@article{ref1,
title="Increased nocturnal arterial pulsation frequencies of obstructive sleep apnoea  patients is associated with an increased number of lapses in a psychomotor vigilance  task",
journal="ERJ open research",
year="2020",
author="Kainulainen, Samu and Duce, Brett and Korkalainen, Henri and Leino, Akseli and Huttunen, Riku and Kalevo, Laura and Arnardottir, Erna S. and Kulkas, Antti and Myllymaa, Sami and Töyräs, Juha and Leppänen, Timo",
volume="6",
number="4",
pages="e277-e277",
abstract="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). <br><br>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. <br><br>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. <br><br>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.<p /> <p>Language: en</p>",
language="en",
issn="2312-0541",
doi="10.1183/23120541.00277-2020",
url="http://dx.doi.org/10.1183/23120541.00277-2020"
}