0659 Lack of Association of Heart Rate Variability on Overnight Oximetry and Periodic Limb Movement Arousals. (12th April 2019)

• Record Type: Journal Article
• Authors: Wasey, Waiz; Seckin, Zaynep; Festic, Nura; Festic, Emir; Castillo, Pablo
• Is Part Of: Sleep. Volume 42(2019)Supplement 1
• Page Start: A263
• Page End: A263
• Publication Date: 2019-04-12
• Subjects: Sleep -- Physiological aspects -- Periodicals; Sleep disorders -- Periodicals; Sommeil -- Aspect physiologique -- Périodiques; Sommeil, Troubles du -- Périodiques; Sleep disorders; Sleep -- Physiological aspects; Sleep -- physiological aspects; Sleep Wake Disorders; Psychophysiology; Electronic journals; Periodicals; 616.8498
• DOI: 10.1093/sleep/zsz067.657
• Languages: English
• ISSNs: 0161-8105

Abstract

Abstract: Introduction: Periodic Limb movements (PLM) are repetitive movements that typically occur in lowerlimbs every 20-40 seconds and can be contributing towards insomnia and/or daytime somnolence. Changes in cardiovascular measures have been advocated as sensitive markers of phasic events arising from sleep. Heart rate variability (HRV) identified on normal oximetry has been associated with the diagnosis of obstructive sleep apnea (OSA), on subsequent Polysomnography (PSG). The current study was aimed to analyze if any association exists between HRV on normal oximetry with PLM arousals on PSG. Methods: Patients who had normal overnight oximetry (ODI <5) and who underwent subsequent PSG due to suspicion for OSA in a period July 1, 2014 to June 30, 2015, were enrolled. The patients were divided based on subjective assignment of presence or absence of HRV on oximetry, which was independently done by a sleep fellow and a research fellow. Consensus was achieved with help of a sleep specialist. A positive PLM arousal index was >5. The association with PLM arousals was adjusted for age, BMI, sex, ODI and use of heart-rate controlling medications. Results: 110 adult patients were enrolled. Median age was 54 years (interquartile ratio [IQR] 44, 67). 60% were females and median BMI was 29 (IQR 25, 32). Median ODI was 1.8 (1, 2.7). 39 (35%) patients were taking heart-rate controlling medications (beta or calcium blockers, or antiarrhythmics). Based on consensus agreement, 77 patients (70%) were determined to have HRV on oximetry. There was no significant association between subjectively observed HRV and PLM arousals on PSG (p=1). After adjusting for pertinent demographic and clinical variables, none had statistically significant association between HRV and PLM arousals. For consensus agreement on HRV, adjusted estimate was OR, 1.35, 95% CI 0.38-4.73, p=0.64. Conclusion: In a cohort of patients with normal oximetry, there was no significant association between subjective determination of HRV and PLM arousals on PSG. Future studies should address possible association of HRV and PLM arousals in a cohort of patients with suspicion for PLM disorder. Support (If Any): none