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Increased nocturnal arterial pulsation frequencies of obstructive sleep apnoea patients is associated with an increased number of lapses in a psychomotor vigilance task

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Date
2020
Author(s)
Kainulainen, Samu
Duce, Brett
Korkalainen, Henri
Leino, Akseli
Huttunen, Riku
Kalevo, Laura
Arnardottir, Erna S
Kulkas, Antti
Myllymaa, Sami
Töyräs, Juha
Leppänen, Timo
Unique identifier
10.1183/23120541.00277-2020
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Self-archived article

Citation
Kainulainen, Samu. Duce, Brett. Korkalainen, Henri. Leino, Akseli. Huttunen, Riku. Kalevo, Laura. Arnardottir, Erna S. Kulkas, Antti. Myllymaa, Sami. Töyräs, Juha. Leppänen, Timo. (2020). Increased nocturnal arterial pulsation frequencies of obstructive sleep apnoea patients is associated with an increased number of lapses in a psychomotor vigilance task.  ERJ open research, 6 (4) , 00277-202. 10.1183/23120541.00277-2020.
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© ERS 2020
Licensed under
CC BY-NC http://creativecommons.org/licenses/by-nc/4.0/
Abstract

Objectives
Besides hypoxaemia severity, heart rate variability has been linked to cognitive decline in obstructive sleep apnoea (OSA) patients. Thus, our aim was to examine whether the frequency domain features of a nocturnal photoplethysmogram (PPG) can be linked to poor performance in the psychomotor vigilance task (PVT).

Methods
PPG signals from 567 suspected OSA patients, extracted from Type 1 diagnostic polysomnography, and corresponding results of PVT were retrospectively examined. The frequency content of complete PPGs was determined, and analyses were conducted separately for men (n=327) and women (n=240). Patients were grouped into PVT performance quartiles based on the number of lapses (reaction times ≥500 ms) and within-test variation in reaction times. The best-performing (Q1) and worst-performing (Q4) quartiles were compared due the lack of clinical thresholds in PVT.

Results
We found that the increase in arterial pulsation frequency (APF) in both men and women was associated with a higher number of lapses. Higher APF was also associated with higher within-test variation in men, but not in women. Median APF (β=0.27, p=0.01), time spent under 90% saturation (β=0.05, p<0.01), female sex (β=1.29, p<0.01), older age (β=0.03, p<0.01) and subjective sleepiness (β=0.07, p<0.01) were significant predictors of belonging to Q4 based on lapses. Only female sex (β=0.75, p<0.01) and depression (β=0.91, p<0.02) were significant predictors of belonging to Q4 based on the within-test variation.

Conclusions
In conclusion, increased APF in PPG provides a possible polysomnography indicator for deteriorated vigilance especially in male OSA patients. This finding highlights the connection between cardiorespiratory regulation, vigilance and OSA. However, our results indicate substantial sex-dependent differences that warrant further prospective studies.

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https://erepo.uef.fi/handle/123456789/24537
Link to the original item
http://dx.doi.org/10.1183/23120541.00277-2020
Publisher
European Respiratory Society (ERS)
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  • Luonnontieteiden ja metsätieteiden tiedekunta [1109]
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