J Clin Sleep Med. 2023 Jan 20. doi: 10.5664/jcsm.10402. Online ahead of print.
STUDY OBJECTIVES: Changes in nasal resistance (NR) during postural changes are influenced by venous filling pressure and autonomic nervous system (ANS) mediation, and heart rate variability (HRV) can reflect changes in the ANS. This study aimed to explore the regulatory mechanisms of NR in patients with obstructive sleep apnea (OSA) during postural changes.
METHODS: Healthy controls (apnea-hypopnea index (AHI) <5 events/h) and patients with OSA were recruited. NR and electrocardiogram (ECG) data were collected in sitting, supine, left-lateral, and right-lateral postures. HRV parameters were obtained by analyzing the ECG data from each posture. Subgroups were divided according to sitting-supine NR changes, and HRV parameters were compared between different postures and groups/subgroups.
RESULTS: In total, thirty-four healthy controls and thirty-nine patients with OSA (mean AHI 34.34±22.44 events/hour) were recruited. During to sitting-supine postural changes, the NR increased in the control group but did not change significantly in the OSA group. None of the ANS-related HRV parameters changed significantly. After the groups were divided into NR-elevated and NR-unchanged subgroups, sympathetic activity-related HRV parameters were higher in the NR-unchanged subgroup but only statistically significant in the OSA group. When comparing the left and right postures, there was no significant change in NR; however, the OSA group had lower parasympathetic activity-related HRV parameters when in the right posture.
CONCLUSIONS: During postural changes from the sitting to supine positions, the total NR increases, and this increment is smaller in patients with OSA. This is likely due to overregulation of sympathetic activity, which may occur in patients with OSA.
PMID:36661101 | DOI:10.5664/jcsm.10402