Obstructive sleep apnea syndrome and autonomic dysfunction in Duchenne muscular dystrophy

BENBİR ŞENEL G., Arkali N. B., KILIÇ H., Incesu G., SALTIK S., YALÇINKAYA C., ...Daha Fazla

SLEEP AND BREATHING, cilt.25, sa.2, ss.941-946, 2021 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 25 Sayı: 2
  • Basım Tarihi: 2021
  • Doi Numarası: 10.1007/s11325-020-02139-5
  • Dergi Adı: SLEEP AND BREATHING
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, PASCAL, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.941-946
  • Anahtar Kelimeler: Apnea-hypopnea index, Cardiac autonomic function, Duchenne muscular dystrophy, Heart rate variability, LF/HF ratio, Obstructive sleep apnea syndrome
  • İstanbul Üniversitesi Adresli: Hayır

Özet

Purpose Cardiac and respiratory involvement constitutes serious complications of Duchenne muscular dystrophy (DMD). We hypothesized that obstructive sleep apnea syndrome (OSAS) may play a role in cardiac autonomic dysfunction in DMD. We sought to assess the presence of cardiac autonomic function in patients with DMD by analyzing heart rate variability (HRV) during polysomnography (PSG). Methods In a prospective study, all participants had whole-night PSG recorded and scored according to American Academy of Sleep Medicine guidelines. HRV analysis was performed on electrocardiography recordings from PSG recordings. Results Twelve consecutive males with DMD (mean age 9.0 +/- 3.1 years, mean BMI 20.6 +/- 4.8 kg/m2) and eight age-matched healthy males were enrolled. On clinical evaluation, 58% of patients with DMD had at least one symptom related to OSAS, such as snoring, witnessed apnea, or restless sleep. None of the controls had OSAS-related complaints. By PSG none of the controls had OSAS, while 42% of patients with DMD had OSAS (p= 0.004). Average R-R duration and mean percentage of successive R-R intervals > 50 ms values were significantly lower in patients with DMD than those in controls (p< 0.006). In patients with DMD and OSAS, LF/HF (low/high-frequency) ratio was significantly increased in NREM sleep compared with those in controls (p= 0.005). Higher apnea-hypopnea index and lower oxygen saturation showed significant correlations with higher LF power and LF/HF ratio (p< 0.001). Conclusion Cardiac autonomic dysfunction is present in DMD, being more pronounced in the presence of OSAS.