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Biomedical Engineering / Biomedizinische Technik

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Volume 56, Issue 4 (Aug 2011)


Volume 57 (2012)

Cardiovascular regulation in different sleep stages in the obstructive sleep apnea syndrome

Andrej Gapelyuk / Maik Riedl / Alexander Suhrbier
  • KIT Karlsruhe Institute of Technology, Institute for Applied Computer Science, Eggenstein-Leopoldshafen, Germany
  • Institute for Biomedical Engineering, University of Dresden, Dresden, Germany
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Jan F. Kraemer / Georg Bretthauer
  • KIT Karlsruhe Institute of Technology, Institute for Applied Computer Science, Eggenstein-Leopoldshafen, Germany
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Hagen Malberg / Jürgen Kurths
  • Department of Physics, Humboldt-Universität zu Berlin, Berlin, Germany
  • Potsdam Institute for Climate Impact Research, Potsdam, Germany
  • Institute for Complex Systems and Mathematical Biology, University of Aberdeen, Aberdeen, UK
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Thomas Penzel / Niels Wessel
Published Online: 2011-08-09 | DOI: https://doi.org/10.1515/bmt.2011.018


Heart rate and blood pressure variability analysis as well as baroreflex sensitivity have been proven to be powerful tools for the assessment of autonomic control in clinical practice. Their ability to detect systematic changes caused by different states, diseases and treatments shall be shown for sleep disorders. Therefore, we consider 18 normotensive and 10 hypertensive patients suffering from obstructive sleep apnea syndrome (OSAS) before and after a three-month continuous positive airway pressure (CPAP) therapy. Additionally, an age and sex matched control group of 10 healthy subjects is examined. Linear and nonlinear parameters of heart rate and blood pressure fluctuation as well as the baroreflex sensitivity are used to answer the question whether there are differences in cardiovascular regulation between the different sleep stages and groups. Moreover, the therapeutic effect of CPAP therapy in OSAS patients shall be investigated. Kruskal-Wallis tests between the sleep stages for each group show significant differences in the very low spectral component of heart rate (VLF/P: 0.0033–0.04 Hz, p<0.01) which indicates differences in metabolic activity during the night. Furthermore, the decrease of Shannon entropy of word distribution as a parameter of systolic blood pressure during non-REM sleep reflects the local dominance of the vagal system (p<0.05). The increased sympathetic activation of the patients leads to clear differences of cardiovascular regulation in different sleep stages between controls and patients. We found a significant reduction of baroreflex sensitivity in slow wave sleep in the OSAS patients (Mann-Whitney test, p<0.05) compared to controls, which disappeared after three months of CPAP therapy. Hence, our results demonstrate the ability of cardiovascular analyzes to separate between healthy and pathological regulation as well as between different severities of OSAS in this retrospective study.

Keywords: baroreflex sensitivity; blood pressure variability; heart rate variability; obstructive sleep apnea syndrome

About the article

Corresponding author: Niels Wessel, Humboldt-Universität zu Berlin, Department of Physics, Robert-Koch-Platz 4, D-10115 Berlin, Germany Phone: +49-30-2093-99181

Received: 2011-02-08

Accepted: 2011-07-18

Published Online: 2011-08-09

Published in Print: 2011-08-01

Citation Information: Biomedizinische Technik/Biomedical Engineering, ISSN (Online) 1862-278X, ISSN (Print) 0013-5585, DOI: https://doi.org/10.1515/bmt.2011.018.

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