Heart Rate Variability (HRV) in Patients with Sleep Apnea and COPD: A Comprehensive Analysis

Area of Science:

• Cardiology
• Pulmonology
• Autonomic Neuroscience

Background:

• Obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) are common conditions impacting autonomic function.
• Heart rate variability (HRV) serves as a non-invasive biomarker for autonomic nervous system activity.

Purpose of the Study:

• To review the role of HRV in assessing autonomic dysfunction in patients with OSA, COPD, and overlap syndrome.
• To explore HRV's potential in diagnosis, prognosis, and treatment monitoring for these conditions.

Main Methods:

• A comprehensive literature review was conducted from January 2015 to December 2024.
• Included studies evaluated HRV parameters in individuals with OSA, COPD, or overlap syndrome.
• 41 studies met inclusion criteria after screening 239 identified articles.

Main Results:

• Reduced HRV is consistently linked to OSA and COPD severity, with more pronounced alterations in overlap syndrome.
• HRV can differentiate disease stages, predict cardiovascular risk, and evaluate treatment efficacy (e.g., CPAP for OSA).
• Short-term HRV reflects acute autonomic changes, while long-term HRV tracks disease progression; wearable technology shows promise for screening.

Conclusions:

• HRV is a valuable non-invasive tool for evaluating autonomic dysfunction in OSA, COPD, and overlap syndrome.
• Integrating HRV into clinical practice can enhance diagnostic efficiency and improve outcomes in high-risk respiratory populations.
• Further longitudinal studies are needed to standardize HRV thresholds for routine screening.