Respiratory Event-Induced Blood Pressure Oscillations Vary by Sleep Stage in Sleep Apnea Patients

Yao Shun Chaung; Raichel M Alex; Mahrshi Jani; Donald E Watenpaugh; Radana Vilimkova Kahankova; Scott A Sands; Khosrow Behbehani

doi:10.1155/2023/8787132

Respiratory Event-Induced Blood Pressure Oscillations Vary by Sleep Stage in Sleep Apnea Patients

Sleep Disord. 2023 Jun 15:2023:8787132. doi: 10.1155/2023/8787132. eCollection 2023.

Authors

Yao Shun Chaung¹, Raichel M Alex², Mahrshi Jani³, Donald E Watenpaugh³, Radana Vilimkova Kahankova⁴, Scott A Sands², Khosrow Behbehani³

Affiliations

¹ School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, Texas, USA.
² Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA.
³ Bioengineering Department, University of Texas at Arlington, Arlington, Texas, USA.
⁴ Department of Cybernetics and Biomedical Engineering, VSB-Technical University of Ostrava, Ostrava, Czech Republic.

Abstract

Obstructive sleep apnea (OSA) pathologically stresses the cardiovascular system. Apneic events cause significant oscillatory surges in nocturnal blood pressure (BP). Trajectories of these surges vary widely. This variability challenges the quantification, characterization, and mathematical modeling of BP surge dynamics. We present a method of aggregating trajectories of apnea-induced BP surges using a sample-by-sample averaging of continuously recorded BP. We applied the method to recordings of overnight BP (average total sleep time: 4.77 ± 1.64 h) for 10 OSA patients (mean AHI: 63.5 events/h; range: 18.3-105.4). We studied surges in blood pressure due to obstructive respiratory events separated from other such events by at least 30 s (274 total events). These events increased systolic (SBP) and diastolic (DBP) BP by 19 ± 7.1 mmHg (14.8%) and 11 ± 5.6 mmHg (15.5%), respectively, relative to mean values during wakefulness. Further, aggregated SBP and DBP peaks occurred on average 9 s and 9.5 s after apnea events, respectively. Interestingly, the amplitude of the SBP and DBP peaks varied across sleep stages, with mean peak ranging from 128.8 ± 12.4 to 166.1 ± 15.5 mmHg for SBP and from 63.1 ± 8.2 to 84.2 ± 9.4 mmHg for DBP. The aggregation method provides a high level of granularity in quantifying BP oscillations from OSA events and may be useful in modeling autonomic nervous system responses to OSA-induced stresses.