repolarization.

Soroosh Solhjoo1,2, Mark C Haigney2,3, Trishul Siddharthan4

  • 1Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Medrxiv : the Preprint Server for Health Sciences
|February 24, 2023
PubMed
Summary
This summary is machine-generated.

Sleep-disordered breathing (SDB) is linked to unstable heart rhythms and sudden cardiac death. Intermittent hypoxemia, a hallmark of SDB, destabilizes heart repolarization, increasing mortality risk.

Keywords:
Beat-to-beat QT variability indexQTVISleep Heart Health StudySleep apneaintermittent hypoxemiaintermittent hypoxia

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Area of Science:

  • Cardiology
  • Sleep Medicine
  • Physiology

Background:

  • Sleep-disordered breathing (SDB) is a known risk factor for cardiac arrhythmias and sudden cardiac death.
  • Ventricular repolarization lability, measured by the QT variability index (QTVI), is associated with increased risk of adverse cardiac events and mortality.

Approach:

  • The study analyzed three cohorts: a cross-sectional cohort (n=122) with and without severe SDB, a longitudinal cohort (n=52) with and without incident SDB, and a cohort of 19 healthy adults exposed to intermittent hypoxia.
  • Electrocardiographic measures, including QTVI, were calculated from one-lead electrocardiograms.

Key Points:

  • Participants with severe SDB exhibited greater QTVI, heart rate, and hypoxemia burden (TST90) compared to those without SDB.
  • Total sleep time with oxygen saturation < 90% (TST90) predicted QTVI, and QTVI during sleep predicted all-cause mortality.
  • Incident SDB was associated with a significant increase in mean QTVI over 5 years, and acute intermittent hypoxia progressively increased QTVI in healthy adults.

Conclusions:

  • Prevalent and incident SDB are associated with ventricular repolarization instability, increasing susceptibility to arrhythmias and sudden cardiac death.
  • Intermittent hypoxemia plays a crucial role in destabilizing ventricular repolarization and may contribute to elevated mortality in individuals with SDB.