Variation of Electrocardiogram Features Across Sleep Stages in Healthy Controls and in Patients with Sleep Apnea Hypopnea Syndrome

Abstract

Sleep apnea hypopnea syndrome (SAHS) is an independent risk factor for various cardiovascular diseases. Electrocardiogram (ECG) features such as the RR, PR, QT, QTc, Tpe intervals and the Tpe/QT, Tpe/QTc ratios are used to predict and study cardiovascular diseases. It is not clear whether regular patterns of PR and Tpe-related features across sleep stages exist in SAHSs or healthy controls nor whether sleep stages affect the short- and long-range influences of respiratory events on ECG indices. We enrolled 36 healthy controls and 35 patients with SAHS in our study and analyzed the abovementioned ECG features. In the healthy controls, a significant regularity existed in these indices across sleep stages, which were weakened or disturbed in the patient group, especially the Tpe-related features. The differences between the patients and healthy controls were generally consistent across all sleep stages: patients had smaller RR, PR, QT and Tpe/QTc values, but larger QTc, Tpe and Tpe/QT values. After filtering the short-range influence of respiratory events, the differences in most features remained highly significant, except the QT interval. In the patient group, respiratory events decreased RR and PR intervals in most sleep stages and increased the Tpe-related features' values in deep sleep stages. These results may aid in the study of the relationships among SAHS, sleep disorders and cardiovascular diseases.