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http://dx.doi.org/10.4046/trd.2009.67.3.183

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

Kim, Sung Kyoung (Department of Internal Medicine, The Catholic University of Korea College of Medicine)
Lee, Sang Haak (Department of Internal Medicine, The Catholic University of Korea College of Medicine)
Kang, Hyeon Hui (Department of Internal Medicine, The Catholic University of Korea College of Medicine)
Kang, Ji Young (Department of Internal Medicine, The Catholic University of Korea College of Medicine)
Kim, Jin Woo (Department of Internal Medicine, The Catholic University of Korea College of Medicine)
Kim, Young Kyoon (Department of Internal Medicine, The Catholic University of Korea College of Medicine)
Kim, Kwan Hyoung (Department of Internal Medicine, The Catholic University of Korea College of Medicine)
Song, Jeong Sup (Department of Internal Medicine, The Catholic University of Korea College of Medicine)
Park, Sung Hak (Department of Internal Medicine, The Catholic University of Korea College of Medicine)
Moon, Hwa Sik (Department of Internal Medicine, The Catholic University of Korea College of Medicine)
Publication Information
Tuberculosis and Respiratory Diseases / v.67, no.3, 2009 , pp. 183-190 More about this Journal
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.
Keywords
Arousal; Polysomnography; Obstructive sleep apnea;
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