Observational studySleep2021
Heart rate variability during wakefulness as a marker of obstructive sleep apnea severity.
Observational study in Sleep, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Association of alternative polysomnographic features with patient outcomes in obstructive sleep apnea: a systematic review.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2023Pooled it
- Mindfulness-Based Movement Intervention to Improve Sleep Quality: A Meta-Analysis and Moderator Analysis of Randomized Clinical Trials.International journal of environmental research and public health · 2022Pooled it
- Therapeutic effects of oxygen inhalation for obstructive sleep apnea patients with high carotid body chemosensitivity.BMC pulmonary medicine · 2026Trial
- Evening binge alcohol disrupts cardiovagal tone and baroreflex function during polysomnographic sleep.Sleep · 2021Trial
- Differential Effects of Sleep Respiratory Event Types on Heart Rate Variability: Central Apnea as the Most Significant.Diagnostics (Basel, Switzerland) · 2026Article
- Deleterious impact of obstructive sleep apnea on autonomic nervous system control during rapid-eye-movement sleep in adult type 1 diabetes.Physiological reports · 2026Article
- Beyond the Apnea-Hypopnea Index: Circulating Biomarkers and Device-Based Metrics for Cardiometabolic Risk Stratification in Obstructive Sleep Apnea.Journal of clinical medicine · 2026Review
- Positive airway pressure therapy and cardiovascular events in obstructive sleep apnoea: an observational clinical cohort study.Sleep medicine · 2026Observational
- Association between minimum nocturnal heart rate and cerebral small vessel disease in patients with obstructive sleep apnea.Frontiers in aging neuroscience · 2026Article
- Heart rate variability during wakefulness reflects sleep apnea indicators but remains context-dependent.Frontiers in physiology · 2026Article
- Obstructive sleep apnea increases heartbeat-evoked potentials and reorganizes Granger-causal coupling between cortical interoception and autonomic variability during wakefulness.Scientific reports · 2025Article
- Heart rate variability analysis in comorbid insomnia and sleep apnea (COMISA).Scientific reports · 2025Observational
- A possible important regulatory role of estrogen in obstructive sleep apnea hypoventilation syndrome.Frontiers in medicine · 2025Review
- Effects of Auto-Titrating Mandibular Advancement Device on Autonomic Nervous System in Obstructive Sleep Apnea.Journal of personalized medicine · 2024Article
- Heart rate variability during sleep onset in patients with insomnia with or without comorbid sleep apnea.Sleep medicine · 2024Article
- Sleep at high altitude: A bibliometric study and visualization analysis from 1992 to 2022.Heliyon · 2024Article
- Article
- Conservative Treatment Using Chiropractic Care and Orofacial Myofunctional Therapy for Obstructive Sleep Apnea: A Case Report.Journal of chiropractic medicine · 2023Article
- 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 : JCSM : official publication of the American Academy of Sleep Medicine · 2023Article
- Nocturnal Heart Rate Variability Might Help in Predicting Severe Obstructive Sleep-Disordered Breathing.Biology · 2023Article
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Authors and funding
19 authors.
Funding
Abstract
STUDY
objectivesPatients with obstructive sleep apnea (OSA) exhibit heterogeneous heart rate variability (HRV) during wakefulness and sleep. We investigated the influence of OSA severity on HRV parameters during wakefulness in a large international clinical sample.
methods1247 subjects (426 without OSA and 821 patients with OSA) were enrolled from the Sleep Apnea Global Interdisciplinary Consortium. HRV parameters were calculated during a 5-minute wakefulness period with spontaneous breathing prior to the sleep study, using time-domain, frequency-domain and nonlinear methods. Differences in HRV were evaluated among groups using analysis of covariance, controlling for relevant covariates.
resultsPatients with OSA showed significantly lower time-domain variations and less complexity of heartbeats compared to individuals without OSA. Those with severe OSA had remarkably reduced HRV compared to all other groups. Compared to non-OSA patients, those with severe OSA had lower HRV based on SDNN (adjusted mean: 37.4 vs. 46.2 ms; p < 0.0001), RMSSD (21.5 vs. 27.9 ms; p < 0.0001), ShanEn (1.83 vs. 2.01; p < 0.0001), and Forbword (36.7 vs. 33.0; p = 0.0001). While no differences were found in frequency-domain measures overall, among obese patients there was a shift to sympathetic dominance in severe OSA, with a higher LF/HF ratio compared to obese non-OSA patients (4.2 vs. 2.7; p = 0.009).
conclusionsTime-domain and nonlinear HRV measures during wakefulness are associated with OSA severity, with severe patients having remarkably reduced and less complex HRV. Frequency-domain measures show a shift to sympathetic dominance only in obese OSA patients. Thus, HRV during wakefulness could provide additional information about cardiovascular physiology in OSA patients. CLINICAL TRIAL INFORMATION: A Prospective Observational Cohort to Study the Genetics of Obstructive Sleep Apnea and Associated Co-Morbidities (German Clinical Trials Register - DKRS, DRKS00003966) https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00003966.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.