Trial reportChest2023
Sleep Arousal-Related Ventricular Repolarization Lability Is Associated With Cardiovascular Mortality in Older Community-Dwelling Men.
Trial report in Chest, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00070681 (Outcomes of Sleep Disorders in Older Men), which is not on this map. Cited by 8 papers.
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.
Outcomes of Sleep Disorders in Older Men
Who cites it
8 citing papers in PubMed.
- Hypoxemia and arousals modulate cardiac responses to respiratory events in obstructive sleep apnea.Sleep · 2026Article
- Characterisation of nocturnal arrhythmia avalanche dynamics: Insights from generalised linear model analysis.Journal of sleep research · 2025Article
- Clinical characteristics and outcomes of positional obstructive sleep apnea: the sleep heart health study.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2025Article
- Arousal burden is highest in supine sleeping position and during light sleep.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2025Article
- Hypoxaemic load in sleep apnoea is associated with acute changes in T-wave amplitude.ERJ open research · 2024Article
- Beat-to-beat cardiac repolarization lability increases during hypoxemia and arousals in obstructive sleep apnea patients.American journal of physiology. Heart and circulatory physiology · 2024Article
- Sleep-Disordered Breathing Destabilizes Ventricular Repolarization.medRxiv : the preprint server for health sciences · 2024Article
- The Influence of Physiologic Burdens Related to Obstructive Sleep Apnea on Cardiovascular Outcomes.American journal of respiratory and critical care medicine · 2023Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundSleep is fragmented by brief arousals, and excessive arousal burden has been linked to increased cardiovascular (CV) risk, but mechanisms are poorly understood. RESEARCH QUESTION: Do arousals trigger cardiac ventricular repolarization lability that may predispose people to long-term cardiovascular mortality? STUDY DESIGN AND
methodsThis study analyzed 407,541 arousals in the overnight polysomnograms of 2,558 older men in the Osteoporotic Fractures in Men sleep study. QT and RR intervals were measured beat-to-beat starting 15 s prior to arousal onset until 15 s past onset. Ventricular repolarization lability was quantified by using the QT variability index (QTVi).
resultsDuring 10.1 ± 2.5 years of follow-up, 1,000 men died of any cause, including 348 CV deaths. During arousals, QT and RR variability increased on average by 5 and 55 ms, respectively, resulting in a paradoxical transient decrease in QTVi from 0.07 ± 1.68 to -1.00 ± 1.68. Multivariable Cox proportional hazards analysis adjusted for age, BMI, cardiovascular and respiratory risk factors, sleep-disordered breathing and arousal, diabetes, and Parkinson disease indicated that excessive QTVi during arousal was independently associated with all-cause and CV mortality (all-cause hazard ratio, 1.20 [95% CI, 1.04-1.38; P = .012]; CV hazard ratio, 1.29 [95% CI, 1.01 -1.65; P = .043]).
interpretationArousals affect ventricular repolarization. A disproportionate increase in QT variability during arousal is associated with an increased all-cause and CV mortality and may reflect ventricular repolarization maladaptation to the arousal stimulus. Whether arousal-related QTVi can be used for more tailored risk stratification warrants further study, including evaluating whether arousal suppression attenuates ventricular repolarization lability and reduces subsequent mortality. CLINICAL
trial registrationClinicalTrials.gov; No.: NCT00070681; URL: www. CLINICALTRIALS: gov.
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