Role of novel automated methods in pulse signal analysis to screen for sleep-disordered breathing among patients on chronotropic medications

Abstract

Study objectives: To investigate the use of automated analysis to detect heart rate accelerations (HRAs) to screen for sleep-disordered breathing (SDB) among patients who use chronotropic medications.

Methods: Nocturnal polysomnography (NPSG) recordings from 933 participants in the Sleep Heart Health Study were analyzed using an automated method to detect HR changes with pulse signals. Participants were included in the study if aged 40 years or older, had complete NPSG and used chronotropic medications prior to enrolling in the study. Nocturnal respiratory-related HRAs were analyzed for any correlation to apnea-hypopnea index (AHI). The heart rate acceleration index (HRAI) is determined by the HRAs based on pulse signal per hour for an entire NPSG.

Results: The total HRAI has a mean ± SD value of 30 ± 19/h. Total AHI and respiratory HRAI has a Spearman correlation coefficient of 0.79 (p < 0.001). In the receiver operating characteristics curve, the area under the curve is greatest when AHI = 5 events/h, yielding a value of 0.96. This indicates that respiratory-related HRAI had the greatest screening ability when AHI = 5 events/h, as compared to other cut-off points of AHI.

Conclusion: The novel automated analysis for nocturnal HR changes correlates with AHI in patients with SDB who use chronotropic medications and provides an accurate prediction for the screening of SDB among these patients. This method may be used for patients irrespective of chronotropic medication use.

Keywords

automated analysis / beta blocker / chronotropic medications / pulse signal / sleep apnea

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