PT  - JOURNAL ARTICLE
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
TI  - Increased nocturnal arterial pulsation frequencies of obstructive sleep apnoea patients is associated with an increased number of lapses in a psychomotor vigilance task
AID  - 10.1183/23120541.00277-2020
DP  - 2020 Oct 01
TA  - ERJ Open Research
PG  - 00277-2020
VI  - 6
IP  - 4
4099  - http://openres.ersjournals.com/content/6/4/00277-2020.short
4100  - http://openres.ersjournals.com/content/6/4/00277-2020.full
SO  - erjor2020 Oct 01; 6
AB  - Objectives Besides hypoxaemia severity, heart rate variability has been linked to cognitive decline in obstructive sleep apnoea (OSA) patients. Thus, our aim was to examine whether the frequency domain features of a nocturnal photoplethysmogram (PPG) can be linked to poor performance in the 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 into PVT performance quartiles based on the number of lapses (reaction times ≥500 ms) and within-test variation in reaction times. The best-performing (Q1) and worst-performing (Q4) quartiles were compared due the lack of clinical thresholds in PVT.Results We found that 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 Q4 based on lapses. 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 polysomnography 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 warrant further prospective studies.Frequency content analysis of PPG measured in peripheral pulse oximetry offers valuable information on the risk of impaired vigilance. This finding provides new research hypotheses on the connection between sleep, cardiovascular regulation, and vigilance. https://bit.ly/2ZO7ZGc