Tuberc Respir Dis.  2009 Sep;67(3):183-190.

Relationship between Arousal Indices and Clinical Manifestations in Patients Who Performed Polysomnography

• Kim SK
• Lee SH
• Kang HH
• Kang JY
• Kim JW
• Kim YK
• Kim KH
• Song JS
• Park SH
• Moon HS

Abstract

BACKGROUND
Repeated arousals during sleep have been known to be associated with excessive daytime sleepiness and cardiovascular complications. We investigated the relationship between arousal indices and clinical parameters. METHODS: We retrospectively reviewed medical records of 41 patients who performed polysomnography for a diagnosis of obstructive sleep apnea syndrome. We defined total arousal index (TAI) as the number of arousals per hour and respiratory arousal index (RAI) as the number of arousals associated with apnea or hypopnea per hour. RESULTS: There were significant positive correlations between arousal indices and apnea-hypopnea index (AHI) (RAI vs. AHI, r=0.958, p<0.001; TAI vs. AHI, r=0.840, p<0.001). RAI and mean oxygen saturation showed a significant negative correlation with each other (r=-0.460, p=0.002). TAI revealed a significant positive correlation with mean systolic blood pressure (MSBP) and mean diastolic blood pressure (MDBP) (TAI vs. MSBP, r=0.389, p=0.014; TAI vs. MDBP, r=0.373, p=0.019). There was no significant correlation between arousal indices and parameters of sleepiness. RAI had a significant positive correlation with body mass index (BMI) and neck circumference (NC) (RAI vs. BMI, r=0.371, p=0.017; RAI vs. NC, r=0.444, p=0.004). When partial correlation analysis was performed to adjust for other variables, there was significant correlation between RAI and AHI (r=0.935, p<0.001). CONCLUSION: This study shows that respiratory arousal index could be a useful index reflecting of severity of obstructive sleep apnea syndrome. Arousal during sleep would be concerned in the development of cardiovascular complication of obstructive sleep apnea. And some anthropometric factors would contribute to the development of arousals during sleep. Further studies are needed to clarify any cause-effect relationship.

Keyword

Arousal; Polysomnography; Obstructive sleep apnea

MeSH Terms

Apnea
Arousal
Blood Pressure
Body Mass Index
Humans
Medical Records
Neck
Oxygen
Polysomnography
Retrospective Studies
Sleep Apnea, Obstructive
Oxygen

Figure

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  Figure 1 Relationship between arousal index and apnea hypopnea index (AHI).

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  Figure 2 Relationship between arousal index and mean O2 saturation and lowest O2 saturation.

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  Figure 3 Relationship between arousal index and blood pressure. MSBP: mean systolic blood pressure; MDBP: mean diastolic blood pressure.

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  Figure 4 Relationship between arousal index and sleepiness scales (All are p>0.05).

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  Figure 5 Relationship between arousal index and body mass index and neck circumference.

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