Study On HRV、DC And The Correlation Between HRV And DC In OSAHS Patients With Phlegm-dampness Constitution

ObjectiveThis study was designed to explore the Heart Rate Variability (HRV) and deceleration capacity (DC) of heart rate as well as the correlation between HRV and DC in patients of Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) with Phlegm-dampness Constitution.MethodsWe collected the patients complaining of snoring who came to sleep medical clinic or ENT department of Guang’anmen Hospital, China Academy of Chinese Medical Sciences. After a specialized examination, the subjects were advised to fill in some questionnaires (include in essential information, clinical symptoms, the Phlegm-dampness Constitution Scale and the Epworth Sleeping Scale) and then take a whole night polysomnography (PSG) test. According to the diagnostic criteria of OSAHS all subjects in this study were divided into OSAHS group and simple snoring group. In OSAHS group, we classified the patients who satisfied the diagnostic criteria of the Phlegm-dampness Constitution into Phlegm-dampness Constitution OSAHS group, and the rest patients into non-Phlegm-dampness Constitution OSAHS group. It was necessary for all subjects to carry out24hours dynamic electrocardiogram detection. Main outcome measures:(1) The general information: neck circumference, body circumference and body mass index(BMI) were included;(2) PSG indexes:apnea-hyopnea index(AHI), the minimum saturation of oxygen and the longest apnea time were included;(3) HRV indexes:SDNN, SDANN, RMSSD, PNN50and Triangle index were included;(4) DC and heart rate:DC, the average heart rate, the minimal heart rate and the maximal heart rate were included;(5) The Epworth Sleeping Scale (ESS) score and the Phlegm-dampness Constitution Scale score were also included. Data analysis was performed by using SPSS16.0for windows.Results(1) The general information:compared with the simply snoring group, BMI, neck circumference and abdominal circumference were higher in Phlegm-dampness Constitution OSAHS group (P<0.01) and non-Phlegm-dampness Constitution OSAHS group (P<0.01). However, there were no statistical differences in BMI, neck circumference and abdominal circumference between Phlegm-dampness Constitution OSAHS group and non-Phlegm-dampness Constitution OSAHS group (P>0.05).(2) The results of PSG and the ESS score:①AHI:in Phlegm-dampness Constitution OSAHS group AHI was higher than non-Phlegm-dampness Constitution OSAHS group (P<0.05) and the simply snoring group (P<0.01). However, AHI of non-Phlegm-dampness Constitution was higher than the simply snoring group.②Minimum Saturation of Oxygen:there were significantly lower in Phlegm-dampness Constitution OSAHS group and non-Phlegm-dampness Constitution OSAHS group than in the simply snoring group. However, there were no statistical differences between Phlegm-dampness Constitution OSAHS group and non-Phlegm-dampness Constitution OSAHS group (P>0.05).③The longest apnea time:there were significantly longer in Phlegm-dampness Constitution OSAHS group and non-Phlegm-dampness Constitution OSAHS group than in the simply snoring group. However, there were no statistical differences between Phlegm-dampness Constitution OSAHS group and non-Phlegm-dampness Constitution OSAHS group (P>0.05).④The ESS score:in the Phlegm-dampness Constitution OSAHS group, the ESS score was statistical higher than non-Phlegm-dampness Constitution OSAHS group (P<0.01) and the simply snoring group (P<0.05). Nevertheless, there were no statistical differences between non-Phlegm-dampness Constitution OSAHS group and the simply snoring group.(3) The HRV indexes:compared with the simply snoring group, SDNN,SDANN and Triangle index were statistically lower in the Phlegm-dampness Constitution group (P<0.05); SDANN and Triangle index were statistically lower in non-Phlegm-dampness Constitution group (P<0.05). RMSSD, PNN50, SDNN, SDANN and SDSD in the Phlegm-dampness Constitution group were lower than the ones in the non-Phlegm-dampness Constitution group, however, there were no statistical differences (P>0.05).(4) DC and heart rate:①DC in the Phlegm-dampness Constitution group decreased statistically, compared with the simply snoring group (P<0.05). DC in the non-Phlegm-dampness Constitution group was lower than the one in the simply snoring group, however, there was no statistical differences (P>0.05). There was no statistical difference between Phlegm-dampness Constitution group and non-Phlegm-dampness Constitution group.②Compared to the simply snoring group, the average heart rate of Phlegm-dampness Constitution group and non-Phlegm-dampness Constitution group increased statically (P<0.05). However, there was no statistical difference showed between Phlegm-dampness Constitution group and non-Phlegm-dampness Constitution group (P>0.05). The minimal heart rate in the non-Phlegm-dampness Constitution group was significantly higher than that in the simply snoring group (P<0.05).There was no statistical difference in the minimal heart rate between Phlegm-dampness Constitution group and the simply snoring group (P>0.05) Besides, there was no statistical difference in the minimal heart rate between Phlegm-dampness Constitution group and non-Phlegm-dampness Constitution group (P>0.05).(5) The analysis of correlation:①there were positive correlations between BMI and neck circumference and abdominal circumference respectively by calculating Pearson correlation coeddicient.②Applying the step regression analysis, we found that AHI was bound up with the longest apnea time and neck circumference positively, and was correlated with the Minimum Saturation of Oxygen and RMSSD negatively.③DC was correlated with PNN50and Triangle index positively, and was correlated with age, the Phlegm-dampness constitution score and average heart rate negatively.Conclusions(1) The Phlegm-dampness constitution increased AHI and daytime sleepiness to a certain degree. It made no difference in the BMI, neck circumference and abdominal circumference of the Phlegm-dampness constitution in OSAHS patients.(2) The Phlegm-dampness constitution made no difference in the HRV.(3) The Phlegm-dampness constitution made no difference in the DC.(4) The Phlegm-dampness constitution made no difference in the average heart rate.(5) AHI was correlated with the longest apnea time and neck circumference positively, and was correlated with the Minimum Saturation of Oxygen and RMSSD negatively. DC was correlated with PNN50and Triangle index positively, and was correlated with age, the Phlegm-dampness constitution score and average heart rate negatively.