Obstructive sleep apnea heterogeneity and autonomic function: a role for heart rate variability in therapy selection and efficacy monitoring.
autonomic dysfunction
heart rate variability
heterogeneity
obstructive sleep apnea
therapeutic efficacy
treatment modalities
Journal
Journal of sleep research
ISSN: 1365-2869
Titre abrégé: J Sleep Res
Pays: England
ID NLM: 9214441
Informations de publication
Date de publication:
14 Sep 2023
14 Sep 2023
Historique:
revised:
23
07
2023
received:
07
02
2023
accepted:
03
08
2023
pubmed:
15
9
2023
medline:
15
9
2023
entrez:
14
9
2023
Statut:
aheadofprint
Résumé
Obstructive sleep apnea is a highly prevalent sleep-related breathing disorder, resulting in a disturbed breathing pattern, changes in blood gases, abnormal autonomic regulation, metabolic fluctuation, poor neurocognitive performance, and increased cardiovascular risk. With broad inter-individual differences recognised in risk factors, clinical symptoms, gene expression, physiological characteristics, and health outcomes, various obstructive sleep apnea subtypes have been identified. Therapeutic efficacy and its impact on outcomes, particularly for cardiovascular consequences, may also vary depending on these features in obstructive sleep apnea. A number of interventions such as positive airway pressure therapies, oral appliance, surgical treatment, and pharmaceutical options are available in clinical practice. Selecting an effective obstructive sleep apnea treatment and therapy is a challenging medical decision due to obstructive sleep apnea heterogeneity and numerous treatment modalities. Thus, an objective marker for clinical evaluation is warranted to estimate the treatment response in patients with obstructive sleep apnea. Currently, while the Apnea-Hypopnea Index is used for severity assessment of obstructive sleep apnea and still considered a major guide to diagnosis and managements of obstructive sleep apnea, the Apnea-Hypopnea Index is not a robust marker of symptoms, function, or outcome improvement. Abnormal cardiac autonomic modulation can provide additional insight to better understand obstructive sleep apnea phenotyping. Heart rate variability is a reliable neurocardiac tool to assess altered autonomic function and can also provide cardiovascular information in obstructive sleep apnea. Beyond the Apnea-Hypopnea Index, this review aims to discuss the role of heart rate variability as an indicator and predictor of therapeutic efficacy to different modalities in order to optimise tailored treatment for obstructive sleep apnea.
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
e14020Subventions
Organisme : American Heart Association
ID : 20CDA35310360
Organisme : National and Guangzhou Key Clinical Specialty (2021- 2024)
Organisme : National Youth Foundation of China
ID : 81900927
Organisme : National Youth Foundation of China
ID : 82301290
Informations de copyright
© 2023 European Sleep Research Society.
Références
Agha, B., & Johal, A. (2017). Facial phenotype in obstructive sleep apnea-hypopnea syndrome: A systematic review and meta-analysis. Journal of Sleep Research, 26(2), 122-131. https://doi.org/10.1111/jsr.12485
Aljadeff, G., Gozal, D., Schechtman, V. L., Burrell, B., Harper, R. M., & Ward, S. L. (1997). Heart rate variability in children with obstructive sleep apnea. Sleep, 20(2), 151-157. https://doi.org/10.1093/sleep/20.2.151
An, J., Glick, H. A., Sawyer, A. M., Arguelles, J., Bae, C. J., Keenan, B. T., Kuna, S. T., Maislin, G., Mazzotti, D. R., Pack, A. I., Shi, J. M., Watach, A. J., & Hwang, D. (2023). Association between positive airway pressure adherence and health care costs among individuals with OSA. Chest, 163, 1543-1554. https://doi.org/10.1016/j.chest.2023.01.025
Appleton, S. L., Gill, T. K., Lang, C. J., Taylor, A. W., McEvoy, R. D., Stocks, N. P., González-Chica, D. A., & Adams, R. J. (2018). Prevalence and comorbidity of sleep conditions in Australian adults: 2016 Sleep Health Foundation national survey. Sleep Health, 4(1), 13-19. https://doi.org/10.1016/j.sleh.2017.10.006
Arredondo, E., DeLeon, M., Masozera, I., Panahi, L., Udeani, G., Tran, N., Nguyen, C. K., Atphaisit, C., de la Sota, B., Gonzalez, G., Liou, E., Mayo, Z., Nwosu, J., & Shiver, T. L. (2022). Overview of the role of pharmacological management of obstructive sleep apnea. Medicina (Kaunas, Lithuania), 58(2), 225. https://doi.org/10.3390/medicina58020225
Bakker, J. P., Campana, L. M., Montesi, S. B., Balachandran, J., DeYoung, P. N., Smales, E., Patel, S. R., & Malhotra, A. (2014). A pilot study investigating the effects of continuous positive airway pressure treatment and weight-loss surgery on autonomic activity in obese obstructive sleep apnea patients. Journal of Electrocardiology, 47(3), 364-373. https://doi.org/10.1016/j.jelectrocard.2014.02.008
Bamagoos, A. A., Cistulli, P. A., Sutherland, K., Ngiam, J., Burke, P. G. R., Bilston, L. E., Butler, J. E., & Eckert, D. J. (2019). Dose-dependent effects of mandibular advancement on upper airway collapsibility and muscle function in obstructive sleep apnea. Sleep, 42(6), zsz049. https://doi.org/10.1093/sleep/zsz049
Barnes, H., Edwards, B. A., Joosten, S. A., Naughton, M. T., Hamilton, G. S., & Dabscheck, E. (2017). Positional modification techniques for supine obstructive sleep apnea: A systematic review and meta-analysis. Sleep Medicine Reviews, 36, 107-115. https://doi.org/10.1016/j.smrv.2016.11.004
Baumert, M., Linz, D., McKane, S., & Immanuel, S. (2023). Transvenous phrenic nerve stimulation is associated with normalization of nocturnal heart rate perturbations in patients with central sleep apnea. Sleep, zsad166. https://doi.org/10.1093/sleep/zsad166
Beebe, D. W. (2006). Neurobehavioral morbidity associated with disordered breathing during sleep in children: A comprehensive review. Sleep, 29(9), 1115-1134. https://doi.org/10.1093/sleep/29.9.1115
Benjafield, A. V., Ayas, N. T., Eastwood, P. R., Heinzer, R., Ip, M. S. M., Morrell, M. J., Nunez, C. M., Patel, S. R., Penzel, T., Pépin, J. L., Peppard, P. E., Sinha, S., Tufik, S., Valentine, K., & Malhotra, A. (2019). Estimation of the global prevalence and burden of obstructive sleep apnoea: A literature-based analysis. The Lancet Respiratory Medicine, 7(8), 687-698. https://doi.org/10.1016/s2213-2600(19)30198-5
Berger, M., Raffin, J., Pichot, V., Hupin, D., Garet, M., Labeix, P., Costes, F., Barthélémy, J. C., & Roche, F. (2019). Effect of exercise training on heart rate variability in patients with obstructive sleep apnea: A randomized controlled trial. Scandinavian Journal of Medicine & Science in Sports, 29(8), 1254-1262. https://doi.org/10.1111/sms.13447
Bokov, P., Mauvais, F. X., Madani, A., Matrot, B., Lecendreux, M., Delanoë, C., Konofal, E., Gallego, J., & Delclaux, C. (2021). Cross-sectional case-control study of the relationships between pharyngeal compliance and heart rate variability indices in childhood obstructive sleep apnoea. Journal of Sleep Research, 30(5), e13337. https://doi.org/10.1111/jsr.13337
Bonsignore, M. R., Parati, G., Insalaco, G., Castiglioni, P., Marrone, O., Romano, S., Salvaggio, A., Mancia, G., Bonsignore, G., & di Rienzo, M. (2006). Baroreflex control of heart rate during sleep in severe obstructive sleep apnoea: Effects of acute CPAP. The European Respiratory Journal, 27(1), 128-135. https://doi.org/10.1183/09031936.06.00042904
Bonsignore, M. R., Saaresranta, T., & Riha, R. L. (2019). Sex differences in obstructive sleep apnoea. European Respiratory Review, 28(154), 190030. https://doi.org/10.1183/16000617.0030-2019
Borker, P. V., Reid, M., Sofer, T., Butler, M. P., Azarbarzin, A., Wang, H., Wellman, A., Sands, S. A., & Redline, S. (2021). Non-REM apnea and hypopnea duration varies across population groups and physiologic traits. American Journal of Respiratory and Critical Care Medicine, 203(9), 1173-1182. https://doi.org/10.1164/rccm.202005-1808OC
Bouzid, Z., Al-Zaiti, S. S., Bond, R., & Sejdić, E. (2022). Remote and wearable ECG devices with diagnostic abilities in adults: A state-of-the-science scoping review. Heart Rhythm, 19(7), 1192-1201.
Butler, M. P., Emch, J. T., Rueschman, M., Sands, S. A., Shea, S. A., Wellman, A., & Redline, S. (2019). Apnea-hypopnea event duration predicts mortality in men and women in the sleep heart health study. American Journal of Respiratory and Critical Care Medicine, 199(7), 903-912. https://doi.org/10.1164/rccm.201804-0758OC
Buyse, B., Nguyen, P. A. H., Leemans, J., Verhaeghe, V., Peters, M., Strobbe, S., van Valckenborgh, I., Belge, C., & Testelmans, D. (2023). Short-term positive effects of a mandibular advancement device in a selected phenotype of patients with moderate obstructive sleep apnea: a prospective study. Journal of Clinical Sleep Medicine, 19(1), 5-16. https://doi.org/10.5664/jcsm.10232
Byun, J. I., Shin, Y. Y., Hwang, K. J., Jung, Y., & Shin, W. C. (2019). Comparison of cardiac autonomic activity between positional and nonpositional obstructive sleep apnea using heart rate variability. Sleep Medicine, 64, 101-105. https://doi.org/10.1016/j.sleep.2019.06.021
Cade, B. E., Chen, H., Stilp, A. M., Gleason, K. J., Sofer, T., Ancoli-Israel, S., Arens, R., Bell, G. I., Below, J. E., Bjonnes, A. C., Chun, S., Conomos, M. P., Evans, D. S., Johnson, W. C., Frazier-Wood, A. C., Lane, J. M., Larkin, E. K., Loredo, J. S., Post, W. S., … Redline, S. (2016). Genetic associations with obstructive sleep apnea traits in Hispanic/Latino Americans. American Journal of Respiratory and Critical Care Medicine, 194(7), 886-897. https://doi.org/10.1164/rccm.201512-2431OC
Camañes-Gonzalvo, S., Bellot-Arcís, C., Marco-Pitarch, R., Montiel-Company, J. M., García-Selva, M., Agustín-Panadero, R., Paredes-Gallardo, V., & Puertas-Cuesta, F. J. (2022). Comparison of the phenotypic characteristics between responders and non-responders to obstructive sleep apnea treatment using mandibular advancement devices in adult patients: Systematic review and meta-analysis. Sleep Medicine Reviews, 64, 101644. https://doi.org/10.1016/j.smrv.2022.101644
Carlson, J. T., Hedner, J. A., Sellgren, J., Elam, M., & Wallin, B. G. (1996). Depressed baroreflex sensitivity in patients with obstructive sleep apnea. American Journal of Respiratory and Critical Care Medicine, 154(5), 1490-1496. https://doi.org/10.1164/ajrccm.154.5.8912770
Carter, J. R., Mokhlesi, B., & Thomas, R. J. (2021). Obstructive sleep apnea phenotypes and cardiovascular risk: Is there a role for heart rate variability in risk stratification? Sleep, 44(5), zsab037. https://doi.org/10.1093/sleep/zsab037
Carter, S. G., & Eckert, D. J. (2021). Effects of hypnotics on obstructive sleep apnea endotypes and severity: Novel insights into pathophysiology and treatment. Sleep Medicine Reviews, 58, 101492. https://doi.org/10.1016/j.smrv.2021.101492
Catai, A. M., Pastre, C. M., Godoy, M. F., Silva, E. D., Takahashi, A. C. M., & Vanderlei, L. C. M. (2020). Heart rate variability: Are you using it properly? Standardisation checklist of procedures. Brazilian Journal of Physical Therapy, 24(2), 91-102. https://doi.org/10.1016/j.bjpt.2019.02.006
Chang, J. S., Lee, S. D., Ju, G., Kim, J. W., Ha, K., & Yoon, I. Y. (2013). Enhanced cardiorespiratory coupling in patients with obstructive sleep apnea following continuous positive airway pressure treatment. Sleep Medicine, 14(11), 1132-1138. https://doi.org/10.1016/j.sleep.2013.04.024
Chen, H., Eckert, D. J., van der Stelt, P. F., Guo, J., Ge, S., Emami, E., Almeida, F. R., & Huynh, N. T. (2020). Phenotypes of responders to mandibular advancement device therapy in obstructive sleep apnea patients: A systematic review and meta-analysis. Sleep Medicine Reviews, 49, 101229. https://doi.org/10.1016/j.smrv.2019.101229
Cipriano, L. H. C., Borges, Y. G., Mill, J. G., Mauad, H., Martins de Araújo, M. T., & Gouvea, S. A. (2021). Effects of short-term aerobic training versus CPAP therapy on heart rate variability in moderate to severe OSA patients. Psychophysiology, 58(4), e13771. https://doi.org/10.1111/psyp.13771
Clark, J. W., Brian, M. L., Drummond, S. P. A., Hoyer, D., & Jacobson, L. H. (2020). Effects of orexin receptor antagonism on human sleep architecture: A systematic review. Sleep Medicine Reviews, 53, 101332. https://doi.org/10.1016/j.smrv.2020.101332
Coruzzi, P., Gualerzi, M., Bernkopf, E., Brambilla, L., Brambilla, V., Broia, V., Lombardi, C., & Parati, G. (2006). Autonomic cardiac modulation in obstructive sleep apnea: Effect of an oral jaw-positioning appliance. Chest, 130(5), 1362-1368. https://doi.org/10.1378/chest.130.5.1362
Dal-Fabbro, C., Garbuio, S., D'Almeida, V., Cintra, F. D., Tufik, S., & Bittencourt, L. (2014). Mandibular advancement device and CPAP upon cardiovascular parameters in OSA. Sleep & Breathing, 18(4), 749-759. https://doi.org/10.1007/s11325-014-0937-5
Dedhia, R. C., Shah, A. J., Bliwise, D. L., Quyyumi, A. A., Strollo, P. J., Li, Q., da Poian, G., & Clifford, G. D. (2019). Hypoglossal nerve stimulation and heart rate variability: Analysis of STAR trial responders. Otolaryngology and Head and Neck Surgery, 160(1), 165-171. https://doi.org/10.1177/0194599818800284
Dempsey, J. A., Veasey, S. C., Morgan, B. J., & O'Donnell, C. P. (2010). Pathophysiology of sleep apnea. Physiological Reviews, 90(1), 47-112. https://doi.org/10.1152/physrev.00043.2008
Ding, Q., Qin, L., Wojeck, B., Inzucchi, S. E., Ibrahim, A., Bravata, D. M., Strohl, K. P., Yaggi, H. K., & Zinchuk, A. V. (2021). Polysomnographic phenotypes of obstructive sleep apnea and incident type 2 diabetes: Results from the DREAM study. Annals of the American Thoracic Society, 18(12), 2067-2078.
Dissanayake, H. U., Bin, Y. S., Sutherland, K., Ucak, S., de Chazal, P., & Cistulli, P. A. (2022). The effect of obstructive sleep apnea therapy on cardiovascular autonomic function: a systematic review and meta-analysis. Sleep, 45(12), zsac210. https://doi.org/10.1093/sleep/zsac210
Dissanayake, H. U., Bin, Y. S., Ucak, S., de Chazal, P., Sutherland, K., & Cistulli, P. A. (2021). Association between autonomic function and obstructive sleep apnea: A systematic review. Sleep Medicine Reviews, 57, 101470. https://doi.org/10.1016/j.smrv.2021.101470
Duan, A., Huang, Z., Hu, M., Zhao, Z., Zhao, Q., Jin, Q., Yan, L., Zhang, Y., Li, X., An, C., Luo, Q., & Liu, Z. (2023). The comorbidity burden and disease phenotype in pre-capillary pulmonary hypertension: The contributing role of obstructive sleep apnea. Sleep Medicine, 101, 146-153. https://doi.org/10.1016/j.sleep.2022.10.029
Dudley, K. A., & Patel, S. R. (2016). Disparities and genetic risk factors in obstructive sleep apnea. Sleep Medicine, 18, 96-102.
Dutta, R., Delaney, G., Toson, B., Jordan, A. S., White, D. P., Wellman, A., & Eckert, D. J. (2021). A novel model to estimate key obstructive sleep apnea endotypes from standard polysomnography and clinical data and their contribution to obstructive sleep apnea severity. Annals of the American Thoracic Society, 18(4), 656-667. https://doi.org/10.1513/AnnalsATS.202001-064OC
Eckert, D. J., Owens, R. L., Kehlmann, G. B., Wellman, A., Rahangdale, S., Yim-Yeh, S., White, D. P., & Malhotra, A. (2011). Eszopiclone increases the respiratory arousal threshold and lowers the apnoea/hypopnoea index in obstructive sleep apnoea patients with a low arousal threshold. Clinical Science (London, England), 120(12), 505-514. https://doi.org/10.1042/cs20100588
Eckert, D. J., White, D. P., Jordan, A. S., Malhotra, A., & Wellman, A. (2013). Defining phenotypic causes of obstructive sleep apnea. Identification of novel therapeutic targets. American Journal of Respiratory and Critical Care Medicine, 188(8), 996-1004. https://doi.org/10.1164/rccm.201303-0448OC
Edwards, B. A., Wellman, A., Sands, S. A., Owens, R. L., Eckert, D. J., White, D. P., & Malhotra, A. (2014). Obstructive sleep apnea in older adults is a distinctly different physiological phenotype. Sleep, 37(7), 1227-1236.
Efazati, N., Rahimi, B., Mirdamadi, M., Edalatifard, M., & Tavoosi, A. (2020). Changes in heart rate variability (HRV) in patients with severe and moderate obstructive sleep apnea before and after acute CPAP therapy during nocturnal polysomnography. Sleep Science, 13(2), 97-102. https://doi.org/10.5935/1984-0063.20200003
Ehsan, Z., Ishman, S. L., Kimball, T. R., Zhang, N., Zou, Y., & Amin, R. S. (2017). Longitudinal cardiovascular outcomes of sleep disordered breathing in children: a meta-analysis and systematic review. Sleep, 40(3), zsx015. https://doi.org/10.1093/sleep/zsx015
Gać, P., Urbanik, D., Macek, P., Martynowicz, H., Mazur, G., & Poręba, R. (2022). Coexistence of cardiovascular risk factors and obstructive sleep apnoea in polysomnography. Respiratory Physiology & Neurobiology, 295, 103782. https://doi.org/10.1016/j.resp.2021.103782
Gagnadoux, F., le Vaillant, M., Paris, A., Pigeanne, T., Leclair-Visonneau, L., Bizieux-Thaminy, A., Alizon, C., Humeau, M. P., Nguyen, X. L., Rouault, B., Trzepizur, W., Meslier, N., Person, C., Priou, P., Goupil, F., Molinier, O., Breton, P., Berkani, K., Langelot-Richard, M., … Pelletier-Fleury, N. (2016). Relationship between OSA clinical phenotypes and CPAP treatment outcomes. Chest, 149(1), 288-290. https://doi.org/10.1016/j.chest.2015.09.032
Gaisl, T., Haile, S. R., Thiel, S., Osswald, M., & Kohler, M. (2019). Efficacy of pharmacotherapy for OSA in adults: A systematic review and network meta-analysis. Sleep Medicine Reviews, 46, 74-86. https://doi.org/10.1016/j.smrv.2019.04.009
Georgoulis, M., Yiannakouris, N., Kechribari, I., Lamprou, K., Perraki, E., Vagiakis, E., & Kontogianni, M. D. (2022). Dose-response relationship between weight loss and improvements in obstructive sleep apnea severity after a diet/lifestyle interventions: secondary analyses of the “MIMOSA” randomized clinical trial. Journal of Clinical Sleep Medicine, 18(5), 1251-1261. https://doi.org/10.5664/jcsm.9834
Glos, M., Penzel, T., Schoebel, C., Nitzsche, G. R., Zimmermann, S., Rudolph, C., Blau, A., Baumann, G., Jost-Brinkmann, P. G., Rautengarten, S., Meier, J. C., Peroz, I., & Fietze, I. (2016). Comparison of effects of OSA treatment by MAD and by CPAP on cardiac autonomic function during daytime. Sleep & Breathing, 20(2), 635-646. https://doi.org/10.1007/s11325-015-1265-0
Golosheykin, S., Grant, J. D., Novak, O. V., Heath, A. C., & Anokhin, A. P. (2017). Genetic influences on heart rate variability. International Journal of Psychophysiology, 115, 65-73. https://doi.org/10.1016/j.ijpsycho.2016.04.008
González, K. A., Tarraf, W., Wallace, D. M., Stickel, A. M., Schneiderman, N., Redline, S., Patel, S. R., Gallo, L. C., Mossavar-Rahmani, Y., Daviglus, M. L., Zee, P. C., Talavera, G. A., Sotres-Alvarez, D., González, H. M., & Ramos, A. (2021). Phenotypes of obstructive sleep apnea in the Hispanic Community Health Study/Study of Latinos. Sleep, 44(12), zsab181. https://doi.org/10.1093/sleep/zsab181
Gottlieb, D. J., & Punjabi, N. M. (2020). Diagnosis and management of obstructive sleep apnea: a review. JAMA, 323(14), 1389-1400. https://doi.org/10.1001/jama.2020.3514
Gozal, D. (2008). Obstructive sleep apnea in children: Implications for the developing central nervous system. Seminars in Pediatric Neurology, 15(2), 100-106.
Guilleminault, C., Connolly, S., Winkle, R., Melvin, K., & Tilkian, A. (1984). Cyclical variation of the heart rate in sleep apnoea syndrome. Mechanisms, and usefulness of 24 h electrocardiography as a screening technique. Lancet, 1(8369), 126-131. https://doi.org/10.1016/s0140-6736(84)90062-x
Guindalini, C., Colugnati, F. A., Pellegrino, R., Santos-Silva, R., Bittencourt, L. R., & Tufik, S. (2010). Influence of genetic ancestry on the risk of obstructive sleep apnoea syndrome. The European Respiratory Journal, 36(4), 834-841. https://doi.org/10.1183/09031936.00146809
Guo, W., Lv, T., She, F., Miao, G., Liu, Y., He, R., Xue, Y., Nu, N. K., Yang, J., Li, K., & Zhang, P. (2018). The impact of continuous positive airway pressure on heart rate variability in obstructive sleep apnea patients during sleep: A meta-analysis. Heart & Lung, 47(5), 516-524. https://doi.org/10.1016/j.hrtlng.2018.05.019
Haba-Rubio, J., Janssens, J. P., Rochat, T., & Sforza, E. (2005). Rapid eye movement-related disordered breathing: Clinical and polysomnographic features. Chest, 128(5), 3350-3357. https://doi.org/10.1378/chest.128.5.3350
Hall, M. H., Middleton, K., Thayer, J. F., Lewis, T. T., Kline, C. E., Matthews, K. A., Kravitz, H. M., Krafty, R. T., & Buysse, D. J. (2013). Racial differences in heart rate variability during sleep in women: The study of women across the nation sleep study. Psychosomatic Medicine, 75(8), 783-790.
He, S., Li, Y., Xu, W., Kang, D., Li, H., Wang, C., Ding, X., & Han, D. (2021). The predictive value of photogrammetry for obstructive sleep apnea. Journal of Clinical Sleep Medicine, 17(2), 193-202. https://doi.org/10.5664/jcsm.8836
Heinzer, R., Petitpierre, N. J., Marti-Soler, H., & Haba-Rubio, J. (2018). Prevalence and characteristics of positional sleep apnea in the HypnoLaus population-based cohort. Sleep Medicine, 48, 157-162. https://doi.org/10.1016/j.sleep.2018.02.011
Hesse, C., Charkoudian, N., Liu, Z., Joyner, M. J., & Eisenach, J. H. (2007). Baroreflex sensitivity inversely correlates with ambulatory blood pressure in healthy normotensive humans. Hypertension, 50(1), 41-46. https://doi.org/10.1161/hypertensionaha.107.090308
Hidalgo Armas, L., Ingles, S., Vaca, R., Cordero-Guevara, J., Duran Carro, J., Ullate, J., Barbé, F., Durán-Cantolla, J., & Spanish Sleep Network. (2021). New forehead device in positional obstructive sleep apnoea: A randomised clinical trial. Thorax, 76(9), 930-938. https://doi.org/10.1136/thoraxjnl-2020-216167
Hill, L. K., Hu, D. D., Koenig, J., Sollers, J. J., 3rd, Kapuku, G., Wang, X., Snieder, H., & Thayer, J. F. (2015). Ethnic differences in resting heart rate variability: a systematic review and meta-analysis. Psychosomatic Medicine, 77(1), 16-25.
Hillebrand, S., Gast, K. B., de Mutsert, R., Swenne, C. A., Jukema, J. W., Middeldorp, S., Rosendaal, F. R., & Dekkers, O. M. (2013). Heart rate variability and first cardiovascular event in populations without known cardiovascular disease: Meta-analysis and dose-response meta-regression. Europace, 15(5), 742-749. https://doi.org/10.1093/europace/eus341
Huang, C. C., Lin, W. C., Chen, H. L., Friedman, M., Lin, M. C., Lin, H. C., & Lu, C. H. (2016). Improvement of baroreflex sensitivity in patients with obstructive sleep apnea following surgical treatment. Clinical Neurophysiology, 127(1), 544-550. https://doi.org/10.1016/j.clinph.2015.05.022
Ida, H., Suga, T., Nishimura, M., & Aoki, Y. (2022). Unique clinical phenotypes of patients with obstructive sleep apnea in a Japanese population: a cluster analysis. Journal of Clinical Sleep Medicine, 18(3), 895-902. https://doi.org/10.5664/jcsm.9752
Ishaque, S., Khan, N., & Krishnan, S. (2021). Trends in heart-rate variability signal analysis. Frontiers Digital Health, 3, 639444. https://doi.org/10.3389/fdgth.2021.639444
Isono, S. (2012). Obesity and obstructive sleep apnoea: Mechanisms for increased collapsibility of the passive pharyngeal airway. Respirology, 17(1), 32-42. https://doi.org/10.1111/j.1440-1843.2011.02093.x
Joosten, S. A., Landry, S. A., Wong, A. M., Mann, D. L., Terrill, P. I., Sands, S. A., Turton, A., Beatty, C., Thomson, L., Hamilton, G. S., & Edwards, B. A. (2021). Assessing the physiologic endotypes responsible for REM- and NREM-based OSA. Chest, 159(5), 1998-2007. https://doi.org/10.1016/j.chest.2020.10.080
Joosten, S. A., O'Driscoll, D. M., Berger, P. J., & Hamilton, G. S. (2014). Supine position related obstructive sleep apnea in adults: pathogenesis and treatment. Sleep Medicine Reviews, 18(1), 7-17. https://doi.org/10.1016/j.smrv.2013.01.005
Jordan, A. S., O'Donoghue, F. J., Cori, J. M., & Trinder, J. (2017). Physiology of arousal in obstructive sleep apnea and potential impacts for sedative treatment. American Journal of Respiratory and Critical Care Medicine, 196(7), 814-821. https://doi.org/10.1164/rccm.201612-2511PP
Kansanen, M., Vanninen, E., Tuunainen, A., Pesonen, P., Tuononen, V., Hartikainen, J., Mussalo, H., & Uusitupa, M. (1998). The effect of a very low-calorie diet-induced weight loss on the severity of obstructive sleep apnoea and autonomic nervous function in obese patients with obstructive sleep apnoea syndrome. Clinical Physiology, 18(4), 377-385. https://doi.org/10.1046/j.1365-2281.1998.00114.x
Kendzerska, T., Mollayeva, T., Gershon, A. S., Leung, R. S., Hawker, G., & Tomlinson, G. (2014). Untreated obstructive sleep apnea and the risk for serious long-term adverse outcomes: a systematic review. Sleep Medicine Reviews, 18(1), 49-59. https://doi.org/10.1016/j.smrv.2013.01.003
Khan, S. U., Duran, C. A., Rahman, H., Lekkala, M., Saleem, M. A., & Kaluski, E. (2018). A meta-analysis of continuous positive airway pressure therapy in prevention of cardiovascular events in patients with obstructive sleep apnoea. European Heart Journal, 39(24), 2291-2297. https://doi.org/10.1093/eurheartj/ehx597
Khoo, M. C., Belozeroff, V., Berry, R. B., & Sassoon, C. S. (2001). Cardiac autonomic control in obstructive sleep apnea: Effects of long-term CPAP therapy. American Journal of Respiratory and Critical Care Medicine, 164(5), 807-812. https://doi.org/10.1164/ajrccm.164.5.2010124
Kim, J., Keenan, B. T., Lim, D. C., Lee, S. K., Pack, A. I., & Shin, C. (2018). Symptom-based subgroups of Koreans with obstructive sleep apnea. Journal of Clinical Sleep Medicine, 14(3), 437-443.
Kim, J. W., Kwon, S. O., & Lee, W. H. (2020). Nocturnal heart rate variability may be useful for determining the efficacy of mandibular advancement devices for obstructive sleep apnea. Scientific Reports, 10(1), 1030. https://doi.org/10.1038/s41598-020-57780-7
Kinouchi, T., Terada, J., Sakao, S., Koshikawa, K., Sasaki, T., Sugiyama, A., Sato, S., Sakuma, N., Abe, M., Shikano, K., Hayama, N., Shiko, Y., Ozawa, Y., Ikeda, S., Suzuki, T., & Tatsumi, K. (2023). Effects of the combination of atomoxetine and oxybutynin in Japanese patients with obstructive sleep apnoea: A randomized controlled crossover trial. Respirology, 28(3), 273-280. https://doi.org/10.1111/resp.14383
Koenig, J., & Thayer, J. F. (2016). Sex differences in healthy human heart rate variability: A meta-analysis. Neuroscience and Biobehavioral Reviews, 64, 288-310. https://doi.org/10.1016/j.neubiorev.2016.03.007
Kufoy, E., Palma, J. A., Lopez, J., Alegre, M., Urrestarazu, E., Artieda, J., & Iriarte, J. (2012). Changes in the heart rate variability in patients with obstructive sleep apnea and its response to acute CPAP treatment. PLoS One, 7(3), e33769. https://doi.org/10.1371/journal.pone.0033769
Kuna, S. T., Reboussin, D. M., Strotmeyer, E. S., Millman, R. P., Zammit, G., Walkup, M. P., Wadden, T. A., Wing, R. R., Pi-Sunyer, F. X., Spira, A. P., Foster, G. D., Freeman, J., Patricio, J., Sifferman, A., McGuckin, B., Krauthamer-Ewing, S., Jones-Parker, M., Anastasi, M., Staley, B., … Vander Veur, S. (2021). Effects of weight loss on obstructive sleep apnea severity. Ten-year results of the sleep AHEAD study. American Journal of Respiratory and Critical Care Medicine, 203(2), 221-229.
Kuramoto, E., Kinami, S., Ishida, Y., Shiotani, H., & Nishimura, Y. (2009). Continuous positive nasal airway pressure decreases levels of serum amyloid A and improves autonomic function in obstructive sleep apnea syndrome. International Journal of Cardiology, 135(3), 338-345. https://doi.org/10.1016/j.ijcard.2008.03.078
Kwon, P. M., Lawrence, S., Mueller, B. R., Thayer, J. F., Benn, E. K. T., & Robinson-Papp, J. (2022). Interpreting resting heart rate variability in complex populations: The role of autonomic reflexes and comorbidities. Clinical Autonomic Research, 32(3), 175-184. https://doi.org/10.1007/s10286-022-00865-2
Labarca, G., Dreyse, J., Drake, L., Jorquera, J., & Barbe, F. (2020). Efficacy of continuous positive airway pressure (CPAP) in the prevention of cardiovascular events in patients with obstructive sleep apnea: Systematic review and meta-analysis. Sleep Medicine Reviews, 52, 101312. https://doi.org/10.1016/j.smrv.2020.101312
Labarca, G., Saavedra, D., Dreyse, J., Jorquera, J., & Barbe, F. (2020a). Efficacy of CPAP for improvements in sleepiness, cognition, mood, and quality of life in elderly patients with OSA: Systematic review and meta-analysis of randomized controlled trials. Chest, 158(2), 751-764. https://doi.org/10.1016/j.chest.2020.03.049
Labarca, G., Saavedra, D., Dreyse, J., Jorquera, J., & Barbe, F. (2020b). Efficacy of CPAP for improvements in sleepiness, cognition, mood, and quality of life in elderly patients with OSA: Systematic review and meta-analysis of randomized controlled trials. (1931-3543 (Electronic)).
Labarca, G., Schmidt, A., Dreyse, J., Jorquera, J., & Barbe, F. (2021). Telemedicine interventions for CPAP adherence in obstructive sleep apnea patients: Systematic review and meta-analysis. Sleep Medicine Reviews, 60, 101543. https://doi.org/10.1016/j.smrv.2021.101543
Lacedonia, D., Carpagnano, G. E., Sabato, R., Storto, M. M., Palmiotti, G. A., Capozzi, V., Barbaro, M. P. F., & Gallo, C. (2016). Characterization of obstructive sleep apnea-hypopnea syndrome (OSA) population by means of cluster analysis. Journal of Sleep Research, 25(6), 724-730. https://doi.org/10.1111/jsr.12429
Lee, R. W., Sutherland, K., Chan, A. S., Zeng, B., Grunstein, R. R., Darendeliler, M. A., Schwab, R. J., & Cistulli, P. A. (2010). Relationship between surface facial dimensions and upper airway structures in obstructive sleep apnea. Sleep, 33(9), 1249-1254. https://doi.org/10.1093/sleep/33.9.1249
Lee, W. H., Kwon, S. O., & Kim, J. W. (2020). Effectiveness of sleep surgery versus a mandibular advancement device for obstructive sleep apnea in terms of nocturnal cardiac autonomic activity. Sleep & Breathing, 24(4), 1695-1703. https://doi.org/10.1007/s11325-020-02048-7
Liao, D., Barnes, R. W., Chambless, L. E., Simpson, R. J., Jr., Sorlie, P., & Heiss, G. (1995). Age, race, and sex differences in autonomic cardiac function measured by spectral analysis of heart rate variability-the ARIC study. The American Journal of Cardiology, 76(12), 906-912. https://doi.org/10.1016/s0002-9149(99)80260-4
Limphanudom, P., Chierakul, N., Pinyopattarakul, N., Nana, A., Naruman, C., Tangchityongsiva, S., Wattanapa, W. B., & Jenwitheesak, A. (2007). Recovery of heart rate variability in patients with moderate to severe obstructive sleep apnea after 6-month continuous positive airway pressure treatment. Journal of the Medical Association of Thailand, 90(8), 1530-1535.
Liu, X., Immanuel, S., Kennedy, D., Martin, J., Pamula, Y., & Baumert, M. (2018). Effect of adenotonsillectomy for childhood obstructive sleep apnea on nocturnal heart rate patterns. Sleep, 41(11), zsy171. https://doi.org/10.1093/sleep/zsy171
Mador, M. J., Kufel, T. J., Magalang, U. J., Rajesh, S. K., Watwe, V., & Grant, B. J. (2005). Prevalence of positional sleep apnea in patients undergoing polysomnography. Chest, 128(4), 2130-2137. https://doi.org/10.1378/chest.128.4.2130
Malhotra, A., Ayappa, I., Ayas, N., Collop, N., Kirsch, D., Mcardle, N., Mehra, R., Pack, A. I., Punjabi, N., White, D. P., & Gottlieb, D. J. (2021). Metrics of sleep apnea severity: Beyond the apnea-hypopnea index. Sleep, 44(7), zsab030. https://doi.org/10.1093/sleep/zsab030
Martinez-Garcia, M. A., Campos-Rodriguez, F., Barbé, F., Gozal, D., & Agustí, A. (2019). Precision medicine in obstructive sleep apnoea. The Lancet Respiratory Medicine, 7(5), 456-464. https://doi.org/10.1016/s2213-2600(19)30044-x
Martín-Montero, A., Armañac-Julián, P., Gil, E., Kheirandish-Gozal, L., Álvarez, D., Lázaro, J., Bailón, R., Gozal, D., Laguna, P., Hornero, R., & Gutiérrez-Tobal, G. C. (2023). Pediatric sleep apnea: Characterization of apneic events and sleep stages using heart rate variability. Computers in Biology and Medicine, 154, 106549. https://doi.org/10.1016/j.compbiomed.2023.106549
Martín-Montero, A., Gutiérrez-Tobal, G. C., Kheirandish-Gozal, L., Vaquerizo-Villar, F., Álvarez, D., del Campo, F., Gozal, D., & Hornero, R. (2022). Heart rate variability as a potential biomarker of pediatric obstructive sleep apnea resolution. Sleep, 45(2), zsab214. https://doi.org/10.1093/sleep/zsab214
Maser, R. E., & Lenhard, M. J. (2007). An overview of the effect of weight loss on cardiovascular autonomic function. Current Diabetes Reviews, 3(3), 204-211. https://doi.org/10.2174/157339907781368931
Mazzotti, D. R., Keenan, B. T., Lim, D. C., Gottlieb, D. J., Kim, J., & Pack, A. I. (2019). Symptom subtypes of obstructive sleep apnea predict incidence of cardiovascular outcomes. American Journal of Respiratory and Critical Care Medicine, 200(4), 493-506. https://doi.org/10.1164/rccm.201808-1509OC
McEvoy, R. D., Antic, N. A., Heeley, E., Luo, Y., Ou, Q., Zhang, X., Mediano, O., Chen, R., Drager, L. F., Liu, Z., Chen, G., du, B., McArdle, N., Mukherjee, S., Tripathi, M., Billot, L., Li, Q., Lorenzi-Filho, G., Barbe, F., … Anderson, C. S. (2016). CPAP for prevention of cardiovascular events in obstructive sleep apnea. The New England Journal of Medicine, 375(10), 919-931. https://doi.org/10.1056/NEJMoa1606599
McGee, J. E., Early, K., Huff, A. C., Clunan, M. C., Hursey, N. R., Osborne, B., Bucher, C., Tanner, C., Brewer, S. B., Brophy, P. M., Clark, A., Pories, W. J., Matarese, L. E., Houmard, J. A., Collier, D., May, L. E., McClung, J. M., Earnest, C. P., & Swift, D. L. (2023). Effects of weight loss and weight loss maintenance on cardiac autonomic function in obesity: A randomized controlled trial. Applied Physiology, Nutrition, and Metabolism, 48(9), 678-691. https://doi.org/10.1139/apnm-2023-0025
Mosca, L., Barrett-Connor, E., & Wenger, N. K. (2011). Sex/gender differences in cardiovascular disease prevention: what a difference a decade makes. Circulation, 124(19), 2145-2154.
Mostafavi, A., Aliabadi, L., Sadeghniyat, K., & Tabatabaei, S. A. H. (2017). Comparison of the efficacy of continuous positive airway pressure and oxygen therapy in increasing heart rate variability in patients with obstructive sleep apnea. Iranian Heart Journal, 18(4), 34-41.
Mukherjee, S., Saxena, R., & Palmer, L. J. (2018). The genetics of obstructive sleep apnoea. Respirology, 23(1), 18-27. https://doi.org/10.1111/resp.13212
Muzumdar, H. V., Sin, S., Nikova, M., Gates, G., Kim, D., & Arens, R. (2011). Changes in heart rate variability after adenotonsillectomy in children with obstructive sleep apnea. Chest, 139(5), 1050-1059. https://doi.org/10.1378/chest.10-1555
Nastałek, P., Bochenek, G., Kania, A., Celejewska-Wójcik, N., Mejza, F., & Sładek, K. (2019). Heart rate variability in the diagnostics and CPAP treatment of obstructive sleep apnea. Advances in Experimental Medicine and Biology, 1176, 25-33. https://doi.org/10.1007/5584_2019_385
Neelapu, B. C., Kharbanda, O. P., Sardana, H. K., Balachandran, R., Sardana, V., Kapoor, P., Gupta, A., & Vasamsetti, S. (2017). Craniofacial and upper airway morphology in adult obstructive sleep apnea patients: A systematic review and meta-analysis of cephalometric studies. Sleep Medicine Reviews, 31, 79-90. https://doi.org/10.1016/j.smrv.2016.01.007
Noda, A., Hayano, J., Ito, N., Miyata, S., Yasuma, F., & Yasuda, Y. (2019). Very low frequency component of heart rate variability as a marker for therapeutic efficacy in patients with obstructive sleep apnea: Preliminary study. Journal of Research in Medical Sciences, 24, 84. https://doi.org/10.4103/jrms.JRMS_62_18
Nolte, I. M., Munoz, M. L., Tragante, V., Amare, A. T., Jansen, R., Vaez, A., von der Heyde, B., Avery, C. L., Bis, J. C., Dierckx, B., van Dongen, J., Gogarten, S. M., Goyette, P., Hernesniemi, J., Huikari, V., Hwang, S. J., Jaju, D., Kerr, K. F., Kluttig, A., … de Geus, E. J. C. (2017). Genetic loci associated with heart rate variability and their effects on cardiac disease risk. Nature Communications, 8(1), 15805. https://doi.org/10.1038/ncomms15805
Oh, S. M., Choi, S. H., Kim, H. J., Park, K. S., & Lee, Y. J. (2019). The association between obstructive sleep apnea during REM sleep and autonomic dysfunction as measured by heart rate variability. Sleep & Breathing, 23(3), 865-871. https://doi.org/10.1007/s11325-018-01779-y
Oksenberg, A., Gadoth, N., Töyräs, J., & Leppänen, T. (2020). Prevalence and characteristics of positional obstructive sleep apnea (POSA) in patients with severe OSA. Sleep & Breathing, 24(2), 551-559. https://doi.org/10.1007/s11325-019-01897-1
Op de Beeck, S., Wellman, A., Dieltjens, M., Strohl, K. P., Willemen, M., van de Heyning, P. H., Verbraecken, J. A., Vanderveken, O. M., Sands, S. A., & the STAR Trial Investigators. (2021). Endotypic mechanisms of successful hypoglossal nerve stimulation for obstructive sleep apnea. American Journal of Respiratory and Critical Care Medicine, 203(6), 746-755. https://doi.org/10.1164/rccm.202006-2176OC
Palma, J. A., Iriarte, J., Fernandez, S., Alegre, M., Valencia, M., Artieda, J., & Urrestarazu, E. (2015). Long-term continuous positive airway pressure therapy improves cardiac autonomic tone during sleep in patients with obstructive sleep apnea. Clinical Autonomic Research, 25(4), 225-232. https://doi.org/10.1007/s10286-015-0297-7
Palmer, L. J., & Redline, S. (2003). Genomic approaches to understanding obstructive sleep apnea. Respiratory Physiology & Neurobiology, 135(2-3), 187-205. https://doi.org/10.1016/s1569-9048(03)00044-2
Pan, W. Y., Su, M. C., Wu, H. T., Su, T. J., Lin, M. C., & Sun, C. K. (2016). Multiscale entropic assessment of autonomic dysfunction in patients with obstructive sleep apnea and therapeutic impact of continuous positive airway pressure treatment. Sleep Medicine, 20, 12-17. https://doi.org/10.1016/j.sleep.2015.11.021
Patel, S. R., Bakker, J. P., Stitt, C. J., Aloia, M. S., & Nouraie, S. M. (2021). Age and sex disparities in adherence to CPAP. Chest, 159(1), 382-389. https://doi.org/10.1016/j.chest.2020.07.017
Patruno, V., Tobaldini, E., Bianchi, A. M., Mendez, M. O., Coletti, O., Costantino, G., & Montano, N. (2014). Acute effects of autoadjusting and fixed continuous positive airway pressure treatments on cardiorespiratory coupling in obese patients with obstructive sleep apnea. European Journal of Internal Medicine, 25(2), 164-168. https://doi.org/10.1016/j.ejim.2013.11.009
Pien, G. W., Ye, L., Keenan, B. T., Maislin, G., Björnsdóttir, E., Arnardottir, E. S., Benediktsdottir, B., Gislason, T., & Pack, A. I. (2018). Changing faces of obstructive sleep apnea: Treatment effects by cluster designation in the icelandic sleep apnea cohort. Sleep, 41(3), zsx201. https://doi.org/10.1093/sleep/zsx201
Pinto, J. A., Ribeiro, D. K., Cavallini, A. F., Duarte, C., & Freitas, G. S. (2016). Comorbidities associated with obstructive sleep apnea: A retrospective study. International Archives of Otorhinolaryngology, 20(2), 145-150.
Poirier, P., Hernandez, T. L., Weil, K. M., Shepard, T. J., & Eckel, R. H. (2003). Impact of diet-induced weight loss on the cardiac autonomic nervous system in severe obesity. Obesity Research, 11(9), 1040-1047. https://doi.org/10.1038/oby.2003.143
Prabhakar, N. R., Peng, Y. J., & Nanduri, J. (2020). Hypoxia-inducible factors and obstructive sleep apnea. The Journal of Clinical Investigation, 130(10), 5042-5051.
Randerath, W., Verbraecken, J., de Raaff, C. A. L., Hedner, J., Herkenrath, S., Hohenhorst, W., Jakob, T., Marrone, O., Marklund, M., McNicholas, W. T., Morgan, R. L., Pepin, J. L., Schiza, S., Skoetz, N., Smyth, D., Steier, J., Tonia, T., Trzepizur, W., van Mechelen, P. H., & Wijkstra, P. (2021). European respiratory society guideline on non-CPAP therapies for obstructive sleep apnoea. European Respiratory Review, 30(162), 210200. https://doi.org/10.1183/16000617.0200-2021
Rizzatti, F. G., Mazzotti, D. R., Mindel, J., Maislin, G., Keenan, B. T., Bittencourt, L., Chen, N. H., Cistulli, P. A., McArdle, N., Pack, F. M., Singh, B., Sutherland, K., Benediktsdottir, B., Fietze, I., Gislason, T., Lim, D. C., Penzel, T., Sanner, B., Han, F., … Magalang, U. J. (2020). Defining extreme phenotypes of OSA across international sleep centers. Chest, 158(3), 1187-1197. https://doi.org/10.1016/j.chest.2020.03.055
Romero-Corral, A., Caples, S. M., Lopez-Jimenez, F., & Somers, V. K. (2010). Interactions between obesity and obstructive sleep apnea: implications for treatment. Chest, 137(3), 711-719.
Sands, S. A., Edwards, B. A., Terrill, P. I., Butler, J. P., Owens, R. L., Taranto-Montemurro, L., Azarbarzin, A., Marques, M., Hess, L. B., Smales, E. T., de Melo, C. M., White, D. P., Malhotra, A., & Wellman, A. (2018). Identifying obstructive sleep apnoea patients responsive to supplemental oxygen therapy. The European Respiratory Journal, 52(3), 1800674. https://doi.org/10.1183/13993003.00674-2018
Sands, S. A., Edwards, B. A., Terrill, P. I., Taranto-Montemurro, L., Azarbarzin, A., Marques, M., Hess, L. B., White, D. P., & Wellman, A. (2018). Phenotyping pharyngeal pathophysiology using polysomnography in patients with obstructive sleep apnea. American Journal of Respiratory and Critical Care Medicine, 197(9), 1187-1197. https://doi.org/10.1164/rccm.201707-1435OC
Sands, S. A., Terrill, P. I., Edwards, B. A., Taranto Montemurro, L., Azarbarzin, A., Marques, M., de Melo, C. M., Loring, S. H., Butler, J. P., White, D. P., & Wellman, A. (2018). Quantifying the arousal threshold using polysomnography in obstructive sleep apnea. Sleep, 41(1), zsx183. https://doi.org/10.1093/sleep/zsx183
Sassi, R., Cerutti, S., Lombardi, F., Malik, M., Huikuri, H. V., Peng, C. K., Schmidt, G., Yamamoto, Y., Document Reviewers, Gorenek, B., Lip, G. Y. H., Grassi, G., Kudaiberdieva, G., Fisher, J. P., Zabel, M., & Macfadyen, R. (2015). Advances in heart rate variability signal analysis: joint position statement by the e-Cardiology ESC Working Group and the European Heart Rhythm Association co-endorsed by the Asia Pacific Heart Rhythm Society. Europace, 17(9), 1341-1353. https://doi.org/10.1093/europace/euv015
Sawyer, A. M., Gooneratne, N. S., Marcus, C. L., Ofer, D., Richards, K. C., & Weaver, T. E. (2011). A systematic review of CPAP adherence across age groups: clinical and empiric insights for developing CPAP adherence interventions. Sleep Medicine Reviews, 15(6), 343-356. https://doi.org/10.1016/j.smrv.2011.01.003
Schmickl, C. N., Landry, S. A., Orr, J. E., Chin, K., Murase, K., Verbraecken, J., Javaheri, S., Edwards, B. A., Owens, R. L., & Malhotra, A. (2020). Acetazolamide for OSA and central sleep apnea: A comprehensive systematic review and meta-analysis. Chest, 158(6), 2632-2645. https://doi.org/10.1016/j.chest.2020.06.078
Schwartz, M., Acosta, L., Hung, Y. L., Padilla, M., & Enciso, R. (2018). Effects of CPAP and mandibular advancement device treatment in obstructive sleep apnea patients: a systematic review and meta-analysis. Sleep & Breathing, 22(3), 555-568. https://doi.org/10.1007/s11325-017-1590-6
Sforza, E., Pichot, V., Martin, M. S., Barthélémy, J. C., & Roche, F. (2015). Prevalence and determinants of subjective sleepiness in healthy elderly with unrecognized obstructive sleep apnea. Sleep Medicine, 16(8), 981-986. https://doi.org/10.1016/j.sleep.2015.03.010
Shaffer, F., & Ginsberg, J. P. (2017). An overview of heart rate variability metrics and norms. Frontiers in Public Health, 5, 258. https://doi.org/10.3389/fpubh.2017.00258
Shi, Y., Lou, H., Wang, H., Zhou, Y., Wang, L., Li, Y., & Han, D. (2023). Analysis of nasal resistance regulation mechanism during postural changes in patients with obstructive sleep apnea by measuring heart rate variability. Journal of Clinical Sleep Medicine, 19(4), 643-650. https://doi.org/10.5664/jcsm.10402
Shiina, K., Tomiyama, H., Takata, Y., Yoshida, M., Kato, K., Saruhara, H., Hashimura, Y., Matsumoto, C., Asano, K., Usui, Y., & Yamashina, A. (2010). Effects of CPAP therapy on the sympathovagal balance and arterial stiffness in obstructive sleep apnea. Respiratory Medicine, 104(6), 911-916. https://doi.org/10.1016/j.rmed.2010.01.010
Shiomi, T., Guilleminault, C., Sasanabe, R., Hirota, I., Maekawa, M., & Kobayashi, T. (1996). Augmented very low frequency component of heart rate variability during obstructive sleep apnea. Sleep, 19(5), 370-377. https://doi.org/10.1093/sleep/19.5.370
Spiesshoefer, J., Aries, J., Giannoni, A., Emdin, M., Fox, H., Boentert, M., Bitter, T., & Oldenburg, O. (2020). APAP therapy does not improve impaired sleep quality and sympatho-vagal balance: A randomized trial in patients with obstructive sleep apnea and systolic heart failure. Sleep & Breathing, 24(1), 211-219. https://doi.org/10.1007/s11325-019-01868-6
Süslü, A. E., Pamuk, G., Pamuk, A. E., Özer, S., Jafarov, S., & Önerci, T. M. (2017). Effects of expansion sphincter pharyngoplasty on the apnea-hypopnea index and heart rate variability. Journal of Oral and Maxillofacial Surgery, 75(12), 2650-2657. https://doi.org/10.1016/j.joms.2017.06.005
Sutherland, K., Keenan, B. T., Bittencourt, L., Chen, N.-H., Gislason, T., Leinwand, S., Magalang, U. J., Maislin, G., Mazzotti, D. R., McArdle, N., Mindel, J., Pack, A. I., Penzel, T., Singh, B., Tufik, S., Schwab, R. J., Cistulli, P. A., & SAGIC Investigators. (2019). A global comparison of anatomic risk factors and their relationship to obstructive sleep apnea severity in clinical samples. Journal of Clinical Sleep Medicine, 15(4), 629-639. https://doi.org/10.5664/jcsm.7730
Sutherland, K., Kim, S., Veatch, O. J., Keenan, B. T., Bittencourt, L., Chen, N. H., Gislason, T., Han, F., Jafari, N., Li, Q. Y., Lim, D. C., Maislin, G., Magalang, U., Mazzotti, D. R., McArdle, N., Mindel, J., Pack, A. I., Penzel, T., Singh, B., … Cistulli, P. A. (2023). Facial and intraoral photographic traits related to sleep apnea in a clinical sample with genetic ancestry analysis. Annals of the American Thoracic Society, 20, 880-890. https://doi.org/10.1513/AnnalsATS.202207-577OC
Sutherland, K., Lee, R. W., & Cistulli, P. A. (2012). Obesity and craniofacial structure as risk factors for obstructive sleep apnoea: Impact of ethnicity. Respirology, 17(2), 213-222. https://doi.org/10.1111/j.1440-1843.2011.02082.x
Sutherland, K., Lee, R. W. W., Chan, T. O., Ng, S., Hui, D. S., & Cistulli, P. A. (2018). Craniofacial phenotyping in Chinese and caucasian patients with sleep apnea: Influence of ethnicity and sex. Journal of Clinical Sleep Medicine, 14(7), 1143-1151.
Sutherland, K., Schwab, R. J., Maislin, G., Lee, R. W., Benedikstdsottir, B., Pack, A. I., Gislason, T., Juliusson, S., & Cistulli, P. A. (2014). Facial phenotyping by quantitative photography reflects craniofacial morphology measured on magnetic resonance imaging in icelandic sleep apnea patients. Sleep, 37(5), 959-968. https://doi.org/10.5665/sleep.3670
Sutherland, K., Smith, G., Lowth, A. B., Sarkissian, N., Liebman, S., Grieve, S. M., & Cistulli, P. A. (2023). The effect of surgical weight loss on upper airway fat in obstructive sleep apnoea. Sleep & Breathing, 27(4), 1333-1341. https://doi.org/10.1007/s11325-022-02734-8
Taranto-Montemurro, L., Messineo, L., Azarbarzin, A., Vena, D., Hess, L. B., Calianese, N. A., White, D. P., Wellman, A., & Sands, S. A. (2020). Effects of the combination of atomoxetine and oxybutynin on OSA endotypic traits. Chest, 157(6), 1626-1636. https://doi.org/10.1016/j.chest.2020.01.012
Taranto-Montemurro, L., Messineo, L., Sands, S. A., Azarbarzin, A., Marques, M., Edwards, B. A., Eckert, D. J., White, D. P., & Wellman, A. (2019). The combination of atomoxetine and oxybutynin greatly reduces obstructive sleep apnea severity. A randomized, placebo-controlled, double-blind crossover trial. American Journal of Respiratory and Critical Care Medicine, 199(10), 1267-1276. https://doi.org/10.1164/rccm.201808-1493OC
Task Force of The European Society of Cardiology and The North American Society of Pacing and Electrophysiology. (1996). Heart rate variability: Standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Circulation, 93(5), 1043-1065.
Tegegne, B. S., Man, T., van Roon, A. M., Asefa, N. G., Riese, H., Nolte, I., & Snieder, H. (2020). Heritability and the genetic correlation of heart rate variability and blood pressure in >29 000 families: The lifelines cohort study. Hypertension, 76(4), 1256-1262. https://doi.org/10.1161/hypertensionaha.120.15227
Teo, D. T., & Mitchell, R. B. (2013). Systematic review of effects of adenotonsillectomy on cardiovascular parameters in children with obstructive sleep apnea. Otolaryngology and Head and Neck Surgery, 148(1), 21-28. https://doi.org/10.1177/0194599812463193
Terrill, P. I., Edwards, B. A., Nemati, S., Butler, J. P., Owens, R. L., Eckert, D. J., White, D. P., Malhotra, A., Wellman, A., & Sands, S. A. (2015). Quantifying the ventilatory control contribution to sleep apnoea using polysomnography. The European Respiratory Journal, 45(2), 408-418. https://doi.org/10.1183/09031936.00062914
Testelmans, D., Spruit, M. A., Vrijsen, B., Sastry, M., Belge, C., Kalkanis, A., Gaffron, S., Wouters, E. F. M., & Buyse, B. (2022). Comorbidity clusters in patients with moderate-to-severe OSA. Sleep & Breathing, 26(1), 195-204. https://doi.org/10.1007/s11325-021-02390-4
Treptow, E., Pepin, J. L., Bailly, S., Levy, P., Bosc, C., Destors, M., Woehrle, H., & Tamisier, R. (2019). Reduction in sympathetic tone in patients with obstructive sleep apnoea: is fixed CPAP more effective than APAP? A randomised, parallel trial protocol. BMJ Open, 9(4), e024253. https://doi.org/10.1136/bmjopen-2018-024253
Trimer, R., Cabidu, R., Sampaio, L. L., Stirbulov, R., Poiares, D., Guizilini, S., Bianchi, A. M., Costa, F. S. M., Mendes, R. G., Delfino, A., Jr., Arena, R., & Borghi-Silva, A. (2014). Heart rate variability and cardiorespiratory coupling in obstructive sleep apnea: Elderly compared with young. Sleep Medicine, 15(11), 1324-1331. https://doi.org/10.1016/j.sleep.2014.05.028
Trzepizur, W., Blanchard, M., Ganem, T., Balusson, F., Feuilloy, M., Girault, J. M., Meslier, N., Oger, E., Paris, A., Pigeanne, T., Racineux, J. L., Sabil, A. K., Gervès-Pinquié, C., & Gagnadoux, F. (2022). Sleep apnea-specific hypoxic burden, symptom subtypes, and risk of cardiovascular events and all-cause mortality. American Journal of Respiratory and Critical Care Medicine, 205(1), 108-117. https://doi.org/10.1164/rccm.202105-1274OC
Ucak, S., Dissanayake, H. U., Sutherland, K., de Chazal, P., & Cistulli, P. A. (2021). Heart rate variability and obstructive sleep apnea: Current perspectives and novel technologies. Journal of Sleep Research, 30, e13274. https://doi.org/10.1111/jsr.13274
Vaschillo, E. G., Vaschillo, B., Buckman, J. F., Pandina, R. J., & Bates, M. E. (2012). Measurement of vascular tone and stroke volume baroreflex gain. Psychophysiology, 49(2), 193-197. https://doi.org/10.1111/j.1469-8986.2011.01305.x
Vavougios, G. D., George, D. G., Pastaka, C., Zarogiannis, S. G., & Gourgoulianis, K. I. (2016). Phenotypes of comorbidity in OSAS patients: Combining categorical principal component analysis with cluster analysis. Journal of Sleep Research, 25(1), 31-38. https://doi.org/10.1111/jsr.12344
Veatch, O. J., Bauer, C. R., Keenan, B. T., Josyula, N. S., Mazzotti, D. R., Bagai, K., Malow, B. A., Robishaw, J. D., Pack, A. I., & Pendergrass, S. A. (2020). Characterization of genetic and phenotypic heterogeneity of obstructive sleep apnea using electronic health records. BMC Medical Genomics, 13(1), 105. https://doi.org/10.1186/s12920-020-00755-4
Vena, D., Taranto-Montemurro, L., Azarbarzin, A., op de Beeck, S., Marques, M., Vanderveken, O. M., Edwards, B. A., Gell, L., Calianese, N., Hess, L. B., Radmand, R., Hamilton, G. S., Joosten, S. A., Verbraecken, J., Braem, M., White, D. P., Redline, S., Sands, S. A., & Wellman, A. (2022). Clinical polysomnographic methods for estimating pharyngeal collapsibility in obstructive sleep apnea. Sleep, 45(6), zsac050. https://doi.org/10.1093/sleep/zsac050
Weaver, T. E., & Grunstein, R. R. (2008). Adherence to continuous positive airway pressure therapy: The challenge to effective treatment. Proceedings of the American Thoracic Society, 5(2), 173-178. https://doi.org/10.1513/pats.200708-119MG
Wellman, A., Eckert, D. J., Jordan, A. S., Edwards, B. A., Passaglia, C. L., Jackson, A. C., Gautam, S., Owens, R. L., Malhotra, A., & White, D. P. (2011). A method for measuring and modeling the physiological traits causing obstructive sleep apnea. Journal of Applied Physiology, 110(6), 1627-1637.
Xu, H., Liu, F., Li, Z., Li, X., Liu, Y., Li, N., Zhang, X., Gao, Z., Zhang, X., Liu, Y., Zou, J., Meng, L., Liu, S., Zhu, H., Tang, X., Wu, H., Su, K., Chen, B., Yu, D., … Shi, Y. (2022). Genome-wide association study of obstructive sleep apnea and objective sleep-related traits identifies novel risk loci in Han Chinese individuals. American Journal of Respiratory and Critical Care Medicine, 206, 1534-1545. https://doi.org/10.1164/rccm.202109-2044OC
Xu, L., Keenan, B. T., Wiemken, A. S., Chi, L., Staley, B., Wang, Z., Wang, J., Benedikstdottir, B., Juliusson, S., Pack, A. I., Gislason, T., & Schwab, R. J. (2020). Differences in three-dimensional upper airway anatomy between Asian and European patients with obstructive sleep apnea. Sleep, 43(5), zsz273. https://doi.org/10.1093/sleep/zsz273
Xu, P. H., Fong, D. Y. T., Lui, M. M. S., Lam, D. C. L., & Ip, M. S. M. (2023). Cardiovascular outcomes in obstructive sleep apnoea and implications of clinical phenotyping on effect of CPAP treatment. Thorax, 78(1), 76-84.
Yamaguchi, K., Ohki, N., Kobayashi, M., Satoya, N., Inoue, Y., Onizawa, S., Maeda, Y., Sekiguchi, H., Suzuki, M., Tsuji, T., Aoshiba, K., & Nagai, A. (2014). Estimation of parasympathetic nerve function during sleep in patients with obstructive sleep apnea by instantaneous time-frequency analysis. Sleep Medicine, 15(1), 33-41. https://doi.org/10.1016/j.sleep.2013.10.005
Yang, H., Liu, Y., Zheng, H., Liu, G., & Mei, A. (2018). Effects of 12 weeks of regular aerobic exercises on autonomic nervous system in obstructive sleep apnea syndrome patients. Sleep & Breathing, 22(4), 1189-1195. https://doi.org/10.1007/s11325-018-1736-1
Ye, L., Pien, G. W., Ratcliffe, S. J., Björnsdottir, E., Arnardottir, E. S., Pack, A. I., Benediktsdottir, B., & Gislason, T. (2014). The different clinical faces of obstructive sleep apnoea: A cluster analysis. The European Respiratory Journal, 44(6), 1600-1607. https://doi.org/10.1183/09031936.00032314
Yeghiazarians, Y., Jneid, H., Tietjens, J. R., Redline, S., Brown, D. L., el-Sherif, N., Mehra, R., Bozkurt, B., Ndumele, C. E., & Somers, V. K. (2021). Obstructive sleep apnea and cardiovascular disease: A scientific statement from the american heart association. Circulation, 144(3), e56-e67. https://doi.org/10.1161/cir.0000000000000988
Young, T., Evans, L., Finn, L., & Palta, M. (1997). Estimation of the clinically diagnosed proportion of sleep apnea syndrome in middle-aged men and women. Sleep, 20(9), 705-706. https://doi.org/10.1093/sleep/20.9.705
Zeineddine, S., Rowley, J. A., & Chowdhuri, S. (2021). Oxygen therapy in sleep-disordered breathing. Chest, 160(2), 701-717. https://doi.org/10.1016/j.chest.2021.02.017
Zhang, L., Wu, H., Zhang, X., Wei, X., Hou, F., & Ma, Y. (2020). Sleep heart rate variability assists the automatic prediction of long-term cardiovascular outcomes. Sleep Medicine, 67, 217-224. https://doi.org/10.1016/j.sleep.2019.11.1259
Zhu, Y., Liu, Y., Xu, H., Zhao, X., Li, X., Huang, W., Zhang, X., Zhu, H., Qian, D., Yi, H., Guan, J., & Yin, S. (2023). Anthropometric determinants of autonomic control in obstructive sleep apnea: A large-scale study. Otolaryngology and Head and Neck Surgery. https://doi.org/10.1002/ohn.347
Zinchuk, A., & Yaggi, H. K. (2020). Phenotypic subtypes of OSA: A challenge and opportunity for precision medicine. Chest, 157(2), 403-420. https://doi.org/10.1016/j.chest.2019.09.002
Zinchuk, A. V., Gentry, M. J., Concato, J., & Yaggi, H. K. (2017). Phenotypes in obstructive sleep apnea: A definition, examples and evolution of approaches. Sleep Medicine Reviews, 35, 113-123. https://doi.org/10.1016/j.smrv.2016.10.002
Zinchuk, A. V., Jeon, S., Koo, B. B., Yan, X., Bravata, D. M., Qin, L., Selim, B. J., Strohl, K. P., Redeker, N. S., Concato, J., & Yaggi, H. K. (2018). Polysomnographic phenotypes and their cardiovascular implications in obstructive sleep apnoea. Thorax, 73(5), 472-480.