TY - JOUR T1 - Increased nocturnal arterial pulsation frequencies of OSA patients is associated with an increased number of lapses in a psychomotor vigilance task JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.00277-2020 SP - 00277-2020 AU - Samu Kainulainen AU - Brett Duce AU - Henri Korkalainen AU - Akseli Leino AU - Riku Huttunen AU - Laura Kalevo AU - Erna S. Arnardottir AU - Antti Kulkas AU - Sami Myllymaa AU - Juha Töyräs AU - Timo Leppänen Y1 - 2020/01/01 UR - http://openres.ersjournals.com/content/early/2020/09/17/23120541.00277-2020.abstract N2 - Objectives Besides hypoxemia severity, heart rate variability has been linked to cognitive decline in obstructive sleep apnea (OSA) patients. Thus, our aim was to examine whether the frequency domain features of nocturnal photoplethysmogram (PPG) can be linked to poor performance in psychomotor vigilance task (PVT).Methods PPG signals from 567 suspected OSA patients, extracted from Type 1 diagnostic polysomnography, and corresponding results of PVT were retrospectively examined. The frequency content of complete PPGs was determined, and analyses were conducted separately for men (n=327) and women (n=240). Patients were grouped to PVT performance-quartiles based on the number of lapses (reaction times ≥500 ms) and within-test variation in reaction times. The best (Q1) and worst-performing (Q4) quartiles were compared due the lack of clinical thresholds in PVT.Results We found the increase in arterial pulsation frequency (APF) in both men and women was associated with a higher number of lapses. Higher APF was also associated with higher within-test variation in men, but not in women. Median APF (β=0.27, p=0.01), time spent under 90% saturation (β=0.05, p<0.01) female sex (β=1.29, p<0.01), older age (β=0.03, p<0.01), and subjective sleepiness (β=0.07, p<0.01) were significant predictors of belonging to lapses Q4. Only female sex (β=0.75, p<0.01) and depression (β=0.91, p<0.02) were significant predictors of belonging to Q4 based on the within-test variation.Conclusions In conclusion, increased APF in PPG provides a possible PSG-indicator for deteriorated vigilance especially in male OSA patients. This finding highlights the connection between cardiorespiratory regulation, vigilance, and OSA. However, our results indicate substantial sex-dependent differences that warrants further prospective studies.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of interest: Dr. Kainulainen reports grants from Academy of Finland (grant number 313697), grants from The Research Committee of the Kuopio University Hospital Catchment Area (project numbers 5041779 and 5041768), grants from the Competitive State Research Financing of Expert Responsibility Area of Tampere University Hospital (grants VTR3221, VTR3228, and EVO2089), grants from Päivikki & Sakari Sohlberg Foundation, grants from The Research Foundation of the Pulmonary Diseases, grants from Alfred Kordelin Foundation, during the conduct of the study.Conflict of interest: Dr. Duce has nothing to disclose.Conflict of interest: Dr. Korkalainen reports grants from Academy of Finland (grant number 313697), grants from The Research Committee of the Kuopio University Hospital Catchment Area (project numbers 5041780 and 5041767), grants from Respiratory Foundation of Kuopio Region, grants from Päivikki & Sakari Sohlberg Foundation, grants from The Research Foundation of the Pulmonary Diseases, grants from Foundation of the Finnish Anti-Tuberculosis Association, during the conduct of the study.Conflict of interest: Dr. Leino reports grants from The Research Committee of the Kuopio University Hospital Catchment Area (project number 5041776), grants from Päivikki & Sakari Sohlberg Foundation, grants from The Research Foundation of the Pulmonary Diseases, grants from The Finnish Cultural Foundation, grants from Respiratory Foundation of Kuopio Region, during the conduct of the study.Conflict of interest: Dr. Huttunen reports grants from Business Finland, grants from The Research Committee of Kuopio University Hospital Catchment Area, during the conduct of the study. Dr. Huttunen reports grants from Business Finland, grants from The Research Committee of Kuopio University Hospital Catchment Area, during the conduct of the study.Conflict of interest: Dr. Kalevo reports grants from Academy of Finland (grant number 313697), grants from The Research Committee of the Kuopio University Hospital Catchment Area (project numbers 5041764 and 5041770), grants from Research Foundation of the Pulmonary Diseases, during the conduct of the study.Conflict of interest: Dr. Arnardottir reports grants, personal fees and non-financial support from Nox Medical, personal fees from Philips, personal fees from ResMed, outside the submitted work.Conflict of interest: Dr. Kulkas reports grants from Seinäjoki Central Hospital, the Competitive State Research Financing of Expert Responsibility Area of Tampere University Hospital, grants from Tampere Tuberculosis Foundation, during the conduct of the study.Conflict of interest: Dr. Myllymaa reports grants from Academy of Finland (grant number 313697), grants from The Research Committee of the Kuopio University Hospital Catchment Area (project numbers 5041770), grants from Paulo Foundation, grants from Tampere Tuberculosis Foundation, during the conduct of the study.Conflict of interest: Dr. Töyräs reports grants from Academy of Finland (decision number 313697), grants from Kuopio University Hospital (project number 5041767), grants from Business Finland (decision number 5133/31/2018), during the conduct of the study.Conflict of interest: Dr. Leppänen reports grants from The Research Committee of the Kuopio University Hospital Catchment Area for the State Research Funding (project number 5041767), grants from Academy of Finland (decision numbers 313697 and 323536), grants from Tampere Tuberculosis Foundation, grants from Respiratory Foundation of Kuopio Region, during the conduct of the study. ER -