The variability in pulse rate can predict stroke in obstructive sleep apnea

Pulse rate variability observed by pulse oximetry could serve as a useful biomarker for stratifying stroke risk in patients with obstructive sleep apnea (OSA), according to a study recently published in the American Journal of Respiratory Critical Care Medicine.

Researchers measured the variability in pulse rate using overnight oximetry during diagnostic sleep studies in patients with OSA with 5 or more events per hour. The primary study result was the first episode of a stroke. The standard deviation of the normal-normal beat intervals and consecutive normal-normal differences were used to retrospectively correlate the variability of the pulse rate with the health outcomes.

Among the 6,075 stroke-free patients with OSA, the mean age was 62 years and the mean apnea-hypopnea index was 28 events per hour. A total of 2536 patients were correctly treated for positive airway pressure, and 3539 patients did not adhere to positive airway pressure or received no active OSA therapy.

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After the median follow-up of 6.5 years, 459 patients had died and 177 patients had been diagnosed with stroke. Overall, patients with a lower sympathetic / parasympathetic tone (LF / HF ratio) had a higher risk of stroke. The association appeared to be stronger in patients with severe OSA.

“People with OSA, especially those with severe disease who have poor sympathovagal balance (LF / HF), are at increased risk [for] Stroke, ”wrote the study’s authors. “[Pulse rate variability] Indexes derived from pulse oximetry data, readily available in routine sleep records, could be a useful biomarker for stratifying stroke risk. “


Sabil A., Gervès-Pinquié C., Blanchard M. et al .; on behalf of the ERMES study group. Overnight pulse rate variability derived from oximetry predicts stroke risk in patients with obstructive sleep apnea. Am J Respir Crit Care Med. Published online April 9, 2021. doi: 10.1164 / rccm.202101-0109LE

This article originally appeared on Pulmonology Advisor


Obstructive Sleep Apnea Sleep Apnea Sleep Disorders Stroke

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