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Abstract
Background
Obstructive sleep apnea (OSA) is a chronic and progressive disease. OSA is associated with increased cardiovascular morbidity and mortality, the risk being more frequently encountered with severe degrees of OSA. Increased sympathetic activation and impaired cardiac autonomic control as reflected by depressed baroreceptor reflex sensitivity (BRS) are possible mechanisms involved in the cardiovascular complications of OSA. However, it is not known at what stage of OSA that changes in BRS appear. The aim of this study was to evaluate BRS in patients with mild OSA.
Methods
The study population consisted of 81 overweight patients with mild OSA and 46 body weight-matched non-OSA subjects. BRS, apnea-hypopnea index, body mass index, and metabolic parameters were assessed. The phenylephrine test was used to measure BRS.
Results
Patients in the OSA group were slightly but significantly older than the non-OSA population (50.3±9.3 years vs 45.7±11.1 years, P=0.02). Body mass index, percentage body fat, blood pressure, fasting glucose, insulin, and lipid levels did not differ between the OSA patients and non-OSA subjects. Absolute BRS values in patients with mild OSA and non-OSA subjects (9.97±6.70 ms/mmHg vs 10.51±7.16 ms/mmHg, P=0.67) and BRS values proportional to age-related and sex-related reference values (91.4%±22.7% vs 92.2%±21.8%, P=0.84) did not differ from each other. BRS <50% of the sex-specific reference value was found in 6% of patients with mild OSA and in 2% of non-OSA subjects (P=0.29).
Conclusion
Patients with mild OSA did not show evidence of disturbed BRS in comparison with weight-matched non-OSA controls.
Acknowledgments
The authors cordially acknowledge the members of the Kuopio Sleep Apnea Group, ie, Taina Poutiainen, Matti Pukkila, Tatu Kemppainen, Aki Ikonen, Ritva Vanninen, Heimo Viinamäki, Keijo Peuhkurinen, Kari Punnonen, Kati Venäläinen, Riitta Pahkala, Erkki Soini, and Janne Martikainen. Marjo-Leena Hannila, who assisted with the statistical analysis, is also gratefully acknowledged. The study was funded by the Hospital District of Northern Savo, Kuopio University Hospital. The Organisation for Respiratory Health in Finland (HELI), Kuopio Breathing Association, Antti and Tyyne Soininen Foundation, Väinö and Laina Kivi Foundation, Finnish Anti-Tuberculosis Foundation, and Finnish Research Foundation of Otology also supported the study with grants. The funding sources had no role in the study design; collection, analysis, or interpretation of the data; or writing of the report.
Author contributions
All authors contributed significantly to the conception and design of the study, acquisition of data, analysis and interpretation of data; drafting and revising of the manuscript; and final approval and agreement of the version to be published.
Disclosure
The authors report no conflicts of interest in this work.