Importance of Entropy of Snoring and Heart Rate Variability for the Detection of OSA Severity
Prof. Dr. med. Haralampos Gouveris
Associate Professor in Otorhinolaryngology, Dept. of Otorhinolaryngology Head & Neck Surgery, Medical Centre of the University of Mainz, Mainz, Germany. Senior physician (sleep laboratory) at University Medicine of the Johannes Gutenberg University Mainz, Mainz, Germany.
Prof. Dr. med. Haralampos Gouveris is a Specialist in ear, nose and throat medicine, somnology. Has a Medical Degree from Medical School, University of Patra, Greece, a PhD in Otorhinolaryngology and Surgical Specialty Training in Otorhinolaryngology / Head & Neck Surgery, at the Department of Otorhinolaryngology, Medical Centre of the University of Mainz, Mainz, Germany. He worked as an Attending surgeon and Assistant Professor in Otorhinolaryngology – Head and Neck Surgery, at the Democritus University of Thrace and Medical Centre of the University of Thrace at Alexandroupolis, Greece. He has also a Interuniversity European Diploma in Skull Base Surgery from the Université Paris 7, France, and a Diploma in Somnology / Sleep Medicine from the German Sleep Research Society (DGSM).
Obstructive Sleep Apnea Detection, Severity Classification and Relationship with Chronic Coronary Syndrome
In this week’s Sleep Science Friday publication, we hear from Prof. Dr. med. Haralampos Gouveris presenting his and his colleagues recent research results related to Obstructive Sleep Apnea (OSA) severity classification through snoring entropy and hear rate variability, and the relationship between OSA and severe Chronic Coronary Syndrome (CCS).
Using entropy of snoring, respiratory effort and electrocardiography signals during sleep for OSA detection and severity classification
In an exploratory study, published in the paper “Using entropy of snoring, respiratory effort and electrocardiography signals during sleep for OSA detection and severity classification” (vide Bahr-Hamm et al., 2023), Dr. Katharina Bahr-Hamm and her colleagues, investigated whether snoring-sound-, very low frequency electrocardiogram (VLF-ECG)- and thoraco-abdominal effort- signal entropy values from standard AASM-polysomnography (PSG) signals during two consecutive nights in the sleep lab could be used as surrogate markers for detection of OSA and possibly OSA severity classification. Using sampling entropy (SampEn) on these three PSG raw signal data and using a support vector machine (SVM) pipeline, it was possible to distinguish between four (i.e. no, mild, moderate or severe) OSA severity classes. The best prediction among the three metrics was achieved by snoring signal-SampEn. Second PSG-night data showed even more accurate results for all three parameters than first-night recordings. On the basis of this evidence, technologies and devices using only a fraction of the standard PSG signal, such as sound-recording devices, may be used for OSA screening and OSA severity group classification.
Heart Rate Variability as a Surrogate Marker of Severe Chronic Coronary Syndrome in Patients with Obstructive Sleep Apnea
Obstructive sleep apnea is also a known risk factor for chronic coronary syndrome (CCS). CCS and OSA are separately associated with significant changes in heart rate variability (HRV). In a proof-of-concept study, publish in the paper “Heart Rate Variability as a Surrogate Marker of Severe Chronic Coronary Syndrome in Patients with Obstructive Sleep Apnea” (vide Seifen et al., 2023), Dr. Christopher Seifen and his colleagues, tested whether HRV values are significantly different between OSA patients with concomitant severe CCS, and OSA patients without known CCS. A significant reduction in both normal-to-normal intervals (SDNN) and the heart rate variability triangular index (HRVTI) was found in the OSA group with CCS compared to the OSA group without CCS. If confirmed in future larger studies, these findings regarding these physiologic metrics have the potential to provide a novel robust surrogate marker of severe CCS specifically in OSA patients.
For more details, you can watch and listen to Professor Gouveris presenting these interesting research results in the video below.
Recent publications from ESRS members
- Tichelman et al. (2023). A genetic variation in the adenosine A2A receptor gene contributes to variability in oscillatory alpha power in wake and sleep EEG and A1 adenosine receptor availability in the human brain. Neuroimage.
- Henry et al. (2023). Does treating insomnia with digital cognitive behavioural therapy (Sleepio) mediate improvements in anxiety for those with insomnia and comorbid anxiety? An analysis using individual participant data from two large randomised controlled trials. J Affect Disord.
- Hartley et al. (2023). Self-administered non-invasive vagus nerve stimulation therapy for severe pharmacoresistant restless legs syndrome: outcomes at 6 months. J Sleep Res.
- De Martin Topranin et al. (2023). The Influence of Menstrual-Cycle Phase on Measures of Recovery Status in Endurance Athletes: The Female Endurance Athlete Project. Int J Sports Physiol Perform.
- Huwiler et al. (2023). Auditory stimulation of sleep slow waves enhances left ventricular function in humans. Eur Heart J.
- Scarpetta et al. (2023). Criticality of neuronal avalanches in human sleep and their relationship with sleep macro- and micro-architecture. iScience.
- K G Ravindran et al. (2023). Three Contactless Sleep Technologies Compared With Actigraphy and Polysomnography in a Heterogeneous Group of Older Men and Women in a Model of Mild Sleep Disturbance: Sleep Laboratory Study. JMIR Mhealth Uhealth.